On February 5, 2018, community health center advocates united across the country in a “Day of Demonstration” aimed at fixing the funding cliff impacting health centers and their patients. Advocates nationwide wore red and voiced concerns to their members of Congress urging them to include health center funding in the budget package that was passed by both houses and signed by the President in the early hours of February 9th. CPCA members throughout California joined with their counterparts in all 50 states and took to social media, traditional media, held events, and put calls into Capitol Hill – showing the strength and solidarity in our movement.
I myself joined colleagues at the Capitol to meet with Congressional members and discuss with them personally what was at stake for community health centers and the communities they serve. I personally met with Congresswoman Judy Chu, Congresswoman Lucille Roybal-Allard, Congressman Tony Cardenas and Congresswoman Doris Matsui – as well as staff for Speaker Nancy Pelosi, Senator Kamala Harris, and Congressman Kevin McCarthy. Throughout our visits, the overwhelming consensus was clear – community health centers have bipartisan support and are greatly valued by all. Unfortunately, we were caught up in the political dysfunction of Washington D.C. This made it even more critical that we rise above the politics of D.C. and make our voice heard in the halls of Congress.
By all accounts we were hugely successful in our efforts, and thanks to our advocacy both chambers of Congress took appropriate action to fix the funding cliff with a two-year extension to health center funding! This is an amazing accomplishment and I want to thank all of the health center leadership, staff, advocates, board members and patients that showed up – both at the Capitol and in their communities – to help us achieve this monumental win. I would especially like to thank the health center leaders that joined me in Congressional District meetings including: Community Health Partnership, Gardner Family Health, North East Medical Services, AltaMed Health Services, and the San Francisco Community Clinic Consortium, among others.
This tremendous effort was led by the National Association of Community Health Centers (NACHC), our national organization, with the help of CPCA staff and one of our federal lobbyists Angie Melton, all of whom played a pivotal role in the overall success of the day. The greatness of the day and the importance of this fly-ins was not lost on me. We are all busy. We all have a million things to do day-to-day. But we cannot lose sight of the critical role these “Days of Action” play in pushing our agendas and promoting our issues, or the fact that our voice is louder when we all come together and advocate as one. We need to continue our efforts on issues that are important to us and the communities we serve – including immigration. While I am very pleased that Congress averted the health center funding cliff, I am deeply concerned about the future for DACA recipients. The Senate will begin their floor debate on immigration legislation next week, and I hope that the House of Representatives shows the same commitment to an open process. DREAMers are an integral part of the fabric of our communities in California – they are patients and, in some cases, employees at our health centers, and they are also our neighbors and friends.
I call on Congress to find a fair solution that allows DREAMers to continue to thrive in their lives as Americans and I hope that you will join me in doing so. We have the opportunity here and now to join together and have our voices heard on DACA. We can build on this momentum and this victory for health centers. I hope to see an even stronger delegation of advocates at NACHC’s Policy and Issues Forum in March and at our own Day at the Capitol in Sacramento in April, because we still have much to fight for!
With all that is going on at the federal level, including the potential loss of 70 percent of federal funding for health centers, it can be easy to lose sight of what is going on here in our own backyard. Our legislative leadership and our Governor have stood up for and continue to protect our immigrant community by making California a sanctuary state and enforcing protections to this population. We are indeed fortunate, especially compared to other parts of the country, considering that California’s proposed budget by Governor Brown had many positives, specifically for our patient population. The Governor remains committed to the ongoing support of vital health programs including the Child Health Insurance Program (CHIP), Medi-Cal and the Affordable Care Act (ACA) – all of which impact our patients. While we don’t take for granted how progressive our state is on many issues, we can’t stand idly by when proposals that undermine our ability to do our work and serve our patients are being considered.
Unfortunately, undermining the safety net is exactly what Governor Brown’s proposal to eliminate the 340B drug discount program from the state’s Medi-Cal program will do. 340B is a federal drug discount program intended to ensure low-income patients receive their prescription drugs at a much-reduced cost. The program also allows the health centers and other safety net providers the ability to utilize the savings (between the discount and the market price of the drug) to reinvest in patient care. The 340B program in Medi-Cal enables health centers to stretch their resources to ensure that underserved and low-income patients receive the necessary comprehensive services they need, services that are beyond the reach of the Medi-Cal program. Without this essential and critical lifeline for the safety-net, there will assuredly be some devastating impacts – ranging from a reduction in clinic hours of operation to the elimination of wrap around culturally competent medication assistance for patients, to staff layoffs.
