Ballot measure deadline looms for some while others drop efforts

Vote concept; handdrawn ballot box on a green chalkboard
Vote concept; handdrawn ballot box on a green chalkboard

A California union has given up on its plan to ask Arizona voters to impose new service and cost restrictions on companies that perform dialysis.

Sean Wherley, spokesman for Service Employees International Union, told Capitol Media Services on Monday his organizations has decided to focus its efforts elsewhere.

Wherley said the SEIU already has filed petitions to get a similar measure on the ballot in California. And he said paperwork is being turned in later this week in a bid to get Ohio voters to adopt a nearly identical plan.

Arizonans will still have plenty of issues to decide in November despite the union’s decision.

The Arizona Association of Realtors is expected to submit petitions Tuesday to impose a constitutional ban on expanding the state sales tax to include services. That would take the possibility of revamping or reconfiguring what is now subject to the state’s 5.6 percent levy off the table even if there is a shift in the economy and what people buy from one based on goods, which are taxable, to one based on services, which would not be taxable under the plan.

Other initiative drives likely to file signatures by Thursday’s 5 p.m. deadline include:

– Putting an income tax surcharge on the top 1 percent of wage earners to pay for education funding;

– Requiring utilities to produce half their power from renewable sources by 2030, not including nuclear;

– Imposing a constitutional requirement for public disclosure of the people and organizations trying to influence elections;

– Legalizing possession of marijuana.

All those are in addition to two measures put on the ballot by lawmakers. One asks voters to undermine some of the powers of the Citizens Clean Elections Commission and the other seeks changes in constitutional provisions about public employee pension benefits.

And voters also will get to decide whether to ratify or reject a measure approved last year by the Republican-controlled Legislature which expands eligibility for who can qualify for taxpayer-funded vouchers to attend private and parochial schools.

The SEIU proposal sought annual inspections to check for compliance with laws and rules and how companies are dealing with potentially hazardous waste.

But the real key was to be a cap on the amount dialysis centers could charge patients at no more than 15 percent above their costs. Any profits that exceeded that amount would have to be refunded.

Wherley conceded the measure was aimed specifically at two firms: Fresenius Kidney Care and DaVita Kidney care. He said the two control more than 80 percent of the licensed dialysis centers in the state. Potentially more significant, Wherley acknowledged that both operate here without SEIU employees.

This isn’t the first time SEIU had started petition drives in its fights with employers.

Two years ago it crafted an initiative drive to cap the pay of hospital executives at no more than what the president of the United States is paid, or $450,000 a year. But after gathering what it said was more than 281,000 signatures — far more than needed — the union decided to scrap the effort in the face of challenges to the validity of many of those signatures.

But Wherley sidestepped questions Monday about whether the SEIU was simply using the Arizona initiative process for political purposes in the union’s ongoing battles with hospitals and health care employers.

“There’s only so many states that have ballot initiatives,” he said.

“So we look at them, where does SEIU have a presence, where can health care workers be benefited, where can patients be benefited,” Wherley said. “That’s kind of the calculus that decides where we introduce an initiative and where we submit signatures to qualify.”

In the end, Wherley said, the union decided to not even try to collect signatures on the Arizona proposal.

The union isn’t the only organization to file the paperwork for to put a measure on this year’s ballot but fold its operation before the deadline.

Earlier this year the Humane Society of the United States pulled the plug on its initiative which would have made it illegal to pursue, shoot, snare, net or capture any “wild cat.” That specifically would have applied to bobcats and mountain lions.

Organizers said the effort to gather the minimum 150,642 valid signatures by Thursday’s deadline were hampered by new Arizona law requiring “strict compliance” with all election statutes. They said that made signature gathering more difficult and made it more expensive to hire circulators.

Other apparent non-starters included a measure to have Arizona join with other states to have the president elected by popular vote instead of by the Electoral College, and another aimed at restricting agricultural chemicals that can harm pollinators.

California union seeks pay raise for Arizona hospital workers

hospital  doctors620

A California union is funding a measure in a bid to convince Arizona voters to force hospitals here to pay their workers more.

An initiative drive being launched Monday would mandate that everyone working at a hospital get an immediate 5 percent pay hike if the measure is approved by voters in 2020. There then would be successive 5 percent pay increases for the following three years.

Rodd McLeod, spokesman for what’s being dubbed the Healthcare Rising Arizona campaign, said that would apply at all levels, including medical staff, nurses, social workers, orderlies and even custodians. And with a prior voter-approved state law already mandating a $12 an hour minimum wage beginning in January, that would put the base salary for hospital workers after the fourth year at $14.59.

McLeod said it is in the public interest to raise hospital wages, even if it does raise costs for hospitals and, potentially, by extension for patients who do not have insurance.

