Bill to improve dialysis clinic safety advances in California legislature

SACRAMENTO, California – Statewide efforts to improve patient care and staffing at dialysis clinics advanced after the state’s Senate Health Committee passed legislation affecting 560 dialysis clinics and 63,000 patients in California.

SB 349, the Dialysis Patient Safety Act, requires annual inspections of dialysis clinics and safer staffing levels. In California, dialysis clinics, which provide a difficult treatment that patients need to survive, are inspected on average only every five to six years. By contrast, nursing homes in the state must be inspected every year. Even California restaurants are inspected annually, six times more frequently than dialysis clinics.

“It bothers me a lot knowing I can’t give my patients the full attention and care they need and deserve because of short staffing,” said Emanuel Gonzales, a dialysis worker from Pomona, California, during his testimony before the committee.

“I should be able to check in with them during their treatment to see how they’re doing, and have adequate time to make sure we thoroughly clean all the equipment before the next patient, but we just don’t have enough people,” he added.

Dialysis workers have reported situations where they must monitor and care for ten 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.

Others testifying at the state Senate hearing included Roberta Mikles of San Diego, whose father died a few days after a dialysis session in 2010. She said there was not enough dialysis staff working when his blood pressure dropped, and they weren’t able to properly intervene. He was taken out of the clinic on a stretcher and died three days later at home.

In addition, Dr. Joseph Merighi of the University of Minnesota told of his decade-long research into staffing at California dialysis clinics. He told the committee that safer staffing levels could improve patient care by allowing social workers to screen patients for depression, motivate them and encourage them to take their medications, and use strategies to reduce missed or shortened treatments that can put patients’ lives at risk.

Dialysis is a life-saving treatment for people with kidney failure who must have their blood removed, cleaned, and put back into their bodies. A typical treatment lasts three to four hours, and must be conducted three days a week for the rest of the patient’s life.

The two largest dialysis corporations – DaVita and Fresenius – made $2.9 billion in profits from their dialysis operations in the United States in 2015, but workers say the companies are not spending enough to improve patient care or provide adequate staffing in their clinics.

Seven states already have minimum staffing levels in dialysis clinics: Georgia, Maryland, Massachusetts, Oregon, South Carolina, Texas and Utah.

Dialysis workers in California have been campaigning with SEIU-United Healthcare Workers West (SEIU-UHW) for safer working conditions and stronger worker and patient protections.

To learn more about the campaign, visit www.morethannumbers.org.