California Primary Care Association

The CPCA consists of more than 800 health centers and community clinics that are not-for-profit in California charged with  provision of health care services that are comprehensive as well as high quality primarily to low-income, underserved and uninsured Californians. The CPCA has however been one of the few providers of health care who has opened  their doors to all people irrespective of them being able to pay for the services, health centers and community clinics play a very vital role in guaranteeing the accessibility to health care services for the people of  California, whereby the program usually serves more than four million patients on annual basis (Bodenheimer and Pham, 2010). However, most of the services are for the people who are not financially well up for instance, almost two-thirds of the beneficiaries of this program are patients with incomes that are below the poverty line set by the federal,  also among this population of patients 83 percent of them are usually living below  the 200 percent of the poverty, whereas almost 50 percent of them usually speak native languages rather than the  English language (California Primary Care Association (CPCA),  3).

Thus the CPCA is the usually the leading program which is recognized all over the state of California as representing the voice as well as the interests of community health centers in California together with their patients (Ethoven and Singer, 1998). CPCA represents numerous community health centers providing health care services that are high quality and comprehensive particularly to Californians, who in other words would have otherwise not been able to access the services of the  health care providers on their own (Miller, 2000).

The main CPCA mission has been the strengthening of its member health centers and community clinics as well as the networks through education, advocacy and services for the purpose of improving the health care status among the communities in which they are situated. Thus since it was formed in the year 1994, California Primary Care Association has been representing as well as unifying the voice of health care providers and that of their patients in California (California Primary Care Association (CPCA),  4).

CPCA’s wide spread membership involves the community and free clinics, that are federally funded as well as the clinics that are federally designated, urban and rural clinics, small and large clinic corporations that are dedicated and determined to special populations and their special health care needs (Bodenheimer and Pham, 2010). CPCA is however designated as the primary care association in the state of California and usually gets the federal program support for the purpose of developing and enhancing services provision for its member clinics.

The CPCA usually works very closely with the Council of Community Clinics in California on a variety of areas, such as the advocacy, quality improvement, emergency preparedness, disease management, case management as well as  health education. Thus the member clinics have been properly working with CPCA and they have continued to benefit from this association in terms of giving an  input regarding to the  legislative issues (Miller, 2000). There has also been increased networking and collaboration with executive directors of these clinics all over the state, as well as  increased accessibility to technical assistance and resources. Moreover, the CPCA’s programs are usually designed for the purpose of ensuring that the community health centers in the state of California are adequately prepared in enabling them to rapidly respond to the  ever changing environment (Bodenheimer and Pham, 2010). Therefore they are on the innovation cutting edge  in the health care provision also they usually  provide diverse programs services in order to make sure that the community health centers are capable of accessing quality technical assistance and training, recent research and analysis, as well as an opportunity to facilitate networking with peers (Sheps, Wagner, Schonfeld et al 1998).

The Community Clinics and Health Centers  initialized as CCHCs works very close with the CPCA in order to actualize their mission which is to mitigate the impacts caused by barriers to health care accessibility such as poverty, immigration status, absence of health insurance, language and culture,  ethnicity, disability, geographic isolation, homelessness, and other varied needs (Rosen, Hawkins, Rosenbaum  et al 1998). This is because such barriers existence still continues irrespective of  recent expansions taking place in the health insurance programs that are publicly supported to cater for the uninsured populations (Bodenheimer and Pham, 2010). Thus CPCA together with CCHCs  usually address accessibility barriers by tailored programs as well as delivery systems offering high quality, culturally appropriate, primary as well as preventive health care services (California Primary Care Association (CPCA),  5).

California’s CPCA and CCHCs are engaged in offering a delivery model which is proven and capable of serving  as a benchmark for addressing the needs of California’s diverse and disenfranchised populations. CCHCs  that works very close with CPCA has developed as an oriented public health model aimed at  reducing health disparities as well as focusing on improving health care provision outcomes for the communities and patients (Ethoven and Singer, 1998).  As stakeholders and policymakers jointly work in developing  health care system more inclusive of the neglected populations of people, the CPCA infrastructure as well as its model delivery system should be acknowledged, supported and also  replicated for  ensuring meaningful and quality health care access for the people of California (Sheps, Wagner, Schonfeld et al 1998).

