Proposed Ohio constitution amendment could threaten dialysis care for rural patients

A proposed amendment to the Ohio constitution that would restrict profits and increase regulations at the state's outpatient dialysis centers could make rural patients have to travel farther for care, the Toledo Blade reports.

The Kidney Dialysis Patient Protection Amendment is backed by Ohioans for Kidney Dialysis Patient Protection, with supporters saying it gives necessary regulation to a highly profitable industry. Opponents of the amendment say it could threaten patient care and close treatment centers.

The amendment is getting closer to being on November's ballot, pending certification of enough valid signatures to qualify, according to the Blade.

The proposal would cap revenue from treatment at 115 percent of "direct patient care services costs and all healthcare quality improvement costs." Dialysis centers charging more than that would have to give rebates to insurers and face fines for noncompliance. 

Under the proposal, the state would have to inspect kidney dialysis centers each year, reviewing compliance with certain processes, including how they handle and dispose of waste, clean equipment and adhere to patient care plans.

Amendment supporters, backed by the Service Employees International Union, say it has turned in enough petition signatures to put the issue on the statewide ballot. The Ohio Secretary of State's Office will verify the ballot by July 24. It requires at least 305,591 valid signatures. 

The amendment will address significantly marked-up services dialysis centers charge patients with private insurance, said Anthony Caldwell, spokesperson for the Service Employees International Union District 1199 and a member of the petitioner committee. It also would strengthen safety and hygiene regulations, Mr. Caldwell said.

But opponents of the amendment say by capping revenue, the amendment will not make it more affordable for dialysis patients since rebates go back to the insurance companies, said Diane Wish, RN, and CEO of Centers for Dialysis Care, a nonprofit dialysis provider chain in northeast Ohio.

Ms. Wish also warned the amendment could mean some centers would close or consolidate, particularly in rural areas with lower patient volumes.

"Patients will have to travel farther, and transportation is very difficult," Ms. Wish told the Blade, adding that increased travel makes missing treatments and adverse side effects requiring hospitalizations more likely. "It's just not good for patients."

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