ARGUMENT IN FAVOR OF PROPOSITION 29

Life-Saving Changes for Dialysis Patients

Three times every week, 80,000 Californians with End Stage Renal Disease go to one of more than 600 commercial dialysis centers in the state where they spend several hours connected to a machine that removes their blood, cleans it, and returns it to their bodies. Dialysis literally is what keeps them alive, and they must continue the treatment for the rest of their lives or until they receive a kidney transplant.

Because the lives of these fellow Californians are so dependent on dialysis done both safely and effectively, we must give our absolute support to the Protect the Lives of Dialysis Patients Act on the Nov. 8 ballot. This initiative makes common-sense improvements to dialysis treatment to protect some of the most medically vulnerable Californians.

The initiative does five major things:

First, it requires a physician, nurse practitioner, or physician assistant to be in the clinic whenever patients are being treated, which is not currently required. Dialysis is a dangerous procedure, and if something goes wrong, a doctor or highly trained clinician should be nearby.

Second, as dialysis patients are prone to infections that can lead to more serious illnesses or even death, it requires clinics to report data on infections to the state so problems can be identified and solved to better protect patients.

Third, as life-saving health care facilities, it requires dialysis corporations to get approval from the state before closing clinics or reducing services. This will protect access to dialysis treatment, particularly for patients in rural communities.

Fourth, it prohibits clinics from discriminating against patients because of their type of insurance and protects patients in every clinic. Whether in a wealthy neighborhood or a poor, rural, Black or Brown community, all clinics will be required to have a doctor or other highly trained clinician on-site and to report their infection rates, and all dialysis corporations will be prohibited from discriminating against patients based on insurance type.

Fifth, it increases transparency and helps patients make informed decisions for their care by requiring clinics and dialysis corporations to disclose information on ownership. As joint ventures between dialysis clinics and doctors become more common, improved transparency is needed to allow stakeholders and policy makers to study the effects of physician ownership.

Don’t fall for big dialysis corporations’ claims that this initiative will create huge new costs, harm patients, or create a shortage of doctors—those fake arguments are just designed as scare tactics in their dishonest public relations campaign. The fact is these corporations can easily make these changes and still profit hundreds of millions of dollars a year without disrupting our healthcare system.

Proposition 29 will make the changes we need to truly protect dialysis patients. We urge you to vote YES!

Emanuel Gonzales, Dialysis Patient Care Technician

Reverend Kisheen W. Tulloss, President

The Baptist Ministers Conference of Los Angeles

Cecilia Gomez-Gonzalez, Dialysis Patient Advocate

REBUTTAL TO ARGUMENT IN FAVOR OF PROPOSITION 29

JOIN DIALYSIS PATIENTS, NURSES, DOCTORS AND FAMILIES: NO ON 29—YET ANOTHER DANGEROUS DIALYSIS PROPOSITION

More than 80,000 Californians with failed kidneys need dialysis treatments three days a week to stay alive. Missing even a single dialysis treatment increases patients’ risk of death by 30%.

Proposition 29’s bureaucratic requirements will force dialysis clinics throughout the state to cut back services or shut down, making it harder for patients to access their treatments—putting their lives at serious risk.

PROP. 29 IS UNECESSARY AND WILL HARM—NOT IMPROVE—DIALYSIS CARE

California’s dialysis clinics have high ratings for quality care and patient satisfaction. Every dialysis patient in California is under the care of their own kidney doctor and treatments are administered by specially trained nurses and technicians. It makes no sense to also require a physician administrator on site full-time who will not be involved in providing care. Prop. 29 will unnecessarily drive-up health care costs, force dialysis clinics to shut down and risk patient lives.

VOTERS HAVE ALREADY REJECTED SIMILAR DIALYSIS PROPOSITIONS—TWICE!

This is the third time in as many elections that a special interest has placed similar dialysis propositions on the ballot. Sixty-three percent (63%) of California voters overwhelmingly rejected Prop. 23—an almost identical measure—just last election.

Enough is enough. Special interests need to respect the will of the voters and stop pushing these dangerous dialysis propositions that threaten the lives of 80,000 dialysis patients.

