Proposition 44 ensures California’s community clinics prioritize patients over executives

California voters will decide this fall if community clinics should be required to spend 90% of their revenue on patient care and whether to empower the state Attorney General to settle disputes. Below, a social worker says Proposition 44 will ensure funding actually reaches patients. The opposing view: A physician argues that the measure’s poor design will end up hurting the vast majority of clinics.

California’s community clinics are meant to help patients when they need care the most. That’s why I chose to go into healthcare. For more than 20 years, I’ve worked in San Diego helping families get the care they need.

Too often, what I see inside our clinics doesn’t align with the mission. The funding doesn’t reach the front lines of patient care, and it’s patients who lose out.

Every day I see people facing barriers to receiving the care they need. Many wait months for an appointment. Others can’t afford their medications, or give up on treatment when an insurance change makes it more expensive.

As a healthcare worker, I support Proposition 44, the Clinic Funding Accountability and Transparency Act. Prop. 44 simply requires community clinics to spend at least 90% of their revenue on patient care and the services that support it, and to report publicly how their money is spent. No more than 10% can go to executive pay, administration and overhead. 

It holds clinics accountable for the public dollars they receive, and it lets patients and taxpayers finally see where the money goes.

It doesn’t limit what clinics can spend on patient care — it does the opposite. Rather than cutting the services patients depend on, it makes sure the funding reaches them. People come to us because they trust we’ll be there when they need us. We owe it to them to have the staff, equipment and resources to care for them the way they deserve.

That responsibility is never more urgent than in an emergency. I’ve been in the room when a patient needed a defibrillator, the device that shocks a stopped heart back into rhythm, and the staff scrambled to find one that actually worked. In a cardiac emergency, every second matters. A patient’s life should never depend on whether we can find working equipment in time.

Community clinics receive billions in healthcare dollars to care for the people who need it most. But some spend as little as half of their funding on actual patient care, while the rest goes to bloated executive salaries and other costs that have nothing to do with the patient in front of us.

When the equipment healthcare workers need isn’t there in an emergency, that’s the money I think about.

California could lose $30 billion in annual healthcare funding thanks to cuts from Congress. Clinics across our state are already closing, and coverage is slipping away for more than a million Californians. Every remaining dollar has to reach patients.

This matters to me personally. My sister has cerebral palsy, and because my mother didn’t speak English, I was translating for my family by the time I was 6 years old so my sister could get the care she needed. For families like mine, interpretation and language access weren’t extras, they were how we got care.

Under Prop. 44, funding for those services would be protected.

Prop. 44 doesn’t take a dollar away from community clinics. It keeps the funding where it is and makes sure it goes where it belongs: to patients. At a moment when California is losing so much, accountability matters more than ever.

I hope the people who run our clinics remember why they chose this work in the first place. Healthcare isn’t about excessive executive salaries or impressive new buildings. It’s about the patient sitting in front of us, trusting that we’ll be there when they need us.

That’s the standard our community clinics should live up to, and it’s the standard every patient deserves.