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Regional dashboard covering 11 Federally Qualified Health Centers across 109 sites in the Sacramento region.
This strategic report is analysis compiled from public sources (HRSA UDS, CMS, WARN Act filings, news coverage, public Glassdoor reviews). Claims about workforce stability, financial positioning, or operational resilience are informational only and may not reflect current operations. For authoritative information, contact the organization directly.
The most important things to know about Sacramento right now. Tap a bullet to jump to the underlying section.
11
across 109 sites
2,218
avg 202 per FQHC
None
No layoffs tracked
3.2/5
9 of 11 rated
How this region compares against the statewide average across the metrics that matter most.
Resilience
69/100
Glassdoor
3.2/5
Open Jobs / FQHC
5
Coverage Vulnerability
31%
FQHCs grouped by exposure to layoffs, low resilience, and H.R. 1 funding impact. Combines resilience score, layoff history, coverage vulnerability, and funding-impact level.
Sacramento · Grade D (46/100)
Sacramento · Grade D (49/100)
Sacramento · Grade B (66/100)
65% patients at coverage risk
Winters · Grade B (66/100)
65% patients at coverage risk
Sacramento · Grade B (70/100)
Moderate exposure
Citrus Heights · Grade B (72/100)
Moderate exposure
Davis · Grade B (79/100)
Moderate exposure
Yuba City · Grade A (87/100)
Sacramento · Grade B (78/100)
Sacramento · Grade B (72/100)
Sacramento · Grade B (72/100)
Average resilience score: 69/100. Distribution of grades across 11 FQHCs.
Search by name or city. Sort any column. Filter by resilience grade or H.R. 1 funding impact.
11 of 11 FQHCs
| Ampla Health - Sacramento Yuba City | Yuba City | 250 | A | 3.7 | 4 |
| CommuniCare Health Centers Davis | Davis | 200 | B | 3.6 | 4 |
| Sacramento Native American Health Center Sacramento | Sacramento | 70 | B | 3.2 | 4 |
| WellSpace Health Sacramento | Sacramento | 375 | B | 2.8 | 5 |
| One Community Health Sacramento | Sacramento | 135 | B | 2.4 | 3 |
| Sierra Vista Community Health Citrus Heights | Citrus Heights | 110 | B | — | 3 |
| Elica Health Centers Sacramento | Sacramento | 600 | B | 2.9 | 12 |
| Health and Life Organization, (h.a.l.o) Sacramento | Sacramento | 391 | B | 4.2 | 6 |
| Winters Healthcare Foundation Winters | Winters | 87 | B | — | 10 |
| Sacramento County Health Center Sacramento | Sacramento | — | D | 3.7 | 8 |
| Cares Community HealthH.R. 1 Sacramento | Sacramento | — | D | 2.5 | 9 |
53 open jobs across 11 FQHCs. No tracked layoffs in the region.
Union organizing, NLRB cases, contract negotiations, strikes, and ballot measures touching FQHCs in this region. Statewide CA cases included.
AB 1113 pursues the same 90% mission-spend ratio through the legislature rather than the ballot box. FQHCs must report total revenues by June 30, 2026, using IRS Form 990 Line 25 (Column B, Part IX) as the basis. DHCS must adopt implementation methodology by January 1, 2027. Includes annual registration fees to fund enforcement. This is a two-pronged SEIU-UHW strategy: AB 1113 through the legislature + the ballot measure as backup/pressure. Opposition campaign active at stopab1113.com.
Next: Jun 30 — FQHCs must report total revenues to department
CA LegislatureSEIU-UHW leads a ballot drive for a one-time 5% wealth tax on California's ~200 billionaires (~$2T combined wealth), projected to generate $100B over 5 years. 90% would fund healthcare programs. If passed, this could be the largest state-level healthcare funding mechanism in US history and would directly offset H.R. 1 Medicaid cuts. This is a rare case where SEIU and FQHCs have aligned interests — more healthcare funding benefits both workers and employers.
Next: Apr 30 — Signature collection deadline (Regan target)
SEIU-UHWSEIU-UHW submitted signatures April 3 for Initiative #25-0008 requiring FQHCs to spend 90% of revenue on 'mission-related expenses.' A Berkeley Research Group study commissioned by Protect Patients CA finds this would redirect $1.7B from community health centers and push two-thirds into operating deficits. The 90% threshold would exclude spending on nurse/physician managers, translation services, enrollment navigators, transportation, community outreach, and new clinic construction. CMA, CPCA, CCALAC, AltaMed, and FHCSD lead the opposition.