Higher wages are just part of what is being promoted by the campaign financed by the Service Employees International Union. The initiative, if it makes the ballot and is approved, also would:

put provisions directly into Arizona law to ensure patients can get coverage for prior existing conditions; impose new infection control protocols for Arizona hospitals; institute a more comprehensive law than now exists to protect patients from “surprise” medical bills.

A spokesman for the Arizona Hospital and Healthcare Association declined to comment.

This isn’t the first ballot foray by the California branch of the union.

But McLeod said the fact that this is being proposed and financed by an out-of-state organization − one with a history of doing battle with hospitals − should not deter Arizonans from supporting it.

“We have a health care system that costs a lot of money and doesn’t deliver results that are as good as they could be,” he said.

McLeod said the measure, if enacted, will improve patient protections, saying that 99,000 people a year get “serious infections” in hospitals.

Then there’s that issue of surprise billing, with patients admitted to hospitals after checking their insurance coverage, undergoing a procedure and only later finding out that someone on the medical team, like an anesthesiologist, isn’t on hospital staff, isn’t part of the insurer’s “in-network” providers, and doesn’t accept what the insurer is willing to pay.

A new law that took effect earlier this year addresses that in part by setting up a procedure for patients and doctors to have disputes resolved. But McLeod said that still doesn’t prevent the surprise bills in the first place, and only covers disputes of more than $1,000.

Potentially more significant would be language prohibiting insurers from denying coverage for patients with prior existing conditions.

McLeod noted that Arizona Attorney General Mark Brnovich is among those trying to get federal courts to kill the Affordable Care Act. If successful that lawsuit also would wipe out the requirement to cover preexisting conditions, as Congress has yet to enact a replacement if the litigation is successful.

But a key part is the issue of salaries for workers at all levels, at least those below management.

“Arizona has among the highest turnover rates for hospital workers in the country,” McLeod said. “You have one in five leaving for jobs in other states or leaving for other professions because the salaries are so low.”

That, he said, results in worker shortages which, in turn, affects patients.

“I sat in the emergency room waiting for a long time because there’s not enough people to handle the work,” McLeod said.

He said the initiative is at least related in part to the fact that there are fewer and fewer people in unions who can engage in collective bargaining on issues like salaries and working conditions.

“I think there’s a real desire to use creative problem solving to figure out how to improve people’s standard of living and the quality of health care,” McLeod said.

The California-based United Healthcare Workers West branch of the SEIU is no stranger to the ballot process here.

This is the same group that sought in 2016 to cap the pay of hospital executives at no more than what the president of the United States is paid, or $450,000 a year. But after gathering what it claimed was more than 281,000 signatures − far more than needed − the union decided to scrap the effort in the face of challenges to the validity of many of those signatures.

Then last year the same organization sought to cap the amount dialysis centers can charge patients at no more than 15 percent above their costs, with a requirement for refunds if profits exceeded that amount. They scrapped that effort, with a union spokesman saying it was instead focusing on similar measures in California and Ohio.

Consider a professional association, not a union

(Photo by Alex Proimus via flickr/Creative Commons)
(Photo by Alex Proimus via flickr/Creative Commons)

Since Arizona passed the Voter Protection Act in 1998, we are a target for citizens’ ballot initiatives used to pass laws championed by out-of-state interest groups. What we have learned is some ballot initiatives are essentially a Trojan horse for unions attempting to enter our state. The union starts by pretending to champion causes to make life better, when in fact these attempts are to get attention and, in the door, to increase their membership. 

Selina Bliss
Selina Bliss

Let’s take Healthcare Rising Arizona as an example. Healthcare Rising Arizona is the name used for the California Service Employees International Union-United Healthcare Workers. Their recent attempt to pass the four-part Stop Surprise Billing & Protect Patients Act using a citizens’ ballot initiative was a disguise for growing bargaining power with their 95,000 union members based in Los Angeles. Fortunately for Arizona, this ballot initiative from this out-of-state special interest group was disqualified from the ballot by a Maricopa Superior Court judge. Had this benign-sounding initiative passed, costs for health care to patients would have increased and staffing of health care workers would have suffered. Worth noting is the unintended consequences this initiative would’ve caused as Arizona already has a law to address surprise billing, so this initiative would have caused more red tape and regulation while taking time with patients away from nurses. After this failed attempt in 2020, we knew they would be back. It appears their next project is targeting debt collectors in a nicely called initiative named the Predatory Debt Collection Protection Act. 

Time to consider an alternative. Most professions have a professional association to advocate for their members. Examples in Arizona include the Arizona Nurses Association, the Arizona Medical Association, and the Arizona Hospital and Healthcare Association. The Arizona Nurses Association is a statewide membership-based professional association of licensed nurses. Founded in 1919, it is the oldest and largest nursing association in Arizona. We are a diverse group of nurses who share a common purpose; to advance excellence in nursing. As a professional association, we are an alternative to a union. We work to advance the nursing profession through advocacy, professional development, research, continuing education, and certification in order to promote a healthy Arizona. 

