California voters appear to have overwhelmingly rejected Proposition 44, which would have required community health clinics to spend a majority of their revenue on program services, AP projects.
The measure would have required community health clinics to spend at least 90% of their annual revenue on program services.
The initiative would have imposed penalties on nonprofit Federally Qualified Health Centers that spend less than 90% of their revenue on program services.
Under the measure, the state would have been responsible for reviewing financial reports and investigating clinics that did not meet the requirements. According to the California Secretary of State, enforcement would have cost tens of millions of dollars per year. The initiative would have also directed the state to cover costs by charging the affected clinics fees.
The initiative would have limited additional clinic expenses, such as administrative costs, to no more than 10% of its revenue.
"The California Attorney General would define in more detail which kinds of expenses are related to providing health care services, and which are other expenses, using existing reports to the federal government as a starting point," according to the California Secretary of State's Voter Guide.
Supporters of Prop. 44 said the initiative would have helped keep clinics and executives accountable for how revenue is spent on patient care and services. They add that it would have also increased transparency and reduced wasteful spending.
Brisa J. Barrera, a community clinic worker listed as a supporter in the Secretary of State's Voter Guide, clarified that the measure would not cut clinic funding or reduce services. She said the measure would ensure that every dollar stays in the healthcare system and is spent directly on patients.
American Academy of Pediatrics - California, an opponent of Prop. 44, argued that it would shut down hundreds of community health clinics, which would harm millions of patients.
"By shutting down clinics, Prop. 44 will force millions of patients into already overcrowded emergency rooms — increasing wait times for everyone," said Dr. Susanne J. Spano, President of the American College of Emergency Physicians - California.
Other opponents, including the California School Nurses Organization and California Medical Association, said the measure was poorly written and would have restricted clinics from spending resources on essential services and staff.