Next: Nov 3 — Election Day — measure on the Nov 3, 2026 statewide ballot (formal certification by June 25)
BallotpediaCompanion measure to #25-0008 capping healthcare executive compensation at $450,000 with a 3.5% annual escalator. It QUALIFIED for the November 3, 2026 statewide ballot (~May 12-13, 2026) — now styled the 'Health Care Executive Compensation Act of 2026' — after SEIU-UHW submitted 1M+ signatures. As drafted it covers private hospitals, physician groups, and special-district hospitals and EXCLUDES physician groups with fewer than 25 employees and county hospitals — so it is the pressure/companion measure to the FQHC-scoped 90% initiative (#25-0008), not itself FQHC-specific. Paired with #25-0008 it nonetheless shapes the leadership-pay and resource-allocation environment FQHCs operate in.
Next: Nov 3 — On the November 3, 2026 statewide ballot (Secretary of State slate certification expected ~June 25, 2026)
BallotpediaGovernor Newsom signed AB 288 in September 2025 to allow California's PERB to process unfair labor practice charges and conduct union elections for private-sector employers — including FQHCs — when the NLRB cannot act, lacks a quorum, or faces significant delays. A federal judge issued a partial preliminary injunction on December 26, 2025, blocking PERB from stepping in for cases where the NLRB is merely delayed or lacks a quorum (on federal preemption grounds). The law is on appeal to the 9th Circuit. If AB 288 survives appeal, California can enforce labor law at FQHCs even if the NLRB is defunded or paralyzed under the current federal administration — a critical backstop for organizing drives like Innercare. If struck down, FQHCs facing organizing would have reduced oversight.
Next: Dec 31 — 9th Circuit appeal ruling (date TBD) — determines whether CA can enforce labor law at FQHCs if NLRB is weakened
California Employment Law Update (Proskauer)SB 525 created a two-tier wage structure: hospitals and large health systems reached $25/hr in October 2024, while FQHCs are phased in more slowly ($21/hr now → $22/hr July 2026 → $25/hr July 2027). This 3-year gap creates a structural recruiting disadvantage during the worst workforce crisis in FQHC history. The July 2027 jump from $22 to $25/hr (a 14% increase in one year) is the real compliance cliff. Zero FQHC waivers have been approved by HCAI. SEIU negotiated the legislation — the slower FQHC timeline was a compromise to avoid small clinic closures.
Next: Jul 1 — FQHC minimum wage increases to $22/hr
CA DIR+ 1 more cases tracked
Coalition actions, ballot initiatives, lawsuits, and legislation actively defending FQHC funding and patients in this region.
The Secretary of State announced June 17 that SEIU-UHW's one-time 5% wealth tax on California billionaires QUALIFIED for the November 3, 2026 ballot (it submitted 1.55M signatures April 27 against an 874,641 threshold). The measure earmarks ~90% of revenue for state healthcare programs including Medi-Cal — a direct counter-narrative to H.R. 1 cuts. On June 18, SEIU-UHW offered Gov. Newsom a deal to abandon the 5% measure if he backed a smaller 2% legislative levy on billionaires; Newsom REJECTED those terms ("strongly opposed to a California-only wealth tax"). Per CalMatters, he is both racing to broker a last-minute withdrawal deal before the June 25 deadline AND backing an opposition coalition (including some left-leaning groups) to defeat the measure if it reaches the ballot. It is distinct from (but coordinated with) the SEIU-UHW 90% patient-care-spend (#25-0008) and exec-pay-cap (#25-0009) measures and CHA's counter-measure (#25-0021). Strategic implication for FQHCs: if it survives to the ballot and passes, it would create a dedicated Medi-Cal revenue stream — but it now faces well-funded opposition led by the Governor.
Follow-up: Jun 25, 2026
CalMattersCPCA Advocates — the political arm of the California Primary Care Association — is listed among Xavier Becerra's organizational endorsers (confirmed on his campaign endorsements page, alongside the California Medical Association, the California Academy of Family Physicians, LA County Medical Association, Planned Parenthood Affiliates of California, UAPD, the Union of Health Care Professionals, and UNAC). Becerra — former U.S. HHS Secretary and California Attorney General — topped the June 2 primary (~27%) and advances to the November 3, 2026 general election. He is the most Medicaid-literate plausible governor in state history: he ran HHS during ACA expansion and has centered Medi-Cal coverage continuity, Prop 35, and MCO-tax durability in his platform. The timing caveat matters for FQHCs: even if elected, Becerra is not sworn in until January 2027 — after the December 31, 2026 'triple cliff' — so an endorsement is a long-game bet on the post-cliff recovery environment, not a rescue for the cliff itself. No specific endorsement date is published; recorded here as confirmed in June 2026.
