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Ohio Limits on Dialysis Clinics' Revenue and Required Refunds Initiative (2018)
| Ohio Limits on Dialysis Clinics' Revenue and Required Refunds Initiative | |
|---|---|
 | |
| Election date November 6, 2018 | |
| Topic Healthcare and Business regulation | |
| Status Not on the ballot | |
| Type Constitutional amendment | Origin Citizens |
The Ohio Limits on Dialysis Clinics' Revenue and Required Refunds Initiative was not on the ballot in Ohio as an initiated constitutional amendment on November 6, 2018.
The initiative would have required dialysis clinics to issue refunds to patients or patients' payers for revenue above 115 percent of the costs of (a) direct patient care, such as wages and benefits of non-managerial clinic staff who furnish direct care to patients, pharmaceuticals, medical supplies, and (b) healthcare improvements, such as staff training and patient education and counseling. Revenue earned above the 115 percent cap would have needed to be refunded to patients or the patients' payers, such as insurers, each year. Clinics that did not issue required refunds within 210 days after the end of the fiscal year would have been penalized. The Ohio Department of Health would have been responsible for enforcing the ballot initiative, including fines for violations. The initiative would have required dialysis clinics to report to the department of health information required to enforce the measure, including the costs associated with operating a chronic dialysis clinic and the amount of each payer’s refund. Clinics would have been allowed to petition the department to keep more than 115 percent of the direct patient care and healthcare improvements costs in revenue to ensure just compensation.[1]
The Ohio Supreme Court ruled on August 13, 2018, that this measure could not be put on the ballot. On July 23, 2018, Secretary of State Jon Husted reported that initiative proponents had filed 296,080 valid signatures. At least 305,591 were required for the initiative to make the ballot. The Ohio Constitution provided initiative proponents that filed signatures but fell short an additional 10 days to collect supplemental signatures. Therefore, proponents had until August 2, 2018, to collect an additional 9,511 valid signatures. On August 1, 2018, proponents filed an additional 41,000 unverified signatures. The Ohio Supreme Court sided with the Ohio Renal Association, which filed the lawsuit against the initiative, concluding that the correct forms required by state law for the use of paid signature gatherers was not filled out prior to signature collection by paid circulators.[2]
Another similar initiative was backed by SEIU-UHW West in California and qualified for the November 2018 ballot as Proposition 8.
Text of measure
Constitutional changes
- See also: Ohio Constitution
The measure would have added a new Article XIX to the Ohio Constitution.[1]
Full text
The full text of the initiative is available here.
Support
Ohioans for Kidney Dialysis Patient Protection led the campaign in support of the initiative.[3] SEIU-UHW West, a labor organization, sponsored the support campaign.[4] Supporters filed the initiative as the Kidney Dialysis Patient Protection Amendment.[1]
Supporters
- Service Employees International Union District 1199[5]
Arguments
Ohioans for Kidney Dialysis Patient Protection issued an informational sheet. The following is an excerpt:[6]
| “ |
Patient care is suffering Patients and caregivers report bloodstains and cockroaches in dialysis clinics. The lack of sanitation and hygiene can contribute to high infection rates. In 2016, 13% of dialysis clinics in OH had worse infection rates than the national average. Overcharging drives up costs Dialysis companies charge patients with private insurance an average $150,000 for a year of dialysis treatment. That’s a 350% markup from the cost of providing care! Insurance companies are forced to pass the costs to all policyholders, driving up healthcare premiums for ALL Ohioans. A national insurance company reports that it takes 3,800 enrollees to offset the cost of one dialysis patient. Clinics are facing penalties for poor performance In 2017 CMS issued Medicare reimbursement rate penalties to 22% of Ohio dialysis clinics because they did not meet or exceed performance standards. Clinics are focused on increasing profits In 2015 DaVita was required to pay $22 million to several states, including Ohio, as part of a whistelblower lawsuit settlement regarding allegations that DaVita violated federal antikickback regulations.[7] |
” |
Opposition
Arguments
- Diane Wish, president of the Ohio Renal Association President, said, "This proposed Ohio Constitutional Amendment is deceptive and unnecessary, and carelessly puts the health of Ohio's kidney dialysis patients at great risk. If passed, this proposal would force some dialysis clinics to cut back, consolidate or close, reducing access to care for Ohioans, especially those in disadvantaged, underserved or sparsely populated areas of Ohio."[5]
- Michael Needham, president of the Kidney Foundation of Ohio, stated, "We know first-hand the high quality level of care patients receive, as well as the importance of patients having safe and reliable access to dialysis centers. If adopted, the amendment threatens to reduce the number of centers available to patients, which is especially harmful to the vulnerable patients the foundation serves. This proposed amendment is unworkable for dialysis providers and proponents demonstrate no understanding of the current reality of the delivery of care in Ohio."[8]
Path to the ballot
The state process
In Ohio, the number of signatures required to get an initiated constitutional amendment placed on the ballot is equal to 10 percent of the votes cast in the preceding gubernatorial election. Ohio also requires initiative sponsors to submit 1,000 signatures with the initial petition application. Ohio has a signature distribution requirement, which requires that signatures be gathered from at least 44 of Ohio's 88 counties. Petitioners must gather signatures equal to a minimum of half the total required percentage of the gubernatorial vote in each of the 44 counties. Petitions are allowed to circulate for an indefinite period of time. Signatures are due 125 days prior to the general election that proponents want the initiative on.
