California Proposition 23: Establishing new care standards at kidney dialysis clinics

Election guide

Voting yes on Prop 23 means requiring a doctor, nurse practitioner or physician assistant to remain at the site of a dialysis clinic while treatment is taking place. 

The clinics would also have to offer the same care to patients regardless of their source of payment or insurance, report infections and get permission from the state health department before closing down. 

The measure would affect the estimated 80,000 patients treated at nearly 600 dialysis clinics across California each month. 

Voting no on Prop 23 means opposing the new rules on patient care standards at kidney dialysis clinics. 

Supporters: The Service Employees International Union-United Healthcare Workers West backs the proposition. The powerful union placed a measure on the 2018 ballot that similarly targeted California’s dialysis clinics. It would’ve capped the companies’ profits, but voters rejected it.

Proponents have contributed more than $6.2 million to promote this year’s initiative.

Critics: Dialysis companies spent more than $111 million to defeat the 2018 proposition, compared to SEIU’s $18 million — making it the most expensive initiative battle that election. 

This time around, opponents have spent at least $93 million to kill Prop 23. 

The California Medical Association is opposed to the measure, saying it would increase costs to patients and make a doctor shortage worse.

A patient undergoes dialysis at a clinic in Sacramento on Sept. 24, 2018. In November 2020, California voters will again weigh the quality of care dialysis clinics provide to about 80,000 people in the state with kidney failure. Proposition 23 would require a doctor or highly trained nurse at each of the state's 600 dialysis clinics whenever patients are being treated to improve patient care. It was placed on the ballot by unions that represent health care workers. (AP Photo/Rich Pedroncelli, File)
A patient undergoes dialysis at a clinic in Sacramento on Sept. 24, 2018. In November 2020, California voters will again weigh the quality of care dialysis clinics provide to about 80,000 people in the state with kidney failure. Proposition 23 would require a doctor or highly trained nurse at each of the state’s 600 dialysis clinics whenever patients are being treated to improve patient care. It was placed on the ballot by unions that represent health care workers. (AP Photo/Rich Pedroncelli, File)

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