Florida Senate - 2017 (NP) SR 1810 By Senator Braynon 35-02776-17 20171810__ 1 Senate Resolution 2 A resolution recognizing the need for, and encouraging 3 policies that improve access to, home dialysis for 4 minorities living with end-stage renal disease. 5 6 WHEREAS, end-stage renal disease (ESRD), also known as 7 kidney failure, currently impacts 661,000 Americans, and more 8 than 89,000 Americans die from ESRD annually, and 9 WHEREAS, more than 117,000 new ESRD cases are diagnosed 10 each year, with 7,500 of those cases diagnosed in Florida, and 11 WHEREAS, dialysis and transplant are the only treatments 12 for ESRD, and 70 percent of patients are on dialysis, and 13 WHEREAS, when dialysis is the method of treatment, a 14 patient may either obtain treatment in his or her home with home 15 hemodialysis (HHD) or home peritoneal dialysis (PD) or be 16 transported to a dialysis center three times each week for 17 hemodialysis, and 18 WHEREAS, HHD provides significant economic and lifestyle 19 advantages, including greater autonomy and flexibility over when 20 a patient dialyzes; reduces dependence on transportation, as 21 there is no travel to a clinic for treatments; and is more 22 conducive to employment, as evidenced by higher rates of 23 employment among home dialysis patients, and 24 WHEREAS, the first 3 months of dialysis cost an average of 25 $43,000 per patient, and 26 WHEREAS, access to an HHD training program allows Medicaid 27 patients to move to Medicare as their primary payer on the first 28 day of treatment, as opposed to at the beginning of the fourth 29 month of treatment, by eliminating the Medicare waiting period 30 and, therefore, saves taxpayers a significant amount of money, 31 and 32 WHEREAS, this 3-month Medicare waiting period drives up the 33 cost to states and, assuming 1,000 new Medicaid ESRD cases, 34 could mean as much as $43 million in Medicaid costs each year, 35 and 36 WHEREAS, only 10 percent of dialysis patients receive 37 treatment at home, and 38 WHEREAS, ESRD disproportionately affects minority 39 Americans, with incidence among African Americans 3.7 times 40 greater than in Caucasians, and 41 WHEREAS, Hispanic patients are 13 percent less likely than 42 Caucasians to receive PD and 37 percent less likely to receive 43 HHD, while African-American patients are 29 percent less likely 44 than Caucasians to receive PD and 17 percent less likely to 45 receive HHD, and HHD and HHD home training are less available in 46 poorer counties, and 47 WHEREAS, significant barriers preclude many patients from 48 accessing HHD, including the lack of sufficient provider 49 education about HHD, insufficient reimbursement for HHD, limited 50 patient awareness of the option of HHD, and potentially 51 burdensome requirements for care partner support, and 52 WHEREAS, policymakers can alleviate these burdens by 53 focusing on telehealth, medical waste laws, and reimbursement 54 levels; by enabling and encouraging providers to offer HHD to 55 more of their patients; and by providing a pathway for staff 56 assisted HHD, NOW, THEREFORE, 57 58 Be It Resolved by the Senate of the State of Florida: 59 60 That the importance of equal access to all dialysis 61 modalities for end-stage renal disease is recognized as a means 62 of preserving state funds by enabling more patients who can 63 benefit from home dialysis to access it. 64 BE IT FURTHER RESOLVED that state agencies and policymakers 65 are encouraged to implement policies to decrease the 66 disproportionate number of African Americans and other 67 minorities who lack access to home dialysis modalities.