I remain flabbergasted that this proposal is in the budget. Why would California want to undermine the safety net at this point in time? The Administration is well aware that health centers are facing a dramatic and unprecedented reduction in federal funding unless Congress reauthorizes the health center program. If the funding is not reauthorized, it will be a hit of some $240 million this year and then over $400 million in the years to come. To layer on top, another multi-million dollar hit by eliminating the 340B program from Medi-Cal simply makes no sense. Not to mention Congress’ continued focus on undermining the ACA and the Medicaid program. The safety net does not have sufficient margins or reserves to withstand such dramatic revenue losses without some dire consequences. And these consequences impact the lives of over 6 million patients that consider a community health center their medical home.
In light of this, we must remain steadfast in the protection of programs currently safeguarded as part of the budget. The continued congressional interest in dismantling the ACA was seen in the passage and signing of a Tax Reform bill that included the elimination of the individual mandate. This proposed state budget reminds us that, while the state continues to safeguard ACA coverage options, significant federal funding changes or an ACA repeal could disrupt benefits and coverage.
We must continue to fight for our patients and the programs that impact them. We are asking the Governor to reconsider his misguided elimination of the 340B program and work with health centers and other safety net providers to make the 340B program work for our state and our patients. Join me in advocating for health centers and their patients! Become a health center advocate today – click here to learn more.
National Conference of State Legislators Capitol Forum attendees at San Ysidro Health Centers
I had the great honor of attending the National Conference of State Legislatures Capitol Forum in Coronado, California on December 12th. This event is where legislators and staff from states across the country come to learn the latest on pressing issues and develop the agenda that guides NCSL’s advocacy work on Capitol Hill. This year’s event included an educational component that involved a tour of the San Ysidro Health Maternal and Child Health Center, San Diego PACE, Senior Health Center and San Ysidro Health Center sites. It was a great event and such an amazing opportunity to highlight the great work our community health centers are doing to legislators and their staff from other states.
I was personally moved by the presentation Assemblymember Lorena Gonzalez Fletcher gave at the event. A long-time champion of the community health center movement, she made a point to feature the great work that San Ysidro Health was doing in the community and the vital role they play in the lives of their patients. It was important for this audience to hear the true impact our health centers have, but it was equally important for these legislators to hear about the great relationship San Ysidro Health and Assmeblymember Gonzalez Fletcher have. We are truly lucky to have such amazing legislative leaders here in California – leaders who continue to be our staunch supporters. Assemblymember Gonzalez Fletcher is a true friend to the health center movement.
Carmela and Assemblymember Lorena Gonzalez Fletcher at the NCSL Capitol Forum Event December 12th
Senator Ben Hueso gave a moving presentation at the San Ysidro Maternal & Child Health Center. Senator Hueso spoke so eloquently about the health center movement being born of a time when communities were being left behind – the poorest neighborhoods with the most need were left without access to much-needed health care services. Like the border town where San Ysidro Health was originally established back in 1969, and how the organization had grown to provide high-quality care to thousands of patients through a vast and integrated network of sites throughout San Diego and El Cajon. His words were inspiring and rang so true for us in the room who are so dedicated to the health center movement.
Carmela with San Ysidro Health CEO Kevin Mattson (l) and Sentor Ben Hueso (m) at the San Ysidro Maternal & Child Health Center
Culminating the day with the San Ysidro Health site visit was probably the most exciting part of the event. I had personally never visited the Maternal & Child Health Center before and was blown away by the programs and services they offered – especially the child development services. It was a beautiful site and was a shining example of the all that our health centers offer. We were also fortunate to be able to see the San Diego PACE, Senior Health Center which provides senior support services along with health care services to those in the community.
It was such an incredible day, made even better by all of the wonderful comments I heard from the other attendees on our way back from the site visit. I’m excited and energized to get to work on our own legislative priorities in 2018 and feel so fortunate to be working with Senator Hueso and Assmeblymember Gonzalez Fletcher on important health center issues next year.
