Time to Fight Back Against Graham Cassidy Repeal Bill and Health Center Funding Cliff

California’s Community Health Centers Are at Risk of Losing Funds

Republicans threaten Medicaid AND Unless Congress Acts, Federally Qualified Health Centers will lose 70% of funding by October 1


San Francisco, CA - Right now, community health centers in San Francisco and across California are under two separate threats at the federal level. First, Senators Graham and Cassidy have introduced new Affordable Care Act Repeal legislation that directly attacks California by threatening to take $27 billion from California’s health care system and redistribute it to other states. Should this bill pass, it will block grant the Medicaid program, which will ultimately mean less coverage, less benefits, and less access for millions of Californians.  While our State continues to be invested in Medicaid, (Medi-Cal in California), without billions of dollars in Federal funding our Medi-Cal program will not be sustainable.


Second, unless Congress reauthorizes mandatory health center funding by the end of the month, health centers will see a 70 percent reduction in their grant funding (which is different from the Medicaid reduction proposed in the Graham-Cassidy Bill).  This will have a direct and immediate impact on the health of California communities as 6.2 million Californians rely on health centers for care – that’s 1 in 7 Californians.  This is referred to as the “fiscal cliff.”


San Francisco Community Clinic Consortium’s members serve over 100,000 people, more than 10% of San Francisco’s population..

California will lose over $300 million dollars if Congress does not extend mandatory funding for health centers. Locally, San Francisco could lose over 5 million dollars in federal investment funds in 2018.


Plain and simple: The Graham – Cassidy legislation punishes California for successfully implementing the Medicaid Program following the passage of the Affordable Care Act. If that happens, health centers – who rely heavily on Medicaid funds and treat 54 percent of the expansion population– will be severely impacted. In terms of the fiscal cliff,


“We are appreciative of the support from our California Senators and San Francisco Representatives Nancy Pelosi and Jackie Speier.  We urge all members of Congress to step forward and realize that there is no reason to put the providers of preventive care for millions of Americans at risk. Community Health Centers provide cost effective care and it is disturbing that Congress would even consider de-stabilizing them.    The cliff must be fixed by September 30, 2017.”

Dave Knego, Chairman, Board of Directors, San Francisco Community Clinic Consortium







Grow your career by taking a leadership role in developing the fundraising capacity of this esteemed advocacy organization representing 12 San Francisco health centers serving the Medi-Cal population. Duties span grant writing, donor development, creative communications, and some event planning in a team setting.

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Please Act to Preserve Community Health Center Funding!

Patients, Community Partners & Supporters – we want to let you know that without Congressional action before September 30th, funding that supports the Federally Qualified Health Centers in San Francisco and throughout the country will be cut by 70%. This would be a devastating blow to our Health Centers – one that could lead to site closures, reduced access to care for our patients, and possibly even staff layoffs. We are among 1400 Health Centers nationwide that are facing what is called the Health Center Funding Cliff – if Congress fails to act to fix the cliff, 9 million patients could lose access to care, including over 100,000 patients here in San Francisco. Please help us ask Congress to TAKE ACTION to fix the Health Center Funding Cliff immediately!


While our particular legislators have been, and continue to be, supportive of us and our mission, we need to create a sense of urgency to act before September 30, 2017!  ACT NOW by posting on Facebook and Twitter to your Members of Congress.  For easy instructions, please go to: 




President Trump Declares an End to DACA (Deferred Action for Childhood Arrivals)

Much to the distress of SFCCC and its partner clinics, workforce, and patients, President Trump announced on Tuesday that he was ending the successful DACA program, which allowed immigrants brought into the country as children to be able to work, go to school, and be productive members of society without fear of deportation. 

This is not over yet!  Congress has six months to act by turning President Obama's Executive Order protecting the childhood arrivals or "dreamers"  into legislation, and several state attorney generals are planning lawsuits. Here in California, where about half of the "dreamers" live, our State Leadership immediately spoke up to defend those who have made their lives here and deserve to stay.


For more details on what this means and to take action,  please see weareheretostay.org.






Defend DACA Today!





The Deferred Action for Childhood Arrivals (DACA) program is under threat! The DACA program allows young immigrants the ability to work, study and live free of fear and uncertainty in the country they call home.


On June 15, the Texas Attorney General, along with 9 other states, released a letter asking the President to rescind DACA before September 5 or face a lawsuit against the DACA program. This has led the President to seriously consider ending the DACA program, which he can do AT ANY TIME by rescinding the executive order that put it in place.


As advocates for our patients, we need to make our voices heard in support of the DACA program and its recipients. We ask that you TAKE ACTION by calling the elected officials listed below. You can also find a call script and more information on how you can help protect DACA by going to http://defenddaca.com/ (hosted by the National Immigration Law Center).