Follow-up: Nov 3, 2026
Becerra for Governor 2026 (campaign endorsements page)The California Hospital Association's counter-initiative — #25-0021, 'Restricts Political Spending by Health Care Unions' — became eligible for the November 3, 2026 ballot on June 5, 2026. It requires healthcare unions with 50,000+ members (i.e., SEIU-UHW) to annually disclose how member dues fund political activity and to obtain majority member approval for such spending. It is a direct counterweight to SEIU-UHW's two qualified measures: the 90% clinic-spending mandate (#25-0008 / Measure 1986, the FQHC-direct threat) and the $450K executive-pay cap (#25-0009 / Measure 1985). Three healthcare measures now sit on the November ballot, and the June 25, 2026 withdrawal deadline opens a classic mutual-disarmament window — a negotiated deal between SEIU-UHW and the hospital industry could pull one or more measures (including the FQHC-threatening #25-0008) before voters ever decide. For FQHC leaders, this means the most consequential clinic-finance measure in California history could be settled in a backroom by June 25, not at the ballot box in November.
Follow-up: Jun 25, 2026
California Secretary of StateThe Community Health Center Fund — ~70% of federal Section 330 grant dollars (~$4.6B/yr), the financial foundation beneath every FQHC's PPS billing — expires December 31, 2026, the same day as CalAIM and the Medi-Cal MCO tax. NHSC mandatory funding was extended only through Jan 30, 2026 and now runs on a continuing resolution (~$350M/yr). NACHC's ask: a multi-year CHCF extension plus $950M/yr in mandatory NHSC funding for two years. 288 House members and 57 Senators have signed Dear Colleague letters, but no standalone reauthorization bill has been introduced — the likely vehicle is a year-end appropriations or reconciliation package. For FQHCs nationally this is the single highest-stakes funding-cliff advocacy of 2026.
Follow-up: Sep 30, 2026
NACHCCalifornia's Department of Health Care Access and Information (HCAI) opened the inaugural application cycle of the Medi-Cal Behavioral Health Recruitment & Retention Program (MBH-RRP) on June 1, 2026 — a BH-CONNECT / Proposition 1-funded workforce program for which FQHCs, Community Mental Health Centers, RHCs, and any setting with 40%+ Medicaid/uninsured patients are explicitly eligible. Awards include recruitment bonuses up to $20,000/hire, retention bonuses up to $4,000, pre-licensure/pre-certification supervision support up to $35,000/year, student support up to $50,000/individual, and licensure/certification fees up to $1,500 (with 2-4 year service obligations scaled to award size). Applications close July 15, 2026 at 3:00 PM. For FQHCs squeezed by H.R. 1 cuts and the July 1 UIS-PPS hit, this is a direct, time-limited behavioral-health staffing subsidy open right now — the state-side complement to the federal H.R. 8629 workforce bill.
Follow-up: Jul 15, 2026
California HCAIAB 1460 would bar drug manufacturers from restricting 340B contract-pharmacy arrangements for California covered entities — closing a gap NACHC's tracker flags (CA is one of ~13 states without this shield). It passed the Assembly (44-6) and is now in the Senate, where it was amended to add annual 340B-compliance reporting and audit requirements — a compromise pairing FQHC/hospital access protection with the transparency demands pharma and others have pushed. For California's 220+ FQHCs, passage would protect a core 340B revenue stream, but the new reporting requirement is operationally meaningful. Opposition has surfaced — the Council for Citizens Against Government Waste (CCAGW) issued a public letter urging the California Senate to reject AB 1460. Pairs with the failed Minnesota 340B bill (a cautionary precedent) and the Eli Lilly / Novo claims-data mandates.
Follow-up: Jun 24, 2026
340B ReportAI implementation news and case studies that mention this region or its FQHCs.
California Health Care Foundation (CHCF) published its Sacramento policy briefing 'Health AI Policymaking: Key Themes' April 2026 — the first formal CHCF positioning on California AI governance. Establishes themes for the 177+ state health-AI bills already noted: oversight committees, bias monitoring, transparency requirements, vendor accountability. Pairs with already-tracked HAIP April 2026 governance brief. Strategic implication: California is moving toward a state-level AI governance framework distinct from federal — FQHCs already constrained by HRSA + Medi-Cal compliance now face a third layer. CHCF's framing typically becomes DHCS framing within 12-18 months. FQHC executives should treat this as the early signal of what AI governance compliance will look like by 2027.
