Hemodialysis, also spelled haemodialysis, or simply dialysis, is the process by which blood is purified of the waste products which would otherwise be removed by properly functioning kidneys. In the event a patient’s kidneys can no longer perform, the client is transported to a dialysis center where a machine operated by trained technicians may perform this task. The life saving process is administered perhaps three times a week.

Proposition 29 mandates that at least one physician (doctor), nurse practitioner (NP) or physician’s assistant (PA) with six months of relevant experience be stationed on site at each facility where such dialysis procedures take place. In addition, it would require clinics to report infection data to the state governing board.

There are at least 80,000 people who require dialysis at 650 facilities in the state of California. These facilities generate nearly $3.5 billion a year in revenue for the state.

Advocates claim additional oversight is needed to ensure safety during the hours-long, complicated process of removing blood, filtering it of impurities, and returning it to affected patients. Additionally, the proposition provides additional reporting requirements to improve industry transparency.

Advocates include the Service Employees International Union-United Healthcare Workers West, the union which represents the technicians who perform these services, and the California Labor Federation.

Opponents argue that existing technicians are more than competent to safely ensure patient health; the addition of the above highly trained personnel adds unnecessary expense to already skyrocketing health costs; and the proposition could force affected facilities to close. 

Those against the proposition include DaVita Medical Care which operates 262 clinics in the state; Fresenius Medical Care with more than 2,600 locations nationally; and the American Nurses Association.

This proposition is similar to Proposition 8 (2018) and Proposition 23 (2020), which were both rejected by voters.

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