2023
ANNUAL
REPORT

New Name, Same Mission
In 2023, CPCA’s board of directors approved the rebranding of its (c)(4) affiliate, CaliforniaHealth+Advocates, to enhance clarity and reinforce alignment with CPCA. Our new name and branding prominently reflect our affiliation and sponsorship by CPCA, ensuring greater transparency and cohesion within our advocacy efforts. After careful consideration, the
CPCA Board and the (c)(4) Board approved the name change to the California Primary Care Association Advocates, or CPCA Advocates.

MAKING the CHANGE

In the final months of 2023, Advocates staff, led by our Associate Director of Grassroots Advocacy, Taylor Beckwith, made the transition from CaliforniaHealth+Advocates to CPCA Advocates by transforming our internal and external communication platforms with a new logo and branding that solidify the connection to CPCA.

A soft launch via social media followed, switching all social media accounts and informing partners and followers. Thereafter, all internal communications and branding were changed. This effort was completed in 2024 with a full launch and website transition. We look forward to continuing advocacy efforts under a new name, but with the same mission.

MISSION and VISION

CPCA Advocates is committed to supporting policies that strengthen health centers and the health care delivery system as a whole, ultimately improving patients’ physical, mental, and family wellbeing. 

CPCA Advocates believes that every Californian is entitled to comprehensive healthcare coverage and timely access. This includes maintaining a strong Medicaid program and removing barriers for vulnerable populations, addressing the social determinants of health, supporting all patients’ ability to access culturally competent and linguistically appropriate care, and ensuring expanded access to care.

POLICY

STATE UPDATES

SPONSORED BILLS

In 2023, Advocates sponsored or co-sponsored four bills highlighting health center priorities.
Assembly Bill 1549 (W. Carrillo)

AB 1549 sought to modernize Federally Qualified Health Center (FQHC) reimbursement rules and PPS, align with state-led care transformation initiatives, and ensure health centers could successfully meet rising operational costs, support a thriving workforce, and continue providing innovative, quality, patient-centered, equitable care to the Medi-Cal members they serve. In addition to the policy issues in question in this bill, the legislation was also intended to educate newly elected officials and their staff on the complexity of CHCs’ reimbursement structure and the need to modernize this antiquated payment system.

Although the bill was held in the Assembly Appropriation Committee, it set the foundation for future educational efforts and PPS modernization. budget trailer Senate Bill 184 and Advocates-sponsored Assembly Bill 32; added more behavioral health support by signing another bill sponsored by Advocates, Senate Bill 966; and added more resources to help strengthen our workforce.

Assembly Bill 1612 (Pacheco)

AB 1612 was a co-sponsored bill seeking to address regulatory barriers, commonly referred to as OSHPD 3, preventing CHC expansion and further efforts to expand access to care. The bill would have decoupled building standards that tie hospital outpatient clinics to CHCs. As currently structured, these building standards do not improve patient safety; rather, they often make it prohibitively expensive for CHCs to build new clinics or take over existing structures. AB 1612 was also vetoed by Governor Newsom. In his veto statement, Newsom claimed the bill “removed important health and safety protections for patients, clinic staff, and the public. Every primary care clinic, regardless of location, should meet the applicable state licensing standards and building codes.” Resolving the OSPHD 3 regulatory barrier remains a priority for Advocates moving forward.

Senate Bill 282 (Eggman)

SB 282 was a co-sponsored bill to address the decades-long issue preventing CHCs from being reimbursed for a primary care and behavioral health visit on the same day. Similar to previous efforts, the bill sailed through the Legislature. The main opposition raised was the associated state cost for such a change. The Department of Health Care Services (DHCS) estimated the bill would cost the state in the “high hundreds of millions of dollars” and the Department of Finance was opposed to such a change because of the estimated cost.

This year, however, seemed different because of the accompanying Managed Care Organization (MCO) tax and an effort to reinstate this tax on health plans to fund Medi-Cal. Through that effort, Advocates made it clear that same day funding was a health center priority and an ideal policy issue to fund using the MCO tax revenue.