As a professional association, when it comes to ethical analysis and decision making, we are bound by our code of ethics. Ratified by the American Nurses Association in 1950, the code of ethics guides how we are accountable to the profession and to society. As a volunteer leader in my professional association, I would be remiss if I sit by and fail to educate our association members, professional nurses, and the public of the differences in advocacy by a professional association versus that of a union. 

In 2020, the Arizona Nurses Association, the Arizona Medical Association, and the Arizona Hospital and Healthcare Association banded together against the union’s most recent ballot initiative. While we as professional associations don’t always agree on legislative policy, we did agree the recent initiative by the Service Employees International Union was bad for the health and health care of Arizonans and would hurt health care workers. My intention is that insight helps enlighten health care professionals and the public for alternatives to out-of-state unions and their influence on Arizona legislation and health care policy. 

-Dr. Selina Bliss is a registered nurse in Prescott, where she has lived since 1971 and is president of the Arizona Nurses Association. 

Groups challenge proposed ballot measures in court


Business groups are trying to keep Arizonans from voting on proposals to hike taxes on the most wealthy and give hospital workers a pay hike.

One challenge, filed by a group financed by the Arizona Chamber of Commerce and Industry, alleges that the legally required 100-word description given to initiative petition signers about the effects of the tax increase to generate nearly $1 billion a year for K-12 education fails to adequately describe how it works. Foes contend that those who were asked to put the measure on the November ballot were never told it was an entirely new tax and how it would result in “a near-doubling” of the marginal tax rates owed by many businesses.

If that claim sounds familiar, it should. The chamber used it successfully two years ago in its bid to keep a similar measure off the 2018 ballot.

The other from a group financed by the Arizona Hospital and Healthcare Association contends that the initiative process was flawed because it never identified as Service Employees International Union – United Healthcare Workers West as its sponsor and source of its funds.

Foes of this measure also claim that the 100-word description on petitions is “highly misleading.”

David Lujan, the director of the Arizona Center for Economic Progress and the author of the tax plan, said the challenge by the chamber is “disappointing but not surprising.”

David Lujan
David Lujan

“The chamber has continually shown that they’re more interested in protecting well-paid CEOs rather than helping Arizona schools,” he said.

The proposal imposes what the initiative calls a 3.5 percent “surcharge” on incomes above $250,000 for individuals and $500,000 for married couples. Put another way, it would only be the earnings above that point that would be affected.

Challengers say that obscures the fact that people in that tax bracket already are paying a 4.5 percent state income tax on earnings at that level.

“Yet by saying the initiative ‘establishes a 3.5 percent surcharge’ on this income, the summary gives signers the misimpression that the income is currently untaxed,” wrote the attorneys for Arizonans for Great Schools and a Strong Economy, the chamber-financed group formed to fight the initiative.

They said it should have been portrayed to petition signers as an 8% tax rate on incomes above the threshold.

“A voter might be willing to tax their fellow citizens 3.5% but not 8%,” the attorneys are telling the judge. They said that should be listed as an 80 percent increase.

Lujan, however, said there’s nothing misleading about it.

For example, Lujan said, a couple earning $501,000 would pay the same tax as now on the money they earn. Then, there would be an additional 3.5% levy on $1,000 — the amount at which the tax kicks in, or $35.

Challengers also contend there are other misleading statements in that 100-word description, like the claim that the money would be used to “hire and increase salaries for teachers.” But they said the actual texts reveals the cash could be spent on those who “support student academic achievement,” a definition they say could include custodians and bus drivers.

There also is a claim that the measure would have a harsh effect on small businesses whose income tax is reported on their owners’ individual tax forms.

But Lujan said that ignores the fact that the tax is imposed not on the gross income of a business but only on what the business owner brings home, after paying all expenses like employees salaries, rent and utilities.


The measure the hospitals are seeking to quash would guarantee 20% raises over four years to certain hospital personnel, impose new infection-control standards on hospitals and put a provision in Arizona law designed to ensure that individuals with pre-existing health conditions can purchase insurance at affordable prices if the federal Affordable Care Act ultimately is voided by the courts or repealed by Congress.

Attorneys for the hospitals, in attempting to keep this off the November ballot, are relying in part on what appear to be technical issues with wording and the failure to define some of the terms.

hospital-featuredBut the lawsuit also takes aim at the claim that the measure, if approved “sets new minimum wages for direct care workers at private hospitals.”

“A reasonable voter would interpret ‘direct care workers’ to mean that wage rates will be adjusted for those directly involved in the care of patients such as a physician, nurse, or an imaging technician,” wrote attorney Brett Johnson.

In fact, he said, the text of the initiative instead refers to “direct care hospital workers.” And it defines that to include nurses, aides, technicians , janitorial and housekeeping staff, food service workers and nonmanagerial administrative staff — but not doctors.

