No on Proposition 29
Require expensive doctors in kidney dialysis clinics
What is it?
Proposition 29 is an Initiative Statute which would require that kidney dialysis clinics enact staffing requirements that force clinics to have at least one physician, nurse practitioner, or physician assistant with "at least six months of experience providing care to end-stage renal disease" onsite during patient treatments. It also adds some mandatory disclosure requirements to the clinics.
Why is this on the ballot?
According to Article II, Section 8 of the California Constitution, citizens may introduce statutes (laws) by collecting signatures (5% of the votes cast in the most recent Governor's race). The statute must then be approved by voters with a simple majority of 50% + 1.
The SEIU union is behind this measure, along with the previous attempts in 2020 and 2018 which both failed.
Fiscal impacts
Prop 29 will increase the costs for dialysis clinics. This may result in higher costs to patients, closure of clinics who serve clients in low-income areas, and fewer dialysis clinics opening.
Prop 29 will also increase the cost to taxpayers by requiring higher payments via Medi-Cal.
- See "Fiscal Effects" section of the Legislative Analyst Office report (PDF)
Why vote No?
The powerful SEIU union is abusing the California initiative process in service of their labor dispute. Rather than negotiate in good faith with the clinics, they are raising and spending tens of millions of dollars to try to force the outcome they want.
Prop 29 will not improve treatment at kidney dialysis clinics. Instead, Prop 29 will mandate that expensive doctors be required to be on-site during all patient treatments. This will immediately create a staffing crisis across the state's kidney dialysis clinics, possibly causing some of them to shut down temporarily so they don't break this new law. This would mean patients would miss appointments. "Physicians warn that patients missing even one treatment increase their risk of death by 30%," according to the Mercury News.
Like Prop 26 and Prop 27, Prop 29 is another example of regulatory capture — the regulated industry writing its own rules. This duty belongs to the State Legislature and the Federal government. In fact, the Federal government already requires that kidney dialysis clinics have a medical director who is a board-certified physician that oversees the clinic and is responsible for ensuring high-quality medical care and staff are adequately trained to handle all aspects of dialysis treatment.
Don't let a powerful union make dialysis treatment more expensive and less available because they want to hire more doctors. The specialized care that this law mandates is not necessary at dialysis clinics — patients have their own regular doctors to see for end-stage renal disease.
Reject Prop 29, and let's pray we don't have to go through this for the fourth time in two years.