For a few days in May, the Governor’s Administration committed to same day funding; however, it came with a caveat that only health centers that had collective bargaining agreements with their workforce or participated in a labor management committee could gain access to same day access funding. CPCA strongly opposed tying funding for patient access to care to whether healthcare providers are part of a collective bargaining agreement, and instead advocated for a system that ensures equitable access and quality care for all patients regardless of their provider’s contractual arrangements. As such, the funding was pulled and reallocated to other areas. Without the budget earmark, SB 282 was held in Assembly Appropriation Committee.

Assembly Bill 85 (Weber)

AB 85 was another co-sponsored bill seeking to identify social determinants of health (SDOH) earlier and intervene by requiring health plans and insurers to pay for SDOH screenings and referrals to community health workers, social workers, and other care members. The bill would have allowed providers to choose what screening method they used and would have authorized reimbursed under Medi-Cal fee for service. Unfortunately, Governor Newsom vetoed the bill, stating that it was premature because federal efforts to create standardized SDOH screening tools are ongoing and the state should await those efforts to avoid conflicting policies.

BILLS OF INTEREST

Health care is always a big issue in California politics, and this year was no different, with major legislation to increase health care workers’ minimum wage, reform the Mental Health Services Act (MHSA), and protect abortion access moving through the process, along with CHCs’ additional policy priorities.

Health Care Worker Minimum Wage Bill

Advocates negotiated a compromise on SB 525 (Durazo) during the final week of the legislative session, securing four out of five priorities in the final compromise.

For CHCs, the minimum wage increases will start to scale up to $21 per hour starting on June 1, 2024, completing the phase-in by June 1, 2027, at the amount of $25 per hour.

Advocates worked relentlessly to reach an agreement that will increase the wages for CHC staff, while at the same

time ensuring health centers will have ample time to prepare for the new law.

The negotiations also provided a waiver program for those health centers that cannot meet the wage increase requirements of the new law.

Additionally, the deal secured a moratorium on local ballot initiatives or local ordinances seeking to increase the health care worker minimum wage inconsistent with the SB 525 law until at least June 2027.

Finally, we were able to limit the scope of the bill to ensure true independent contractors were not included in the minimum wage increase.

While we were unable to secure additional funding this session to cover the costs associated with the wage increase in the negotiations, we are committed to continue pursuing new revenue sources through the MCO tax and advance PPS reform through legislative and administrative advocacy.

SB 487 (Atkins)

Numerous bills of impact sought to close remaining gaps in California’s abortion protection and access network. One bill of interest was SB 487, which prohibits health insurers and the state from penalizing abortion providers who have been sanctioned in other states. This bill was sponsored by Planned Parenthood Affiliates of California, supported by Advocates, and signed into law.

SB 326 (Eggman)

Governor Newsom spent much of this year focused on changing the MHSA to the Behavioral Health Services Act with a new focus on addressing homelessness. These policy changes were placed in SB 326 late in the legislative session.

Advocates supported funding for supportive housing to those who need it; however, we had concerns with taking these

funds away from CHCs that have been able to access this funding. For Advocates, moving funding from one major priority to another without filling the funding gap would not resolve the mental health and homelessness crises.

As it was Governor Newsom’s top priority, SB 326 was signed into law.

AB 616 (Rodriguez)

Advocates opposed and successfully pushed for a veto on AB 616, which would have allowed the financial information of CHCs that have created risk-bearing organizations and partnering organizations to be disclosed to any person or organization upon request. The bill would have disincentivized CHCs from taking on more risks for the sake of improved patient outcomes because of the ability to have its financial information disclosed to potential adversarial persons or entities.

BUDGET ADVOCACY

California state flag against a blue background.

“Local organizations and federally qualified health centers have been foundational to expanding provider capacity and enrolling undocumented adults into coverage programs leading up to the latest Medi-Cal expansion.” ~ Laura Sheckler, Deputy Director of Policy & Regulatory Affairs, interviewed by Modern Healthcare.

Despite the bleak fiscal outlook, with a projected state deficit of nearly $32 billion, Advocates successfully secured a total of $160 million dollars for health centers in the 2023-24 budget.