Moreover, being the providers for the people who are vulnerable in California, CPCA clearly understands  that for it to attain the goal of accessibility of health care for all, then the state of California can’t continue relying on increased expansion of existing health insurance programs that are publicly funded (Bodenheimer and Pham, 2010). Thus  health care access will definitely require: (1) Continuous investment in models of services and delivery that acknowledges as well as appreciating special needs of the people of California; (2) making sound policies aimed at maintaining a responsive attitude towards  the people who continue to encounter barriers to health care; and (3) strategies that are comprehensive to improving the health care status of communities as well as individuals by eliminating or reducing the underlying causes responsible for poor health provision to the underserved communities such as lack of education, unemployment, high-risk behaviors, low wage employment, as well as  unhealthy living conditions.

The CPCA is among the three members of Cal-REC which is the Regional Extension Center in California state whereby the other two members are the California Medical Association and the Public Hospitals Association making up a total of three members. However,  according CPCA reports, the CCHC plays a very vital role in the achievement of safe, affordable and accessible health care services in the state of  California (Bodenheimer and Pham, 2010). Thus for the purpose of alleviating the federal government allocates money to Cal-REC of which the CPCA is a member allowing it to work with providers of health care services as they undergo a transition from records that are paper-based to electronic records (California Primary Care Association (CPCA),  5).

Moreover, as individual members of CPCA, health centers and community clinics participate in joint advocacy, regional collaborations, consensus building, group training and educational forums as well as other shared activities in order to enhance the CCHCs to continue serving their communities’ health care provision needs  through collaboration, innovation and commitment (Sheps, Wagner, Schonfeld et al 1998). However, the CPCA program which is funded by the federal government in overall has led to increased healthcare provision due increase in awareness among the most vulnerable populations in the California state (Ethoven and Singer, 1998). Also the continuous assessment of the implementation of the program has so far led to its success whereby the monitoring and evaluation usually makes sure that the implementation and planning process of the program is in the right track (Rosen, Hawkins, Rosenbaum  et al 1998). All of these are mainly meant to ensure that the program assessment is carried out often in order to make sure it progress can be evaluated (California Primary Care Association (CPCA),  6).

However, as a result of the benefits that accrue from the program then the program can be termed as one of the most successful government interventions in the state of California (Miller, 2000). This is mainly because it has in overall revolutionarized the health care provision in California mainly through the programs and services it offers to its members that are aimed at benefiting the vulnerable populations that cannot afford health care insurance program on their own (Bodenheimer and Pham, 2010). Thus most of the programs that are implemented through the CCHCs ends up improving the health care status of the less fortunate populations hence the improved health care provision facilitated by the funds availed to the health care providers by CPCA translates to better health care services delivery to the CCHC patients as well as communities (California Primary Care Association (CPCA),  6).

Some of the services and programs that are usually offered by the CPCA  may include advocacy it actively involved in representing its members in legislative as well as regulatory forums. CPCA also sets very aggressive advocacy in ensuring and sustaining both federal and state funding for the member clinics and also making sure that the clinics are in a position of offering quality and affordable health care. CPCA  has also placed emphasis on advocacy and education regarding the needs and requirements of special populations (Miller, 2000). In addition to advocacy the CPCA also sustains the research capacity in ensuring accurate and timely analysis and action about legal and  regulatory issues that affects clinics together with their patients. Hence the staffs of CPCA are involved in  monitoring and informing their members of pertinent regulatory and legislative developments likely to affect the clinics (California Primary Care Association (CPCA),  7).

