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California Proposition 23, the Dialysis Clinic Requirements Initiative, is on the ballot in California as an initiated state statute on November 3, 2020.
The proposition authorizes State regulation of kidney dialysis clinics and establishes minimum staffing requirements.
| A “yes” vote supports this ballot initiative to require chronic dialysis clinics to: have an on-site physician while patients are being treated; report data on dialysis-related infections; obtain consent from the state health department before closing a clinic; and not discriminate against patients based on the source of payment for care. |
| A “no” vote opposes this ballot initiative to require chronic dialysis clinics to: have an on-site physician while patients are being treated; report data on dialysis-related infections; obtain consent from the state health department before closing a clinic; and not discriminate against patients based on the source of payment for care. |
Summary
PROPOSITION 23 would require chronic dialysis clinics to:
- have at least one licensed physician on site during treatment at outpatient kidney dialysis clinics. Authorizes Department of Public Health to exempt clinics from this requirement due to shortages of qualified licensed physicians if at least one nurse practitioner or physician assistant is on site.
- report dialysis-related infection data to state health department and federal governments (National Healthcare Safety Network (NHSN). Require the principal officer of the clinic to certify under penalty of perjury that he or she is satisfied, after review, that the submitted report is accurate and complete.
- provide a written notice to the state health department and obtain consent from the state health department before closing a chronic dialysis clinic.
- not “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 questions I am investigating are:
- What are the statistics, or can we even get them, for the need of a doctor on site in the clinic? How do nurses handle emergencies? Do they just call a doctor, 911, or?
- Are clinics typically located near a hospital?
- Are profits going to be used to hire the doctor or are dialysis prices just going to rise? Probably a silly question.
- What do doctors and patients think of this?
- Is this another attempt to government regulate everything?
- Is this another attempt to unionize all dialysis clinics?
The devil is clearly in the details of this Proposition.
Out of the depths of the full Ballot Initiative you will find:
(4) “Licensed physician” means a nephrologist or other physician licensed by the state pursuant to Chapter 5 of Division 2 of the Business and Professions Code. How many physicians are nephrologists?
NOTE: SEC. 10. Pursuant to subdivision (c) of Section 10 of Article II of the California Constitution, this Act may be amended either by a subsequent measure submitted to a vote of the People at a statewide election; or by a statute validly passed by the Legislature and signed by the Governor, but only to further the purposes of the Act.
If this Proposition passes and someone in the government doesn’t like something about it, this Act may be amended by a statute validly passed by the Legislature and signed by the Governor, not REQUIRED BY VOTE OF THE PEOPLE!
Clearly a lot more to review and report, but dialysis is critical to a patient’s life and I don’t believe adding layers of control always makes situations better. More to come!
More info can be found at:
https://ballotpedia.org/California_Proposition_23,_Dialysis_Clinic_Requirements_Initiative_(2020)
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