PROTECT DIALYSIS PATIENTS. VOTE NO ON 29!

www.NoProp29.com

Marketa Houskova, DNP, RN, Executive Director

American Nurses Association\California

Margarita Mendoza, Kidney Dialysis Patient

Robert E. Wailes, M.D., President

California Medical Association

ARGUMENT AGAINST PROPOSITION 29

DIALYSIS PATIENTS STRONGLY OPPOSE PROP. 29 BECAUSE IT PUTS OUR LIVES AT RISK

"This is the third time a special interest has placed a proposition on the ballot putting my life and the lives of 80,000 other dialysis patients at risk. Twice, voters have overwhelmingly rejected these dangerous propositions. Please, reject Prop. 29 to stop yet another dangerous dialysis proposition."—Angel De Los Santos, dialysis patient, Los Angeles

"I’ve been on dialysis for two years. Dialysis is literally my life support. I am so angry that one special interest is pushing a third proposition that puts my life at risk. Please, protect patients like me . . . again. Vote NO on 29."—Rachel Sprinkle-Strong, dialysis patient, Sacramento

PROP. 29 WOULD FORCE COMMUNITY DIALYSIS CLINICS TO CUT SERVICES OR SHUT DOWN—RISKING PATIENTS’ LIVES

Dialysis patients, nurses and doctors strongly oppose Prop. 29. More than 80,000 Californians with failed kidneys need dialysis treatments three days a week to stay alive. Missing even a single dialysis treatment increases patients’ risk of death by 30%.

Proposition 29 would force dialysis clinics to have new administrators on-site at all times—even though they would not provide direct patient care. This unnecessary requirement would cost hundreds of millions every year, forcing dialysis clinics throughout the state to cut back services or shut down, making it harder for patients to access their treatments—putting their lives at risk.

DIALYSIS CLINICS ARE STRICTLY REGULATED AND PROVIDE HIGH QUALITY CARE

California’s dialysis clinics are regulated by federal and state agencies and have high ratings for quality care and patient satisfaction. Each dialysis patient in California is under the care of their own kidney specialist and dialysis treatments are administered by specially trained nurses and licensed technicians. It makes no sense to also require a physician administrator on-site full-time who will not be involved in providing care.

PROP. 29 WOULD WORSEN OUR HEALTH CARE WORKER SHORTAGE AND LEAD TO MORE EMERGENCY ROOM OVERCROWDING

"Proposition 29 would take thousands of doctors, physician assistants and nurse practitioners away from hospitals and clinics—where they’re needed—and place them into administrative jobs at dialysis clinics where they aren’t."—Marketa Houskova, Doctor of Nursing Practice, RN, Executive Director of American Nurses Association\California.

"Prop. 29 would make our growing physician shortage even worse by taking doctors away from hospitals and clinics where they are needed, increasing wait times and reducing capacity to deal with other medical emergencies."—Robert E. Wailes, M.D., President, California Medical Association

ANOTHER SPECIAL INTEREST ABUSE

This is the third time this special interest has placed similar dialysis measures on the ballot. Twice, California voters have overwhelmingly rejected these measures. Special interests need to respect the will of the voters and stop threatening dialysis patients’ lives.

JOIN DIALYSIS PATIENTS, FAMILIES, NURSES AND DOCTORS: NO ON 29

Prop. 29 opposed by: • Tens of thousands of dialysis patients and families • American Nurses Association\California • American Academy of Nephrology Physician Assistants • Dialysis Patient Citizens, representing thousands of patients • California Medical Association, representing 40,000 California physicians • Emergency room doctors

www.NoProp29.com

Anthony Hicks, Kidney Dialysis Patient

Angelic Nicole Gant, Kidney Dialysis Patient

Gregory Ridgeway, Kidney Dialysis Patient

REBUTTAL TO ARGUMENT AGAINST
PROPOSITION 29

BIG DIALYSIS CORPORATIONS WANT TO PROTECT THEIR PROFITS, NOT PATIENTS

In 2020, the California dialysis industry spent over $100 million to defeat an initiative to improve conditions for patients in dialysis clinics. Why did they spend so much? To protect their massive $561 million in profits in California in 2020.

To patients, dialysis is lifesaving. But to industry executives, it’s a huge money-maker, so they’re at it again, stoking fear by threatening to close clinics if Prop. 29 passes and they’re held accountable to higher standards. Once again they are using gravely ill dialysis patients to shield their perks and million-dollar salaries.

They claim, falsely, that the initiative will hurt patients.

They claim dialysis doctors and nurses are against it, but those are doctors and nurses on their payroll.

They say dialysis clinics are already highly regulated, but they face far fewer inspections than other health facilities, and even so, deficiencies are often uncovered.

Prop. 29 makes commonsense improvements to protect patients’ lives, like having a doctor or nurse practitioner required on-site to deal with emergencies, requiring the centers to report infection data, ending discrimination against some patients based on the type of insurance they have, and requiring the state to approve any clinic closures so patients aren’t left without treatment.

Once and for all, Californians can protect fragile dialysis patients by voting Yes on Prop. 29.

Shama Aslam, Former Dialysis Patient

Richard Elliott, Dialysis Patient

Ruben Tadeo, Dialysis Patient