Last Thursday, I had the honor of attending the Hispanas Organized for Political Equality’s (HOPE) 28th Anniversary Awards Dinner in Los Angeles. I have always been a strong supporter of HOPE and the important work it does in advancing Latinas. I have always admired the mission of HOPE and think that they are doing wonderful work in ensuring political and economic parity for Latinas through leadership, advocacy, and education to benefit all communities and the status of women. This event had a special significance for me personally, because one of my dear friends was receiving an award. It was made even more memorable as I was joined by some Los Angeles-based CPCA members: Richard Veloz, CEO of South Central Family Health Center; Margie Martínez, Chief Executive Officer of ChapCare; and Dr. Anitha Mullangi, CMO of Saint John’s Well Child & Family Center.
Helen Torres, Executive Director of HOPE, is a powerhouse Latina doing wonderful work to develop future leaders for the state. Serving in this position for more than 17 years, Helen has dedicated her professional life to bettering the lives of Latinas through the advancement of important issues and personal empowerment.
Olga accepting the “Spirit of Hope” Award
I also had the pleasure of seeing my friend of many years Olga Talamante, Executive Director of the California-based Chicana/Latina Foundation, who received the “Spirit of Hope” Award that night. I was overjoyed to see Olga receive this award from HOPE – it is so well deserved. She has been such a trailblazer and a leader within the Latina community for many years now, spending nearly 15 years running the Chicana/Latina Foundation. Prior to that, she spent a number of years relentlessly working to improve and uplift the lives of Latinas. I have always been so inspired by Olga’s boundless energy and her tremendous leadership and dedication. She was entirely dedicated to the Chicana/Latina Foundation as a volunteer Board member long before she accepted a leadership role at the organization.
Olga and I
The Chicana/Latina Foundation has been a grantee of the Castellano Family Foundation (CFF) since its inception over 15 years ago. As a result, I’ve been able to witness Olga’s hard work from multiple perspectives. My mother is a former Board member of the Chicano/Latino Foundation, and she has always been extremely supportive of the organization. When my siblings and I transitioned onto the CFF Board five years ago, we continued that commitment to Olga and her organization and have enjoyed being able to work with her.
Margie Martinez, Myself, and Anitha Mullangi
HOPE and the Chicana/Latina Foundation are two organizations that are making a tremendous contribution to advancing and empowering Latina women. Through this event, I was able to celebrate Olga and HOPE, and all of the amazing work they do. But on a daily basis, I celebrate all the women who are involved and dedicated to advancing and bringing up the next generation of women leaders in our state.
This week we are celebrating community health centers on a national level as part of National Health Center Week. We are celebrating the community health center movement, the historic role health centers have played in community health, and the value they have in our communities – which is especially important in our current political climate.
Community health centers were founded by community health and civil rights activists who fought more than 50 years ago to improve the lives of Americans living in deep poverty and in desperate need of health care. Over the years, health centers have grown to become a model of care throughout the country — offering more services beyond just primary and preventative care, including behavioral health, prenatal care, dental care, nutrition counseling and more. Community health centers are also known for offering patients supportive services that can include nutrition education, translation services, care coordination and case management, transportation to and from health care sites, outreach and enrollment activities.
Today, more than 1,200 community health centers serve the state of California, and provide comprehensive, high quality care to 6.2 million people – one out of every seven Californians. Community health centers are economic engines within their communities. In fact, according to a 2017 report from Capital Link, California’s community health centers contributed more than $8 billion to the California economy and supported nearly 60,000 jobs in 2015. Health center staff and providers are often from the very communities they serve – giving them the unique ability to live, work and give back to their community. Health centers also provide a highly-competitive working environment that offer staff opportunities to build on and learn new skills allowing for upward mobility.
The legislation that created the community health center program also created the Medicare and Medicaid programs, all of which have helped millions of Americans access health care services. These monumental programs, along with the network of community health centers throughout the nation, laid the ground work for the Affordable Care Act (ACA) and helped make it a reality and a success nationwide. Unfortunately, that success is being threatened by the President and certain GOP members of Congress who are working to dismantle the ACA and leave millions without health care coverage. While initial proposals have been thwarted – through the amazing advocacy efforts and the GOP’s own inability to achieve agreement on this issue – the fight is not over.
