To help clinics explore strategies for greater sustainability, CHCF launched an initiative that provided technical assistance to clinics interested in strategic restructuring. The five participating clinics included: North County Health Services in San Diego; Mountain Valley Health Centers in Northern California; St. Anthony Medical Clinic in San Francisco; The Children’s Clinic in Long Beach; and Santa Barbara Neighborhood Clinics.

The case studies describe the activities of the clinics between October 2010 and October 2012. They include the clinics’ purpose in exploring strategic restructuring, the process, the takeaways, and the next steps anticipated.

Ultimately, four main themes emerged regarding the challenges and opportunities facing California’s community health centers as they strive to become more sustainable:

• The urgency dilemma. To consider a major change like strategic restructuring, clinics may need to reach a tipping point where the pain of the current situation is greater than the anxiety of an unknown future.
• One strategy among many. Strategic restructuring is not always the right solution; to determine the best strategy, a health center first needs to clearly define the problem it is trying to solve.
• Money matters. Organizations best able to leverage strategic restructuring are those that approach it from a position of strength. A clinic that is already in poor financial shape may not be seen as a viable partner.
• Testing new ground. Some clinics are looking to partner with large organizations such as hospitals or integrated health systems. To do so, they have to market themselves and demonstrate the value they can bring to the table.

The complete case studies report is available under Document Downloads.