California Prop 44 would force health clinics to spend 90% on patient care | CA Politics 360
A measure aimed at changing how community health clinics spend taxpayer dollars is heading to the ballot box this November. Voters will decide the fate of Proposition 44. Supporters say it will increase accountability, but opponents warn it could threaten services patients rely on.
In November, California voters will consider Proposition 44, otherwise known as the “Clinic Funding Accountability and Transparency Act.” It’s sponsored by SEIU United Healthcare Workers West.
“We want to ensure that these community health clinics, which receive a large amount of taxpayer dollars, that they are spending the money on direct patient care and other mission related services,” said Renee Saldana, a spokesperson for SEIU UHW West.
Prop 44 requires federally qualified health centers, or FQHCs to spend 90% of their revenue on program services, and report their financial records. Community health clinics that don’t meet that 90% would face penalties.
Wellspace Health Chief Health Officer Dr. Janine Bera says its network of nonprofit community health clinics, and many like it, are already stretched thin after funding changes under the “One Big Beautiful Bill.”
“We already put patients first. Prop 44 is basically ridiculous. Our mission again at Wellspace Health is to achieve regional health through high-quality comprehensive care, and we mean it,” Bera said. “At Wellspace Health, we are not-for-profit, and this means that we don’t have shareholders and the majority of our board are actually our patients. All of our money goes back into providing those vital services. Those services, such as nursing managers, patient advocates, community health workers, are things that really make the difference to helping people get to right place to get their care.”
Under Prop 44, administrative costs, management, and other non-program expenses would be limited to no more than 10% of revenue. Saldana says this proposition is meant to put patients first and keep clinics accountable.
“What we have seen is there are certain clinic systems that spend less than 60% of their total funding on things that aren’t patient care,” Saldana said. “What we’re seeing is often times, some of these community clinics are spending on non-essentials like art collections, fundraisers where they lose money, and I think a lot of people would be surprised to know that many of these CEOs and other executives at these community health clinics that receive federal funding, make millions of dollars a year.”
KCRA 3 asked Bera how much Wellspace spends on patient care.
“Being not-for-profit, it’s 100 percent. Everything is needed in order to get people where they need, meaning the patient advocate helps to make sure the person knows where to get their services,” Bera said. “This proposition even has the ability to cut janitorial services. Why should my patients not be able to go to a health center that is clean?”
So the biggest question for voters come November: Will requiring clinics to spend at least 90% of their money on patient services improve healthcare, or make it harder for clinics to serve California’s low-income, uninsured, and medically underserved patients?
If approved, Prop 44 would authorize California’s attorney general to define qualifying expenses; penalties could be refunded if centers become compliant within five years, and centers could face criminal charges for false reports on spending.
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