On June 20, the California Secretary of State announced an initiative to enact staffing requirements, reporting requirements, ownership disclosure, and closing requirements at dialysis clinics had qualified for the November ballot. Californians for Kidney Dialysis Patient Protection, the campaign behind the initiative, submitted over 1 million signatures. The random sample concluded that 725,890 signatures were valid, surpassing the 623,212 signature threshold for initiated state statutes.
The proposed requirements include:
- requiring clinics to have at least one physician, nurse practitioner, or physician assistant—with at least six months of experience with end-stage renal disease care—onsite during patient treatments;
- requiring clinics to report dialysis-related infections to the California Department of Public Health (CDPH);
- requiring clinics to provide patients with a list of physicians with an ownership interest of 5 percent or more in the clinic;
- requiring clinics to provide the CDPH with a list of persons with an ownership interest of 5 percent or more in the clinic; and
- requiring clinics to obtain the CDPH’s written consent before closing or substantially reducing services to patients.
The ballot initiative would also prohibit clinics from refusing to care for a patient based on the patient’s form of payment, whether the patient is an individual payer, the patient’s health insurer, Medi-Cal, Medicaid, or Medicare.
The campaign is sponsored by SEIU-UHW West, which has contributed over $3.5 million. On its campaign website, Californians for Kidney Dialysis Patient Protection said, “We are dialysis workers and patients who are coming together to challenge the profiteering business model of the dialysis industry, to push dialysis corporations to make needed investments in patient care, and to stop extreme consumer overcharging.”
Similar measures were defeated in California in 2018 and 2020 by 60% and 63% of voters, respectively. The 2022 initiative is facing opposition from the same organizations. Stop Yet Another Dangerous Dialysis Proposition Committee has received endorsements from the American Academy of Nephrology PAs, California Chamber of Commerce, California Medical Association, California Taxpayer Protection Committee, and National Hispanic Medical Association. The campaign reported over $2.2 million in contributions from dialysis providers—DaVita, Inc. and Fresenius Medical Care.
Six initiatives have qualified for the 2022 ballot, including the dialysis initiative. An initiative to increase the cap on medical malpractice lawsuits qualified for the ballot in July 2020. However, in April 2022, the sponsors reached a legislative compromise with the California State Legislature and withdrew the initiative in May.
The other four initiatives relate to sports betting legalization, plastic waste reduction, K-12 art and music education funding, and a flavored tobacco products ban.
Between 2010 and 2020, an average of 87 initiatives were filed for even-numbered year ballots with an average of 10 making the ballot.