August 25, 2017

Doctors, health care and policy experts agree No evidence staffing ratios in dialysis clinics will improve patient care.

For Immediate Release:  August 24, 2017 Contact: Kathy Fairbanks, 916-443-0872

Doctors, health care and policy experts agree

No evidence staffing ratios in dialysis clinics will improve patient care.

SACRAMENTO – Supporters of SB 349 (Lara) are suggesting that mandated staffing ratios in dialysis clinics will improve quality of care. Yet so far, they’ve produced no evidence to back up that claim. Doctors, health care and policy experts can’t find any evidence, either. Renal Physicians Association (representing kidney specialists)
  • “… there is no evidence that regulations with specific nurse to patient staffing ratios, or technician staffing ratios, have led to greater safety or improved outcomes in states where those regulations exist.”
California State Dept. of Finance review of SB 349:
  • “Finance is opposed to this bill because it will likely result in increased General Fund costs for the Medi-Cal program during a time of limited resources without a demonstrated improvement in patient outcomes.”
  • “Finance is not aware of any evidence demonstrating systemic deficiencies in dialysis patient outcomes in California that are attributable to insufficient staffing.”
Health Management Associates (HMA)
  • “…there is no demonstrated relationship between staffing ratios, on the one hand, and improved patient outcomes and patient satisfaction, on the other.”
Los Angeles Times, Editorial, August 21, 2017
  • “But supporters of the Lara bill [SB 349] offer no evidence to … support the specific ratios and time limits they’re advocating.”
San Jose Mercury News, Editorial, August 1, 2017
  • “… there is no empirical evidence that higher staffing levels per patient result in better care.”
East Bay Times, Editorial, August 1, 2017 
  • “The problem is, that narrative doesn’t fit with the facts. First, there is no empirical evidence that such staffing changes result in better care.”
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.