August 21, 2017

In Case You Missed It: LA Times opposes SB 349 (dialysis center staffing ratios)

For Immediate Release:  August 21, 2017 Contact: Kathy Fairbanks, 916-443-0872

In Case You Missed It:

LA Times opposes SB 349 (dialysis center staffing ratios)

Bill “would make costly dialysis treatment even more expensive without trying to incentivize or measure any improvement in care.”

SACRAMENTO – The LA Times today opposed SB 349 (Lara) saying the bill “would make costly dialysis treatment even more expensive without trying to incentivize or measure any improvement in care.” DialysisPatients1st, a coalition of doctors, nurses, patients, veterans, hospitals and others opposed to the bill, warn that the increased staffing costs from SB 349 could reduce dialysis patients’ access to care. The Times agrees: “The Lara bill also could reduce the availability of dialysis in some communities, if centers decide to treat fewer patients and keep more limited hours rather than hire the extra personnel.” The full list of editorial boards opposed to SB 349:
  • LA Times
  • San Diego Union-Tribune
  • East Bay Times
  • San Jose Mercury News
  • Southern California News Group:
    • LA Daily News
    • Orange County Register
    • Riverside Press-Enterprise
    • San Bernardino Sun
    • Redlands Daily Facts
    • Inland Valley Daily Bulletin,
    • San Gabriel Valley Tribune
    • Whittier Daily News
    • Pasadena Star News
    • Torrance Daily Breeze
    • Long Beach Press Telegram
SB 349 mandates costly staffing ratios in dialysis clinics and is pending in the Assembly in the final weeks of the legislative session. United Healthcare Workers West is pushing the bill as part of its campaign to unionize California dialysis clinics. There is no evidence that staffing ratios lead to better care. Federal government data that tracks dialysis clinics’ quality performance nationwide demonstrates that on average California clinics are outperforming other states with mandated ratios in both quality and patient satisfaction. SB 349 is a solution in search of a problem. More from the LA Times editorial:
  • “But supporters of the Lara bill offer no evidence to show centers in those states have better safety and quality records than the ones in California do, or to support the specific ratios and time limits they’re advocating.”
  • “But measuring the number of nurses and technicians in a building, like tallying profit margins or counting the minutes between patients, isn’t the same as measuring the quality of care.”
  • “To hold down costs and improve quality, policymakers across the country have sought to give healthcare providers more incentives to deliver better care more efficiently. The Lara bill steers in a very different direction, proposing rules that would make costly dialysis treatment even more expensive without trying to incentivize or measure any improvement in care.”
  • “The Lara bill also could reduce the availability of dialysis in some communities, if centers decide to treat fewer patients and keep more limited hours rather than hire the extra personnel. That seems a particular risk for the many smaller companies operating in the shadow of DaVita and Fresenius.”
About SB 349: SB 349 would mandate rigid staffing ratios at dialysis clinics and adds a 45-minute “time out” transition time between patient appointments. Doctors, nurses, patients and dialysis clinics warn the bill is:
  • Dangerous for Patients ­– Arbitrary staff ratios would result in fewer available appointments, more missed treatments and a dangerous backlog of needed care. California already faces a shortage of dialysis clinics and appointment times, as well as staff. SB 349 will reduce the availability of treatment slots, increasing hospitalizations and emergency room visits, and will end in less flexibility for working patients as evening and overnight treatments would be jeopardized.
  • Costly for California and Medi-Cal – According to the Senate Appropriations Committee analysis of SB 349: “By imposing staffing requirements that exceed current practices in chronic dialysis clinics, the bill will increase the costs to operate those clinics. This is likely to increase Medi-Cal managed care payments to chronic dialysis clinics…. To the extent that chronic dialysis clinics have difficulty meeting the required staff to patient ratios, it is possible that patients would seek treatment in emergency departments and/or hospital inpatient dialysis units. Receiving dialysis in those settings is likely to be substantially more expensive than receiving dialysis in a clinic. Any such increases in the cost to provide dialysis would impact Medi-Cal.”
  • Unnecessary Federal data collected by the Centers for Medicare & Medicaid Services (CMS) show that California dialysis clinics outperform dialysis clinics nationwide in both clinical quality and patient satisfaction, including outperforming states with some form of mandated staffing ratios.
Visit our website to learn more about the provisions that will be dangerous for patients.