FilAms supporting reform to keep patients safe, from left: Isaac Lubag, Vicky Santos and Daisy Dizon Reyes.
Patients and caregivers listen to a panel of speakers, from left: FilAm Cass Gualvez, Dr. Randall Maxey, Joan Allen, Megallan Handford, and Vince Gonzales.
Text and photos by Lydia V. Solis
COMMERCE, CA – Patients and caregivers (a large number of whom are Filipinos) support passage of SB 349, the Dialysis Patient Safety Act, introduced on February 14, by State Sen. Ricardo Lara (D-Bell Gardens) to protect dialysis patients and improve care at 562 California dialysis clinics. The Senate Health Committee voted 7-2 in favor of the measure.
“I was born with kidneys that make stones all the time which disintegrates my kidneys,” said Isaac Lubag, 42, when interviewed on May 4, at the SEIU-United Healthcare Workers West office here. “Only 60 percent of my kidneys work, he continued, “and I fear that one day I will be a dialysis patient myself, and after hearing my father’s horror stories about mistakes committed at the dialysis facility where he works, I’m really worried, unless reform happens, and soon.” The former Navy corpsman from Bulacan, lives with his wife and two pre-teen kids in Hacienda Heights, CA, He said his mother and grandmother have ‘polycystic kidney disease’ (an inherited disease that causes many cysts to form in the kidneys). “Only 20 percent of my mom’s kidneys work, said Lubag. “And the disease runs in the family – my tita’s, siblings, and cousins all have it.” Lubag receives care from Kaiser Permanente, regulating his blood pressure and blood sugar. “They remove stones every time I pass them,” he noted.
The problem: According to SEIU-UHW, the United States has one of the worst dialysis patient outcomes in the industrialized world. An American dialysis patient is three times as likely to die within the first year of starting dialysis as a patient in Japan or Europe. Only one in three American patients on dialysis survives for five years.
The solution: To ensure enough patient care staff is available to warrant patient safety. SB 349 establishes minimum staffing ratios at dialysis clinics of one registered nurse per eight patients; one patient care technician per three patients; and one social worker per 75 patients.
SB349 will improve safety and care for dialysis patients receiving treatment at outpatient clinics by requiring safe staffing levels; increasing the frequency of inspections; and requiring adequate time between patients to clean the dialysis machines, and allowing patients to rest after finishing treatment.
Vicky Santos, a technician at DaVita clinic, one of two for-profit companies (the other is Fresenius), supports SB 349, “not only for patient safety,” she says, “but also for the worker. If SB 349 passes, technician-patient ratio will be one to three, unlike where I work… one to five.” Santos said she’s a School of Business graduate in Manila, “but ended up working for DaVita for 15 years now. We also need longer than 15 minutes between patients to clean and disinfect,” she added, “at least 45 minutes, so we don’t rush patients out when they are not stable yet, when they still feel woozy.” (SB 349 establishes a minimum 45 minute transition time after one patient finishes treatment and before the next patient begins treatment using the same dialysis equipment. The transition time includes the time that the previous patient rests and recovers in the dialysis chair after their treatment.)
Almost three-quarters of California’s clinics are owned by DaVita and Fresenius, companies that earn billions of dollars in profits, according to SEIU-UHW, yet fail to invest in adequate staffing and quality care. Patients have been exposed to TB and HIV, and many centers have been found with dried bloodstains, pests, and bed bugs. State Inspectors have found that some clinics reused bloodlines and tubing, which creates a serious infection risk for dialysis patients. Inspections are only required every six years. (SB 349 requires annual inspections of more than 562 dialysis clinics.)
Registered Nurse Daisy Dizon Reyes works at DaVita Norco. An FEU graduate, she was a medical doctor in the Philippines, who decided to take up nursing. She and a few other physicians took the local nursing board exams given in Manila, and successfully passed.
“I open the clinic at 4:30 a.m.,” said Reyes, “and already there are 15-18 patients waiting during the first hour before another nurse comes at 5:30 a.m. I’m not able to give all of them safe and quality care; at most, I can attend to 10 patients.” (SB 349 will establish minimum staffing ratios at dialysis clinics of one registered nurse per eight patients.)
Audience members heard from the following speakers: Dr. Randall W. Maxey, nephrologist in private practice in Los Angeles, and past president of the National Medical Association; Cass Gualvez, daughter of Filipino immigrants, an SEIU-UHW organizing director who has, for the last 17 years, worked with staff and union members to organize 30,000 hospital workers into SEIU-UHW at various major chains; Joan Allen, SEIU-UHW government relations advocate, specializes in health care policy and advocates for legislation to improve California’s health care system for patients and healthcare workers; dialysis worker Megallan Handford, RN; and Vince Gonzales, a dialysis patient.
Both Cass Gualvez and Joan Allen expounded on healthcare justice for dialysis patients and workers.
Dr. Randall Maxey feels there is a need for “more funding (from the government) for staff, and less money to take people’s oil.” His statement “nobody cares for the patient… very few people are interested in patient care” met opposition from Megallan Handford, a 15-year LAPD veteran-turned-nurse. “I care,” he asserted, “it’s not about pay, we know we deserve better. How many have to die before we say patients first.” There were testimonies from Handford and other workers that they care for their patients; that they have established a bond with their patients; that they are invited to patient family’s milestones; and that patients call their cell phones if they have questions.
Handford admitted that workers had a hand in putting SB 349 together. “We drafted this collectively,” he said. They also have plans to unionize.
“Yes,” said Allen, “we’re open to unionize workers.” She feels that until workers have a voice and claim their power, changes won’t happen.
The last speaker is a dialysis patient, who said he has seen “numerous things that need to be looked at. It’s a wake-up call,” said Vince Gonzales. He lamented that because of lack of staffing – “there were 16 patients, two technicians, and one nurse” in the treatment room when a patient collapsed. “He died,” added Gonzales, “but they left him there unattended while we continued our dialysis treatment.”
The Dialysis Patient Safety Act is sponsored by SEIU-United Healthcare Workers West, SEIU State Council, and United Nurses Associations of CA/Union of Health Care Professionals, which are supporting dialysis center workers who want to improve patient care.
“This legislation will improve patient care by holding these corporations (for profit companies) accountable to patients and workers – not just their oversized bottom line,” stated Handford.