Innovation + Impact:
Engaging Communities, Empowering Change

MESSAGE FROM
PRESIDENT & CEO
Francisco J. Silva, Esq.

As I reflect on our impact this year, I am filled with pride and gratitude. Our three-year strategic plan with bold steps for the future was announced early in 2023 and has been our roadmap throughout the year, guiding us to achieve regulatory equity, health center optimization, a diverse workforce, advocacy influence, and association sustainability. As we navigate the ever-evolving complexities of the health care landscape, our emphasis remains on impact, innovation, and collaboration to engage the communities that health centers serve, empower them to bring about positive change, and amplify the health center movement across California.

Our commitment to engaging communities is reflected in the launch of the Civic Engagement Department. In partnership with AltaMed Health Services, CPCA civic engagement staff are hard at work spreading the word about the My Vote. My Healthtm initiative, which aims to reach CHC patients, staff, and communities, building their civic power to address issues of health equity. This new team will build capacity in this area, providing both statewide and regional support, as we work to expand our civic engagement efforts throughout California.

And when we talk about impact, there can be no greater impact than increasing access to health care for all Californians. CPCA’s Medi-Cal Health Navigator Project, which launched in early 2024, aims to do just that. Through the program, CHCs and consortia will receive crucial support to assist with Medi-Cal outreach, enrollment, and renewal efforts across California. Through these navigation services, our goal of health access for all is one step closer to reality.

Our innovative work in payment modernization has continued this year, as have our efforts to continue centering justice, equity, diversity, and inclusion in all that we do. By doing so, we can continue to empower change among health centers and the patients and communities they serve. I saw this firsthand as I toured some of our member centers for the launch of our Health Center Site Visit Program. This initiative is close to my heart, as I had the chance to connect personally with so many of you and hear firsthand the challenges and victories you experience each day. This on-the-ground understanding is priceless because it enables us to tailor our strategies and support to meet the evolving needs of our diverse members.

In closing, I want to extend my appreciation to our dedicated members, partners, and advocates who have been instrumental in our successes this year. Let’s forge ahead, inspired by the progress we’ve made, and work collaboratively to ensure that the citizens of our communities receive the comprehensive, whole person care they deserve.

CPCA BOARD / OFFICERS & MEMBERS

Chair

Paulo Soares
Chief Executive Officer
Camarena Health

Chair-Elect

Rakesh Patel, MD
Chief Executive Officer
Neighborhood Healthcare

Immediate Past Chair

Britta Guerrero
Chief Executive Officer
Sacramento Native American Health Center

Secretary

Andrea Schwab-Galindo
Chief Executive Officer
Tiburcio Vasquez Health Center, Inc.

Treasurer

Asa Satarino
Chief Executive Officer
South of Market Health Center

Speaker

David Lontok
President & Chief Executive Officer
Comprehensive Community Health Centers, Inc.

Vice Speaker

Melissa Marshall, MD
Chief Executive Officer
CommuniCare Health Centers, Davis Community Clinic

Members at Large

Warren J. Brodine
President & CEO
Eisner Health

Benjamin Flores, MPH
President & CEO
Ampla Health

Kerry Hydash
President & CEO
Family HealthCare Network

COMMITTEE MEMBERS

Doreen Bradshaw
Executive Director
Health Alliance of
Northern California 

Alvaro Fuentes
Chief Executive Officer
Aliados Health 

Jane Garcia
Chief Executive Officer
La Clinica de La Raza, Inc.

Franklin Gonzalez
Chief Administrative Officer
Via Care Community Health Center-Administrative Headquarters

Virginia Hedrick
Executive Director
California Consortium for Urban Indian Health

Julia Liou, MPH
Chief Executive Officer
Asian Health Services

Kevin Mattson
President & CEO
San Ysidro Health

Louise McCarthy
President & CEO
Community Clinic Association of Los Angeles County

Danielle Myers, MD
Director of Health Informatics
Golden Valley Health Centers – Robertson Road

Andie Patterson, MPP
Chief Executive Officer
Alameda Health Consortium

Jonathan Porteus
Chief Executive Officer
WellSpace Health

Tim Rine
Executive Director
North Coast Clinics Network

Corrine Sanchez
President & CEO
El Proyecto del Barrio, Inc.

Graciela Soto-Perez
Chief Executive Officer
Altura Centers for Health

Tory Starr
Chief Executive Director
Open Door Community Health Centers

Adel Syed
CEO
University Muslim Medical Association (UMMA) Community Clinic

Pedro Toledo
Chief Administrative Officer
Petaluma Health Center

Richard Veloz, MPH, JD
Chief Executive Officer
South Central Family Health Center

David B. Vliet, MBA
Chief Executive Officer
LifeLong Medical Care

Christy Ward
Chief Executive Officer
Share Our Selves

IMPACT

Governance Modernization

The work on the initiative to modernize CPCA’s governance system, first launched by the Board of Directors in 2022, has continued this year with the goal of strengthening member engagement while also improving the overall effectiveness of CPCA’s governance model and member participation. The Board-appointed Governance Modernization Technical Advisory Committee (TAC) has been working to develop recommended governance modifications for the Board’s consideration following successes from 2022 (details can be found in the 2022 Annual Report).

Throughout 2023, the Governance Modernization TAC focused on developing two policies and procedures to ensure consistency and transparency. The first policy and procedure establishes defined committee rosters and the procedures by which those rosters are determined, and it includes a clear process and guiding principles for the selection of Executive Committee members. Establishing a process by which membership eligibility, responsibilities, and committee rosters are defined is integral to meeting CPCA’s organizational and policy priorities and is foundational to CPCA governance stability and sustainability. This policy and procedure was approved by the CPCA Board and will be implemented in 2024.

The second policy and procedure developed by the Governance Modernization TAC and approved by the CPCA Board serves as guidance for vacancies on the Board that may occur because of a board member’s resignation from their position, or if the board member is no longer eligible to remain in office due to the termination of their delegate status. Per the CPCA Bylaws, except in special circumstances, the exact manner in which a vacancy on the Board of Directors is filled is discretionary; the policy and procedure allows for consistency in how the Board fills vacancies until the seat term expires.

The Governance Modernization TAC wrapped up their 2023 efforts by conducting a comprehensive review of the CPCA Bylaws and will share their recommended modifications with the CPCA Governance Committee for determining next steps early 2024.

Bold Steps for the Future: 2023-2025

In January 2023, CPCA brought together the Board of Directors for a retreat to develop an updated strategic plan. Led by Syphax Strategic Consulting, the Board discussed the current landscape of both healthcare delivery and association management in a post-COVID environment. These discussions led to the prioritization of key areas that were then further refined by CPCA senior leaders post-retreat. The final three-year strategic plan (2023-2025), approved in February 2023, outlines key initiatives in the areas of health center optimization, regulatory equity, workforce, advocacy, and association sustainability.

Graph showing the five strategic plan goals for CPCA along with supporting activities

Staff developed detailed workplans for each of the key areas and utilized the remainder of the calendar year to move work forward. Achievements in 2023 included:

  • Partnering with coalition members to successfully file the Protect Access to Healthcare Act of 2024 and with a member-led workgroup to develop and refine a tax distribution plan.
  • Securing $20 million in grant funding and partnering with the California Department of Health Care Services to launch the Medi-Cal Health Navigator Project.
  • With support from The California Endowment and in partnership with AltaMed Health Services, launching CPCA’s Civic Engagement Program.
  • Conducting important workforce advocacy efforts that led to funding for student rotations, accreditation programs, and teaching health centers, among others.
  • Creating an initial charter for a Legal Action Fund, resources from which were used to file an amicus letter brief in the California Supreme Court in support of a health center’s efforts to identify the legal issues around the rate adjustment process.
  • Raising over 20 percent of the Political Action Fund goal of $300,000.
  • Increasing engagement in the Community Health Center Mode of Practice Forum within the California Medical Association.
  • Continuing discovery on how to focus and refine Association sustainability efforts through a variety of efforts, including research into member affinity programs and venture fund expansion.

We are excited about the strong start and look forward to continued momentum and success in 2024.

The CPCA Medi-Cal Health Navigator Project distributes $17.75 million in subcontracts across the state to support Medi-Cal outreach, enrollment, renewal, utilization, and troubleshooting across California. Over 123 organizations, including 113 community health centers and 10 regional clinic associations, are receiving these funds across 38 counties. Notably, some of these counties have not received any SB 154 funding to date or remain underfunded based on their percentage of Medi-Cal patients. Most organizations supported through this funding have not received any SB 154 funding previously, which demonstrates the wide impact of this program and investment.

