California’s billionaires are not the only ones fighting back against the state’s largest health workers union this election season. Now the clinics are too.

The California Primary Care Assn., which represents more than 2,300 community health clinics, and Open Door Community Health Centers filed a lawsuit Thursday to stop Service Employees International Union-United Healthcare Workers West from placing an initiative on the November ballot that would dictate how clinics spend money.

The clinic measure is less prominent than the billionaire-backed fight against a wealth tax, but recently came closer to appearing before voters.

The clinic’s lawsuit, which was filed in the U.S. District Court for the Northern District of California, argues that the union’s ballot measure would interfere with federal laws and regulations that place strict spending requirements on nonprofit health clinics that serve low-income patients.

Joey Cachuela, general counsel for the clinic association, said in a statement the initiative threatens patient care. “We are filing this preelection challenge and need the courts to act to prevent this drastic measure from ever going to the ballot. Patient lives are at risk,” Cachuela said.

Renée Saldaña, a spokesperson for the healthcare workers union, said the proposed initiative was “legally sound” and called the lawsuit a “desperate attempt by the clinic industry to avoid accountability.”

Last month, union members turned in more than 1 million signatures to qualify the “Clinic Funding Accountability and Transparency Act” for the ballot. The union collected nearly double the number of signatures required to place the proposal before voters.

Under California’s election rules, proposals that gather enough signatures qualify for the ballot after the secretary of state’s office verifies their validity.

The union proposal would require federally qualified health centers to spend 90% of revenue on services that fulfill the stated mission to “provide primary and preventive care to low-income and underserved populations.” It would also punish clinics that do not adhere to this spending formula and place the money in a state-operated account that could later be used for worker training and staffing programs.

“It is the intent of this initiative to create a reasonable minimum standard of mission-directed spending … to ensure clinic patient service delivery and workforce stability is prioritized over management and overhead spending,” the initiative states.

Union leaders and members argue that clinics spend too much money on executive pay and administrative overhead and too little on patients. They also contend that some clinics spend only half of their revenue on direct patient care, an allegation that clinics call misleading.

“We have one message for our clinics: Put patients first. It’s time for an end to wasteful spending. It’s time to make sure clinics are putting their money in patient care and not CEO pay,” said Brisa Barrera, a medical assistant from Santa Rosa Community Health during an April rally to celebrate delivering the signatures.

The clinic association, however, argues that the initiative would illegally force hundreds of community health centers to close by stripping nearly $2 billion from health systems.

Tory Starr, chief executive of Open Door Community Health Centers, which operates clinics in Humboldt and Del Norte counties, said the measure would be “devastating” to the organization’s rural patients and would result in layoffs, reduced services and closures.

A nearly identical version of the ballot initiative failed to pass in the state Legislature earlier this year.

The initiative is one of three measures the union has submitted to the ballot. Another aims to limit healthcare executive pay at $450,000, and SEIU-UHW is also backing the “billionaire’s tax” that has drawn ire from both Democrats and Republicans.

Hwang writes for CalMatters.

For the next week or so, in homes all over California, ballots will be arriving for the June 2 primary.

Since 2020, a ballot has been mailed to every active registered voter in the state — more than 23 million, by last count. The time to choose is drawing nigh.

In addition to the race for governor, Californians will vote in contests for seven other statewide offices, the Board of Equalization — which oversees the property tax system — and a great many congressional, legislative and local races, including the primary for Los Angeles mayor.

What’s a voter to do?

If you’ve waited your entire life for a candidate like Republican Chad Bianco, the Riverside County sheriff running for governor, or you’ve been jonesing to cast a gubernatorial ballot for Democrat Katie Porter from the moment she whipped out her famous whiteboard, the choice is easy. Fill out that ballot and toss it in the mail, stat! No postage needed.

“Don’t mess around,” said Paul Maslin, a veteran Democratic campaign strategist. (His candidate for governor, Betty Yee, quit the race late last month, so he’s a neutral observer at this point.)

“If you have pretty good inkling what you want to do,” Maslin urged, “vote.”

But if, like many, you’re not wed to a particular candidate, what then? If you’re worried about mailing in your ballot and then having some awful, Eric Swalwell-like revelations surface, or if you fret about wasting your vote by supporting someone who drops out before June 2, then what?

There are no do-overs in a California election. Once you’ve cast your ballot, you’ve made your choice. That’s it, however sorry you may be.

Which is why Republican strategist Rob Stutzman, who’s worked in California politics for decades, urged voters not to mail their ballot too soon. Like Maslin, he’s unaffiliated with any of the gubernatorial campaigns.

