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Proposition 29

October 10, 2022

Proposition 29 would help ensure that patients receive safe treatment in dialysis clinics under the care of a trained clinician.

California’s dialysis treatment industry makes billions in revenue each year, yet a lack of onsite staffing requirements leaves patients vulnerable to complications during the treatment process. Proposition 29 would require each dialysis clinic to have at least one physician, physician assistant, or nurse practitioner onsite at the clinic during the hours that patients are treated. This proposition has appeared on the ballot twice before and was rejected by voters both times after dialysis clinics poured millions of dollars into defeating the measures.

A YES vote on Proposition 29 means: Dialysis clinics would be required to have a physician, physician assistant, or nurse practitioner onsite during hours of treatment.

A NO vote on Proposition 29 means: No changes would be made to current regulations regarding dialysis clinic staffing.

More information:

  • Proposition 29 requires each dialysis clinic to have, at its expense, at least one physician, nurse practitioner, or physician assistant onsite during all the hours that patients receive treatments at that clinic.
  • Prop. 29 would require clinics to secure state approval before closing or reducing services, ensuring that patients do not abruptly lose access to treatment. The measure would also require that a clinic disclose information about physicians who own at least 5% of the clinic.
  • There are about 650 dialysis clinics in California, and a vast majority of them are owned or operated by DaVita Inc. and Fresenius Medical Care, who enjoy about $3.5 billion annually in revenue from them. Prop. 29 would increase transparency and accountability in an industry that is dominated by these two large, wealthy corporations.

Top funders of Proposition 29:

  • Yes on Prop 29: The measure was placed on the ballot by Service Employees International Union-United Healthcare West. As of August 1, the primary ballot measure committee supporting Proposition 29, also sponsored by SEIU-UHW, has raised $7 million and has spent $7 million since Jan. 1, 2022. In addition, a separate SEIU-UHW committee supporting Prop. 29 has raised and spent $7 million since Jan. 1, 2022. Notable supporters of Proposition 29 include the California Democratic Party and the California Labor Federation.
  • No on Prop. 29: The top funders of the ballot measure committee opposing Proposition 29 are DaVita, Fresenius Medical Care, and U.S. Renal Care. As of August 1, the No on 29 committee has raised $36 million and spent $3 million since Jan. 1, 2022. Notable opposition to Proposition 29 includes the California Chamber of Commerce and the California Republican Party.

Misinformation about Proposition 29 includes:

  • The California Republican Party claims that Prop. 29 is focused on “unionizing kidney dialysis clinics.” The ballot measure language does not mention unionization. 
  • Opponents of Prop. 29 claim it will negatively affect patients’ access to care. However, the measure requires that clinics receive state approval before closing or reducing services, which would prevent clinics from abruptly shuttering or otherwise slashing treatment options.