Signatures filed for California ballot initiative related to dialysis clinic requirements


Californians could vote on a ballot initiative related to dialysis clinics for the second general election in a row. In 2018, 59.9 percent of voters rejected a proposal, titled Proposition 8, to require dialysis clinics to issue refunds to patients or patients’ payers for profits above a defined threshold. The SEIU-UHW West, a labor union that sponsored Proposition 8, announced that a similar ballot initiative would be filed for 2020.

On April 21, 2020, the Los Angeles County Clerk’s office told Ballotpedia that the union-backed campaign submitted signatures for a ballot initiative to enact several requirements for dialysis clinics. Counties have eight working days to count signatures followed by 30 working days to conduct a random sample of signature validity. At least 623,212 signatures need to be valid.

The ballot initiative would require chronic dialysis clinics (CDCs) to:

  1. have a minimum of one licensed physician present at the clinic while patients are being treated, with an exception for when there is a bona fide shortage of physicians
  2. report data on dialysis-related infections to the state health department and National Healthcare Safety Network (NHSN);
  3. provide a written notice to the state health department and obtain consent from the state health department before closing a chronic dialysis clinic.

The proposal would also state that a chronic dialysis clinic cannot “discriminate with respect to offering or providing care” nor “refuse to offer or to provide care, on the basis of who is responsible for paying for a patient’s treatment.”

The SEIU-UHW West is also sponsoring the campaign in support of the 2020 ballot initiative, which is called Californians for Kidney Dialysis Patient Protection. The campaign had raised $5.91 million, all of which came from the labor union. The Stop the Dangerous & Costly Dialysis Proposition PAC was registered to oppose the ballot initiative. The committee had raised $2.02 million, with $1.01 million from DaVita, Inc. and $1.01 million from Fresenius Medical Care.

In 2018, the committees in support of and opposition to Proposition 8 raised a combined $130.43 million, making the ballot measure the most expensive of 2018 and the third most expensive in California history. Opponents raised $111.48 million of the total, with 90 percent coming from DaVita and Fresenius Medical Care North America.

The recommended deadline for California campaigns to file signatures was April 21, 2020. Election officials need to verify signatures by June 25, 2020. As of April 22, four citizen-initiated measures have qualified for the election on November 3, 2020, and four more are awaiting signature verification. An additional five ballot measures may submit signatures, but at least two of them have announced that their in-person signature drives have been negatively impacted by the coronavirus pandemic.

Additional reading:
California 2020 ballot propositions
SEIU-UHW West
California Proposition 8, Limits on Dialysis Clinics’ Revenue and Required Refunds Initiative (2018)