In addition to the attacks on the ACA, the Trump Administration recently released its proposed budget. While it shouldn’t surprise anyone that it gives tax breaks to the wealthy, the devastating impacts to lower-income Americans and people of color is astounding. Included in these cuts are $800 million to the federal Medicaid program – a program aimed at empowering people and communities to be healthier and thrive. In California alone, 3.7 million people enrolled in Medi-Cal – California’s Medicaid program – under the ACA expansion. Additionally, more than 180,000 undocumented children have enrolled in comprehensive Medi-Cal coverage under the Health4AllKids (Senate Bill 75) expansion. All of these Californians stand to lose their coverage if these cuts to the program are realized.
Trump’s proposed budget also includes cutting the funding to programs aimed at reducing poverty. We all know that where a person lives and what resources are available to them directly impacts their quality of life. Yet, numerous programs that address these critical resources are on the chopping block. For example, Trump would like to see 25 percent ($193 billion) cut from the Supplemental Nutrition Assistance Program (SNAP) – also known as the food stamp program – over the next 10 years.
SNAP, which is called CalFresh in California, is the largest food assistance program in the nation and services about 43 million low-income individuals. Those eligible for the program generally have a gross monthly income at or below 130 percent of the poverty level. Trump’s budget proposes implementing more stringent eligibility and work requirements for SNAP recipients. And what group is the largest recipient of SNAP benefits? Children. According to the Public Policy Institute of California, children are more likely than adults to receive CalFresh assistance – in California 62.2% of low-income children ages 0 to 5, 58.7% of those ages 6 to 12, and 44.7% of those ages 13 to 17 received CalFresh benefits on average in any given month in 2014.
Cuts to SNAP are just the tip of the iceberg. Trump has also proposed cuts to the Children’s Health Insurance Program (CHIP), which provides about 6 million low-income children with health insurance, a $6 billion cut to Housing and Urban Development which provides low-income housing and a cut to the Temporary Assistance for Needy Families (TANF), also known as CalWORKs in California, which gives financial support to extremely low-income parents and children. Additionally, he’s proposed slashing funds for unemployed insurance, the Earned Income Tax Credit, Supplemental Security Income, Social Security Disability Insurance and Social Security Old-Age and Survivors insurance. These cuts to vital programs will hurt our most vulnerable populations the most – negatively impacting the ability of these communities to thrive and be healthy.
But that’s not all – health center funding is also at stake. Policymakers have long recognized the value of community health centers on a bipartisan basis, and have made investments through both Republican and Democratic administrations. A key source of funding for health centers is the Health Center Trust Fund, created by the ACA, which is comprised of both discretionary and mandatory funding and is currently scheduled to expire in September of this year. If Congress does not take action to restore the Health Center Trust Fund to previous levels, grants will be cut by more than $160 million.
While community health centers will continue to treat anyone and everyone who walks through their door, regardless of their ability to pay, the absence of these dedicated funds may force health centers to close some sites, eliminate services, and even lay off health care providers and staff. This would be truly devastating for the many communities our health centers serve throughout the nation. Health centers have been and remain the front line responders in addressing emerging public health challenges, and they generate $24 billion in savings to the health care system every year by efficiently managing and treating chronic disease, even among the most economically challenged populations.
So as we celebrate all that community health centers have accomplished over the next week, let us not lose sight of what is still at stake for so many. Cutting programs that millions of Californians depend on to be healthy is detrimental to everyone. We must remain vigilant against attacks on our most vulnerable and continue to be vocal and advocate for those that need us most. We must come together and support the programs that provide assistance and improve the quality of life of all Californians.
The Castellano Family Foundation, created by my parents, Alcario and Carmen Castellano, recently celebrated its 15th anniversary on June 23, 2017, at the Mexican Heritage Plaza in San Jose. This is such a huge milestone for my family and an important opportunity to reflect on what it means for the Latino community of Santa Clara County to house this unique and extraordinary philanthropic endeavor.
When my father won the lottery in 2001, my family was thrown into the spotlight and the story made national news. After the excitement of their win settled down, they made it a priority to establish the Castellano Family Foundation. Having been committed to the Latino community in San Jose for years, it only seemed right that they found a way to give back to the people that they have so much love for.