This is the first project dedicated exclusively to CHCs’ Medi-Cal enrollment and retention efforts and is the result of funds advocated for and secured by CPCA Advocates, regional clinic associations, and CHCs through the FY2023-2024 state budget cycle. CPCA administers these funds through a Third-Party Administrator contract with the Department of Health Care Services (DHCS), who is the designated recipient of the state and federal funding. CPCA is responsible for the Navigator Project’s implementation including program design, funding allocations, data collection, and reporting requirements. The CPCA Navigator Project builds on DHCS’s Medi-Cal Health Enrollment Navigator Project, which provides funding to counties and community-based organizations.

The Navigator Project will support California’s Medi-Cal redetermination and expansion goals through 2025 and will play a critical role in helping thousands of individuals across California maintain or establish their Medi-Cal coverage. In addition, it will support the Medi-Cal Adult Expansion that commenced on January 1, 2024, which allows enrolled adults ages 26 through 49 to access full scope Medi-Cal services, regardless of their immigration status. The essential support provided by the CPCA Medi-Cal Health Navigator Project is a crucial step towards achieving health equity in our state.

Click here to view more information about the CPCA Medi-Cal Health Navigators Project. Email HealthNavigators@cpca.org with questions.

INNOVATION

Payment Reform

In 2023, CPCA worked diligenty in the reimbursement landscape and moved the needle in two areas in particular regarding payment reform: the Medi-Cal Prospective Payment System and the Alternative Payment Model (APM).

PPS Policy

2023 brought the transition of Medi-Cal Prospective Payment System (PPS) policy responsibility from the Department of Health Care Services’ (DHCS) Audits & Investigations unit to the Fee-For-Service Rates Development Division. CPCA worked closely through the year to help DHCS staff better understand Federally Qualified Health Centers, including hosting DHCS and Department of Finance staff for a health center site visit. Looking ahead to 2024, this work will continue with CPCA and DHCS collaborating to establish a central repository of all PPS policy guidance, tentatively being called the FQHC Policy Guide. We look forward to continuing this work and ensuring that our members have access to clear and comprehensive guidance on Medi-Cal PPS policy.

APM Implementation Readiness

Throughout 2023, CPCA and health centers persisted in deliberating the details of the California Federally Qualified Health Center (FQHC) Alternative Payment Methodology (APM). The APM is intended to offer FQHCs (and FQHC look-a-likes) a capitated alternative to the Prospective Payment System (PPS) through the financial flexibilities available under a fully capitated reimbursement model in lieu of traditional per-visit reimbursement.

Seventeen health center organizations (representing 121 parent and intermittent sites) applied and were selected in early 2023 for Cohort 1. Given implementation readiness concerns, DHCS decided to split “Cohort 1” into separate go-live dates in July 2024 and July 2025. Health centers may choose the launch date that is right for them or choose to opt out of Cohort 1 without any prejudice to reapplying for a future cohort. Based on the current APM design, not every health center (or contracted managed care plan) currently has the administrative, contracting, data, financial, and other capacity and infrastructure to succeed in the new model. DHCS says their goal is and has been to provide interested and suited health centers the opportunity to participate in the APM when it is right for them based on the program design. DHCS is interested in launching the APM as a pilot which can be refined based on lessons learned.

Unanticipated challenges arose during the design and pre-implementation stages this year. The Cohort 1 health centers were important FQHC ambassadors to DHCS as the department worked through these challenges. CPCA, along with partners at the statewide managed care plan and public hospital associations, continued to offer policy and practice solutions for DHCS to adopt that comported with the state of health center operations and mitigated participating health centers’ risk. We pushed aggressively with DHCS on policies that would meaningfully increase the access and quality footprint of health centers without risking their financial sustainability.

CPCA is proud that we put our energy and efforts into pushing the state to center transformation and value-based care. Despite the unanticipated challenges, we have collectively learned much of value through this process. The APM has already sparked valuable conversation about broader topics related to PPS rate setting and audit processes, assignment practices, and data exchange.

Looking forward, CPCA will continue to foster robust communication with DHCS to address these issues and urge the State to make favorable policy decisions that move health centers into participation by lowering their risk. CPCA will also support CHCs’ understanding of the APM structure so they may make the best business decision about whether to participate. Finally, CPCA will continue to offer forums where clinics can strategize together about how to maximize opportunities for leveraging other Medi-Cal benefits and services to provide critical wraparound supports.

The next opportunity to apply and participate in the APM (Cohort 2) will not be until 2025 for a 2026 implementation. In the meantime, we encourage you to learn more about the APM structure and pre-implementation lessons learned through CPCA’s asynchronous course, California FQHC APM.

medical personnel in white and green scrubs placing hands in the middle of the circle

Population Health Management Strategies to Improve Care

The Population Health Management Initiative (PHMI) is a California partnership of the Department of Health Care Services (DHCS), Kaiser Permanente, and community health centers (CHCs) to co-design and implement the latest population health management infrastructure with the goal to improve quality and health equity outcomes for all patients and families served by California’s CHCs.

In 2021, leaders from 32 CHCs, four Regional Associations of California (RACs), CPCA, DHCS, and Kaiser Permanente came together for interactive sessions to collaboratively align on PHMI, think through ideal future state experiences for patients and care team members, and brainstorm solution concepts to consider for detailed design of the PHMI change package.

This past year, participating PHMI CHCs received nine months of practice coaching and subject matter expertise on “Building the Foundation” competencies, including:

1

Developing a business case for PHMI sustainability

2
Enhancing capacity to report data and monitor key quality measures
3
Implementing empanelment methodology and developing continuity reports
4
Building high-functioning care teams to provide population health management services

We also worked together to identify key “Populations of Focus” and related quality outcomes we’d like to measure to see improvement. These measures are directly aligned with APM to help organizations align payment structure with equity-based population health. Throughout 2023, PHMI CHCs focused on the “Building the Foundation” areas with metrics that are most meaningful for the care they deliver and the people they serve.

Additionally, PHMI successfully completed a proof-of-concept for the PHMI Platform with three CHCs and one RAC. The PHMI Platform is an opt-in technology enablement solution to support CHC population health management needs and PHMI goals, including data integration (e.g. claims and eligibility, clinical, ADT), care management, quality management, and data and reporting. PHMI has recently launched Release 1 for the PHMI Platform, where activities have included establishing platform governance through a new advisory council, initiating data acquisition activities, and facilitating tech grant funding for CHC implementers.

PHMI is continuously offering free population health management resources, including implementation guides, clinical guidelines, a capabilities assessment tool, and best practices around expanding specific population health management capabilities. These resources support any organization interested in population health improvement for providers and practices in the Medi-Cal delivery system.

Not surprisingly, we recognized through this initiative that the ability to effectuate PHMI relies heavily on favorable FQHC reimbursement policies. We anticipate leveraging the lessons learned in PHMI to offer case studies into important policy changes that support value-based care delivery.

Looking ahead to 2024, we are excited about the next phase of the PHMI, the implementation of a Learning Action Network (LAN) in partnership with the new Practice Transformation Partners. The LAN will support our CHC cohort with statewide and regional in-person and virtual peer learning opportunities. It will also introduce coaching and access to subject matter expertise around Populations of Focus, health information technology, equity, and social health. Combined, these efforts aim to educate and inspire CHCs’ already stellar progress towards population health management.

Taking Strides Toward Justice, Equity, Diversity, and Inclusion

JEDI Peer Network

The JEDI Peer Network aims to promote Justice, Equity, Diversity, and Inclusion, share best practices and actionable items to operationalize JEDI in the CHC workforce, and explore how it supports optimum quality measures and patient outcomes. Thank you to LifeLong Medical Care, Santa Cruz Community Health, and Alliance Medical Center for presenting to the Peer Network and sharing their journey of implementing diversity, equity, and inclusion programs within their respective organizations.

Supporting Black Communities (SBC) Peer Network

The vision of the SBC Peer Network is to achieve health equity for Black communities by improving education and outreach efforts, removing barriers to healthcare access, and addressing internal biases and racism. Presentations and discussions have focused on understanding and addressing historical racial trauma resulting in Black institutional mistrust and ways CHCs can develop partnerships and projects to address these challenges, build opportunities, and create trust for Black and African American patients and communities. Presenters have also shared “how-to” strategies to support and address issues impacting Black patients and communities.

Internal JEDI Taskforce

The CPCA Internal JEDI Taskforce was developed to recommend systems, policies, practices, and activities that remove barriers (racism, discrimination, and all forms of oppression) and create a culture of belonging at CPCA so that our workforce feels fully valued, fully heard, and fully engaged. The taskforce is comprised of 12 CPCA staff members from diverse backgrounds committed to promoting justice, equity, diversity, and inclusion for all groups and identities. The role of this task force is to recommend to Senior Leadership practices, policies, and initiatives that fulfill approved microstrategies.

