Ballotpedia includes editorials from newspapers and outlets based on: To submit a media editorial for inclusion, email editor@ballotpedia.org. CDPH must post each clinic's infection information on the CDPH website, including the name of the clinic's owner or operator. Another potential issue for Prop. Even though abortion is legal in California, Prop. Proposition 29 would set new requirements for dialysis centers including the hiring of more staff with the goal to make clinics safer. A "no" vote opposed this ballot initiative to require dialysis clinics to have at least one physician, nurse practitioner, or physician assistant while patients are being treated; report data on dialysis-related infections; and not discriminate against patients based on the source of payment for care. if(document.getElementsByClassName("reference").length==0) if(document.getElementById('Footnotes')!==null) document.getElementById('Footnotes').parentNode.style.display = 'none'; American Indian issues [8], .ballot-measure-endorsements p { 29 differs from Prop. } A YES vote on this measure means: Chronic dialysis clinics would be required to have a physician, nurse practitioner, or physician assistant on-site during all patient treatment hours. Prop. Continue Current Operations, but With Lower Profits. -webkit-columns: 1; Report dialysis-related infections to the California Department of Public Health (CDPH). Quieres leer este artculo en espaol? Proposition 29 requires clinics to report dialysis-related infection information to CDPH every three months. You can hear KCBS In Depth, a weekly half-hour news interview, Saturdays at 5:30a.m. CDPH must specify which information clinics should report, and how and when to report the information. Charges Penalties if Dialysis Clinics Do Not Report Required Information. California has implemented an online voter registration system. Requires physician, nurse practitioner, or physician assistant on site during treatment. This measure isnt really about patient care. SUMMARY Put on the Ballot by Petition Signatures Requires physician, nurse practitioner, or physician assistant on site during treatment. Group and Individual Health Insurance. SEIU-UHW West was the primary sponsor and contributed over $7.97 million to the support committee. Patients Own Physician Oversees Treatment. All rights reserved. Dialysis patients who are in kidney failure typically require several hours of dialysis three times a week. Join dialysis patients, American Nurses Association\California, California Medical Association and patient advocates: NO on 29another dangerous dialysis proposition! } Finally, the dangers of dialysis could be better minimized by reducing the number of patients who require this procedure. As noted earlier, an owner or operator might be able to support these clinics with its higher-earning clinics. It was not intended to be weaponized in this way. Opponents claim that it may force some clinics to close. Conditional voter registration is available beginning 14 days before an election through Election Day. Like last time, this latest proposition will again jeopardize access to care, worsen our health care provider shortage and increase health care costs for all Californians. Ana B. Ibarra, A Heavy Burden: Should Dialysis Rules Be up to Voters?, Cal Matters, October 14, 2020, Stephanie Hedt, Dialysis Costs the Healthcare System Three Times More in the Individual Market, USC Leonard D. Schaeffer Center for Health Policy & Economics, Laura C. Plantinga et al., Frequency of PatientPhysician Contact in Chronic Kidney Disease Care and Achievement of Clinical Performance Targets,. Most people on dialysis undergo hemodialysis. The payer could be the patient, a private entity, the patients health insurer, Medi-Cal, or Medicare. Dialysis is recommended when a person's kidneys lose most of their function. Dialysis companies are so profitable that they can easily afford to make the proposed changes while still covering their operating costs. Prop 28 is supported by numerous famous California musicians, actors, and media industry executives. California voters have seven propositions to vote on in the Nov. 8 general election. Medicare pays for dialysis treatment for the majority of people on dialysis in California. California's current cigarette tax is 87 cents per pack. Proposition 29 imposes new regulatory responsibilities on CDPH. If this proposal seems familiar thats because its virtually the same as two previous measures on the 2018 and 2020 ballots. } California Proposition 29, Dialysis Clinic Requirements Initiative (2022). You can read more about the boards mission and its members at About The Times Editorial Board. .ballot-measure-endorsements td { width: 35% !important;} "[19] Dave Regan stated, "The reason Prop. If the random sample estimates that more than 110 percent of the required number of signatures are valid, the initiative is eligible for the ballot. However, if trained nephrologists are present during treatment, these patients could receive improved quality of care. Prop. However, some voters may be asked to show a form of identification when voting if they are voting for the first time after registering to vote by mail and did not provide a driver license number, California identification number, or the last four digits of their social security number.