The SEIU United Healthcare Workers West (SEIU-UHW) is a statewide local union of the Service Employees International Union in California in the United States. In 2020, it had 97,000 members, down from nearly 150,000 in 2013. UHW is headquartered in Oakland, California and has offices statewide. UHW is an industrial union representing all classifications of health care workers in hospitals, nursing homes, clinics, home health agencies as well as homecare workers. Ballot propositions SEIU-UHW has filed dozens of ballot initiatives since 2012, generally proposing increased regulations on healthcare companies; few if any have passed. In the 2018, 2020, and 2022 elections, three successive propositions from SEIU-UHW related to kidney dialysis clinics appeared on the California statewide ballot. The 2020 measure would have required a physician on-site during all dialysis treatments, among other requirements; the 2022 measure loosened this and would require a physician, physician assistant, or nurse practitioner. Otherwise, they are "nearly identical". The 2018 measure would have capped profits of dialysis clinics. There are no unionized employees of dialysis clinics in California, meaning the campaigns have not been undertaken for the benefit of the union's current members. Most commentators other than SEIU-UHW itself, including Democrats, progressive groups, hospital groups, and other labor unions, believe that these ballot propositions are a negotiation tactic in SEIU-UHW's effort to cause dialysis clinics to unionize, by leveraging the threat of continued costly ballot fights (or regulation) if they do not—rather than an earnest attempt to improve patient safety. Some have called the tactic inappropriate and an "abuse of the initiative process." SEIU has used ballot initiatives for this purpose repeatedly since 2012. The Sacramento Bee called SEIU-UHW "one of California’s fiercest political players" for its funding of the initiatives since 2018. History UHW was created by the merger of two SEIU local unions: Local 250 in Northern California and Local 399 in Southern California. The larger of those two locals, Local 250, began when workers at San Francisco General Hospital, who were inspired by the 1934 general strike in San Francisco, organized a union at their hospital in 1934 as the Hospital and Institutional Workers Union #19818, later affiliating with the Building Service Employees International Union, becoming BSEIU Local 250. After affiliation, they won a groundbreaking first contract with the San Francisco Hospital Conference, covering 11 hospitals. BSEIU Local 399 emerged in 1949, when several Southern California local unions consolidated under the leadership