Leadership Equity Program (LEP)

The LEP Program shared a collective vision that all patients, their communities, and marginalized populations in California have equitable access to resources and assets that promote and sustain joy, peace, security, and well-being. This year, 14 participants graduated from Cohort 3 of the program, which was comprised of 16 virtual sessions and three in-person meetings focused on leading and advancing strategic change for their organizations and communities centered around Justice, Equity, Diversity, and Inclusion (JEDI). Cohort participants also developed a community well-being capstone project centered on creating health equity teams, and they participated in executive coaching to advance their leadership goals. Over 25 executive team members participated in four capacity-building sessions focused on advancement practices, the creation of a JEDI-centered and innovative organizational culture, and racial and structural equity. Executive teams also participated in organizational coaching to develop and advance a JEDI-centered bold step with their respective organizations.

ENGAGING COMMUNITIES

Prioritizing Civic Engagement

CPCA’s new Civic Engagement and Community Affairs (CECA) department was formed this year with support from The California Endowment. The CECA Department includes five new staff positions, including Vice President of Civic Engagement Lindsey Freitas.

Under the CECA umbrella, CPCA and AltaMed Health Services have partnered on My Vote. My Health. (MVMH)TM, or Mi Voto. Mi Salud., a statewide non-partisan initiative that seeks to mobilize health professionals and health care institutions to serve as civic engagement advocates, and to help patients and community members understand how negative social determinants of health are connected to low civic participation and voting.

Logo for My Vote. My Health civic engagement program. My Vote is in red and My Health is in blue. Below are the titles AltaMed Health Services and California Primary Care Association in black

The MVMH campaign was developed by AltaMed Health Services to mobilize patients, families, and residents in their Southern California service areas to address the social and political determinants of health. The expanded MVMH initiative was launched during CPCA’s Annual Conference. The initiative is geared to increase voter engagement in low propensity Latino communities in six regions across the state for the 2024 election: Fresno County, Los Angeles County, Orange County, San Diego County, Santa Clara County, and Sonoma County.

Over the next year, this project will launch voter outreach efforts in the six regions, encouraging voters to show up. This effort seeks to engage 270,000 low propensity Latino Voters, 560,000 community health center patients, and 4000 community health center staff in non-partisan, non-issue related efforts to encourage the civic health of our communities.

CPCA’s Civic Engagement team will also partner with other community healthcare providers and local civic engagement organizations to help increase Latino civic participation to improve the quality of life of underserved and underrepresented communities locally.

Member Engagement

To emphasize member engagement, recruitment, and retention, CPCA expanded the membership department by adding the role of Associate Director of Member Engagement.

In this position, Elle Grant prioritized efforts to complete a member market analysis, develop and implement the Health Center Site Visit Program, and worked to support staff more broadly in member engagement activities. 

Health Center Site Visit Program

CPCA launched the Health Center Site Visit Program in August during National Health Center Week. Through the program, CPCA aims to increase health center visibility, increase connection between Health Center and CPCA staff, and support CPCA’s goal of knowledge sharing across the state. The Site Visit Program also allows CPCA staff to hear best practices implemented by health center organizations across the state, serving as a source of inspiration and learning. The program kick-off included 19 health center visits throughout the week of August 6-12, with a total of 33 visits for the year as a whole.

Measuring Member Satisfaction
CPCA’s annual Membership Satisfaction Survey continues to be a valuable tool in evaluating the effectiveness of our work and engagement of our members. This year, 184 individuals responded to the survey. An overwhelming 91 percent reported finding high value in their CPCA membership. The areas reported for highest member engagement included trainings, peer networks, committees, workgroups and task force discussions.

Of the recommendations offered for ways to improve membership satisfaction, the top area was training. Specifically, recommendations centered around more closely aligning training content with relevant and current-day priorities, such as payment models, Medi-Cal, and quality improvement efforts. To that end, CPCA staff have begun auditing existing recorded content to identify opportunities for additional training in 2024. Additionally, CPCA continues to assess training platforms and outreach efforts to ensure that both the training products and the tools and resources meet members’ needs.

Connected Community Continues to Grow

CPCA’s Connected Community peer learning platform, adopted to provide a means for CHC staff to connect with their peers across the state, continues to increase in value for our members since it launched in 2019.

In all, Connected Community houses 38 communities which are spearheaded by members and supported by CPCA staff. Last year, 691 conversation threads were posted on subjects such as recommendations for call center oursourcing, medical record releases, and retinal screening. The most utilized feature in Connected Community is the resource library. In 2023, 190 resources were uploaded and more than 1,200 resources were downloaded across our communities.
photo of the back of a person with a blue shirt and short hair flexing their arms and backlit by the sun

EMPOWERING CHANGE

Climate Change

Photo of desert with Joshua Trees and sunset

Creating a resilient and sustainable healthcare system that addresses climate challenges

The California Primary Care Association (CPCA) is committed to supporting health centers in building capacity to become resilient to the impacts of climate change, ensure the continuity of essential healthcare services, and protect the health and wellbeing of communities in the face of environmental challenges.

CPCA recognizes that climate change is essential to public health, and led efforts this year to create a more resilient and sustainable healthcare system that addresses climate challenges while advancing health equity.
Climate Change Workgroup

This year, CPCA’s Climate Change Workgroup convened to formulate strategic priorities that inform CPCA’s programmatic and policy efforts in climate and environmental health:

  • Influence Legislation, Policies, Programs, and Funding: Advocacy plays a crucial role in driving meaningful change. By actively influencing legislation, policies, programs, and financial investments, we can advance climate change, environmental health and justice issues that directly impact health center operations, patient wellbeing, and community health.
  • Promote Sustainability Practices at Health Centers: As healthcare providers, we have a responsibility to mitigate the healthcare industry’s contribution to the climate crisis. Promoting sustainability practices within health centers not only reduces our carbon footprint but also builds resilience to the impact of climate change on our operations and access to care. By implementing sustainable measures, we can lead by example and inspire positive change in our communities.
  • Integrate Climate Health Practices into Care Delivery Models: Recognizing the profound impact of climate change on public health, it is imperative to integrate climate health practices into our care delivery models. This approach ensures that health centers are equipped to address the unique health challenges arising from climate change. By incorporating climate health considerations into our daily operations, we enhance our ability to provide comprehensive, patient-centered care that prioritizes the wellbeing of our communities.

The momentum and leadership of CPCA’s Climate Change Workgroup were recognized by the Health Resources and Services Administration’s PCA Learning Collaborative. The workgroup’s leadership was invited to speak during an educational session on promoting climate change resilience at health centers, held on May 10, 2023. The session featured insights into the impact of climate change on health and access to care, the imperative of integrating climate health practices into care delivery models, and experiences in forming climate change workgroups at both the association and health center levels.

Additionally, CPCA’s 2023 Annual Conference featured a dedicated session titled “Leveraging Innovative Strategies to Build Climate Resilient Community Health Centers” as part of its strategic leadership track. The session underscored the pivotal role of CHCs as critical hubs for climate health adaptation, further highlighting the transformative potential of innovative strategies to benefit communities disproportionately affected by climate change.

CPCA encourages all members interested in learning more about climate change initiatives to join the Climate Change Workgroup. Together, we can create a stronger and more resilient healthcare system that effectively addresses the challenges posed by climate change while advancing health equity.

Pursuing Federal Infrastructure Funding
In an exciting first for CPCA, this year brought an opportunity to pursue a federal infrastructure grant aimed at bolstering climate resiliency at CHCs. In partnership with Collective Energy Co., CPCA applied for the Department of Energy’s Renew America’s Nonprofits funding opportunity, a $50 million investment under the Bipartisan Infrastructure Law. Our application sought the maximum funding of $9 million to subaward energy efficiency upgrades at health center facilities; reducing energy costs, freeing up resources for patient care, programs, and operations, all while reducing environmental footprint and enhancing community resilience.

CPCA received remarkable support from our partners, including 11 letters of commitment from consortia and 20 CHC organizations. The competition was intense—over 2,400 organizations expressing interest and only nine awards granted— and while the outcome of our application was not what we had hoped for, our commitment to the cause remains unwavering.

We are excited to apply the insight and experience gained to position CPCA in a strong place for future opportunities to secure funding that advances clean energy resiliency at health centers across California.

As we continue to navigate the path towards a more sustainable and resilient future, we welcome any questions or further discussions on this journey. Please feel free to reach out to Amanda Carbajal, CPCA’s Associate Director of Health Center Operations, at acarbajal@cpca.org.

Emergency Preparedness

against a background of smoky air, mountain, and grassland, image of sign saying "Today's Fire Danger" with graph labeled low, moderate, high, and extreme. The arrow points to extreme.

Enhancing Emergency Management Capacity for Public Health and Emergency Response

As community health centers (CHCs) continue to navigate an evolving landscape of public health and climate-related emergencies, the California Primary Care Association (CPCA) continues to be vigilant and proactive to support CHCs take on these challenges, strengthen their emergency management programs, and continue providing care to their patients and communities.

Public Health Emergencies
Navigating the Unwinding of the COVID-19 Public Health Emergency

After three years, the COVID-19 Public Health Emergency (PHE) and associated national emergency declaration ended on May 11, 2023.

