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SACRAMENTO, Calif. (AP) — California voters on Tuesday rejected a ballot measure that would have capped dialysis clinics' profits in an effort to improve patient care.Proposition 8 would have limited profits for dialysis clinics that provide vital treatment for people whose kidneys don't work properly.The measure was the most expensive initiative on the 2018 ballot in California, generating more than 0 million in campaign contributions. A health care workers union, Service Employees International Union-United Healthcare Workers West, funded the million supporting campaign. Dialysis companies contributed more than 1 million to kill the initiative.The union argued Proposition 8 would stop the dialysis companies from cutting corners to make money and force them to invest more of their revenue into patient care. Supporters say the profit-hungry companies don't adequately clean clinics and overwork staff.Dialysis providers say the measure was actually a tactic to pressure the dialysis companies to let workers unionize and would have forced clinics to close. They say most California clinics provide high quality care.Dialysis companies' effort to kill the measure was the most expensive campaign on one side of a ballot initiative in the U.S. since at least 2002. Most of that money came from the two largest dialysis companies operating in California: Denver-based DaVita Inc. and Germany-based Fresenius Medical Care.The measure would have barred dialysis clinics from charging patients more than 115 percent of what providers spend on patient care and quality improvement. If clinics exceeded that limit, they would have to provide rebates or pay penalties.Although the measure didn't spell out exactly which expenses counted toward the limit, dialysis companies argued critical management expenses would be classified as profits and bankrupt clinics.RELATED CONTENT 1898

SACRAMENTO, Calif. (AP) — For decades, California and the federal government have had a co-parenting agreement when it comes to the state's diverse population of endangered species and the scarce water that keeps them alive.Now, it appears the sides could be headed for a divorce.State lawmakers sent to the governor early Saturday morning a bill aimed at stopping the Trump administration from weakening oversight of longstanding federal environmental laws in California. The lawmakers want to make it easier for state regulators to issue emergency regulations when that happens."The feds are taking away significant pieces of water protection law, of air protection law, and California has to step into the void," Democratic Assemblyman Mark Stone said.Democratic Gov. Gavin Newsom has 30 days to decide whether to veto the bill, sign it into law or allow it to become law without his signature.The bill survived a furious lobbying effort on the Legislature's final day, withstanding opposition from the state's water contractors and Democratic U.S. Sen. Dianne Feinstein."We can't really have a California system and a federal system," said Jeffrey Kightlinger, general manager of the Metropolitan Water District of Southern California, which delivers water to nearly 19 million people. "We're all in the same country here, so we need to find a way to make this work."California has a history of blunting Republican efforts at the federal level to roll back environmental protections. In 2003, shortly after the George W. Bush administration lowered federal Clean Air Act standards, the Legislature passed a law banning California air quality management districts from revising rules and regulations to match.More recently, after the Trump administration announced plans to roll back auto mileage and emission standards, Newsom used the state's regulatory authority to broker a deal with four major automakers to toughen the standards anyway.State lawmakers tried this last year, but a similar proposal failed to pass the state Assembly. But advocates say several recent announcements by the Trump administration — including plans to weaken application of the federal Endangered Species Act — have strengthened support for the bill.The bill would potentially play out most prominently in the management of the state's water, which mostly comes from snowmelt and rain that rushes through a complex system of aqueducts to provide drinking water for nearly 40 million people and irrigation to the state's billion agricultural industry.The bill would make it easier for state regulators to add animals protected under California's Endangered Species Act — animals that have historically been protected under federal law. It would then apply the state's Endangered Species Act to the Central Valley Project, a federally operated system of aqueducts and reservoirs that control flooding and supply irrigation to farmers.But it's not clear if a state law would apply to a federal project, "which could generate years of litigation and uncertainty over which environmental standards apply," according to a letter by Feinstein and four members of the state's Democratic congressional delegation.Plus, Kightlinger warns the proposal would disrupt complex negotiations among state and federal entities and water agencies over the Water Quality Control Plan. If all sides can sign these voluntary agreements, it would avert costly litigation that would delay environmental protections for fish and other species impacted by the water projects."We're pretty close. We believe we can get to completion by December. If (this bill) passes, half of the water districts pull out and go to litigation instead," Kightlinger said. "That's something that would be terrible for our ecosystem and what we're trying to achieve here."Senate President Pro Tempore Toni Atkins, the bill's author, insisted early Saturday the bill would not impact those voluntary agreements."We really and truly did work in good faith to try to address those concerns," she said. 4049

SACRAMENTO, Calif. (AP) — California Gov. Jerry Brown's role as a crusader against the existential threats of nuclear war and climate change was elevated Thursday when he was named executive chairman of the Bulletin of Atomic Scientists, the group famous for managing the Doomsday Clock."We really see him as a global ambassador for the issues that we work on — manmade existential threats, nuclear, climate, disruptive technology," said Rachel Bronson, the group's president and chief executive.The Chicago-based bulletin was founded in 1945 after the creation of the atomic bomb and in the decades since has expanded its mission to a broader discussion of threats to human survival. The Doomsday clock is a visual representation of how close the Bulletin believes the world is to catastrophe.RELATED: California law makes milk or water default kids' meal drinkIn January, the group moved the hand to just two minutes from midnight.It's a topic Brown speaks of frequently, even noting it in his 2018 State of the State Address."Our world, our way of life, our system of governance — all are at immediate and genuine risk," he warned.As executive chairman, Brown will preside over the Bulletin's three boards — a governing board, a science and security board and an editorial board. It's a new role created just for Brown, and he'll focus on generating global urgency around nuclear and other threats.RELATED: California to audit DMV amid hourslong wait times, outages"We know that he thinks about big issues," Bronson said. "These are really hard to talk about — climate change and nuclear risk — because they're so big and they seem so intractable."The new position ensures Brown will stay relevant on the global topics he cares most about when he leaves office in January after four terms as California governor spanning four decades. He warned of nuclear threats during his governorship and presidential bids in the 1970s and 80s and has renewed his focus on the topic during his final years in office.He also sits on the board of the Nuclear Threat Initiative, attending meetings of the group in Washington, D.C., this week. While there, he also discussed nuclear threats with U.S. Defense Secretary Jim Mattis. Brown spokesman Evan Westrup declined to provide specifics on the conversation.REPORT: Gas tax funds reportedly being used to campaign against Prop 6?Brown was not made available for an interview early Thursday.But he offered a dark take on the global state of affairs in an article released Thursday on the Bulletin's website."There's a great risk of radical disruption being set in motion, and to turn it back and turn to a sustainable future is something that has to start now," he said. "Can we wake people up before the absolute horror has occurred, while these patterns that are inexorably leading to the horror are building up and occurring?" 2884