  • Texas State Attorney General Ken Paxton (888-343-2060)
  • Speaker of the House, Paul Ryan (213-335-2244)
  • Majority Leader Mitch McConnell (855-336-0788)
  • Representative Mike Coffman (855-336-0898)
  • Representative Martha McSally (855-336-0858)
  • Representative Will Hurd (855-336-0916)
  • Senator Dean Heller (202-640-5612)
  • Representative Pete Sessions (202-629-0434)



  • .@SpeakerRyan, come out publicly to #DefendDACA, and our immigrant community. We are #HeretoStay
  • .@PeteSessions it is time to come out and publicly #DefendDACA, #TPS, immigrant youth and their families.
  • .@SenDeanHeller it is time to come out and publicly #DefendDACA, #TPS, immigrant youth and their families.
  • .@HurdontheHill it is time to come out and publicly #DefendDACA, #TPS, immigrant youth and their families.
  • .@RepMcSally it is time to come out and publicly #DefendDACA, #TPS, immigrant youth and their families.
  • .@RepMikeCoffman it is time to come out and publicly #DefendDACA, #TPS, immigrant youth and their families.
  • .@KenPaxtonTX we are taking to the streets to #DefendDACA & #TPS! Our immigrant community is #HeretoStay
  • .@SenateMajLdr ‏our community is fighting to #DefendDACA, TPS and our families. Come out in support of immigrant youth now!.

If President Trump rescinds the DACA program, 800,000 immigrant youth could immediately lose their right to work in the United States and may face immediate deportation. This would have a detrimental impact on our workforce. Health Centers are already experiencing a severe shortage of health care providers throughout California, and the elimination of the DACA program could further hamper your ability to provide cultural and linguistically competent services. Let’s support our immigrant community!


(This message created by California Health Plus Advocates) 

Did You Know that One-Third of Californians Receive Health Care Through Medi-Cal?

Wewill continue to resist any efforts to reduce funding for the Medicaid Expansion that was created through the Affordable Care Act (ACA) for the following reasons:

The Medicaid Expansion has proven to be one of the most important aspects of the ACA, providing comprehensive coverage to some of the most chronically ill people who have no other healthcare options.

The cost of the Medicaid expansion is shared among federal, state, and local governments, so that collectively everyone is invested in lowering costs and improving care. Continuing this under a per capita cap or a block grant is not possible.

 California’s providers in public and private hospitals, private practices and safety net health centers have embraced Medicaid Expansion because it’s allowed millions of Californians to get covered and receive comprehensive health benefits for the first time. 

 Community Health Centers are the primary care provider to more than 54 percent of the Medicaid beneficiaries in California who gained coverage under the ACA.

More than one-third of Californians are Medicaid beneficiaries.  

Update: Relief from Repeal

Early this morning, a few minutes after Speaker Paul Ryan stated"ObamaCare will stay in place for the foreseeable future." Democratic Leader Nancy Pelosi announced: "What happened on the floor was a victory for the American people, for our seniors, for people with disabilities, for our children, for our veterans."

While advocates against a plan that would have resulted in between 15 and 23 million Americans losing health coverage have prevailed for now, it is important to remain vigilent through future budget processes, where Congress could seek to significantly reduce Federal funding for the Medicaid program (Medi-Cal in California.)  For now, however, thanks to all those who visited, protested, tweeted, wrote letters, called, and tried to bring fact based analysis to what had become a political and emotional fight, we can all breathe a sigh of relief.




Attempts to Take Health Coverage Away Not Over Yet...

While two different versions of ACA repeal have failed this week, an unknown number of Senators are planning to vote on a "skinny repeal" bill.  If they are able to pass this bill, the danger is that it would then be sent tobe reconciled with the House-passed AHCA, which would deprive over 20 million Americans of health coverage. Legislative language on the "skinny repeal" has not been made public, but the danger is that the reconciliation process would result in something that decimates Medicaid like the original House bill.






Motivating Healthy Behavior

SFCCC is pleased to announce that the following people have been trained and certified as faculty in the Institute for Healthcare Communication Choices and Change: Motivating Healthy Behavior course:

·        Alexa Madrid, SFCCC Consumer Advisory Panel Member

·        Cyndi Musto BSN MA, Clinical Nurse Educator, NEMS

·        Jennifer Mangaccat RN Nurse Manager, St. Anthony Medical Clinic

·        John Hunsaker MPP MBA, Director of QI, SFCCC

·        Beth Midanik-Blum MA, Clinic Manager, Women's Community Clinic

·        Maribel Lopez MA Case Manager, Mission Neighborhood Health Center

·        Merrill Buice MPH MCP, Director, Health Care Coverage & Access

·        Octavio Nevarez, QI Manager, HealthRIGHT 360

Thanks to a grant from the Blue Shield of California Foundation, these eight staff and patients representing SFCCC and six of our member health centers can now provide training to providers and front line staff on motivational interviewing techniques and communication skills. Core skills include teaching others to practice empathy, open-ended questioning, and reflective listening, all of which have been demonstrated in clinical trials to increase patient adherence to taking life-saving medication and increase healthy behaviors. These skills will lead to better clinical outcomes, lower per patient cost, and increased patient and staff satisfaction – and improve the quality of life for the communities and 100,000 patients our clinics serve.