This funding included a one-time $20 million investment in DHCS’s budget for Medi-Cal health navigation services specifically dedicated to CHCs. Funding will support outreach, enrollment and renewal assistance, and processing, troubleshooting, and technical assistance efforts across California to assist patients in gaining and maintaining Medi-Cal coverage. These activities will support California’s Medi-Cal redetermination goals and the enrollment of income-eligible adults ages 26 through 49 into full-scope Medi-Cal, regardless of their immigration status, starting in January 2024.

While previous rounds of funding for the DHCS Medi-Cal Health Navigators program have historically been distributed through counties, a further success was convincing DHCS to contract with CPCA to administer these funds as a Third-Party Administrator. This has allowed CPCA to partner with regional consortia and CHCs across the state to ensure funding is equitably distributed. This has the potential to serve as a model for future funding to flow from the state directly to health centers through CPCA.

Additionally, CHCs will receive one-time funding of $40 million towards the Providing Access and Transforming Health (PATH) Initiative. The funding will give health centers infrastructure dollars to build Enhanced Care Management or Community Supports programs. Finally, CPCA and coalition partners were also able to secure $75 million for Graduate Medical Education as part of the MCO tax advocacy in the budget.

MCO Tax Budget & Ballot Initiative

Throughout 2023, CPCA and Advocates worked in partnership with a broad coalition of healthcare leaders across the state to advocate for the reinstatement of a tax on managed care organizations and ensure that its revenues are dedicated to the Medi-Cal system.

As a part of the Governor’s Fiscal Year 2023-24 state budget, the MCO tax was renewed. Subsequent negotiations between the Administration and the coalition led to a historic investment in Medi-Cal rate increases, along with $100 million dedicated to CHCs in the FY 2024-25 budget.

CPCA was one of the main coalition partners seeking to permanently keep MCO tax revenue funding Medi-Cal. Historically, the sitting Governor’s Administration often used the generated tax revenue to support the General Fund and address budget deficits. As such, on September 7, 2023, the Coalition to Protect Access to Care filed a statewide ballot initiative with the Attorney General.

The ballot initiative, known as the Protect Access to Healthcare Act of 2024, will seek to make the funding permanent, unlock billions of dollars for Medi-Cal, and expand access to care for all Californians. If passed, this funding would potentially provide up to $5.5 million per health center corporation a year (if divided evenly), which includes $300 million dedicated to CHCs through a new quality improvement program. Funding allocated through the ballot initiative would be prohibited from being used to supplant existing funding streams, and would not be subject to reconciliation, protecting CHCs’ ability to access funding in addition to their PPS rate.

Pursuing this ballot initiative is one way in which CPCA is working to achieve two of the bold steps identified in CPCA’s strategic plan: Becoming a Center of Advocacy Power & Influence and Health Center Optimization. This exciting new strategy is in addition to the variety of ways we are already pursuing these steps, including ongoing legislative, budget, and regulatory advocacy; and building health center capacity for civic engagement. If successful, the payoff for health centers, patients, and California’s public health care system overall, will be significant.

On the importance of locking in permanent funding into Medi-Cal, President & CEO Francisco Silva said to California Healthline, “We should invest today because the need is so high.”

If successful, the payoff for health centers, and California’s public health care system overall, will be significant. CPCA is working closely with several of our member health centers and consortia to raise $5 million dollars for the Protect Access to Healthcare Act. This contribution will be crucial in ensuring this policy will be approved by voters when it comes before them on November 5, 2024. As a trusted voice within our communities, health centers have an important role in educating the public about the importance of this policy. With the help of our members, we will ensure that every patient, staff, or family member we talk to understands the significance of passing this initiative. With signature gathering underway, members will hear a lot from us about ways to support this monumental and historic effort.

Political Endorsements & Fundraising

This year was the unofficial kick-off to the 2024 election season. Over the course of 2023, Advocates, along with CHC leaders from across California, held 43 different candidate interviews with individuals running for State Assembly and State Senate. This was in addition to the more than 50 meetings held with California’s potential future leaders. These interviews and meetings are part of a critical component of our endorsement process, allowing health center leaders the opportunity to educate the candidates on the most pressing CHC issues and begin the process of cultivating relationships.