The Foundation was founded with a mission to uplift the Latino community in four main areas: education, arts & culture, leadership, and diversity. Over the years, we’ve awarded five million dollars in the form of grants and scholarships, supporting organizations that advance the Latino community. Our grantees are the reason why we continue to do what we do. We are thrilled with their incredible work and the important contributions they are making to Santa Clara County. For example, Movimiento de Arte y Cultura Latino Americana (MACLA), an organization my parents were longtime donors to even before winning the lottery, is supported by the Foundation and we appreciate their continued commitment to celebrating the arts in the Latino community. Somos Mayfair is another important organization we’ve supported that has shown dedication to uplifting Latino leadership, families, and the community in the San Jose Mayfair neighborhood. The School of Arts and Culture at the Mexican Heritage Plaza is an organization my father played a role in helping to establish and we are proud of how far it has come and the role it is playing in advancing the arts among youth. There are many other organizations we have supported over the past 15 years that have been an excellent investment for advancing our mission.
I can’t help but reflect on my parents’ very humble beginnings. My father was a grocery clerk for Safeway and a farmworker in his youth. My mother was an executive secretary at San Jose City College for decades. And in addition to their regular jobs, they were both also working to advance the Latino community by promoting their children’s education, and through championing change as community volunteers. For as long as I can remember, my parents have been active, involved community members in San Jose. From a very young age, they instilled in my siblings and I a love for being involved in and giving back to the community. Attesting to these deeply held values is the fact that, in addition to my mother, my siblings and I now serve as Trustees of the Foundation. Continuing our parents’ legacy of giving back to the community is a role we cherish.
Now that the Castellano Family Foundation is celebrating its 15th year, we debuted something truly special during the anniversary celebration at the Mexican Heritage Plaza on June 23, 2017. It was the premiere of my father’s documentary, “Memories of Cinco de Mayo and 16th of September Celebrations in San Jose 1986-1997” which highlights the phenomenal celebrations that occurred in San Jose as sponsored by the San Jose GI Forum during the 80s and 90s. All the footage and photographs in the documentary were captured by my father and the video represents the only comprehensive record of these historic events.
A few years ago during a visit with my father I sat with him in the family room, watching footage of the fiestas he recorded decades ago in San Jose. Seeing the joy and sense of pride on his face and hearing him speak with a high level of nostalgia concerning his past involvement as a GI Forum volunteer, I knew we couldn’t let this footage continue to gather dust on his office shelves. With the support of the Castellano Family Foundation, we decided to turn his video collection into a documentary. For over two years, my father and I spent hours at a time meticulously looking at each video scene-by-scene to pick out the footage that would later go into the documentary that premiered on June 23rd.
Words cannot accurately express what an amazing experience it was to work with my father on this project. Not only did I help produce the film, I had the privilege of conducting the foundational interview of my father, which ultimately served as the documentary narration. My father speaks with love, passion and humor about a whole range of topics and items featured in the parades and fiestas. From the floats and the ballet folklorico, the music and horses, the food and the low rider cars to the elected officials and the grand marshals. There wasn’t any item in the footage about which he didn’t have an observation or an opinion on its cultural relevance or significance to the community. I learned so much about his passions during this process and am honored to share this part of my father with the community.
My father played a very important role behind the scenes in these fiestas. He was responsible for bringing the unprecedented art show to the San Jose Convention Center, which featured local Latino artists. He took a lead on bringing local community colleges to display at the Fiestas and reach out to our youth. He developed the “Go to School – Stay in School” motto which was prominently featured at the Fiestas to attract youth and encourage them to stay in school. And he played an instrumental role in bringing voter registration efforts to the events. I want people to understand who my father was before he won the lotto. Through this documentary people will come to recognize that his commitment to the community – to arts and culture, education and leadership – the mission of the Foundation – is something he has lived for decades.
The Castellano Family Foundation’s 15th anniversary celebration was truly a momentous occasion and we were honored to share it with the community that it all started in. From the Foundation’s establishment to our father’s documentary, our collective hope is that the Castellano Family Foundation continues to enrich the Latino community in Santa Clara County and beyond.