The requirements to get an initiated constitutional amendment certified for the 2018 ballot:
- Signatures: 306,591 valid signatures were required to get an indirect initiative on the ballot, including 1,000 signatures to file the proposal and 305,591 signatures for the initiative.
- Deadline: The deadline to submit the signatures was July 4, 2018.
County boards of elections are responsible for verifying signatures, and the secretary of state must determine the sufficiency of the signature petition at least 105 days before the election. If the first batch of signatures is determined to be insufficient, the petitioners are given a ten-day window to collect more signatures.
Details about the initiative
Ultimately, this initiative petition was ruled invalid by the Ohio Supreme Court because documentation required for managing paid signature gatherers was not filed prior to signature gathering by paid circulators.[2]
The initiative application was filed on January 30, 2018, along with more than 2,001 initial signatures, with the attorney general.[1] Attorney General Mike DeWine determined that the initiative petition was fair and truthful on February 9, 2018.[9] The Ohio Ballot Board then determined that the petition met the state's single-subject rule, allowing the initiative to begin circulating petitions.
Initiative proponents filed 501,201 signatures for the ballot initiative on July 4, 2018.[10] On July 23, 2018, Secretary of State Jon Husted reported that initiative proponents had filed 296,080 valid signatures. At least 305,591 were required for the initiative to make the ballot. The Ohio Constitution provided initiative proponents that filed signatures but fell short an additional 10 days to collect supplemental signatures. Therefore, proponents had until August 2, 2018, to collect an additional 9,511 valid signatures.[11] On August 1, 2018, proponents reported filing an additional 41,000 unverified signatures.[12] The Ohio Supreme Court ruled on August 13, 2018, that the initiative petition was invalid.[2]
Lawsuit
| Lawsuit overview | |
| Issue: Signature validity; whether or not required documentation for paid signature petition efforts was filed in time | |
| Court: Ohio Supreme Court | |
| Ruling: Ruled in favor of paintiffs, invalidating the initiative petition | |
| Plaintiff(s): Ohio Renal Association and Ian Weir | Defendant(s): Kidney Dialysis Patient Protection Amendment Committee, Anthony Caldwell, Mary Jo Ivan, Samara Knight, and Secretary of State Jon Husted |
| Plaintiff argument: Signatures were invalid because documentation required for paid siganture gathering efforts was not filed prior to circulation. | Defendant argument: The lawsuit was an abuse of the court system, the spirit of the law was followed with regard to the documentation, and it was possible that the petition management company had been operating on a volunteer basis until after the required documentation was submitted. |
Source: Cleveland.org
The Ohio Renal Association filed a lawsuit requesting the Ohio Supreme Court to invalidate this initiative in late July 2018. The lawsuit stated that documentation required to hire and manage paid signature gatherers had not been filed prior to the circulation of the petition by the paid signature gatherers.[2]
Anthony Cadwell of Service Employees International Union District 1199, who was named in the lawsuit, responded to the filing of the lawsuit, "This is right out of the dialysis corporations' playbook to protect its massive profits without having to improve patient care or conditions in its clinics. The industry knows this ballot initiative is highly popular, so apparently they figure 'if you can't beat 'em, sue 'em.' It's an abuse of the court system and an outrageous attempt to deny Ohio voters their democratic rights."[13]
On August 13, 2018, the Ohio Supreme Court ruled the petition invalid. Concerning the law requiring the documentation to be filed prior to signature gathering by paid circulators, the ruling stated, "That rule applies with particular force in this election case, in which 'strict compliance' with the law is required unless the statutory provision at issue expressly states that substantial compliance is acceptable." The office of Secretary of State Jon Husted, which is responsible for determining the sufficiency of an initiative petition, filed a brief in support of the validity of the initiative petition. The brief argued that the petition company and managers hired to oversee signature gathering could have been operating on a volunteer basis prior to when the documents required for a paid petition effort were filed. The company hired by sponsors of the initiative was AAP Holding Company LLC, which is based in California.[2]
See also
External links
Footnotes
- ↑ 1.0 1.1 1.2 1.3 Ohio Attorney General, "Kidney Dialysis Patient Protection Amendment," January 30, 2018
- ↑ 2.0 2.1 2.2 2.3 2.4 Cleveland.com, "Ohio kidney dialysis ballot issue invalidated by state Supreme Court," August 13, 2018
- ↑ Ohioans for Kidney Dialysis Patient Protection, "Homepage," accessed March 29, 2018
- ↑ Healio, "Union launches ballot campaign on dialysis profits in Ohio," February 22, 2018
- ↑ 5.0 5.1 Cleveland.com, "Signatures submitted for initiative to improve dialysis care in Ohio," July 4, 2018
- ↑ Ohioans for Kidney Dialysis Patient Protection, "Fact Sheet," accessed March 29, 2018
- ↑ Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
- ↑ Cleveland.com, "Ohioans could see costly campaign fight over dialysis issue in November," June 28, 2018
- ↑ Ohio Attorney General, "Ballot Initiatives," accessed February 1, 2018
- ↑ Cleveland.com, "Signatures submitted for initiative to improve dialysis care in Ohio," July 4, 2018
- ↑ Ohio Secretary of State, "Secretary of State Announces Verified Signature Totals for Proposed Constitutional Amendments," July 23, 2018
- ↑ Healio, "Union submits more signatures for dialysis profits ballot initiative in Ohio," August 6, 2018
- ↑ Cleveland.org, "Kidney dialysis proposal, not yet on the ballot, faces first court challenge," July 25, 2018
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