In October, Advocates completed its first round of endorsement interviews. The Advocates Board ultimately voted to support:

Additionally, our Political Action Committee (PAC) was able to raise $67,520 from more than 68 donors. We are very grateful and fortunate to have donors who support the mission of community health centers. With every dollar, these investments help to advance our mission in Sacramento. Having a robust PAC allows us to contribute directly to candidates and elected officials running for office, thus putting our financial endorsement towards the candidates’ election efforts.

This year alone, our PAC was able to support the Speaker of the Assembly, Robert Rivas; Assembly Majority Leader Cecilia Aguiar Curry; Assemblymembers Wendy Carrillo, Megan Dahle, Corey Jackson, Blanca Pacheco, and Dr. Akilah Weber; and Senators Monique Limon and Caroline Menjivar. Furthermore, the PAC contributed towards the campaigns of Mark Gonzalez and Jose Solache in their first legislative election.

If you would like to join the many community health center leaders in supporting our PAC and political efforts, please contact Victor Christy at victor@cpcaadvocates.org.

FEDERAL ADVOCACY

The Health Center Fund

On average, FQHCs receive the majority of their operating expenses through reimbursements. A smaller, but vital, source of funding is the 330 grant, often called the Health Center Fund.
Pie chart in CPCA Advocates colors of orange, dark blue, and light blue. Total Medicaid (40%), total Medicare (8%), and Federal Grant 330 (13%) are called out.

The Health Center Fund comes from about one third annual discretionary appropriations and two thirds mandatory funding.

Annual discretionary appropriations are adopted by Congress each year, and the Health Center Fund is included in the Departments of Labor, Health and Human Services, and Education Appropriations bill. The first five years of mandatory funding was included in the Affordable Care Act and has been extended several times since the passage of that bill in 2010. Both the mandatory and annual discretionary portions of the Health Center Fund were set to expire on September 30, but they have been extended via a Continuing Resolution through January 19 and February 2, respectively.

The House and Senate Committees that have oversight over the mandatory portion of the Health Center Fund have very different approaches for the extension.

On the House side, H.R. 5378, the Lower Costs, More Transparency Act, includes a two year and three month extension of the Health Center Fund with 10 percent increases annually. This bill was passed the House of Representatives in December on a vote of 320 to 71. California health centers’ advocacy efforts were instrumental in encouraging their representatives to vote for the bill.

The Senate Health, Education, Labor, and Pensions Committee has approved S. 2840, the Bipartisan Primary Care and Health Workforce Act, which would extend the Health Center Fund for three years with a 45 percent increase. It is not clear if S. 2840 will come up for a vote on the Senate floor as a standalone bill.

Both H.R. 5378 and S. 2840 also include extensions of the National Health Service Corps mandatory funding and the Teaching Health Center Graduate Medical Education funding, along with other provisions not related to health centers.

EVENTS

National Health Center Week

During the week of August 6, 2023, we celebrated National Health Center Week (NHCW), a week dedicated to community health centers. Each year, NHCW, sponsored by the National Association of Community Health Centers (NACHC), honors and recognizes community health centers, their amazing staff, and the community organizations that support our mission. As we look back on NHCW, Advocates wants to acknowledge the health centers and their staff who hosted numerous events across the state and engaged in various forms of advocacy.

Although NHCW focuses on raising awareness about the important work that CHCs do, it also is an opportunity to grow the community health center movement and increase those engaged in advocacy. This includes involving elected officials in NHCW to increase their awareness of CHCs and give them the opportunity to hear directly from their constituents Some ways that Advocates and CHCs engaged with elected officials and participated in advocacy during NHCW this year include the following:

  1. Invited and hosted elected officials for site visit tours of community health centers.
  2. Passed city and statewide resolutions or proclamations declaring August 6th-12th National Health Center Week
  3. Shared their “Why:” their reason for supporting the community health center movement in a video on social media.
  4. Invited and hosted elected officials at community-wide events.
  5. Hosted a roundtable with an elected official to discuss community health center issues.
  6. Tagged their elected official on social media posts.

