Community clinics across California exist for one reason: to make sure people get care when they need it most. That mission is what drew me into this field in the first place. For more than two decades, I’ve worked as a social worker in San Diego, helping local families navigate a healthcare system that too often makes them wait, worry and go without.
What I’ve witnessed inside our clinics doesn’t always match that founding purpose. Money meant to support patients doesn’t always make it to the front lines, and the people who pay the price are the patients themselves.
I see it constantly. Families wait months just to get an appointment. Others can’t keep up with the cost of their prescriptions, or they abandon treatment altogether after an insurance change pushes the price out of reach.
That’s why, as someone who works in this system every day, I’m supporting Proposition 44 this fall — the Clinic Funding Accountability and Transparency Act. The measure would require community clinics to direct at least 90% of their revenue toward patient care and the services that support it, while publicly disclosing how the rest of their money is spent. Under the proposal, no more than 10% of clinic revenue could go toward executive salaries, administrative costs and overhead.
This isn’t about restricting care. It’s about accountability — making sure clinics that receive public healthcare dollars are transparent about where that money actually goes, and ensuring patients and taxpayers can see it for themselves.
Prop. 44 doesn’t cut what clinics can spend on care. It does the opposite: it protects that spending. Patients walk through our doors because they trust that we’ll have what we need to treat them properly. We owe them the staffing, equipment and resources to make that trust worth something.
That obligation becomes especially critical in emergencies. I’ve stood in a room where a patient’s heart had stopped and staff scrambled to locate a working defibrillator. In situations like that, seconds decide outcomes. No patient’s life should hinge on whether working equipment can be found fast enough.
Community clinics statewide receive billions of dollars annually to serve some of the most vulnerable Californians. Yet some spend as little as half of that funding on direct patient care, while a significant share goes toward high executive salaries and expenses unrelated to the person sitting in the exam room.
When I think about moments like the one with that defibrillator, that’s exactly the kind of funding gap that comes to mind.
The stakes are only growing. California could lose as much as $30 billion annually in healthcare funding because of federal cuts moving through Congress. Clinics are already shutting their doors across the state, and more than a million Californians are at risk of losing coverage. In this climate, every dollar clinics receive needs to reach the patients who depend on them.
This issue is personal for me. My sister has cerebral palsy, and because my mother didn’t speak English, I was interpreting for my family by the time I was six years old, just so my sister could get proper medical care. For families like mine, interpretation and language access aren’t optional extras — they’re essential to getting treated at all. Prop. 44 would help safeguard funding for those exact kinds of services.
This measure wouldn’t take a single dollar away from community clinics. It would simply ensure the money already flowing into these clinics ends up where it’s supposed to: with patients. At a time when California’s healthcare system is under so much strain, that kind of accountability matters more than ever.
I hope the people leading our clinics remember why they got into this work to begin with. Healthcare was never supposed to be about inflated executive pay or shiny new facilities. It’s about the person sitting across from us, trusting that we’ll show up for them when it counts.
That’s the standard our community clinics should be held to — and it’s the standard every patient in California deserves.
Original source: CalMatters
