Backers: They said the new rules are designed to keep dialysis patients safe and to hold dialysis providers accountable. They point out that multiple states, including Georgia, Louisiana, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, Texas and Utah, have staff-to-patient ratio requirements at dialysis clinics.
David Miller, research director for SEIU-UHW, said the group denies accusations about using the proposition system to unionize dialysis center workers. He said the proposition is not designed to dictate what doctors may do on-site or how they would oversee care.
He said dialysis patients have expressed concern that the centers lack adequate staff if something goes wrong. He pointed out that earlier this year SEIU-UHW filed an administrative complaint alongside other groups and patients with the U.S. Department of Health and Human Services about the disparate effect of dialysis on Latino and Asian patients.
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Critics: The No on Prop 29 campaign has a long list of medical industry associations opposing the ballot measure, including the California Medical Assn., the American Nurses Assn.’s California chapter, the American Academy of Nephrology Physician Assistants, which represents dialysis technicians, and multiple dialysis patient advocacy groups. Opponents say paying for increased staff could lead to clinic closures. In addition, they say the federal Centers for Medicare and Medicaid Services agency already requires clinics to report bloodstream infections among patients.
Jeff Goffman, chief executive of Satellite Healthcare, said he worries about how the company’s clinics will survive Proposition 29 if they have to pay for more staff.
Goffman said a potential increase of hundreds of thousands of dollars in staffing is risky for a nonprofit like his, where much of the revenue is from government programs. He said that many of the patients served are people of color, and that the majority have comorbidities such as high blood pressure, obesity or heart disease. “It’s a risk to an underserved population, because it is certainly a risk to access to care, and a racial inequity issue when we look at that population of patients that get treated with dialysis,” he said.