Proposition 29 would set new requirements. Centers would have to hire more staff, which could include nurses and doctors.
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"The requirement would be an MD or a nurse practitioner, or physician assistant, would be required to be present while the medical treatment is taking place inside the clinic," said David Miller from Service Employees International Union-United Healthcare Workers West (SEIU-UHW).
The proposal is pushed by the Service Employees International Union, which claims it would make clinics safer.
"The clinics are run incredibly efficient," said Miller. "They're very short staffed, so this would add just one extra staff person into the clinic who will be responsible for quality of care."
But opponents say there aren't any major problems now.
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Jon Coupal with the Howard Jarvis Taxpayers Association says calls it "a solution in search of a problem."
"They have not made their case that the existing dialysis services are inadequate," he said. "They're arguing that infection rates are up a little bit. The data on that is really mixed. I think they're overstating it."
The last two propositions lost by wide margins at the polls.
"Polling certainly doesn't seem to like it, neither do most of the editorial board ... pretty broad-based opposition to Proposition 29," said Coupal, who believes the proposal is a power grab by the union to add workers that might not be needed.
"SEIU is looking at this as a potential for expanding their membership. My guess is they have enough money to qualify this every cycle," he said.
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Miller, however, said it's all about safety.
"These companies make millions and millions of dollars every year, and they give millions of dollars to shareholders," said Miller. "We think there's a ton of money in this industry to improve quality of care and we're going to keep coming out to get something for the folks."
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