FILE - A patient undergoes kidney dialysis at a clinic in Sacramento, Calif., on Sept. 24, 2018. A state ballot measure would require a doctor, nurse practitioner or physicians' assistant to be present during treatment at an outpatient kidney dialysis clinic. This will be the third consecutive general election where voters have been asked this question. The two previous measures failed. This measure is backed again by labor unions who represent health care workers. And again, kidney dialysis companies are opposing it. Some have suggested the subtext of these ballot initiatives is a broader battle of labor unions attempting to organize workers at the state's more than 600 kidney dialysis clinics. (AP Photo/Rich Pedroncelli, File)