Lifesaving Dialysis Ratios One Step Closer to Law after State Assembly Health Committee Votes in Favor

June 2017

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June 27, 2017

Contact: Jeff Rogers, Communications Specialist
Jeff.Rogers@unacuhcp.org | 909-263-7230

Lifesaving Dialysis Ratios One Step Closer to Law after State Assembly Health Committee Votes in Favor

SACRAMENTO—By passing the Dialysis Patient Safety Act (SB 349) today, the California State Assembly Health Committee took a key step in protecting the lives of 66,000 Californians who rely on thrice-weekly dialysis treatments in 560 clinics around the state to stay alive.

“The big dialysis companies making outsized profits off some of the most vulnerable patients in California have been throwing up a smoke screen about the consequences of this bill, but the returns from the research are all in,” said Denise Duncan, RN, President of UNAC/UHCP, co-sponsor of the bill. “More nurses and more technicians per patient means that patient gets more and higher quality attention. The math is commonsense, and it’s backed by a body of evidence from decades of studies in multiple settings, including dialysis clinics. Safe staffing saves lives.”

The Dialysis Patient Safety Act, first introduced in the California State Senate as Senate Bill 349, takes several key steps to increase patient safety in chronic dialysis clinics. SB 349 establishes reasonable ratios for direct caregivers to patients: no more than 75 patients per social worker, 75 per dietitian, eight per registered nurse, and three per patient care technician. The bill mandates a minimum transition time of 45 minutes between patients, so that the treatment area and dialysis equipment can be safely cleaned of blood and fluids to prevent the spread of infection. The bill also calls for annual inspections of chronic dialysis clinics, now inspected only ever five to six years.

“Dialysis patients need to be closely monitored at all times,” said Carol Harrison, RN, who testified in favor of the bill during today’s hearing. “They have multiple health issues which put them at risk during treatment. If a needle dislodges, they could bleed to death. They’re at risk for cardiac arrest, stroke, pulmonary embolism. But without nurse to patient ratios I’ve been responsible for 25 patients for extended periods of time. That’s not safe. There have been times when I’ve had to go to the bathroom but I couldn’t do it because I was the only nurse in the building. All California hospitals already have patient to staff ratios and they’ve been proven to improve patient outcomes. The dialysis industry needs to institute similar measures to protect patient safety.”

SB 349’s patient care mandates are grounded in decades of research which show that better staffing means better patient outcomes, fewer hospitalizations and lower rates of infection. One 2010 study found a 19% higher risk of death at Fresenius facilities and a 24% higher death risk at DaVita facilities than for patients receiving care at the biggest non-profit chain. Poorer staffing has been suggested as the reason for this difference. Yet Fresenius and DaVita have mounted a concerted campaign against SB 349’s commonsense patient safety protections.

“The public should not be fooled by scare tactics,” Duncan continued. “Whenever they’re forced to invest more in patient care the big dialysis companies trot out the same old gloom-and-doom predictions, but by now they should have no credibility. When Centers for Medicare and Medicaid Services (CMS) in 2008 instituted a rule that one RN had to be on-site during dialysis treatments, Fresenius and DaVita predicted clinics would close across the country, treatment hours would be cut and patients would lose access. None of it happened. Both companies have seen dramatic growth nationwide. Their profits have soared. Still, they made the same predictions in Texas and New Jersey, when those states passed ratios. Once again, none of it happened. Now they’re giving California state legislators the same old song and dance. Why would anyone listen?”

SB 349 will move next to the Assembly Appropriations Committee.


United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) represents over 28,000 registered nurses and other health care professionals, including RNs who specialize in dialysis; optometrists; pharmacists; physical, occupational and speech therapists; case managers; nurse midwives; social workers; clinical lab scientists; physician assistants and nurse practitioners. UNAC/UHCP is affiliated with the National Union of Hospital and Health Care Employees and the American Federation of State, County and Municipal Employees, AFL-CIO.