Capitol Alert

Union-backed dialysis clinic bill shelved by California lawmaker

Tad Suwa, 41, receives a dialysis treatment in West Sacramento, Calif. on Monday, April 15, 2013.
Tad Suwa, 41, receives a dialysis treatment in West Sacramento, Calif. on Monday, April 15, 2013.

A California bill to require more oversight of dialysis centers has been sidelined for the year in the state Legislature.

Sen. Ricardo Lara, D-Bell Gardens, introduced Senate Bill 349 earlier this year at the behest of the Service Employees International Union-United Healthcare Workers West. The bill faced heavy opposition from corporations that operate for-profit dialysis centers in California and other parts of the country.

The measure would have required dialysis centers to provide one nurse for every eight patients and one technician for every three patients, among other new standards.

Lara’s office said he tabled the bill until next year to give the industry, the union, the Brown administration and other stakeholders more time to work together to find common ground.

“To give this process time to develop, I will not seek a vote in the Assembly before the end of session and will bring SB 349 up for consideration when the Legislature reconvenes (in 2018) after we have conducted stakeholder meetings,” Lara said.

The bill passed the state Senate with a 24-15 vote in late August and cleared two Assembly committees. The measure was expected to encounter a more difficult battle on the Assembly floor.

DaVita, one of the nation’s largest dialysis center companies, dished out $86,350 in campaign contributions to members of the California Assembly in May and June. Fresenius Medical Care, another major dialysis company, gave $58,600 to Assembly members in the same period.

“We are grateful that legislators heard the concerns of thousands of California doctors, nurses, dialysis caregivers, patients, local clinics and many others who contacted their legislators to warn that SB 349 would be dangerous for dialysis patients and costly for Medi-Cal,” said Mark Shapiro, a San Diego nephrologist who testified against the bill, in a statement.

A coalition that included DaVita, Fresenius, the California Hospital Association, the California Chamber of Commerce and other groups argued against the need to change staffing requirements in California and said dialysis clinics in the state already offer higher quality care than the rest of the country.

SB 349, sponsored by the United Healthcare Workers West union, mandates mandatory staffing ratios in dialysis clinics in California. Analyses of the legislation found the bill would have jeopardized dialysis access for more than 15,000 patients and cost the state Medi-Cal program as much as $270 million annually.

Proponents were unable to provide any evidence that staffing ratios lead to better care. In fact, evidence from the federal Centers for Medicare & Medicaid Services (CMS) shows that, on average, California dialysis clinics outperform the rest of the nation in both quality of patient care and in patient satisfaction.

SB 349 is opposed by more than 50 groups and editorial boards across the state.

The bill marked a play by the union as it seeks to add more dialysis workers to its ranks. SEIU alleges that DaVita has retaliated against dozens of workers for their advocacy in support of the bill.

The effort to rein in dialysis centers, which treat more than 60,000 Californians a year, may continue through a pair of ballot initiatives the union filed last month to similarly increase oversight.

“If the discussions are not productive, we will ask California voters to stand up for dialysis patients through a statewide ballot initiative planned for the November 2018 election,” said Dave Regan, president of SEIU-United Healthcare Workers West, in a statement.

Editor’s Note: The story was updated at 1:35 p.m. Sept. 8, 2017, to clarify that Lara said he is sidelining the bill to provide more time for an agreement among supporters and opponents.

Taryn Luna: 916-326-5545, @TarynLuna