[40][41]. Improved transparency and accessibility of information can help patients make informed decisions for their care. They argue that California voters have overwhelmingly rejected similar dialysis propositions twice. For example, clinics must report when a patient develops a bloodstream infection and the suspected cause of the infection. Not a lot. Original story follows below. Proponents of Prop. Specifically, the measure would require that clinics: Prop. color:white !important; Sacramento TheSanta Rosa Press Democratand the 11 papers that make up theSouthern California News Grouptold voters to reject Proposition 29 in recent editorials. Currently, there are over 19,000 candidates in California on the kidney organ transplant waiting list. NoProp29.com, No on 29Yet Another Dangerous Dialysis Proposition. The California Democratic Party and California Labor Federation supported the campaign. Californias shortage of medical professionals would also pose challenges for implementing the on-site medical staffing requirement in Prop. Here's what's different this time around. Petitions are allowed to circulate for 180 days from the date the attorney general prepares the petition language. Life is stressful. CDPH must specify which information clinics should report, and how and when to report the information. The SEIU-UHW West sponsored Californians for Kidney Dialysis Patient Protection, which raised $18.94 million. MORE | What's the difference between Prop 26 and Prop 27? requiring clinics to obtain the CDPH's written consent before closing or substantially reducing services to patients. 8 is on the ballot is because they have a terrible business model and theyre gouging patients and insurers. The word count for the ballot summary is 84. Gavin Newsom wisely used his powers under the states COVID-19 state of emergency to authorize the state director of public health to waive licensing requirements on medical practitioners and restrictions on out-of-state medical professionals to help increase the number of medical practitioners in California. .sbtotaltable td { By Vittorio Nastasi and Austill Stuart December 12, 2022. Read more. Under federal rules, the physician must visit the patient during dialysis treatment at the clinic at least once per month. [12], The following were the top donors to the committee. This proposition, for the third time, attempts to regulate dialysis clinics. Its shameful that this union would continue to use vulnerable patients as pawns to advance their political agenda. Voters correctly rejected the last two propositions, and they should do so a third time. Two private for-profit companiesDaVita, Inc. and Fresenius Medical Careown or operate nearly 75percent of licensed clinics in California. As the verification process can take multiple months, the secretary of state provides suggested deadlines for ballot initiatives. Its true that clinics often have to call for help if a kidney patient has an emergency, but that wont change even with extra staff because they are not emergency medical facilities. Patients need about three treatments per week, and missing a treatment can result in serious health complications. Sean Fleming and Jonathan Everhart filed the ballot initiative on August 24, 2021. [33], On June 20, 2022, the secretary of state reported that the random sample concluded that 725,890 signatures were valid.[34]. An individual who is in line at the time polls close must be allowed to vote. You can't legally bet on sports in California right now, but Proposition 27 would change that, allowing online betting operated by Native American tribes and gambling companies. .endorsements-header { Peritoneal dialysis typically occurs three to five times every day, with each treatment taking about 30 to 40 minutes, according to the National Kidney Foundation. The cost to have a physician, nurse practitioner, or physician assistant on-site would affect individual clinics differently depending on their finances. [1], In 2020, 63.4% of voters rejected Proposition 23, which was also sponsored by SEIU-UHW. Nor is there evidence that the current arrangement has harmed patients. 23 in 2020 included similar requirements for dialysis clinics, and both failed when taken to voters. Most Dialysis Patients Receive Treatment in Clinics. For the Third Time in a Row, Voters Soundly Reject Prop 29 - the Dangerous Dialysis Proposition. Ballot measures, Who represents me? [4] Code of Federal Regulations Title 42, Chapter IV, Subchapter G, Part 494: Conditions for Coverage for End-Stage Renal Disease Facilities, last modified July 11, 2022, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-494. Plus, kidney dialysis clinics, arts and music education in public. Instead, this measure would increase the cost of care to the detriment of patients. This is the third ballot measure since 2018 sponsored by UHW targeting dialysis providers. width: 100%; The initiative was also opposed by the Republican Party of California, California Chamber of Commerce, and California Medical Association. Property inherited after Prop 19 would have a $7k tax billa whooping 736 percent increase. The committee reported nearly $86.4 million in contributions from DaVita Inc. and Fresenius Medical Care. Cities | Residents can register to vote by visiting this website. Note: supporters of the measure have not said whether or not they will put a fourth measure on the 2024 ballot if this measure fails. } CDPH licenses clinics to operate in California. All Rights Reserved. There are two main types of dialysis treatmenthemodialysis and peritoneal dialysis. [1] Legislative Analysts Office, Proposition 23, November 3, 2020, https://lao.ca.gov/BallotAnalysis/Proposition?number=23&year=2020. The California state government, the states two public university systems, and many local governments in California provide group health insurance coverage for their current workers, eligible retired workers, and their families. Requires dialysis clinics to enact extra procedures and restrictions that increase patient oversight, including on-site medical practitioners, data reporting and financial transparency. (202) 986-0916, Senior Managing Director, Transportation Policy, Photo 193235704 Saengsuriya Kanhajorn | Dreamstime.com, Innovators in Action: James Small, public safety director of Palmyra, Wisconsin, Florida must stop relying on taxation by citation, Properly designed impact fees could help Wakulla County accommodate population growth. The treatment involves pumping a solution into the abdomen. These waivers, intended to ensure adequate staffing at medical facilities, remained in place as of Aug. 2022, with no end in sight but Prop. The SEUI-UHW says the 9-1-1 service calls from dialysis centers suggest the need for more staff, though they offer no data that the volume is higher than might be expected given that dialysis patients often have other serious health conditions. Proposition 30 wants to tax the wealthiest Californians -- a 1.75% personal income tax hike on those who make more than $2 million per year. / CBS San Francisco. Since many dialysis patients are highly vulnerable, the requirement that a licensed medical professional is on-site during procedures appears to make sense. 