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SD public defense duties shift from counties to state; SCOTUS appears skeptical of restricting government communications with social media companies; Trump lawyers say he can't make bond; new scholarships aim to connect class of 2024 to high-demand jobs.

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The SCOTUS weighs government influence on social media, and who groups like the NRA can do business with. Biden signs an executive order to advance women's health research and the White House tells Israel it's responsible for the Gaza humanitarian crisis.

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Midwest regenerative farmers are rethinking chicken production, Medicare Advantage is squeezing the finances of rural hospitals and California's extreme swing from floods to drought has some thinking it's time to turn rural farm parcels into floodplains.

Signatures Filed Today For Controversial CA Dialysis Ballot Initiative

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Thursday, April 5, 2018   

LOS ANGELES – Today, supporters of an initiative to reform the dialysis industry are filing more than 600,000 signatures with county officials up and down the state in an effort to get on the November ballot. The so-called "Fair Pricing for Dialysis Act" would limit dialysis corporations' revenues to 15 percent above what they spend on patient care – and rebate anything above that to insurance companies.

However, it does not require insurers to pass that on to consumers. Sean Wherley, senior communications specialist for the union SEIU-United Healthcare Workers West, says the idea is to incentivize the companies to plow more profits back into patient care.

"Hiring staff is patient care. Getting new equipment is patient care. Improving the facilities is patient care,” says Wherley. “If they do all that, they can charge more. They just can't take more than 15 percent above that cost."

Wherley notes that dialysis giants Fresenius and DaVita made $3.9 billion in 2016 – and says the union has heard complaints that some clinics are dirty, have faulty equipment or are so understaffed, patients with low blood pressure pass out while others soil themselves waiting to be unhooked in order to go to the restroom.

DaVita and Fresenius argue that limiting revenues will cause clinics to cut back or close, limiting access for the 66,000 Californians with kidney disease who could die if they don't get their blood filtered several times a week.

Miguel Estrada, a patient-care tech for almost 20 years, belongs to the group "Patients and Caregivers to Protect Dialysis Patients," which is funded by DaVita and Fresenius. He argues that the initiative's definition of patient care doesn't cover necessary staff such as the physician medical director. And he thinks the union has an ulterior motive.

"Clinics are gonna close, and then my patients are gonna be at risk,” he says. “I mean, this initiative is really just a way to negotiate because the union has been trying to get into dialysis for the last almost two years without success."

Last year, a bill to establish minimum staffing levels in dialysis clinics, Senate Bill 349, passed the state Senate but is still awaiting a vote in the State Assembly. About 16,000 people work at 570 clinics in California.


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