The CPCA has also been committed to provide its members with the technical assistance and training they require in order to be effective in the aggressively managed health care environment in California. This is mostly done to advance health care service delivery by the clinic to the patients (Ethoven and Singer, 1998). Clinics usually  have information and programs access regularly on  diverse timely topics such as federal and state regulatory compliance, leadership development, change management, managed care, financial management, chronic disease management, operational efficiency, quality improvement, technology management, and assurance. Moreover, the CPCA helps member clinics to keep in pace with drastic changes taking place in information and technology systems in  the sector of health care (Sheps, Wagner, Schonfeld et al 1998).

The members of the  CPCA  are capable of  accessing multiple professional forums  that provides networking as well as opportunities for education to clinic professionals and managers. The CPCA Committees and Board  usually brings representatives of individual clinics together for debating and considering the pressing social and political issues the CCHCs  are facing hence collaboratively developing strategic guidance and direction for CPCA activities and programs (Rosen, Hawkins, Rosenbaum  et al 1998). Peer networks are also in place for providing a collaboration forum, sharing of information and strategy development. Peer networks that are available include: CFO, Clinic Emergency Preparedness, Dental Director, Compliance Officer, 330 New Starts and Mental Health. CPCA also dedicates its staff works and resources close to its members for the purpose of enhancing the quality of the clinics’ health care services as well as reducing the health disparities that are documented among the populations that are vulnerable and  served by the CCHCs (Miller, 2000). Thus despite the ongoing educational, training and networking opportunities, an initiative referred to as AQICC-MU  was also established whose main  goal is to help in supporting clinics’ proper use of  information technology in improving operational efficiency clinical outcomes and via data benchmarking statewide, learning communities and regional trainings. Currently  there are approximately 291 clinic sites that are taking part in the initiative (Bodenheimer and Pham, 2010).

Regional collaboration and support is also so much embraced in the entire program of CPCA. This is mainly because of the sheer size, diversity and scope of California, as well as the complexity of health programs usually necessitate the need for both strong presence of clinics statewide as well as solid representation of the interests of clinics both at local and also regional forums (Miller, 2000).  CPCA also seeks out as well as developing strategic partnerships with federal and state foundations, agencies, advocacy groups, national health organizations, and elected officials for the purpose of forging consensus together with establishing coalitions aimed at attaining mutual goals (Ethoven and Singer, 1998). Thus the CPCA has played a leading role in facilitation as well as organizing collaborations in key sectors of concern to the health care providers and also their patients. CPCA is also engaged in regular and frequent strategic communications in order to educate and inform the media as well as  the public on clinic patients, clinic services and critical issues on public policy that affect clinics as well as their patients (Bodenheimer and Pham, 2010). The CPCA public and media relations program is a collaboration between the CPCA together with its members for celebrating the CCHCs achievements and alerting the public as well as opinion makers about pressing health concerns that affect the clinics together with the communities they serve (California Primary Care Association (CPCA),  7).

In conclusion, the CPCA program has been playing a very vital role in the entire of the health care provision sector all over the state of California. It has increased the accessibility of health care facilities to the vulnerable populations that cannot be able to take health care insurance hence this program has greatly contributed to the reduction of health care provision disparities (Miller, 2000). Its implementation, planning and continuous assessment has contributed to its enormous success making it to be one of the most helpful health care intervention program in California state.


Bodenheimer, T. and Pham, H.H. (2010). Primary care: Current problems and proposed solutions. Health Affairs, May;29:799-805

California Primary Care Association (CPCA). Available at: [Accessed on 17 February 2011]

Ethoven, A.C. and Singer, S.J. (1998). The managed care backlash and the taskforce in California. Health Affairs, July;17:95-110

Miller, G. (2000). The California Primary Care Association: protecting community clinics and the people they serve in price-driven health care systems. Harvard: John F. Kennedy School of Government

Rosen, S., Hawkins, D.R., Rosenbaum, E. et al. (1998).State funding of comprehensive primary medical care service programs for medically underserved populations. American Journal of Public Health, March;88:357-363

Sheps, C.G., Wagner, E.H., Schonfeld, W.H. et al. (1998). An evaluation of subsidized rural primary care programs: A typology of practice organizations. American Journal of Public Health, January;73:138-149


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