To facilitate the unwinding of the PHE, CPCA held an All-Member call on March 20th to provide insights about the changes the expiration of the PHE would bring and how it would impact CHCs and their patients. CPCA staff also compiled a PHE Unwinding Dashboard intended to provide summaries, important dates, and other resources related to the expiration of the PHE.

Additionally, the Emergency Management Peer Network hosted a training on developing After Action Reports / Improvement Plans (AAR/IPs) for the COVID-19 pandemic, which includes a recap of the requirements for AAR/IPs for emergency responses within the CMS Emergency Preparedness Rule and other grant/accreditation programs.

Supporting Health Centers with Vaccine Access and Reimbursement

This year saw vast changes in the COVID-19 landscape. During the COVID-19 PHE, health centers were provided with free COVID-19 vaccines by the federal government. These free doses were accessible to all health center patients. Following the end of the PHE on May 11, 2023, the process for receiving COVID-19 vaccines changed. Health centers now purchase their own supply through wholesalers or receive free doses through local health departments and/or the California Department of Public Health (CDPH). Unlike before, these free doses are now only accessible to eligible providers and to uninsured or underinsured patients. Health centers must use their purchased supplies of doses for patients with public and private insurance.

To support health centers during the transition to commercialization, the Department of Health and Human Services released “Bridge” funding to the Centers for Disease Control (CDC) and the Health Resources and Services Administration (HRSA). This funding added an additional layer of complexity to the new post-PHE vaccine environment. To help health centers navigate these complexities, CPCA provided extensive training and technical assistance to health centers throughout the year, with a marked increase in fall 2023 of member communications, individualized technical assistance to health centers and health center staff, and external efforts to support health centers in the transition of COVID-19 vaccines to the commercial market.

CPCA continues to provide support to health centers challenged with accessing increasingly costly vaccines, including newer RSV vaccines. While CPCA will not be addressing vaccines through its 2024 policy platform, CPCA will continue to represent health centers through various communications with state and federal partners. CPCA will also continue to provide resources, training, and technical assistance opportunities to health centers to support their efforts vaccinating their patients and their communities.

Responding to Climate-Related Emergencies

At the beginning of the year, numerous winter storms and a series of atmospheric rivers brought heavy rain, snow, and strong winds. During the summer, the first-ever Tropical Storm Watch was issued for the state, triggered by Hurricane Hilary’s landfall that was predicted to impact much of Southern California. Many of these climate-related incidents prompted multiple emergency declarations, some by both the Governor and the President, and ensured funding and resources were made available to impacted communities.

Through outreach and communication efforts, CPCA staff learned that many members’ operations and patient care were impacted during these events due to flooding, power outages, unsafe driving conditions, and road closures. We acted quickly to connect members with available support, including funding through FEMA and the U.S. Small Business Administration and our disaster relief partners, Americares and Direct Relief.

As CHCs continue to confront the increasing frequency and intensity of climate related events, CPCA will continue to support CHC preparedness, response, and recovery efforts, and advocate for needed funding and resources to build resilience.

Enhancing Emergency Management Capabilities
Training Events

Two training events offered by CPCA brought together health center staff from a variety of disciplines and professional levels to learn strategies and promising practices that enhance emergency planning efforts and build community resilience. The Emergency Management Succession Planning Workshop marked a significant milestone, being the first day-long, in-person training at the CPCA office in Sacramento since the onset of the pandemic. This event focused on the long-term implications of emergencies on workforce management, as well as a review of continuity and succession planning strategies.

The 2023 Emergency Preparedness Symposium also welcomed attendees back in-person. For a deep dive into the symposium’s sessions, see the conferences and events section. Both events provided CHC staff an opportunity for learning, collaboration, and knowledge sharing.

Training Resources

Thanks to the participation and input from Emergency Management Peer Network (EMPN) members, and in partnership with Westward Disaster Consultancy, LLC, CPCA developed two new resources to support CHCs in preparing for, responding to, and recovering from certain incidents. First, a video series helps staff recognize the signs of a potentially violent scenario and implement steps to de-escalate. Designed to be used during a training session or staff meeting, these videos are easy to implement, relevant, and respectful of patient vulnerability and communication barriers.

Second, CPCA commissioned the creation of a case study report to examine the magnitude of Public Safety Power Shutoff impacts on CHCs and their communities. The report outlines key findings, possible strategies to help CHCs become more power resilient, and recommendations for further investment and advocacy.

CPCA staff continues to support the EMPN, which brings members together to discuss emergency management issues such as business continuity planning, drills, exercises, and preparedness training. The EMPN meets virtually for one hour every quarter.

If you would like updates, additional information or have questions about CPCA’s Emergency Management efforts, please reach out to our Emergency Management team:

Ivan Prado, Program Coordinator of Health Center Operations and Emergency Management: iprado@cpca.org

Amanda Carbajal, Associate Director of Health Center Operations: acarbajal@cpca.org

workforce

diverse group of health care professionals, including different ages, gender and race

The California Primary Care Association (CPCA) is committed to growing and diversifying the health care workforce, inclusive of the variety of disciplines and professional levels.

Our cross-department and cross-disciplinary team of staff worked on several different initiatives and projects to ensure that community health centers (CHCs) were well represented and had access to a variety of resources that met their needs.

This work includes both policy and programmatic efforts and spans the range of workforce development activities – from health professions education and training to recruitment and retention.

Recruitment and Retention

Data-Informed Workforce Development

CPCA partnered with Gallup to conduct the 2023 Workforce Development Survey, which yielded profound insights on key priorities and challenges clinics are experiencing. The top challenge clinics reported in 2023 was managing the rising cost of labor and subsequent wage compression. A majority of health centers (54 percent) support enhancing the employee experience to bolster recruitment and retention. In light of CPCA’s 2023 Workforce Development Survey, CPCA continues to host a series of trainings and technical assistance opportunities that align with key challenges and priorities.

Continuing to focus on the importance of data in modern-day recruitment and retention, CPCA partnered with Gallagher surveys to collect and analyze CHC compensation data, as we do each year. CPCA’s 2023 Compensation & Benefits Survey, both the final report and webinar offering a deep dive into the data, were provided in January 2024.

SB 525 Implementation

As a response to the passage of SB 525, CPCA developed an internal SB 525 implementation team dedicated to providing comprehensive support and resources for members as the law went into effect. CPCA launched a members-only SB 525 resource webpage which houses all implementation tools, including a Frequently Asked Questions (FAQ) document that addresses key questions from members and recordings of webinars and office hours. Additionally, CPCA hosted a webinar with employment law attorney, Treaver Hodson, to discuss employment law considerations for CHCs, including who are covered employees under SB 525, contract considerations with subcontractors, and best practices for implementing SB 525 at CHCs. The recording for the employment law webinar can be found on CPCA’s OnDemand training portal. CPCA remains in discussion with key stakeholders throughout the implementation process and continues to work with external legal experts to update member resources.

Health Professions Education & Training

Sharing Promising Practices

CPCA created two promising practices that showcase innovative opportunities for CHCs to “grow their own” workforce and build strategic partnerships. Both resources— trainee retention and leveraging Community Health Workers/Promotoras/Representatives (CHW/P/R)—were developed through in-depth interviews and feedback from CHCs across California. The trainee retention promising practice discusses how positive learning experiences, mentorship, and career development opportunities encourage trainees to pursue careers in CHCs. The CHW/P/R resource showcases how CHCs integrate CHW/P/Rs to improve health outcomes and increase efficiency. These resources are free and available on the CPCA store.

Teaching Health Centers

Given newly enacted limitations that have disproportionate impacts to Teaching Health Center (THC) funding, CPCA met with Department of Health Care Access and Information (HCAI) and wrote a stakeholder letter alongside the California Academy of Family Physicians to call for critical changes to the Song Brown Primary Care Residency application. The Song Brown Program prioritizes funding for physician residency programs that recruit and graduate racially and ethnically diverse cohorts of residents. THCs perform well compared to other program applicants given their commitment to recruiting physicians that come from and represent their communities. Advocating for changes that decrease restrictions to THC funding facilitates training of diverse physicians in community health centers.

CHW/P/Rs

CPCA wrote a recommendation letter and attended various stakeholder meetings with the CA Department of Health Care Access & Information (HCAI) to offer CHC feedback on CHW/P/R certification and training. CPCA is also involved in statewide CHW coalitions, created a frequently asked questions (FAQs) resource to support CHW/P/R billing, sat on an advisory board with the CA Department of Health Care Services (DHCS), supported a statewide survey on CHW’s roles and has hosted two webinars to provide health centers with innovative ways to employ and train CHWs. The HCAI certification process is being paused until 2024 but CPCA will continue to follow and advocate for the CHW/P/R workforce within CHCs.