One additional way that Advocates prioritized advocacy this NHCW was through a California State Senate resolution. At the request of Advocates, Senator Caroline Menjivar authored a resolution recognizing NHCW as August 6-12th and honoring community health centers and the vital roles they play in serving their communities.

Six attendees of CPCA Advocates 2023 Day at the Capitol stand together before legislative visits
Day at the Capitol 2023
Day at the Capitol is Advocates’ annual statewide advocacy day that allows California’s community health center leaders, clinicians, staff, patients, and advocates to lobby their Legislators and staff and champion budget and legislative priorities impacting health centers and the communities they serve.

Day at the Capitol was held in person on Wednesday, April 26th, and it was a remarkable success. Over 200 health center leaders from across the state came to Sacramento to collectively advocate on behalf of CHCs’ budget and legislative priorities. Our members and advocates convened at the Elks Tower, starting the day with a breakfast briefing. Advocates’ Vice President of Government Affairs, Dennis Cuevas-Romero, reviewed materials, answered questions, and then allowed time for networking opportunities prior to legislative meetings.

Members lobbied their legislators and legislative staffers on top priority issues such as payment reform, workforce, and access to care. For those that had downtime between legislative meetings, Advocates hosted educational sessions on civic engagement with speakers from AltaMed Health Services and Asian Health Services. During lunch, keynote speaker Senator Caroline Menjivar, introduced by Advocates President and CEO Francisco J. Silva, shared why CHCs – and additional resources for CHCs – are so critical, and the personal connection she had with her local health center. The event concluded with a legislative reception at the Mix Downtown where members celebrated a successful event.

Community Health Association Inland Southern Region staff members with Congressman Pete Aguilar and Dennis Cuevas-Romero from CPCA Advocates.
NACHC Policy & Issues Forum 2023
NACHC’s first in-person Policy & Issues (P&I) Forum post-pandemic was held in March 2023. The conference was an exciting opportunity to learn, network, and advocate for health center priorities. P&I is where change-makers and thought leaders in the health center movement convene to share best practices on policy issues and focus on the challenges and opportunities that lie ahead.

In preparation for Hill Day on March 9, 2023, Advocates hosted over 100 health center leaders at a California State Delegation meeting on March 8th, where we briefed attendees on topics of interest and ways to enhance their advocacy on Capitol Hill. Health center leaders from around the country – doctors, nurses, CEOs, and consumer board leaders – descended on the halls of Congress, shared their stories and emphasized the importance of health center funding, protecting 340B savings, and the urgent health center workforce crisis.

Advocates and health center leaders from California also held partner meetings with Health Resources and Service Administration leadership to discuss waiving state licensing for physicians practicing in other states and supporting CHC Infrastructure Development for Health Professions Education & Training. We also met with NACHC leadership to discuss west coast representation, full integration of Native American/Tribal Issues, workforce development, health center viability and California-specific challenges that tie to the federal advocacy work.

Francisco Silva Named Top 100 Policy Influencer
CPCA President and CEO, Francisco J. Silva, joined exclusive company this year when he was named amongst the Top 100 policy influencers in California by Capitol Weekly, a nonpartisan news publication covering California government and politics.

This significant achievement is an example of how CPCA is becoming a center of Advocacy Power and Influence, one of CPCA’s bold steps for the future. This list is comprised of influential political leaders who are seen by their peers as people who can move the needle in Sacramento in support of their organization.

GRASSROOTS ADVOCACY

Using Phone2Action, a digital platform that allows advocates to contact elected officials, Advocates launched 11 different campaigns related to CHC legislative and budget priorities at both the state and federal levels. With over 8,000 California advocates in Phone2Action, advocates were able to connect with 1,004 elected officials. This included 89 Tweets, 910 emails, and five phone call campaigns. Further, 479 letters of support or letters of opposition were directly submitted to the California legislature. Twelve videos were also collected from Advocates and health center staff to be used for advocacy and to uplift community health center voices.
Graphic with stats of CPCA Advocates grassroots successes in 2023

FINANCIALS

Logo for CPCA Advocates, three gradient swooshes in the colors orange and blue with the outline of the California Capitol building dome in white.

