By Carmela Castellano-Garcia
President and CEO of the California Primary Care Association

I have been President and CEO of the California Primary Care Association (CPCA) for 23 of its 26-year history as the leading voice for California’s 1,300 community clinics and health centers. When COVID-19 hit California, it tested many things about our organization, including our ability to be nimble, member-responsive, and outcome-driven during an unprecedented public health and economic catastrophe. Overnight we had to become a virtual organization, while at the same time our industry was facing financial devastation as shelter-in-place orders discouraged people from seeking non-emergency healthcare. Because our members are paid for face-to-face visits, they have taken a huge financial hit.

Becoming a virtual organization was easier than I had imagined, primarily because we had made some important infrastructure decisions years ago. In 2016, we moved our servers to the cloud in a move that was disruptive and unpopular at the time. We’ve always contracted out our IT needs, and while it’s more costly, it meant we had top-notch IT support which certainly served us well here. Because we had implemented a telecommuting policy as a staff retention effort years ago, we were ready for this change.

COVID-19 changed our organizational priorities in an instant. Instead of planning for our future, we immediately focused on the survival of our industry. In order to do this, we needed to change what most of our staff was working on in a significant way, which led to a complete change in our organizational structure. Within one week of going virtual, we reconfigured ourselves from a departmental structure to one based on small, project-based teams within larger issue-specific pods. Focused on the needs of our members, we were able to deploy staff based on their skill-set, not based on their department or job title.

We also had to look at adjusting our annual budget. We are a nonprofit that relies heavily on membership dues, in addition to grants and other sources of revenue. With our members facing economic hardship, we needed to look at how that might also affect our own financial viability. We immediately revised our annual budget and made the critical decision that we would prioritize people – our staff. As a result, all other areas of our budget were drastically cut, eliminating almost all discretionary spending and travel, and we are now operating much leaner than we ever have. We feel good about our decision to keep our staffing intact as it is in our best interest as we keep an eye toward the future.

As the organization’s CEO, I have found that having a strong leadership team in place during this crisis has been a saving grace. They serve as a tremendous brain trust as we think through and implement these important changes. Having a strong leadership team has meant that I have been able to focus on what was most important when I needed to, and pivot between emerging internal and external priorities. I am able to do what I do best while my team is able to do the same. I am so very proud of what we have been able to do at CPCA, both in meeting members’ needs and being nimble, in these trying times.


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