For questions on promising practices, teaching health centers, or CHW/P/Rs, contact Araceli Valencia, Program Coordinator of Health Professions Education, at avalencia@cpca.org

NP/PA Postgraduate Training

CPCA, alongside our affiliate, CPCA Advocates, championed new state investments in nurse practitioner (NP) and physician assistant (PA) postgraduate training, which were secured through the budget process and AB 204. This year, CPCA engaged existing NP and PA postgraduate programs in CHCs to obtain their feedback on funding and application process and to shape critical discussions with the Department of Health Care Access and Information (HCAI), who is implementing the application. CPCA shared this feedback with HCAI and supported outreach to ensure programs knew key dates. Awards are to be released early 2024. Contact Nataly Tellez, Director of Health Center Operations, at ntellez@cpca.org with questions.

A Spotlight on Advancing Access to Oral Health Care

CPCA recognizes the importance of ensuring health centers have the financial resources and regulatory flexibility to provide and enhance comprehensive, accessible oral health care. The following initiatives not only enhance the capacity of health centers to deliver quality services but also contribute to improving the overall oral health outcomes of the patients and their families served by community health centers (CHCs) across the state.

Ensuring Regulatory Flexibility

This year, we achieved significant success in ensuring the flexibility and comprehensiveness of dental care delivery at health centers. In collaboration with member dental directors, we engaged with the Department of Health Care Services (DHCS) Medi-Cal Dental Program and Audits & Investigations (A&I) to address member concerns regarding current DHCS dental provider policy and future Center for Medicare & Medicaid Services (CMS) dental audits. Our advocacy led to several key outcomes:

  • Policy Clarification: DHCS agreed to update the language in its Medi-Cal dental provider policy, explicitly stating that health centers can provide both covered and non-covered services during the same visit. This revision enhances the flexibility of dental care delivery, ensuring that health centers can better meet the unique needs of their patients.
  • Training Collaboration: DHCS and CPCA collaborated to develop training on documentation best practices. This training provides ongoing support for health center dental programs, helping them operationalize and comply with DHCS’s dental provider policy effectively. You can access the training recording and materials here.
  • Ongoing Collaboration: Quarterly meetings between CPCA and Medi-Cal Dental Program leadership were established. These meetings foster ongoing collaboration, enabling us to address emerging issues that impact health center dental programs promptly.

Regarding future CMS health center dental program audits, our efforts also led to a significant development. We successfully secured a delay in the timeline for the resumption of audits in California. This extension, from August 2023 to April 2024, ensures that health centers have adequate time to implement the dental provider policy effectively.

Furthermore, A&I agreed to only engage with CMS on dental audits after this date if CMS’ contractors express interest in resuming health center dental audits. This proactive approach safeguards health centers’ ability to comply with policy changes.

State Budget Implementation

  • CalAIM Dental Program: This year, CPCA continued to help CHC dental programs implement the CalAIM (California Advancing and Innovating Medi-Cal) Dental initiative, which seeks to improve access to dental care with incentives to Medi-Cal dental providers that increase the use of preventive oral health services, establish dental homes, and add two new statewide benefits to the Medi-Cal Dental Program. CPCA leveraged its quarterly Dental Director Peer Network meetings to provide health centers with strategies and best practices to operationalize the program requirements.
  • Community-Based Dental Rotation Grant Program: CPCA has partnered with the California Dental Association (CDA) Foundation on the implementation of the 2022-23 state budget’s $10 million grant investment to create new and enhanced community-based dental student rotations. Through our participation on the grant advisory committee, we successfully educated committee members and state regulators on how CHCs are uniquely positioned to be prime candidates for this grant opportunity given the communities they serve and their Health Professional Shortage Area designation. As a result, CDA and the California State Dental Director of the California Department of Public Health Office of Oral Health reached out to CPCA staff to strategize and partner on recruitment efforts of health center dental program applicants. CPCA is excited to share that, as of December 2023, three grant applications have been approved by the advisory committee with 11 health center partner organizations receiving funding for their dental student rotation program. The advisory committee will continue to review funding applications on a rolling basis through January 2026. CPCA encourages health centers with existing or potential dental infrastructure to explore partnership opportunities with participating dental schools to ensure the funds draw down to health center dental programs.

To learn more about CPCA’s oral health work, contact CPCA’s Associate Director of Health Center Operations, Amanda Carbajal, at acarbajal@cpca.org.

Behavioral Health

black family sitting on a couch with the father smiling at the mother holding the child while a white woman observes

2023 was a thrilling year for developments in the behavioral health space.

California continued its push to modernize and integrate the behavioral health delivery system through policy and regulatory reforms like the Behavioral Health Services Act ballot measure and early implementation barriers facing California Advancing and Innovating Medi-Cal (CalAIM) initiatives.

CPCA was committed to helping community health centers (CHCs) navigate these proposals to support the increased demand for behavioral health services facing the safety net. We also forged important relationships with delivery system and community partners aimed at joint advocacy, like the expanding recognition of Certified Community Behavioral Health Clinics (CCHBC) among California providers.

We continue to offer peer networking opportunities for health centers through the Behavioral health Peer Network and newly adopted Specialty Behavioral Health Task Force (intended to support health centers with county specialty contracts and/or CCBHC programs).

New Benefits and Services

The Department of Health Care Services (DHCS) submitted a State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services to implement dyadic care as a new benefit for youth and their caregivers. Dyadic care is a form of treatment that targets family wellbeing as a mechanism to support healthy child development and mental health. When coupled with regular well-child visits and family therapy (also a Medi-Cal benefit), dyadic care is a nice complement to wholistic behavioral health services for children and youth. CPCA continues to deliberate the dyadic care reimbursement structure with DHCS that affords sustainability for health center providers. CPCA was also awarded a multi-year grant from DHCS to provide training and technical assistance to health centers on the dyadic care model. More updates on the training plan and updates on billing/coding for dyadic care services to come in 2024!

Behavioral Health Policy Addressing Homelessness in California

However, last year the Governor’s administration worked with the legislature to revise how funding is disseminated within the MHSA, leading to decreased funding for services that exist today. These changes include allowing funds to go towards addressing substance abuse disorder (SUD), changing the name of the MHSA to the Behavioral Health Services Act (BHSA), but without increasing funding for these services. The new BHSA would also require counties to allocate 30% of their funds towards housing support while defunding prevention and early intervention services, which CHCs help to provide.

Counties and their contracted providers, like CHCs, will be forced to cut services that were previously funded by MHSA if voters approve to transition to BHSA through Proposition 1 in March. CHCs have reported using MHSA funds to support programs that expand their behavioral health service in a culturally and linguistically appropriate manner. This includes programs that are provided in different languages, including Spanish and Asian languages. Services being offered in these programs include mental health education, community outreach, workshops, individual and community consultations, referrals, support groups and preventative counseling to diverse communities. With MHSA dollars CHCs can expand their behavioral health workforce to include providers, such as community health workers/promotoras, traditional healers, or peers, that are not covered by Medi-Cal or the prospective payment system (PPS) that FQHCs are funded under.

CPCA worked with CHC members and behavioral health advocates to voice concerns regarding the newly proposed BHSA. We were successful in getting some amendments, such as increasing funding originally proposed for prevention and early intervention, expanding community defined practices and allowing counties more flexibility to move dollars between buckets. However, we werent able to maintain current funding levels for prevention and early intervention and innovation buckets under the MHSA.

To further respond to the homeless crisis in California, legislation was passed that increases the ability to institutionalize individuals with severe behavioral health issues. This includes the passage of the Community Assistance, Recovery and Empowerment (CARE) Court initiative & SB 43 helping to expand involuntary conservatorships.

More specifically, SB 43 expands the definition of “gravely disabled,” for purposes of involuntarily detaining an individual with a severe substance use disorder (SUD), or a co-occurring mental health (MH) disorder and a severe SUD, or chronic alcoholism that leads that individual to be unable to care for themselves and their medical needs.

Given that California is moving towards increasing involuntary institutionalization, we are hoping investments can be made to fund the needed infrastructure and behavioral workforce to implement these initiatives. We are concerned that California’s behavioral health system is working to expand services without properly funding these expansions. Like much of the United States, California is facing a workforce shortage, this must be addressed to ensure proper implementation of new behavioral health initiatives.

Workforce

In 2023, we saw that, of the top five most challenging roles to fill in clinics, Licensed Clinical Social Workers was second, confirming the challenge health centers face in recruiting and retaining mental health providers. We were delighted to see health centers adopting the Associate workforce to a high degree; Associate Marriage and Family Therapists (MFTs) and Associate Clinical Social Workers became PPS eligible providers under the billing NPI of their supervising clinicians). Late in the year, we also saw Medicare adopt MFTs and Mental Health Counselors as billable providers, which will add parity between coverage types and increase access to services. The State intends to submit a SPA to also include Licensed Professional Counselors as a Medi-Cal billable provider within FQHCs.

Social Drivers of Health

Health outcomes of populations are more often determined by social factors than by medical care.

