Prop. 23 pits dialysis clinics against government regulations

Proposition 23 establishes state requirements for kidney dialysis clinics, including having at least one physician, nurse practitioner or physician assistant on-site whenever a patient is having a dialysis treatment. The clinics also would have to report data on dialysis-related infections to state and federal governments.

The measure also would prohibit clinics from closing or reducing services without state approval, or refusing to treat patients based on the source of payment for care.

The state’s Democratic Party supports the measure, along with the Service Employees International Union-United Healthcare Workers West. They argue Proposition 23 is necessary to protect the 80,000 California residents who need dialysis to survive by ensuring they receive basic standards of care.The Republican Party opposes the measure. The “No on Prop 23” coalition has more than 110 supporters from business, taxpayer and community groups; dialysis providers, doctors and patients; and veterans and seniors’ organizations, according to its website.

Opponents argue the ballot initiative would force many community dialysis clinics to shutter, threatening the lives of those 80,000 California patients who need dialysis to survive.

They also state that if the measure passes, health care costs would increase by hundreds of millions of dollars annually; and the doctor shortage and overcrowding at emergency rooms would worsen.

Opponents, led by DaVita Inc. and three other dialysis companies, have spent more than $85 million to defeat Proposition 23. DaVita, which has 20 clinics in the North Bay region, donated nearly $60 million of the total.

SEIU-UHW West, the main proponent of Proposition 23, has spent $6 million in support of the measure.