August 23, 2017

Sacramento Bee: Union bill will harm dialysis patients

Union bill will harm dialysis patients August 23, 2017 Naveen Atray The United Healthcare Workers West union is in all-out attack mode against California dialysis clinics and providers in its attempt to unionize dialysis workers. But in its war, dialysis patients are the ones who will be harmed. SEIU-UHW is pushing Senate Bill 349, which would impose mandatory staffing ratios for nurses, technicians, social workers and dieticians in hundreds of clinics that treat more than 60,000 patients with kidney failure.

Authored by Sen. Ricardo Lara, a Bell Gardens Democrat, the bill would increase clinic staffing costs by an estimated 35 percent. Clinics unable to afford that increase will have to treat fewer patients, or close altogether. Patients in underserved, low-income and rural communities will be hit hardest, as clinics in these areas typically operate on the slimmest margins.
Many clinics are already at maximum capacity and demand for dialysis in California is increasing at about 5 percent a year. We need to be increasing access to dialysis care, not legislating policy that will restrict it. With fewer clinics and treatment times available at clinics, patients could be forced to go farther away from their homes. There will likely be more missed appointments and medical complications, which will land patients in the hospital. Patients who miss even one dialysis appointment face a 30 percent higher death rate. SB 349 is dangerous. It is also costly. A recent analysis by the state’s Director of Finance estimates that Medi-Cal costs could go up by $270 million annually because of SB 349. And for what? There is zero evidence that mandating staffing levels equates to better care. In fact, data from the federal government, which regulates dialysis clinics, shows that California exceeds other states in both quality care and patient satisfaction, including the few states that have mandatory staffing ratios. As a nephrologist serving patients in suburban Sacramento for the last 11 years, I’d support this bill if I thought it would improve care in dialysis clinics. But the downsides and risks to patients are too great. The UHW seems intent on pushing its membership agenda despite the grave risk to patients. The union recently filed two statewide ballot measures, presumably as a means to increase pressure on dialysis clinics to meet its demands. Using ballot measures in an attempt to extort what they want is a common tactic of this organization. Doctors, nurses, hospitals, patients, veterans groups, dialysis clinic workers and many others are all standing steadfast in our opposition to SB 349. We urge legislators to stand with patients and reject the bill.