By The San Fernando Valley Sun/El Sol Editorial Board
This newspaper, the San Fernando Valley Sun/El Sol, has decided to support the campaign in favor of “No” to Proposition 44.
In 1973, with the support of local civic leaders, the original San Fernando Health Center opened its doors, realizing a vision of building a healthcare system designed around the needs of this community. More than 50 years later, that clinic has grown into Northeast Valley Health Corporation (NEVHC), which now operates more than a dozen health centers in the San Fernando and Santa Clarita valleys, serving over 80,000 patients annually. Care is offered on a sliding scale of fees adjusted to the patient’s income, and the clinics accept Medi-Cal, Covered CA, and MyHealth LA, a program created specifically for Los Angeles County residents without other health insurance options. NEVHC also operates school-based clinics, including one at San Fernando High School.
For a city where a significant portion of families live below the poverty line—a strong predictor of poor health—this type of affordable and accessible care is essential. It often means the difference between a family receiving medical care and going without it altogether. Proposition 44, a statewide measure on the November ballot, would put that model at serious financial risk. This publication urges a “no” vote.
Proposition 44 requires nonprofit community health clinics to allocate 90 percent of their budget to what the federal government calls “direct patient care,” with financial penalties for those that fail to comply. But there is no established definition for this term. Instead, the measure tasks the state attorney general with defining it, using a methodology based on IRS tax returns—a system designed to track how nonprofits report their expenses for tax purposes, not to decide what counts as care that actually benefits patients.
What might not count as “direct patient care”? A case manager who spends an afternoon helping an immigrant enroll in Medi-Cal without fear of putting their family at risk. A receptionist who translates a form into Spanish so a parent understands exactly what they are signing. A staff member who coordinates transportation for a patient without a car so they can get to a follow-up appointment. Under this measure, these services might not count toward the minimum target clinics are required to meet.
The clinics most likely to be penalized are precisely those that do the most difficult and necessary work: building relationships of trust with families who have every reason to distrust institutions. Losing that established trust isn’t something the Attorney General’s formula can measure, but it is reflected in the number of people who stop attending the clinic.
Federal law already requires nonprofit community health clinics to have a majority of patients on their boards of directors, ensuring representation and accountability to the community they serve. Proposition 44 does not build upon that governance model but rather competes with it, adding a new layer of financial risk unrelated to how well a clinic is run.
This measure has generated opposition from all sectors: doctors, teachers, business groups, and both major political parties, including the California Medical Association, the California Teachers Association, and both the state’s Democratic and Republican parties. Local community health centers, including Northeast Valley Health Corporation and San Fernando Community Health Center, also oppose the measure.
The trust between this community and its clinics wasn’t built overnight, and it shouldn’t be jeopardized by a measure that can’t even define what it’s asking the clinics to do. Vote No on Proposition 44.