According to Healthy People 2030, social drivers of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks; and while the estimated impact of clinical care on health outcomes is 20 percent, SDOH can affect as much as 50 percent, making it a huge focus for overall population health.

Community health centers (CHCs) have a history of, and commitment to, addressing community health needs and have a unique opportunity to delve into assessing and understanding the root causes of poor health such as education, poverty, housing, violence, and other SDOH issues. Strong partnerships across sectors help engage key stakeholders and pool efforts and resources to address SDOH.

CPCA is committed to helping CHCs address the SDOH affecting patients. This past year, we assisted CHCs in understanding the screening tools available, collecting patient-level data with the necessary workflows, building partnerships, and understanding the resources in their community through the following:

California Social Health Network

In April and November 2023, CPCA spearheaded pivotal meetings with the California Social Health Network (CSHN), strategically identifying programmatic and policy goals for cross-sectoral approaches to address SDOH in the state. These sessions facilitated the exchange of insights and prioritization of organizational goals. Notably, CPCA shared the current landscape of SDOH data collected at CHCs, aligning priorities for 2024 policy and programmatic partnerships. Building on this momentum, CPCA actively engaged with individual CSHN members, fostering connections and amplifying shared goals and interests in SDOH advocacy and data collection.

Following this series of impactful engagements, CPCA participated in The Root Cause Coalition Summit in Kansas City, Missouri in December 2023. Here, CPCA showcased the origins and emerging partnerships of the CSHN to a national audience, reinforcing the commitment to addressing SDOH on both state and national levels.

Z Codes

CPCA, in collaboration with Blue Shield of California and various electronic health record (EHR) vendors, successfully completed the recruitment phase of the SDOH Z-Codes Pilot Project in fall of 2023. To support the CalAIM Population Health Management initiative and overcome challenges of collecting SDOH data, the California Department of Health Care Services issued a list of 25 priority SDOH codes (Z codes) for managed care plans and providers to use when coding for SDOH. Quantitative and qualitative feedback gathered from 23 health centers across EHR vendors revealed key insights. Variations in Z-code integration and limited workflows due to time constraints highlighted adaptability and the need for enhanced workflow management. Balancing automation with specificity in billing and progress notes emerged as a challenge, offering opportunities for careful ongoing enhancement. Effectiveness challenges in digitization and automation, especially with older patients, prompted a call for refined strategies for continuous improvement. Continuous review of assigned Z codes and limited patient willingness to share SDOH information highlighted the need for ongoing enhancement and tailored patient engagement strategies.

SDOH Screening Learning Cohort

CPCA is excited to announce the launch of our SDOH Online Learning Cohort available via CPCA OnDemand Trainings. Building on the success of our SDOH screening learning cohorts, this initiative focuses on engaging stakeholders in the Protocol for Responding to & Assessing Patients’ Assets, Risks & Experiences (PRAPARE). The program now features interactive webcasts on an online platform, providing ease of access, a broader audience reach, and flexible engagement.

The course equips participants with skills to analyze and respond to SDOH data, empowering them to address the root causes of health inequities. In addition to training CHC staff in SDOH data collection using PRAPARE, the cohort fosters a shared learning environment and connects participants to regional resources. This initiative reflects our commitment to supporting CHCs in incorporating SDOH components into their clinical workflows and work environments.

Training & Techinical Assistance

In 2023, CPCA continued to provide timely, informative, and high-quality training and technical assistance (T/TA) to the community health centers of California.

statistic against blue background reads 88 training opportunities

With a gradual return to more of our hybrid and in-person offerings, CPCA hosted 88 learning opportunities exclusive of conferences and symposiums, that were attended by nearly 5,000 registrants.

statistic against blue background reads 960 technical assistances instances

Staff provided 960 instances of phone, email, and in-person technical assistance to California’s CHCs. Popular topics included 340B/pharmacy transition, billing, PPS, workforce, and licensing and certification.

CONFERENCES & EVENTS

CPCA’s 2023 Conferences and Events Were a Great Success!

CPCA’s conferences and events offer engaging learning and networking opportunities for our members, partners, and community health stakeholders. These convenings leverage our collective strength, insights, and strategies to contribute to the advancement of our state’s community health centers (CHCs). By coming together and sharing knowledge, contacts, and ideas, we all grow.

Along with our annual conference, CPCA offers four boutique conferences and two symposiums, each focusing on different aspects of our healthcare system and bringing together top decision makers and key players. Attendees leave CPCA events informed and inspired to push forward on our shared vision of providing high quality, accessible care to all. Here’s a look back at our 2023 conferences and events.

Symposiums
Workforce Symposium
CPCA’s 2023 Workforce Symposium was convened virtually, recognizing the value of easy-to-access content for a wide-ranging audience. We brought together 99 attendees on January 24-26, 2023 to share best practices related to recruitment and retention, compensation, employee wellbeing, and other key workforce challenges and opportunities. We were pleased to welcome experts from academic partners, consortia, law firms, and consultants, each providing unique insights in the field of workforce development.
Emergency Preparedness Symposium
Ninety-four attendees joined CPCA’s annual Emergency Preparedness Symposium in person on April 13-14 at the California Endowment in Sacramento. Francisco J. Silva Esq., CPCA President and CEO, kicked off the event by highlighting CHCs’ critical role during the COVID-19 pandemic in ensuring an equitable healthcare response. Session speakers offered invaluable insights and practical approaches to bolster emergency preparedness programs at CHCs. Sessions covered critical topics, including:
  • Complying with emergency preparedness rules
  • Creating effective preparedness exercises
  • Building an integrated emergency management program
  • Using a trauma-informed approach to discuss emergency planning with diverse populations
  • Active shooter and “Stop the Bleed” training
CPCA remains committed to supporting CHCs providing essential care to their patients and communities, and extends its gratitude to attendees, speakers, and symposium sponsors for contributing to the success of the 2023 Emergency Preparedness Symposium.
Boutique Conferences
Quality & Technology Conference
On March 2-3, 2023, 269 attendees gathered in beautiful Sonoma County for our annual Quality & Technology Conference. General sessions, kicked off by CPCA President and CEO Francisco J. Silva, Esq., focused on continuous learning models and data sharing. Breakout sessions explored various aspects of quality improvement, population health management, and leveraging technology. What brought attendees to this event? One participant stated “This was my first time attending the conference and I LOVED IT! From networking and learning pearls from other health center peers to engaging in meaningful discussions around moving the quality needle, this was a rich experience.” CPCA is proud to bring together leading voices to share their expertise in the ever evolving and changing landscape of healthcare access, payment, and quality at this annual event for health center QI, HIT, Data, and Clinical Teams.
Day at the Capitol
CPCA Advocates’ Day at the Capitol brought together 237 health center advocates and leaders to Sacramento on April 26, 2023 to have their voices heard. This annual event is an opportunity for health centers and consortia to organize meetings with their legislators and staff about top priorities. Read the CPCA Advocates Annual Report for more details of this exciting event.
Financial Conference
On May 31 – June 2, 2023, CPCA hosted the 2023 Financial Conferences for Billing Managers and CFOs in San Diego, CA. Four hundred and thirty-four participants convened to learn about topics related to billing and finance systems, processes, and opportunities for health centers. Session topics included revenue cycle management, compliance, alternative payment methodology, KPIs, revenue growth opportunities, Medi-Cal and Medicare billing, and more. This year, CPCA increased the peer learning and networking opportunities available to attendees through a designated peer learning session, driven by member needs. As always, our valued sponsors and exhibitors participated in networking opportunities, raffle prizes and giveaways. Thank you for your support!
Region IX Clinical Excellence & Leadership Conference
CPCA is committed to supporting our clinicians to build joy and achieve successful outcomes in their work. We know that when clinicians are supported, patients benefit. That’s why we partner with the Western Clinicians Network (WCN) each year to host the Region IX Clinical Excellence and Leadership Conference. This event brought together 206 participants in San Diego on June 27-29, 2023. Attendees include Chief Medical Officers, Medical Directors, Dental Directors, Behavioral Health Providers, and fellow clinicians as well as CEOs, COOs, and state, regional, and national community health leadership to exchange knowledge and develop new strategies for clinical excellence. CPCA President and CEO Francisco J. Silva, Esq. provided opening remarks, followed by WCN Board President Dr. Javier Luna, PhD, and general session speakers Dr. Ron Yee, Chief Medical Officer at the National Association of Community Health Centers, and Dr. Sue Lin, then Acting Director of the Office of Quality Improvement, Health Resources and Services Administration. Conference sessions provided valued insights into the current landscape and explored emerging issues such as integrating oral and behavioral health, addressing burnout, clinical innovations, and more. Combined with exciting exhibitor networking opportunities in a beautiful location, this was not a conference to miss!
Annual Conference
On October 12-13, 2023, CPCA members, partners, stakeholders, and supporters of community health gathered at the iconic Westin Bonaventure in Los Angeles, CA for our premier convening – the 2023 CPCA Annual Conference. The theme, “Innovation & Impact: Engaging Communities, Empowering Change,” was woven throughout the event. The opening session started with a musical performance from the Urban Voices Project (UVP) choir, which partners with a health center and uses the power of music to meet the mental and physical needs of residents of LA’s Skid Row neighborhood. Marilyn, a choir member and patient, shared how she has gotten her blood pressure under control through regular appointments at the health center, coupled with UVP choir practice. Urban Voices Project uses music to change minds and bodies. Talk about innovation! CPCA’s President and CEO Francisco J. Silva, Esq. opened the conference immediately after this performance, thanking the choir and going on to share his own story in a powerful speech. Dr. Bob Ross, CEO at the California Endowment, delivered a powerful “farewell letter” to the audience, sharing his lessons learned and advice for carrying forward the movement of health access and equity. CPCA is honored to have had a longstanding relationship with the California Endowment and to have Dr. Ross join us to share his words of wisdom. Dr. Kyu Rhee, President & CEO at the National Association of Community Health Centers (NACHC) shared why NACHC believes we are stronger together, and how, as a unified system, community health centers in California and across the country are making an impact. During the conference, CPCA celebrated the official launch of the civic engagement program (for more details, click here and we were honored to feature community and civic engagement leader Maria Teresa Kumar on our general session stage. Kumar is a groundbreaking leader in the civic engagement space, and her organization Voto Latino has been recognized nationally for increasing voter registration amongst underrepresented communities. She shared her experience and advice for effective civic engagement and was joined on stage for Q&A with Dr. Rakesh Patel, CPCA’s incoming board chair. Dr. Patel also took a moment to share his vision for CPCA and California’s health centers in the coming year when he officially received the gavel from outgoing board chair Paulo Soares. To close out the conference, CPCA honored key figures in the CHC movement in California. The awards ceremony was a chance to thank these critical players in advocating for and sustaining thriving health centers. Our awardees are nothing short of amazing, and CPCA thanks them for their years of service, commitment, and accomplishments on behalf of California’s community health centers. Congratulations to:
  • Judy Belk, Senior Advisor, The California Wellness Foundation, following her tenure since 2014 as president and CEO
  • Mary Renner, former Chief Operating Officer, Central Valley Health Network (CVHN)
  • Luisa Buada, RN, MPH, CEO, Ravenswood Family Health Network
  • Colleen Curtis, President and Chief Executive Officer, United Health Centers (2008-2022)
  • Debra Drew, retired Chief Executive Officer, Camino Health Center
  • Reymundo c. Espinoza, MPH, Chief Executive Officer, Gardner Family Health Network
  • Brenda Storey, former Executive Director and CEO, Mission Neighborhood Health Center (MNHC)

