A dangerous measure is on the November ballot that will harm the very people it claims to help – Prop 44, which imposes rules on how community health clinics spend their revenue. The measure seems straightforward: Ensure that at least 90% of community health clinic revenues go toward patient care. Here’s the reality: Prop 44 will result in service reductions and staff layoffs, hurting patients and healthcare workers.
California’s community health centers care for 7 million patients. In Los Angeles County alone, community clinics serve more than 2 million patients annually. These clinics serve everyone, regardless of ability to pay.
Most of the patients have low incomes. Nearly 80,000 experience homelessness. Harbor Community Health Centers delivers healthcare to the South Bay community.
Everything we do at HarborCHC serves and supports our patient population which is made up of low-income families, adults and seniors, children, pregnant mothers, and anyone who needs medical, dental or behavioral health care.
Our mission is to provide quality, comprehensive healthcare and supportive services to those in our community. We treat patients with services well beyond primary care, including treatment for substance use disorders, depression and anxiety, dental care, heart health, diabetes care, podiatry, nutrition, mammograms, and more. If Prop 44 passes, the care we provide our communities and workers’ jobs will be at risk.
Proponents of Prop 44 say the measure will protect clinic workers. Prop 44 is simply a veiled attempt to force community clinics across California to unionize. The labor union backing the measure and its leader have repeatedly abused the ballot box to advance their goals.
Community clinics are the union’s latest target, after the union unsuccessfully led ballot measures in 2018, 2020 and 2022 against the dialysis industry. When the California Primary Care Association, which represents community clinics across the state, could not guarantee workers to unionize, the union drafted Prop 44.
Measure is a ballot box abuse
Harbor does not oppose unionization. HarborCHC has been operating in pro-union San Pedro for more than 55 years and we support our local ILWU. Abusing the ballot box to force clinics to unionize, however, is not the way to do it. Voters rejected the measures targeting the dialysis industry and they should reject Prop 44.
Additionally, Prop 44 takes away decision-making power from clinics. The measure’s 90% spending ratio is an arbitrary percentage. Clinics already spend most of their revenue on patient care. Yet, critical services and capital improvement projects to expand capacity do not count toward that 90% mandatory spend. Under Prop 44, community clinics will be forced to choose between keeping essential services or paying a penalty fee if they don’t meet the 90% spend ratio.
‘Non-essential’ is a misnomer
If Prop 44 passes, essential patient services and organizational supports to meet the needs of our patients could be cut. Clinics across California will have to decide whether to cut janitorial services to keep facilities clean, call centers to schedule patient appointments and security to keep our clinics safe, or pay a massive fine for investing in these services.
Case management, referrals, care coordination, insurance benefits enrollment, translation services, technology, facilities and other services could also be cut. Our patients rely on these services as part of their whole person care. Prop 44 says these services are non-essential and are not patient focused care.
We disagree.
Community clinics are firmly rooted in the communities they serve. As federally funded entities, community clinics are already heavily regulated by the federal and state government.
Further, they are required to have at least 51% of their board of directors comprised of patients to help ensure revenue is spent on patient care. Leave the decision-making to clinics, who partner with their patients and communities to deliver the best quality care.
Prop 44 is dangerous to patients and the community clinics that serve them. Patients will lose care. Staff will lose jobs. Community clinics already operate on thin margins.
They cannot afford millions of dollars in penalty fees. That’s why a broad coalition of patients, healthcare providers and hundreds of community clinics across the state oppose Prop 44. The California Chamber of Commerce, California Medical Association, California Hospital Association, Democratic Party and Republican Party all say No to Prop 44. The stakes are too high. Patients’ lives and workers’ jobs are on the line. Voters must reject Prop 44.
Tamra King is the chief executive of Harbor Community Health Centers, a federally qualified health center in San Pedro and Long Beach.
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