29 would increase the states need for more medical professionals. "Government can only take so much of a bite out of the economy.". Federal regulations require each clinic to have a medical director who is a board-certified physician. If they miss a treatment because of reduced hours or access, it could be fatal. font-weight:bold; California voters have overwhelmingly rejected similar dialysis propositions twice. 29 is the third attempt in four years by labor organization Service Employees International Union-United Healthcare Workers West (SEIU-UHW West) to regulate dialysis clinics. On November 7, 2018, Californians for Kidney Dialysis Patient Protection announced that a similar ballot initiative would be filed for 2020. } ABC7 is breaking down all of the propositions Californians are voting on this Election Day. Given the higher costs a clinic would face, some owners and operators may decide to seek consent from CDPH to close some of their clinics that are operating at a loss. [3], The committees in support or opposition of Proposition 8 had raised a combined $130.43 million, making the ballot measure the most expensive of 2018. However, the owner or operator might not be willing or able to do this over the longer term. Federal regulations do not require medical directors to spend a set amount of time at the clinic. By Vittorio Nastasi and Adrian Moore December 9, 2022. 29 aims to improve reliability and accuracy of data, which can be difficult to obtain, and to maximize the time that a trained physician, nurse practitioner or physician assistant is present during a patients treatment. If CDPH approves the exception, the clinic can meet the requirement through telehealth. In the time Small has served in this role, the property crime rate has plummeted by 88% to just over five property crimes per 1,000 residents. Proponents of Prop. This proposition was placed on the ballot through the collection of signatures, and a simple majority (50% plus one vote) is required for it to pass. Summary of General Obligation BondsElection Results 1986 to Present (Excel File). Stop yet another dangerous dialysis proposition. Kidney donors must take time off work, suffer discomfort, and accept the increased health risks that come with having only one kidney. To receive payments from Medicare, clinics must report specific dialysis-related infection information to the National Healthcare Safety Network at the federal Centers for Disease Control and Prevention. Voters rejected Prop 8 in 2018 by 60% and Prop 23 in 2020 by 63%. } Proposition 29 Increases Costs for Dialysis Clinics. In 2018, the campaign Californians for Kidney Dialysis Patient Protection supported a ballot initiative to require dialysis clinics to issue refunds to patients or patients' payers for revenue above 115% of the costs of direct patient care and healthcare improvements. [32], The initiative campaign submitted 1,018,730 raw signatures. Elections in 2023 | And the trained nurses and technicians at dialysis clinics are just as equipped to deliver basic lifesaving care as doctors or nurse practitioners required under the proposition. If Proposition 26 passes this November, another form of gambling would be permitted at horse racing tracks and tribal casinos in California: Sports betting. The word count for the ballot title is 17. The 2022 initiative and the two before it was placed on the ballot by the Service Employees International Union-United Healthcare West . What's the difference between Prop 26 and Prop 27. Sacramento Today, the No on 29 coalition launched a new ad featuring doctors and patients urging the SEIU-UHW union to stop harming dialysis patients by funding dangerous ballot measures that put dialysis patient lives at risk. Propositions on the November 8, 2022 Ballot. California does not require proof of citizenship for voter registration, although individuals who become U.S. citizens less than 15 days before an election must bring proof of citizenship to their county elections office to register to vote in that election.[39]. [7], The summary provided for inclusion on signature petition sheets was as follows:[6], Requires physician, nurse practitioner, or physician assistant, with six months relevant experience, on site during treatment at outpatient kidney dialysis clinics; authorizes exemption for staffing shortage if qualified medical professional is available through telehealth. The attorney general of California issued ballot language for the initiative on October 29, 2021, allowing a signature drive to begin. Supporters claim that the industry makes billions of dollars each year, but does not reinvest those profits into patient care. SAN FRANCISCO (KCBS) One of the hot button issues heading into the June Presidential Primary Election is Proposition 29, the Tobacco Tax for Cancer Research Act. Ballotpedia lists the positions of and excerpts from editorials supporting or opposing ballot measures from the editorial boards of certain media outlets. When a patient has kidney failure, the patients physician develops a plan of care, which could include a referral for dialysis. Proposition 29 includes several requirements affecting clinics, as discussed below. 