Politichaos

Resolving the Ruckus

Proposition 23

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Establishes State Requirements for Kidney Dialysis Clinics. Requires On-Site Medical Professional.

initiative statute

Official Summary

Requires physician, nurse practitioner or physician assistant on site during dialysis treatment. Prohibits clinics from reducing services without state approval. Prohibits clinics from refusing to treat patients based on payment source.

Fiscal Impact: Increased state and local government costs likely in the low tens of millions of dollars annually.

Notes

Two companies operate approximately 75% of dialysis clinics: DaVita and Fresenius. Apprx $3 Billion is paid for dialysis services in CA. Medicare pays for the majority of people on dialysis, plus Medi-Cal and individual or group health insurance (which are often charged significantly more). CDPH is governing entity. This proposition states that:

  1. a doctor must be on-site during all treatment hours

  2. clinic must report infection-related information to CDPH and face penalties if they do not

  3. clinic must notify and obtain consent from CDPH before closing or substantially reducing services

  4. clinic cannot refuse care to a patient based on who is paying for the patient’s treatment.