California Health Care Foundation · Apr 2026Sacramento Native American Health Center (SNAHC) adopted AI medical scribes to reduce clinician documentation burden, becoming one of the first tribal health centers in California to implement ambient AI. The adoption addresses a critical challenge: SNAHC providers serve urban Native American, Alaska Native, and surrounding communities with complex care needs, and after-hours documentation was consuming significant provider time. Key lessons: ensure cultural sensitivity in AI-generated content for Native populations, integrate outputs directly into EHR workflows, and start with willing champions before expanding.
Sacramento Native American Health Center · Aug 202531 intelligence items relevant to this region.
Update (June 10): Measure ER has come from behind to WIN. LA County's half-cent (0.5%) health sales tax now leads ~50.4% yes / ~49.6% no — ahead by roughly 24,000 votes out of ~1.9 million counted — after trailing by ~25,500 on June 5 and ~11,500 on June 7; backers declared victory June 10 as the final late-arriving mail ballots broke 'yes' (the count climbed 47.3% → 48.5% → 49.66% → 50.4%). The county certifies by July 2 and the California Secretary of State by July 10, but the outcome is no longer in doubt. The tax takes effect October 1, 2026 (countywide rate 9.75% → 10.25%), raising ~$1 billion a year through 2031 — roughly 45% flowing directly to nonprofit clinics serving uninsured patients, ~22% to LA County Health Services (the hospital and specialty-referral backbone every LA FQHC depends on), and the remainder need-weighted by ED volume — to backfill H.R. 1 Medi-Cal cuts and shore up county hospitals, clinics, and public health. For LA-area FQHCs this is the positive resolution of the central FY2027-28 question: the largest local-government replacement for federal Medicaid cuts in the country now arrives exactly as the July 1 UIS-PPS cut lands and LA Health Services absorbs a >$662M (rising to ~$700M by 2029) federal revenue decline while consolidating three county health centers. It does NOT erase the state-budget risk — LA County's June 8 alarm warns the Sacramento budget (June 15 deadline) could still cut provider rates on top of the federal loss. The statewide pattern now reads 2 wins (Santa Clara Measure A + LA Measure ER) vs. 1 loss (Contra Costa Measure B, ~42% yes): voters will fund a county-anchored health system but rejected Contra Costa's general-fund version.
Sacramento County's recommended FY2026-27 budget totals $8.9 billion (down 2.8% from the prior year) and trims the Health Services base budget by $5.4 million, cuts Correctional Health by $4.1 million, and deletes 194.5 full-time-equivalent positions countywide — with funding for dozens of those positions tied directly to H.R. 1 revenue loss. Adoption hearings run June 10-12 at 700 H Street. For WellSpace Health and Sacramento Native American Health Center, the erosion of the county health backstop accelerates the patient-demand pipeline toward FQHCs without any matching county referral funding.
The California Health Care Foundation released its 2026 California Community Clinics Almanac on May 28 — the authoritative annual dataset on the state's community health center sector. It documents that California's community health centers served roughly 7.4 million patients in 2024, with Medi-Cal the dominant payer, and tracks centers' growing reliance on patient-service revenue as the federal grant share of total revenue continues to shrink. For FQHC CFOs and boards, this is the benchmark report that quantifies why H.R. 1 Medicaid cuts and the State-Only (UIS) Medi-Cal freeze are existential: a sector whose revenue is overwhelmingly Medi-Cal-dependent has little cushion when Medi-Cal coverage and reimbursement contract. Expect this Almanac to be cited in board decks, grant applications, and Sacramento advocacy testimony all year.
California Hospital Association VP of Policy Sheree Lowe publicly warned that FQHC closures will drive up emergency department visits and emergency-response strain, citing UCSF Fresno 2019 research showing FQHC geographic density is linked to a 26-35% drop in ED use among uninsured patients. ≥1,500 FQHCs nationwide are in financial hardship per the article. This is a notable strategic shift: the first time the hospital lobby is publicly making the 'save FQHCs or your EDs drown' argument — a natural-ally narrative FQHC executives can leverage in hospital-FQHC contracting, county budget asks, and Sacramento advocacy. Pairs with KFF rural Medicaid analysis and Geiger Gibson cross-subsidy research already tracked. Strategic implication for FQHC CEOs negotiating with Dignity, Sutter, Adventist, and Kaiser on referral and uncompensated-care arrangements: the lobbying frame just changed.