SACRAMENTO, Calif. (AP) — California voters on Tuesday rejected a ballot measure that would have capped dialysis clinics' profits in an effort to improve patient care.Proposition 8 would have limited profits for dialysis clinics that provide vital treatment for people whose kidneys don't work properly.The measure was the most expensive initiative on the 2018 ballot in California, generating more than 0 million in campaign contributions. A health care workers union, Service Employees International Union-United Healthcare Workers West, funded the million supporting campaign. Dialysis companies contributed more than 1 million to kill the initiative.The union argued Proposition 8 would stop the dialysis companies from cutting corners to make money and force them to invest more of their revenue into patient care. Supporters say the profit-hungry companies don't adequately clean clinics and overwork staff.Dialysis providers say the measure was actually a tactic to pressure the dialysis companies to let workers unionize and would have forced clinics to close. They say most California clinics provide high quality care.Dialysis companies' effort to kill the measure was the most expensive campaign on one side of a ballot initiative in the U.S. since at least 2002. Most of that money came from the two largest dialysis companies operating in California: Denver-based DaVita Inc. and Germany-based Fresenius Medical Care.The measure would have barred dialysis clinics from charging patients more than 115 percent of what providers spend on patient care and quality improvement. If clinics exceeded that limit, they would have to provide rebates or pay penalties.Although the measure didn't spell out exactly which expenses counted toward the limit, dialysis companies argued critical management expenses would be classified as profits and bankrupt clinics.RELATED CONTENT 1898

SACRAMENTO, Calif. (AP) — California has overhauled its sex education guidance for public school teachers, encouraging them to talk about gender identity with kindergarteners and giving advice to help LGBT teenagers navigate relationships and practice safe sex.The guidance won't recommend students read books that describe anal sex, bondage and other sex acts after getting hundreds of complaints from concerned parents and conservative groups.A few hundred people gathered on the state Capitol grounds in Sacramento on Wednesday morning, carrying signs that read "stop sexualizing my kids" and "respect parental rights." The crowd soon filled the lobby of the California Department of Education, with parents busily handing out snacks to occupy their children for what could be a long day. Those who could not get inside circled the building holding signs.Patricia Reyes traveled more than 400 miles from her home in Anaheim Hills to bring her six children, who attend or have attended public schools, to Wednesday's board meeting. They included her 4-year-old daughter, Angelie, who carried a sign that read: "Protect my innocence and childhood.""It's just scary what they are going to be teaching. It's pornography," the 45-year-old mother said. "If this continues, I'm not sending them to school."Michele McNutt, 49, focused on the framework's attention to healthy relationships and consent, something she said is never too soon to teach her two daughters in public school, ages 11 and 9."Withholding medically accurate, scientific information from them actually causes more harm and does not actually protect innocence," she said while wearing a purple T-shirt that read "protect trans students." ''If you don't give kids accurate information about their own body ... how are they able to make good choices?"California's education standards tell school districts what students should know about a particular subject at the end of every grade level. The state's curriculum framework gives teachers ideas on how to do that. The state updated its health education standards in 2008. But because of a budget crisis, state officials never gave schools a framework for how to teach them.The more-than-700-page document compiled over three years does not require schools to teach anything, but it is designed to expose teachers to current research about health education and give guidance about how to teach it. It's also influenced by a 2015 state law that made California one of the first states to address LGBT issues as part of sex education.The framework tells teachers that students in kindergarten can identify as transgender and offers tips for how to talk about that, adding "the goal is not to cause confusion about the gender of the child but to develop an awareness that other expressions exist.""I think that people hear the word 'transgender' or 'gender identity' in guidance for kindergarten through grade three and they think the worst," said Stephanie Gregson, director of the Curriculum Frameworks and Instructional Resources Division at the California Department of Education. "It's really about civil rights issues."The framework gives tips for discussing masturbation with middle-schoolers, including telling them it is not physically harmful, and for discussing puberty with transgender teens that creates "an environment that is inclusive and challenges binary concepts about gender."Much of the pushback has focused not on the framework itself, but on the books it recommends students read. One suggested book for high schoolers is "S.E.X.: The All-You-Need-to-Know Sexuality Guide to Get You Through Your Teens and Twenties." It includes descriptions of anal sex, bondage and other sexual activity — depictions California Family Council President Jonathan Keller described as "obscene."On Wednesday, State Board of Education member Feliza I. Ortiz-Licon asked the board to remove that book, and a few others, from the guidance. She said the books had "created panic" and distracted from the framework's goals, including teaching students about consent and sex trafficking."It's important to know the board is not trying to ban books. We're not staying that the books are bad," she said. "But the removal will help avoid the misunderstanding that California is mandating the use of these books." 4326