For additional information, or the request a training, please contact John Hunsaker, SFCCC’s Director of Quality Improvement, at jhunsaker@sfccc.org or by calling (415) 355-2274.



SFCCC Has a New Interim President/CEO

Yesterday, with laughter and tears, SFCCC staff said a final farewell to SFCCC's leader for 26 years, John Gressman.  While conducting a national search for a new President/CEO, the Board of Directors is pleased to announce that Ms. Beth Schecter has been named Interim President/CEO. 

Beth is a nonprofit consultant specializing in Executive Transition Management. She has over 20 years of executive management experience and has directed four health and social service organizations in Contra Costa, Marin and Santa Clara Counties. She also served as Director of Business Development for WestEd and for United Behavioral Health. Since 2010, Beth has provided interim leadership, planning, board support, and program development services to dozens of organizations. Her primary goal is to help nonprofits become more streamlined and sustainable during pivotal transition times in order to be better prepared for new leadership. She enjoys working with staffs and boards to achieve their financial, fundraising, and programmatic and governance goals.

Advocacy Alert! Senate Vote Delayed! Stories Needed!

The Senate has delayed a vote on the terrible Senate version of "repeal and replace"called the Better Care Reconciliation Act.  Unfortunately, however, they are still moving forward by asking the Congressional Budget Office to score new amendments.  The amendments would not substantially improve the devastating impact of proposed Medicaid cuts.  The amended bill would still take health insurance for working middle and low income working people and use the money saved for tax cuts for the wealthiest Americans.

While our California Senators continue to stand firmly with us, we must continue to encourage our elected representatives to stand up and fight for access to health care for our communities.

SHARE YOUR STORY: Click here to download the Share your Health Center Story template. Please scan and email stories to  and dlahn@sfccc.org.

Patient stories helps legislators understand the scope of care our patients rely on. Health centers are the foundation of community health, providing excellent care and good jobs where it is needed the most!

Communities and organizations around the country are standing up to put patients before politics. With limited time, urge your networks to join in and share their story!

Senate "Health Care" Bill released: Contains Devastating Medicaid cuts

Despite promises to create a "better" repeal and replace bill than the House version, the bill that Senate Republicans released today contains devastating Medicaid (Medi-Cal in California) cuts.  It slows the elimination of the Medicaid expansion, which delays the pain past the time when some legislators must face their constituents, but would still result in millions becoming uninsured.  The Medicaid program would be capped or block granted to the states, and the rate of growth in this bill is lower than the health bill, and far lower than the reality of health care costs.  


What can you do?

Thank our Senators Feinstein and Harris and our Representatives Nancy Pelosi and Jackie Speier for continuing to stand up for the Health of all Americans.

Contact friends, relatives and colleagues in Republican Senatorial Districts and House districts (since the bill will need to be reconciled with the House) and ask them to contact their Republican members to remind them that the health of people in their district will be impacted by this bill.

Write down your story or the story of patients you know and send it to dlahn@sfccc.org.  Our Senators need these stories to defend Medicaid and therefore keep community clinics thriving. 

The picture here ( (Photo: Screenshot/CNBC)  is of protesters with disabilities being carried away from Senator Mitch McConnell's office hallway.

No Sunlight on Senate Health Bill

A small group of Republican Senators are reportedly putting together a Senate Version of the repeal and replace of the Affordable Care Act.  Although they are trying to take a vote on it before the July 4 recess, they are keeping the details carefully guarded, not even sharing information with fellow Senators.  It is likely, however, that it will provide a devastating blow to Medicaid and therefore to the patients we serve. 

The Center on Budget and Policy Priorities has put together a chart based on predictions about the Senate Bill.  http://www.cbpp.org/research/health/tracking-reports-about-the-emerging-senate-bill-to-repeal-the-affordable-care-act.  The House version of the bill was so damaging that we run the risk of policymakers seeing it as a baseline.

What can you do?

Thank our Senators Feinstein and Harris for continuing to stand up for the health of all Americans.

Contact friends and colleagues in Republican Senatorial Districts and House districts (since the bill will need to be reconciled with the House) and ask them to contact their members.

Write down your story or the story of patients you know.  Our Senators need these stories to defend Medicaid and therefore keep community clinics thriving.