California dialysis clinic workers are pushing for union work over staff shortages and low wages

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Guadalupe Tellez, a licensed nurse, has worked in the kidney dialysis industry for 29 years and currently works for the Fresenius Kidney Care in the city of Ventura, one of several dialysis clinics where workers are currently pushing for a union in California.

“We want to improve our wages, benefits and patient care in general. There are a lot of problems in dialysis that need improvement and it’s been years and years and years, and it doesn’t seem like the companies are doing anything to improve it,” Tellez said.

Related: ‘It Can Be Scary’: How Corporate America Hits Back at Unions

Nearly 500,000 Americans undergo some type of kidney dialysis treatment each year at more than 7,500 dialysis clinics in the US, costing about $90,000 per patient each year. The U.S. kidney dialysis market is worth more than $24 billion annually.

Workers in the dialysis industry — vital to many Americans with health problems — are often understaffed, paid low wages with expensive amenities, and significantly lower than wages paid to comparable workers in other health care industries.

Two companies, DaVita and Fresenius, own about 70% of dialysis clinics in the U.S., and the growth of major corporate chains in the market resulted in an 11.7% increase in patient load per employee, according to a 2019 analysis of 1,200 dialysis clinic acquisitions in the United States. a period of 12 years.

The dialysis industry has aggressively resisted legislative efforts to rein in the industry’s immense profits in California, spending millions of dollars to oppose bills and ballot initiatives, including more than $110 million against a ballot initiative from 2018 to limit profits to 15% above the amount spent on patient care.

The Service International Employees Union-United Healthcare Workers (SEIU-UHW) has been campaigning for years to improve working conditions and unite workers in dialysis clinics.

That struggle has become more intense lately. In November, about 300 employees of 13 California dialysis clinics filed for union elections to become the first dialysis clinics in the state to unionize. In December, the first three clinics successfully won their union elections, becoming the first dialysis clinics in California to unionize and four more clinics later that month. Four other California clinics won union elections in January.

Since the Tellez clinic called for a union election in November, management has enlisted consultants to evade labor unions, which often hold public rallies and hand out anti-union flyers.

“Management has been very aggressive and intimidating in harassing union supporters,” Tellez added. “I want them to respect the workers’ decision about unions. We do this not only to improve the quality of life of employees, but we also want to improve patient care.”

Mike Badilla, a dialysis technician in Gilroy, California, at Satellite Healthcare, where employees recently won their union election, explained that when he first started in the dialysis industry, he worked in a role dedicated to setting up dialysis machines that since disbanded and merged with other employees’ duties.

“The patient-to-staff ratio increased from when I first started working in the industry from three to one to four to one and now sometimes five to one,” says Badilla. “I’ve been in the industry for 20 years and I keep losing and losing and losing. When I first started, I used to get a bi-weekly stipend to get insured through Kaiser Healthcare, but that slowly dropped to zero dollars and now I was paying about $1,000 a month to get insured.

Badilla said working conditions and staffing problems worsened during the Covid-19 pandemic and that those experiences were a catalyst for workers seeking to organize dialysis clinics despite strong management resistance.

“A lot of people were like, wow this abuse is real and this is how they treat us this is what they think of us and this is how they are going to protect us and our families if we put our , our heart and soul into the community to give our best, but it felt like we got nothing in return,” Badilla added.

Eugene De La Pena, a dialysis technician for 23 years and currently employed by Satellite Healthcare in San Francisco, where workers recently won their union election, said poor working conditions put patients at risk.

“It’s really tough working as dialysis technicians on those days when you’re short-staffed,” De La Pena said. “That puts patients at risk because if you have to support more than four patients, that’s really a lot and it makes it even more difficult for us to really comply with policies and procedures.”

He said he is often asked to perform maintenance or troubleshoot dialysis machines, but those extra duties are not compensated in his salary. The low pay, De La Pena said, forces many workers in the industry to move between different companies to get higher wages because annual pay increases are typically low.

“We raised our concerns and no one from management came to talk to us and now they are coming to tell us to stop the union. I stood up to say enough is enough, we want the company to be held accountable for their actions going forward,” De La Pena added.

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