Following Governor Newsom's May 14 May Revise, California State Association of Counties CEO Graham Knaus issued sharp public pushback: counties want $6.4B over two years to backfill Medi-Cal coverage losses, hospital support, and BH services. Knaus' quote: 'The governor proposes to hide from state responsibility while demanding counties do the state's job for free.' County-by-county requests align with prior figures: Sacramento County (Lutz) wants $1.9B FY26-27 + $4.5B FY27-28; Fresno County is $241M indigent care exposed (already tracked); LA County preserves DPH via $63.2M new ongoing local funds plus reserve drawdowns. CSAC/CWDA may litigate or block budget elements. Affects ALL counties operating clinic systems: LA DHS, AHS (Alameda), SF DPH, Sacramento DHS, San Diego HHSA, Riverside RUHS, Ventura County HCA, Monterey County Health, Santa Cruz HSA, San Bernardino DBH. Strategic implication for FQHCs: (1) county Medi-Cal cost-shifts will likely translate to reductions in county-FQHC contracts (ECM, CalAIM Community Supports, BH crisis services); (2) FQHCs serving as residual safety-net for closed county clinics will absorb uninsured volume; (3) align CPCA/CCALAC advocacy with CSAC/CWDA testimony in June 15 budget conference committee window.
AFSCME Local 3299 (42,000 University of California service and patient-care technical workers) begins an open-ended strike on May 14, 2026 over housing affordability and healthcare premium costs. UCSF, UC Davis, UC San Diego, UCLA, and UC Irvine hospital operations face significant disruption. FQHCs in UC catchment areas (San Francisco, Sacramento, San Diego, Los Angeles, Orange County) should expect patient spillover — particularly for primary care visits diverted from UC ambulatory clinics. Strategic implication: (1) Operations directors should brief front-line staff on expected demand surge starting May 14, (2) Establish referral channels with UC discharge planners for safety-net patients losing continuity, (3) Coordinate with CPCA/CCALAC for regional capacity messaging, (4) Track strike duration — open-ended posture means weeks-to-months potential exposure. Compounds existing AHS, Kaiser, and WellSpace capacity pressures across the state.
NUHW therapists at Kaiser ratified a new contract 1,799-24 on May 8, 2026, ending the longest healthcare strike in US history. Tentative agreement was reached May 4, 2026, mediated by former HHS Secretary Mark Ghaly, MD and former Sacramento Mayor Darrell Steinberg at Governor Newsom's request. The strike began October 2025 in Southern California, expanded to NorCal and Central Valley in March 2026, and lasted 6+ months. Contract includes wage increases and a new pension — though Healthcare Dive notes NUHW therapists still earn ~50% less than Kaiser medical staff. FQHC implications for Bay Area / SoCal behavioral health teams: (1) the BH-wage benchmark pressure on FQHC hiring continues but is now a known number; (2) FQHCs should stop assuming a steady stream of strike-fatigued Kaiser BH clinicians peeling off — most are returning; (3) the Newsom-Ghaly mediation playbook is now a model for resolving large CA labor disputes — Watch for similar templates in other CA labor cases (Innercare ALJ, SEIU-UHW ballot campaign, AHS aftermath). Strategic action: (1) Update BH workforce comp benchmarks against Kaiser's new contract terms; (2) Brief boards that Kaiser-NUHW resolution removes one statewide labor distraction but other 2026 labor fights remain active (AFSCME UC strike, SEIU-UHW ballot, Innercare hearing).
Sacramento County DHS Director Timothy Lutz quantified the H.R. 1 cost-shift to county safety nets: 73,000 county residents will lose Medi-Cal coverage in the next year, with 6,500 becoming the county's indigent care responsibility — 'tens of millions of dollars' that the county must absorb. This is the precise pipeline that will drive uninsured walk-ins to WellSpace Health, Elica Health Centers, One Community Health, CommuniCare Health Centers, and Health for All. Through CSAC and CWDA, California's 58 counties are asking the state for $1.9B in FY2026-27 + $4.5B in FY2027-28 to offset the cost-shift. This ask is timed to the May 14 May Revise budget release. Strategic implication for Sacramento-region FQHCs: model FY2026-27 patient mix shift assuming +10-15% uninsured walk-ins, build a sliding-fee-scale capacity plan, document indigent-care subsidy gaps for county advocacy, and engage the CSAC ask through CPCA regional coalition channels. Counties without the state backfill will absorb the cost by cutting other public-health programs — meaning FQHCs lose contracts (CalAIM, BHCIP grants) AND gain uninsured volume simultaneously. Both edges of the squeeze hit at once.