“It’s a slow-developing race,” Stutzman said of the contest for governor, the marquee attraction on the June ballot. “These are still relatively little-known candidates. There’s going to be a lot more campaigning to go in the weeks ahead. [So] unless you feel really strongly about somebody, I’d hang on to that ballot and see what happens over the next several weeks.”

Then again, with all the talk of clamping down on mail-in ballots and concerns about processing delays by a stretched-thin Postal Service, is there a danger of waiting too long to vote? What if your ballot arrives past the deadline to be tallied?

In March, the U.S. Supreme Court strongly signaled a likelihood it would require mail ballots to be received by election day if they are to be counted as legal. As it stands, California accepts mail-in ballots that were cast before the end of election day, so long as they arrive no later than seven days after.

The court seems unlikely to issue its ruling before the June primary — but that’s not guaranteed.

So is there a sweet spot, somewhere between voting in haste and having your ballot go to waste?

The Official Voter Information Guide, produced by California’s secretary of state, urges those voting by mail to “return your ballot … as soon as you receive it.”

But Kim Alexander, head of the nonpartisan California Voter Foundation, falls into the wait-a-bit camp. “Don’t vote too early,” she counseled, “because this is a very dynamic election.”

Once you’ve made up your mind, her best advice is to mail your ballot at least a full week before election day, which is May 26, to ensure it arrives on time to be processed and counted. If someone wants to drop their ballot off in person, either at a vote center or secure drop box, Alexander suggests doing so by May 30, which is three days before the election.

“The good news,” she said, “is that under a new state law … all county election offices will be open at least six hours on Saturday, May 30, for voters to come vote in person or to turn in their vote-by-mail ballots.”

Voting in person is an option right up until 8 p.m. on election day, even if you received a ballot in the mail. That applies everywhere in California, save for three sparsely populated, rural counties — Alpine, Plumas and Sierra — which conduct their elections entirely by mail. Bring your unused vote-by-mail ballot to your local polling place and swap it for a polling-place ballot you can use instead.

For procrastinators or those wanting to wait until election day to mail their ballot, they run the risk that it won’t be postmarked until after June 2. That means it won’t be counted, regardless of when it arrives at their county elections office.

“Voters who want to hold out as long as possible … ought to be planning to turn their ballot into a drop box or a voting site and not use the mail at all,” Alexander said.

Having spent decades working to make voting easier and elections safer and smoother, Alexander knows that voting by mail has made many people miss “the election day experience.” (Things like bringing the kiddos into the voting booth, or posing for selfies with an “I Voted” sticker.)

Her suggestion is to find other ways to mark the occasion.

“Help somebody else go and vote,” Alexander suggested, “or volunteer to help with an organization” running a get-out-the-vote operation.

“If you want to help election officials get ahead on the vote count” — a source of repeated upset as the country awaits California’s lagging results — “you can be part of the solution by getting your own ballot in just a little bit earlier.”

All of which sound like fine ideas. That way you can celebrate election day and make sure your ballot isn’t cast for naught.

A California man is galloping to court after a Dutch horse dealer allegedly saddled him with a $500,000 lemon.

Gary Kamins sent his now 25-year-old daughter Gabby, who did competitive horse riding as a child, and her trainer Charmaine Levinson to Europe in August 2021, to pick out a horse for her to ride in competitions, he said in a lawsuit.

The pair settled on a $475,000 male horse named Grodino from Alan Waldman, whose Netherlands-based Waldman Horses allowed only a brief medical exam and provided no veterinary records, Kamins claimed in court papers.

But by the time the horse, whose barn name was “Dino,” was transported to the port of Los Angeles and on his way to Levinson’s Pacific Palisades stable, Kamins alleged it was clear something wasn’t right.

“Once Dino arrive at Cha Cha’s horse and training facility…[the horse] showed signs of physical pain and distress,” Kamins alleged in the California Federal Court papers.

Dino refused to do any jumps or training, and vets eventually realized he had a painful bone spur in its spine and a “progressive negative spinal condition.”

“Notwithstanding intensive veterinary care by Kamins for Dino, Dino never recovered and never competed in competition,” he claimed in the lawsuit, which alleged Waldman refused to refund the purchase price.

The doting dad was also out four years of funds he paid to Levinson to train and try to rehabilitate Dino, he said in the lawsuit, without detailing the amount.

He claims Waldman also paid Levinson an unknown commission.

Neither Waldman nor Levinson could immediately be reached for comment.