Johnson also finds fault with the claim that the initiative, if approved, “prohibits insurers from discriminating against pre-existing conditions.” But he said that doesn’t make it clear that it would apply only to health and disability insurance and not things like life or property and casualty insurance.

“This broad overstatement is fraudulent and/or would cause a significant danger of confusion to a reasonable person,” the lawsuit says.

The lawsuit also takes aim at the wording of another provision designed to protect patients from “surprise out-of-network bills” they receive after it turns out that someone who cared for them in the hospital was not actually part of their insurer’s health care network.

Holly Ward, spokeswoman for the Arizona Hospital and Healthcare Association, said a measure like this is a bad idea in these “extraordinary times,” mentioning that staffers “are working tirelessly to care for everyone who comes in for care.”

“We don’t need to drive costs up for hospitals and ultimately patients,” she said.

Rodd McLeod, spokesman for the initiative, said the fact that the hospitals are going to court is telling.

“This lawsuit is just an admission by the hospitals that they’re not going to be able to convince Arizonans to vote against affordable health care at the ballot box so they’re going to try to deny voters a chance to have a vote at all,” he said.

McLeod also took a separate swat at state Sen. Vince Leach, R-Tucson, who signed on as a plaintiff with the hospitals. He said that Leach opposed legislation pushed by then-Gov. Jan Brewer to expand the state’s Medicaid program.

“So it’s no surprise to see him standing with millionaire CEOs and against ordinary families that get stuck with surprise bills,” McLeod said.

Leach declined to comment.

Both lawsuits now head to Maricopa County Superior Court where judges will consider the merits of the arguments. But in both cases the final decision is likely to come from Arizona Supreme Court.

Judge disqualifies health care initiative from ballot


Arizonans won’t be voting in November on a proposal to hike pay of hospital workers and guarantee that those with pre-existing conditions can get affordable health insurance.

In an extensive ruling late Friday, Maricopa County Superior Court Judge Pamela Gates said there are not enough valid signatures on petitions submitted by a California union to put the issue on the ballot. Gates found that some circulators were not legally qualified to circulate the petitions.

In other cases, she said, some of the 332 circulators subpoenaed by foes of the initiative failed to appear in court to be questioned. Gates said the signatures they gathered also cannot be counted.

All that left the backers of the Healthcare Rising measure with fewer than the 237,645 valid signatures needed to qualify for the ballot.

Campaign spokesman Rodd McLeod said there will be an appeal to the state Supreme Court.

Pamela Gates
Pamela Gates

The initiative sought to require a 20% pay hike for hospital workers — excluding executives and doctors — over a four year period.

It also proposed a guarantee that people with pre-existing conditions will be able to obtain affordable insurance if the federal Affordable Care Act is repealed. Another provision was designed to protect patients against “surprise” medical bills from doctors and others in hospitals who turn out to be “out of network.”

And it also sought to require hospitals to comply with certain national standards of infection control.

Foes, led by the hospitals and the Arizona Chamber of Commerce and Industry, filed suit. They cited a litany of what they said were flaws in both how signatures were gathered and in the wording of the description of the initiative provided to petition signers.

They also charged that signers were deceived because the names used by the backers of the initiative and of the campaign committee did not disclose that it was being financed by the California-based Service Employees International Union — Union Healthcare Workers West.

Gates acknowledged that virtually all of the $6.7 million raised by June 30 came from the union. But she also said there was not “sufficient credible evidence” to conclude that potential petition signers were defrauded or that anyone was confused or misled because SEIU-UHW was not included in the committee’s name.

But Gates did find other legal problems, even if some of the signatures are restored.

One, she said, goes to the 100-word description which says it will “prohibit insurers from discriminating based on preexisting conditions.”

Gates said the evidence shows that about 60 percent of Arizonans are insured through an employer’s self-funded insurance plan. More to the point, the initiative would apply only to those who purchase individual or group plans. And she said it was misleading not to tell signers that the provision would not aid a majority of Arizonans.

She also said it was misleading to say that the initiative would set “new minimum wages” for workers at private hospitals. Gates said there was evidence that people, confronted with that phrase, would equate it with some bottom-level wage set by federal and state law and not the fact that the raises would be on top of what could be a current $37-an-hour salary paid to an experienced nurse.

Friday’s ruling was cheered by Garrick Taylor, spokesman for the Arizona Chamber. He said it would “have forced tremendous cost increases onto patients and hospitals.”

Two other initiatives have cleared their first legal challenges, one to legalize recreational use of marijuana by adults and another to give judges more discretion in sentencing “nondangerous” offenders.

But a proposal to increase income taxes on the highest income earners to fund K-12 education was found to have a flawed description.

All of those rulings, however, are subject to Supreme Court review.