Balance Sheet

as of 3/31/2024
ASSETS
Current Assets
Cash836,869.00 
Accounts Receivable9,751.00 
TOTAL ASSETS846,620.00 
LIABILITIES & EQUITY
Current Liabilities
Accounts Payable20,672.00 
Due to CPCA4,658.00 
Deferred Revenue0.00 
TOTAL LIABILITIES25,330.00 
Equity
Retained Earnings267,736.00 
Net Income553,554.00 
TOTAL EQUITY821,290.00 
TOTAL LIABILITIES & EQUITY846,620.00 

DONORS

CPCA Advocates would like to thank each of the donors who generously and personally donated this past year towards our political advocacy efforts.

Advocates is grateful to all of our donors who believe in the mission of community health centers, and we would like to especially acknowledge the people who supported our efforts in this past year. We are grateful for you and thank you for your continued support.

If you are interested in supporting the CPCA Advocates PAC with a donation, you can click here.

Below is a list of this year’s donors.

Executive: $9100
CALPAC – CA Medical Association PAC
The California Dental Association PAC
The Doctors Management Company

Champion: $2100-$5000
AltaMed Action Fund
Centene/HealthNet (Louise McCarthy)
Corinne Sanchez
Francisco J. Silva

Justice: $2500
Facktor

Advocate: $1000-$2000
Californians Allied for Patient Protection (CAPP)
Berenice Nunez Constant
Tim Fraser
Kevin Mattson
Asa Satariano
Anthony White

Ally: $500-$1000
Leslie Abasta Communigs
Warren Brodine
Dr. Joel Ramirez
Dr. Christopher Lau
Karen Lauterbach
Jessica Ho
Johanna Liu
Louise McCarthy
Dr. Rakesh Patel
Andie Patterson
Paulo Soares
Tory Starr
Pedro Toledo
Vernita Todd

Impact: $250+
Warren Brodine
Allie Budenz
Joey Cachuela
Alexes Degenfelder
Jane Garcia
Julia Liou
David Lontok
Dr. Melissa Marshall
Julie Minardi
Lucy and Leo Myers-Peeci
Max Perrey
Andrea Schwab Galindo
Ralph Silber
Toni Panetta
Ginger Smith
Graciela Soto Perez
Sonja Spowart
Richard Veloz
David Vliet

Benefactor: $100+
Rolando Chavez
Alvaro Fuentes
Franklin Gonzalez
Britta Guerrero
Kerry Hydash
Cathy Hyde
Marty Lynch
Lisa Maas
Sal Melendez
Lourdes Olivares
Becky Paplanus
Rosie Gilb
Kearsten Shephard
Adel Syed
Brandon Thornock
Yamilet Valladolid
Christy Ward

BOARD & STAFF

Chair
Britta Guerrero
Chief Executive Officer
Sacramento Native American Health Center
VICE CHAIR
Paulo Soares
Chief Executive Officer
Camarena Health
SECRETARY
David Vliet, MBA
Chief Executive Officer
LifeLong Medical Care
TREASURER
Berenice Nunez Constant, MPH
Vice President, Government Affairs & Civic Engagement
AltaMed Health Services Corporation
Director at large

Leslie Abasta-Cummings
Chief Executive Officer
Livingston Community Health

Director at large
Lisa Maas
Executive Director
Californians Allied for Patient Protection
Director at large
Yamilet Valladoid
Government Affairs Manager
Golden Valley Health Centers – Merced
Director at large
Anthony White
Vice President of Government and Community Affairs
TrueCare
EX OFFICIO

Francisco J. Silva, Esq.
President & Chief Executive Officer
California Primary Care Association

STAFF
Francisco J. Silva, Esq. President & Chief Executive Officer

Dennis Cuevas-Romero, Esq.
Vice President of Government Affairs

Kelley Aldrich
Associate Director of Legislative Affairs

Taylor Beckwith
Associate Director of Grassroots Advocacy

Victor Christy
Director of Political Engagement 

Taylor Jackson
Deputy Director of Government Affairs

Marisa Melendez
Senior Administrative Assistant

Elizabeth Oseguera
Assistant Director of Policy 

Laura Sheckler
Deputy Director of Policy and Regulatory Affairs

Close up of California poppy

2023 Annual Report