Sponsors and Exhibitors
CPCA thanks our sponsors and exhibitors whose products and services support health centers. Our annual sponsors support the mission of community health centers, working with CPCA to provide a year-round presence showcasing their products and services to streamline health center operations, care coordination and delivery, and more.CPCA also acknowledges all event sponsors and exhibitors for their presence at our conferences and events. Thank you for your support!

CPCA MEMBERSHIP

CPCA strives to be a strong Association, one that is built on staff and member partnership, developed through engaged members giving constructive feedback to staff to make informed decisions and direct priorities. This process creates meaningful, rewarding, and insightful connections that promote trust, increase the value of membership, and enhance the member’s experience with CPCA.

Looking ahead to 2024, we look forward to learning more about our members’ accomplishments and how CPCA can better assist members in any challenges they are facing.
CONSORTIA

Alameda Health Consortium

Aliados Health

California Consortium for Urban Indian Health

Central Valley Health Network

Coalition of Orange County Community Clinics

Community Clinic Association of Los Angeles County

Community Health Association Inland Southern Region

Community Health Partnership

Essential Access Health

Health Alliance of Northern California

Health Center Partners of Southern California

North Coast Clinics Network

Planned Parenthood Affiliates of California

San Francisco Community Clinic Consortium

Southside Coalition of Community Health Centers

COMMUNITY HEALTH CENTERS

Alexander Valley Healthcare

All for Health, Health for All

Alliance Medical Center, Inc.

AltaMed Health Services Corporation

Altura Centers for Health

American Indian Health & Services

AMH Comprehensive Medical Centers dba CareMed Community Health Centers

Ampla Health

Anderson Valley Health Center, Inc.

APLA Health & Wellness

Arroyo Vista Family Health Center

Asian Americans for Community Involvement

Asian Health Services

Asian Pacific Health Care Venture, Inc

Avenal Community Health Center

Axis Community Health

BAART Community Healthcare

Bartz-Altadonna Community Health Center

Bay Area Community Health

Big Sur Health Center

Borrego Community Health Foundation

Camarena Health

Camino Health Center

Celebrating Life Community Health Center

Center for Comprehensive Care Diagnosis of Inherited Blood Disorders

Central City Community Health Center, Inc.

Central Neighborhood Health Foundation

Chapa-De Indian Health Program

Children’s Clinic Serving Children & Their Families

Chinatown Service Center Family Health Clinic

Clinica De Salud Del Valle De Salinas

Clinica Monsenor Oscar A. Romero

Clinica Sierra Vista

Clinicas del Camino Real, Inc.

CommuniCare+OLE

Community Health Centers of the Central Coast, Inc.

Community Health Systems, Inc.

Community Medical Centers, Inc.

Comprehensive Community Health Centers, Inc.

DAP Health

Davis Street Community Center Inc.

Dientes Community Dental Care

East Valley Community Health Center, Inc.

Eisner Health

El Dorado County Community Health Center

El Proyecto del Barrio, Inc.

Elica Health Centers

Equity Health

Families Together of Orange County

Family Health Care Centers of Greater Los Angeles

Family Health Centers of San Diego

Family Health Matters Community Health Center

Family HealthCare Network

Fresno American Indian Health Project

Friends of Family Health Center

Gardner Family Health Network, Inc.

Golden Valley Health Centers

Harbor Community Health Centers

Harmony Health Medical Clinic and Family Resource Center

Health and Life Organization, Inc. (H.A.L.O.)

HealthRIGHT 360

Hill Country Community Clinic, Inc.

Hurtt Family Health Clinic

Indian Health Center Of Santa Clara Valley, Inc.

Indian Health Council, Inc.

Inland Behavioral & Health Services, Inc.

Innercare Formerly Clinicas De Salud Del Pueblo, Inc.

Jewish Community Free Clinic

JWCH Institute

Kings Winery Medical Clinic / Greater Fresno Health Organization

La Clinica de La Raza, Inc.

La Maestra Community Health Centers – City Heights

LifeLong Medical Care

Livingston Community Health

Livingstone Community Health Clinic

Long Valley Health Center

Los Angeles Christian Health Centers

Los Angeles LGBT Center

MACT Health Board

Marin City Health and Wellness Center

Marin Community Clinic

Mendocino Coast Clinics, Inc.

Mendocino Community Health Clinic, Inc.

Mission City Community Network, Inc.

Mission Neighborhood Health Center

Mountain Valleys Health Centers

Native American Health Center

Neighborhood Healthcare

North East Medical Services

Northeast Community Clinic

Northeast Valley Health Corporation

Northeastern Rural Health Clinics

Omni Family Health

One Community Health (Cares Community Health)

Open Door Community Health Centers

Operation Samahan, Inc. dba OPSAM Health

Parktree Community Health Center

Peach Tree Healthcare

Petaluma Health Center

QueensCare Health Centers

Ravenswood Family Health Network

Redwood Coast Medical Services, Inc.

Redwoods Rural Health Center

Ritter Health Center

ROADS Community Care Clinic 

Saban Community Clinic

SAC Health System

Sacramento Native American Health Center

Salud Para La Gente

Samuel Dixon Family Health Centers, Inc.

San Benito Health Foundation

San Fernando Community Health Center

San Francisco Community Health Center, Formerly Asian and Pacific Islander Wellness Center, Inc.

San Ysidro Health

Santa Barbara Neighborhood Clinics

Santa Cruz Community Health Centers

Santa Rosa Community Health

School Health Clinics of Santa Clara County

Share Our Selves

Shasta Cascade Health Center

Shasta Community Health Center

Shingletown Medical Center

Sierra Family Medical Clinic

Sonoma Valley Community Health Center

South Central Family Health Center

Southern California Medical Center

Southern Trinity Health Services

St. John’s Community Health

St. Jude Neighborhood Health Centers

St. Vincent De Paul Village, Inc.

T.H.E. Health & Wellness Center

Tarzana Treatment Center

Tender Care Community Clinic

The Achievable Foundation

Tiburcio Vasquez Health Center, Inc.

Tri-State Community Healthcare Center

TrueCare

Unicare Community Health Center

United Health Centers of San Joaquin Valley, Inc.

