By Maria Carriedo-Ceniceros
For more than two decades, I’ve had the privilege of practicing family medicine at one of the San Diego region’s largest community clinics. I’ve experienced firsthand the vital role that health centers like ours play in the lives of the families, older adults and children we serve. Community health centers provide essential care for millions of patients across the state, and this care is put at risk with one sweeping motion through Proposition 44.
That’s why I’m gutted at the thought of what Proposition 44 could do to our community.
The measure, sponsored and supported by one politically motivated organization, includes arbitrary requirements that will strip critical resources from health centers — money that would come directly out of the patient care that clinics are centered around.
A study that examined Proposition 44 found that, if the measure were to pass, clinics would be penalized to the tune of $1.7 billion in the first year alone and billions thereafter. To put that in perspective, that means 88% of clinics across California would be operating at a loss and hundreds of clinics across the state would be forced to close or cut services.
While Proposition 44 is a politically motivated initiative from proponents who have long abused the ballot process, it has very real-world implications that will have devastating impacts on millions of lives. More than 7 million patients rely on community clinics across the state — people who would be without access to critical primary care, prenatal care, mental health services, telehealth, dental services and much more if Prop. 44 passes.
Moreover, in eastern parts of San Diego County, like the rural clinic where my son works, community health centers are the only source of care for miles. The nearest hospital and other health facilities are an hour away. If those clinics close their doors, reduce services or cut back hours, patients and workers will be the ones who will feel the burden the most. However, they’re not the only ones.
When primary care is threatened and removed, patients are forced to rely on emergency rooms for their care rather than the preventive care that we know is essential in keeping our communities healthy. If patients can’t get access to care, they delay treatment and wind up in San Diego’s already overcrowded emergency rooms — making wait times longer for everyone, and ultimately, increasing costs for taxpayers and consumers.
What’s worse, Proposition 44 is so poorly drafted with major legal flaws that it financially penalizes clinics if they spend resources on important staff and patient services that the proponents exclude from the definition of patient care.
These penalties would force clinics to cut back on essential staff and services like nurse managers, physician leaders, interpreters, transportation services, information technology that keeps medical records safe, even radiology and mammogram machines.
Community clinics are so much more than just a doctor’s office. We provide the kind of whole-person, whole-community care that ensures our patients have the resources they need at the clinic, and when they leave. That means having patient enrollment staff following up with them, ensuring they are connected to local food banks, and that older adults have access to the activities that keep their community going.
As a physician leader, I know how regulated community health centers already are — between federal and state oversight and regular audits. Most importantly, clinics are living our mission every day — serving the communities where we have opened our doors and ensuring our patients receive the services that are essential for their well-being. This measure is, simply put, wholly unnecessary.
At our clinic, compassion and care for others are at the heart of everything we do. Our staff believe in our mission and ensure patients receive care grounded in respect, dignity and cultural humility. They drive us to improve the health and well-being of every community we serve. We won’t let Proposition 44 get in the way of that.
Join me, along with the doctors, nurses, patients, teachers, advocates of children, business groups, community leaders and more in voting no on Proposition 44.
Carriedo-Ceniceros is president of the San Diego County Medical Society, secretary-treasurer of the California Academy of Family Physicians and chief medical officer at San Ysidro Health.