Giving You Props: What is Proposition 29?

Proposition 29 would require physicians, nurse practitioners or physician assistants to be on-site during kidney dialysis treatment. It would also require clinics to disclose physicians’ ownership interests and report infection data. 

When would Proposition 29 go into effect? 

According to the LA Times, unless otherwise specified, the propositions approved by voters will take effect once the election results are certified in December.

Who will be affected by Proposition 29? 

Proposition 29 will primarily affect patients who rely on the regular kidney dialysis treatment clinics and the nurses that will now required to be on site. This proposition will also affect the nurses and physicians who will be required to be onsite during treatment at outpatient clinics. 

Why would I support Proposition 29? 

This proposition is supported by Californians for Kidney Dialysis Patient Protection, International Union-United Healthcare and Healthcare Workers West.  

According to Dialysis Patient Citizens Education Center, each kidney has about a million tiny filters called nephrons. The nephrons filter blood and when they become damaged, the kidney becomes less efficient at doing its many jobs. 

Chronic kidney disease occurs when the nephrons are damaged or destroyed. Over time, as fewer nephrons are available to clean the blood, the kidneys are diseased and less able to keep the body healthy.

The National Kidney Foundation has classified five stages of kidney failure to help better treat patients based on how much kidney function they have left. 

During the first three stages, patients are recommended to alter their daily routine in order to practice healthy habits and to limit the proteins in their diet, control their blood sugar intake and monitor their blood pressure levels.

By stage four patients begin to experience kidney failure and explain the treatment options for them including dialysis and transplantation. 

If the patient chooses dialysis, there are various types of dialysis treatments available such as hemodialysis and peritoneal dialysis, that the patient must get access to wherever local dialysis occurs.

Hemodialysis allows the blood to come out of the body to be cleaned and then put back into the body. For peritoneal dialysis, the catheter is placed in the abdomen to allow for dialysate to go into and out of the peritoneal cavity, which acts as a filter in place of the kidneys.

At stage five the kidneys no longer function well enough to keep a person alive, so dialysis or a transplant must be done.

A “yes” vote on this measure would mean chronic dialysis clinics would be required to have a physician, nurse practitioner or physician assistant on-site during all patient treatment hours.

Currently, nurses and physicians are not required to be present during all hours of treatment of dialysis patients due to the fact that most types of dialysis can be performed at home with proper instructions. 

This proposition ensures patients receive safe treatment in dialysis clinics under the care of a doctor or another highly trained clinician in case of emergencies, without risk of infection and without discrimination.

Why would I oppose Proposition 29? 

This proposition is opposed by taxpayers, businesses and healthcare providers as well as various coalitions focused on patient advocacy, social justice and senior care for dialysis patients.

A “no” vote on this measure would mean chronic dialysis clinics would not be required to have a physician, nurse practitioner or physician assistant on-site during all patient treatment hours.

According to NoProp29, this measure would move thousands of doctors, nurses and physician assistants away from patients that need care and into administrative roles at dialysis clinics where they will not be providing care.

Nearly half of all of California’s 600 dialysis clinics could be forced to cut back services or close, making it more difficult for dialysis patients to access their life-saving treatments and would put patients' lives at risk. 

If clinics shut down, dialysis patients who miss treatment will get very ill and wind up in the emergency room.Missing even a single treatment increases a patient’s risk of death by 30%.

This would force tens of thousands of dialysis patients into emergency rooms and will exacerbate overcrowding of hospitals. 

This would threaten the lives of 80,000 California patients who need dialysis to survive. California voters have overwhelmingly rejected similar dialysis propositions twice in the previous two elections. 

The fiscal impactwould also increase state and local government costs by tens of millions of dollars annually due to the increased need for labor provided by nurses and staff.  

How will Proposition 29 affect the OCC community? 

According to OCKidney, chronic kidney disease is a life altering diagnosis and requires dedicated management tailored to an individual patients cause for kidney disease. 

“We know this can be overwhelming for individuals with a new diagnosis and even those who have been aware of their kidney disease for many years,” OCKidney mentions on their website. "We are dedicated to helping you manage your health regardless of the severity of your condition.” 

Requiring nurses and physicians to be on-site during all patient-treatment hours would take away the personal and tailored care patients currently receive, and replace it with clinical and impersonal care.

At UCI Health, the increased number of nurses and practitioners that are required to be present at outpatient clinics could ultimately lead to being shut down, due to the demand that would follow if the state of California raises the cost of outpatient dialysis treatment while inflation is at its highest. 

Where can I find more information on Proposition 29? 

To find more information on Proposition 29, you can visit CalMatters, Reason Foundation, Ballotpedia, CA voter guide and NoProp29.


Editor’s Note: Coast Report is covering 2022 election races and proposition issues that are expected to have a meaningful impact on our audience, change the balance of power in government and/or be particularly compelling and competitive. Coast Report’s election coverage is intended to inform voters – specifically OCC student voters – and promote the democratic process of free and fair elections. 


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