Legislation to improve staffing levels and patient care for 66,000 people on dialysis in California continues moving ahead after being passed by the California Assembly Health Committee.
“I stopped going to dialysis clinics in 2012 because the care was so bad, and instead I got trained on how to hook myself up to the machine and I’ve been doing dialysis at home ever since,” said Banbury Holmes, a dialysis patient from Oakland, Calif. “The only thing that would get me to go back to a dialysis clinic for treatment is if the companies have more staff on hand and they can spend more time with patients like me.”
SB 349, The Dialysis Patient Safety Act, now heads to the California Assembly Appropriations Committee for consideration. Last month, the California Senate passed the legislation.
The bill calls for annual inspections of dialysis clinics, safer staffing levels and more recovery time for patients. In California, dialysis clinics are inspected on average only once every five to six years, whereas nursing homes in the state must be inspected every year.
The legislation mandates 45 minutes between patients to allow more time for them to recover and for staff to sanitize the equipment. Earlier this month, federal regulators sent a letter to the California Department of Public Health emphasizing the importance of transition time to ensure that patients are clinically stable after dialysis treatment and to “prevent cross contamination between patients.”
The two largest dialysis corporations – DaVita and Fresenius – made a combined $3.9 billion in profits from their dialysis operations in the United States in 2016 but fiercely resist efforts to reform the industry.
Workers say they are being retaliated against for supporting SB 349 and efforts to form a union with SEIU-United Healthcare Workers West (SEIU-UHW). Last month, DaVita fired a 16-year employee less than a day after he spoke at the California State Capitol in support of the legislation. He is one of 22 DaVita employees either fired or disciplined for such involvement since October 2016.
Dialysis workers have reported situations where they must monitor and care for 10 or more patients at the same time for hours on end, raising concerns when multiple patients are at risk of falling blood pressure, fainting, having some other complication or just needing to use the restroom.
Eight states already have minimum staffing levels in dialysis clinics: Georgia, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, Texas and Utah. California would become the first state to enact such changes through legislation, whereas the other states did it through agency rulemaking.