Universal Community Health Center

University Muslim Medical Association (UMMA) Community Clinic

Valley Community Healthcare

Valley Health Team, Inc.

Venice Family Clinic

Via Care Community Health Center

Vista Community Clinic

Watts Healthcare Corporation

WellSpace Health

West County Health Centers, Inc.

West Oakland Health Council, Inc.

Western Sierra Medical Clinic

Westside Family Health Center

White Memorial Community Health Center

Wilmington Community Clinic

Winters Healthcare Foundation

EMERITUS MEMBERS
Carl Coan
Irma Cota
Debra Farmer
Susan Fleischman, MD
Harry Foster
Cathy Frey, MHA
Naomi Fuchs
Jose Joel Garcia, JD
C. Dean Germano
John Gressman
Nik Gupta
Ray Hamby
Sherry Hirota
Marty Lynch
Tracy Ream
Gladys Sandlin
Stephen Schilling
Ralph Silber
Mike Sullivan
Sophie Wong

Peer Networks

CPCA understands the power of peer-to-peer learning, which is why we offered 24 different peer networks in 2023 for members to connect with peers who work in health centers throughout the state. These peer networks provide an opportunity to exchange valuable information, share best practices and templates, and provide feedback on state association activities, policies, and training programs.

340B Peer Network

Alternative Payment Method (APM) Peerk Network

Behavioral Health Peer Network

Billing Managers Peer Network

Chief Executive Officer (CEO) Peer Network

Chief Financial Officer (CFO) Peer Network

Compliance Officer Peer Network (COPN)

Consortia Policy Group (CPG)

Dental Directors Peer Network

Emergency Management Peer Network

Health Information Technology Peer Network

Health Professions Education & Training (HP-ET) Peer Network

HIV Prevention Peer Network

Human Resources Peer Network

Immigration Peer Network

IPA/Clinically Integrated Networks Peer Network

Justice, Equity, Diversity and Inclusion (JEDI) Peer Network

Outreach & Enrollment Peer Network

Primary Care Peer Network

Public Affairs Peer Network

Social Determinants of Health Peer Network

Special Populations, Agricultural, Rural Peer Network

Statewide Quality Improvement Committee (SQIC) Peer Network

Supporting Black Communities Peer Network

CPCA STAFF

Executive Leadership

Francisco Silva
President & Chief Executive Officer

Joseph Cachuela, Esq.
General Counsel

Ginger Smith
Chief Operating Officer

Sonja Spowart, CPA
Chief Financial Officer

Finance

Eva Avila
Finance Coordinator

Hortencia Avila Lopez
Associate Director of Finance

Jeanette Hernandez
Finance Coordinator

Lydia Ossentjuk
Assistant Director of Budget Management

Steve Robinson-Burmester
Controller

Civic Engagement & Community Affairs

Lindsey Freitas
Vice President of Civic Engagement & Community Affairs

Ayo Taylor
Assistant Director of Strategic Communications & Public Affairs

Carlos Aguilera
Associate Director of Civic Engagement

Denise Chavez
Civic Engagement Coordinator, Fresno

Graciela Silva
Civic Engagement Coordinator, Santa Clara County

Joanna Valdez Castro
Civic Engagement Coordinator, San Diego

Health Access & Quality

Cynthia Keltner
Vice President of Health Access & Quality

Allie Budenz
Director of Population Health Management

Takhmina Amin-Rahbar
Associate Director of Data Science

Phanit Dy
Associate Director of Care Transformation

Yarin Gomez
Senior Program Coordinator of Care Transformation

Charlotte Labbe
Senior Administrative Coordinator

Ekeoma Nwadibia
Senior Coordinator of Quality Improvement

Lucy Saenz
Deputy Director of Data Informatics

Jesus Torres
Senior Program Coordinator of Data Science

Development & External Relations

Kearsten Shepherd
Vice President of Development & External Relations

Kokaale Amissah-Aidoo
Deputy Director of Events & Continuing Education

Katie Cappello
Assistant Director of Marketing & Communications

Chelsesa Coss
Senior Grant Coordinator

Abby Nuño
Sponsorship & Trade Show Coordinator

Ashley Owens
Assistant Director of Development

Courtney Rodseth
Marketing & Communications Coordinator

Rachel Tyberg
Event Coordinator

Leadership Equity

Buddy Orange
Senior Vice President of Justice, Equity, Diversity & Inclusion

Lizbeth Bayardo Cardenas
Assistant Director of Leadership Equity

Operations

Christina Hicks
Vice President of Operations & Membership

Heather Barclay
Executive Assistant and Board Liaison

Glenna Davido
Senior Member Services Representative

Rosie Gilb
Director of People Operations

Elle Grant
Associate Director of Member Engagement

Becky Paplanus
Executive Assistant to the CEO

Erin Perry
Deputy Director of Member Learning

Tiffany Ruvalcaba
Assistant Director of Member Learning

Daniel Sanchez-Cruz
People Operations Specialist

Shelby Toth
Senior Administrative Assistant

Kimberly Yost
Deputy Director of Finance

Government Affairs

Dennis Cuevas-Romero
Vice President of Government Affairs

Kelley Aldrich
Associate Director Legislative Affairs

Taylor Beckwith
Associate Director of Grassroots Activity

Victor Christy
Director of Political Engagement

Taylor Jackson
Deputy Director of Government Affairs

Marisa Melendez
Senior Administrative Assistant

Liz Oseguera
Assistant Director of Policy

Laura Sheckler
Deputy Director of Policy & Regulatory Affairs

Legal Affairs & Health Center Operations

Nataly Tellez
Director of Health Center Operations

Denise Alfaro
Senior Administrative Assistant

Amanda Carbajal
Associate Director of Health Center Operations

Isaias Iniguez
Associate Director of Workforce Development & Special Populations

Mahnoor Khan
Associate Director of Legal & Regulatory Affairs

Ivan Prado
Program Coordinator of Health Center Operations

Catrina Reyes
Deputy General Counsel

Emily Shipman
Deputy Director of Health Center Operations

Aracei Valencia
Program Coordinator of Health Professions Education

CPCA FINANCIAL STATEMENT

Summary of 2022 - 2023

(April 1, 2022 – March 31, 2023)
Consolidated Statements of Activities
CPCA and AFFILIATES
NET ASSETS WITHOUT DONOR RESTRICTIONS REVENUES:
Grants and Contributions$6,710,501
Membership dues$3,356,037
Clinic support services$1,126,062
Conferences$1,174,758
Training and workshops$1,252,984
Interest income from loans$481,355
Interest and investment incomes$14,926
Other income$47,479
Net assets released from restrictions$4,466,978
Total revenues$18,631,080
NET ASSETS WITHOUT DONOR RESTRICTIONS EXPENSES:
Program Services:
Clinic Operations Support$15,337,802
Legislative$946,168
Loan program$237,845
Total program services$16,521,815
Management and General$2,659,407
Total expenses$19,181,222
INCREASE (DECREASE) IN NET ASSETS WITHOUT DONOR RESTRICTIONS  ($550,142)
NET ASSETS WITH DONOR RESTRICTIONS:
Grants and contributions
$22,334,367
Net assets released from restrictions($4,466,978)
INCREASE (DECREASE) IN NET ASSETS WITH DONOR RESTRICTIONS$17,867,389
INCREASE (DECREASE) IN NET ASSETS$17,317,247
NET ASSETS, Beginning of Year$18,903,352
NET ASSETS,  End of Year$36,220,599
ASSETS
CURRENT ASSETS:
Cash and equivalents  
$12,945,724
Grants receivable$7,908,641
Dues and accounts receivable$432,174
Current portion of loans receivable$3,291,926
Prepaid expenses$468,724
Total current assets$25,047,189
NONCURRENT ASSETS:
Long-term certificates of deposit 
$926,179
Grants Receivable, Net$7,763,312
Loans Receivable, Net$10,479,987
Property and Equipment, Net$3,578,401
Total Assets$47,795,068
LIABILITIES AND NET ASSETS
CURRENT LIABILITIES:
Accounts payable
$320,898
Accrued expenses$707,116
Deferred revenues$384,350
Current portion of loans payable$1,729,035
Total current liabilities $3,141,399
LOANS PAYABLE, NET$8,433,070
Total liabilities$11,574,469
NET ASSETS: 
Without Donor Restrictions 
$16,602,273
With Donor Restrictions$19,618,326
Total net assets$36,220,599
TOTAL LIABILITIES AND NET ASSETS$47,795,068

2023 FUNDERS

Bureau of Primary Health Care
California Department of Public Health
California Department of Health Care Services
California Health Care Foundation
Center for Data Insights and Innovation
HealthNet
International Pre-Diabetes Center
Kaiser Permanente Community Benefits
Molina Health Foundation
Sunlight Giving
The California Endowment
The California Wellness Foundation
United Health Group

2023 ANNUAL SPONSORS

EXCLUSIVE

PREMIER

ELITE

TRIFECTA