1 would amend California's constitution to say that the state would not be allowed to interfere with or deny a person's right to abortion or contraceptives if it passes. However, an owner or operator may be less likely to keep an individual clinic open over the longer term if that clinic is likely to keep operating at a loss. Proposition 29 would establish a set of regulations for the staffing and operations of chronic dialysis clinics in the state. | While our example was specifically drawn from a home in Los Angeles, a similar story is likely to play out in other areas of California. Fiscal Impact: Increased state and local government costs likely in the tens of millions of dollars annually. Help expand Ballotpedia's elections coverage - volunteer with us. To register to vote in California, you must be a resident of the state. Further, tying up physicians and other highly trained medical personnel at dialysis centers would worsen the shortage of healthcare workers across the state and increase waiting times at emergency rooms. If the total number is equal to at least 100 percent of the required signatures, then local election officials perform a random check of signatures submitted in their counties. Federal guidelines, however, consider the position to reflect about one-quarter of a full-time position. The site Voter Status, run by the California Secretary of State's office, allows residents to check their voter registration status online. 30 Millionaires Tax: no. Kidney Failure. [7], The full text of the ballot initiative is below:[1]. Most people with kidney failure receive dialysis at chronic dialysis clinics (clinics), although some may receive dialysis at hospitals or in their own homes. The opponents include patient advocates and healthcare associations whose members might benefit from the expanded job opportunities the proposition would create: the California Medical Assn., the California chapter of the American Nurses Assn., and the American Academy of Nephrology PAs, along with the Renal Physicians Assn. State and local courts | Ads for and against Proposition 29 have been running non-stop for the last several months. margin-top: 10px !important; Some patients requiring treatment in costlier settings like hospitals if some clinics closed in response to the proposition. 23 in 2020 included similar requirements for dialysis clinics, and both failed when taken to voters. Under the proposition, state Medi-Cal costs, and state and local employee and retiree health insurance costs, could increase due to: Owners and operators negotiating higher payment rates. In particular, the propositions requirement that each clinic have a physician, nurse practitioner, or physician assistant on-site during all treatment hours would increase each clinics costs by several hundred thousand dollars annually on average. Constitutional rights Tobacco, What's on my ballot? Opponents view the measure as a further attempt to politically and financially weaken DaVita and Fresenius Medical Care and to unionize dialysis workers, and assert that the shortage of nephrologists in the state would leave clinics unable to meet the requirements of Prop. Proponents reported collecting 25% of the required signatures (155,803) on January 24, 2022. The last time a cigarette tax was on the California ballot was in 2006, when Proposition 86 was narrowly defeated. A NO vote on this measure means: Chronic dialysis clinics would not be required to have a physician, nurse practitioner, or physician assistant on-site during all patient treatment hours. Thats the tension: theres enormous profitability, then you meet folks of enormous need, and you realize that some of that money should be diverted to patient care. Los Angeles, CA 90230 Supporters also say that greater financial disclosure is required so that researchers and the public can better assess the impact of physician ownership of clinics. In the less likely event that a relatively large number of clinics would close due to this proposition, having obtained consent from CDPH, state and local governments could have additional costs in the short run. Signatures were due on April 27, 2022. It would also require increased disclosure of clinic ownership and dialysis-related infections. Hemodialysis: Before hemodialysis treatments can begin, surgeons create an access point, typically in an arm, to allow technicians to remove blood for treatments. School districts | "[19] In 2017, legislation was introduced, but not passed, to require staff-patient ratios in dialysis clinics and, like the ballot initiative, limit the revenue of businesses. It gives duties to CDPH to implement and administer the proposition, including adopting regulations within one year after the law takes effect. Clinics Could Respond to Higher Costs in Different Ways. columns: 2; According to a 2012 report by the California Legislative Analyst's Office, Proposition 29 would generate approximately $735 million a year in new tax revenues. The Los Angeles Times editorial board determines the positions of The Times as an institution. Dialysis, a treatment that removes waste and chemicals from the bloodstream, is administered to people whose kidneys no longer function properly. Signatures need to be certified at least 131 days before the general election. Higher costs could result in clinics being forced to close, which would reduce access to dialysis care or cause higher costs to be passed along to patients. [6] Prop. Many people in the state have group health insurance coverage through an employer or another organization (such as a union). NO The proposition allows CDPH to determine whether or not to consent. State approval of clinic closures would protect rural communities from losing access to needed dialysis services. Prop. The clinic may request a hearing if it disagrees with the penalty. Prop 22 california 2020 pros and cons. The additional tax revenue would be used to fund cancer research, smoking reduction programs and tobacco law enforcement. California voters are being asked to weigh new regulations for dialysis clinics for a third straight election.
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