ACCMA News

A Local Advocacy Win

This past month, ACCMA helped secure an important victory for patients and physicians across Alameda County.

For more than three decades, Alameda County has maintained what is known as an “Exclusive Operating Area (EOA)” for emergency ambulance services. By having one contracted ambulance company, the County has been able to ensure equitable access to emergency medical services, consistent response standards across communities, and the ability to implement advanced clinical innovations. The current system is not without its opportunities for improvement, but the model has ensured that the County has oversight and leverage with the sole ambulance company that is contracted to take our patients to our local emergency rooms for care.

Every 5 to 10 years, the County goes out to bid for a new contract. In 2025, however, the Board of Supervisors declined to approve a new contract and raised the possibility of a rapid shift to an open EMS system, whereby upwards of a dozen different ambulance providers could operate in the County without the same consistency, oversight and accountability as a sole provider under the EOA. This raised significant concerns about equity, patient safety, and accountability – particularly for Medi-Cal and uninsured patients and for residents of underserved neighborhoods.

Working closely with emergency physicians and County EMS experts, ACCMA helped elevate the clinical and equity implications of this issue. Our message was simple: decisions about emergency medical services must prioritize patient care. A rapid move away from the current model to an untested open system was a risky bet that could harm patients.

After careful deliberation – and strong advocacy from our Association and physician leaders – the Alameda County Board of Supervisors voted to extend the current ambulance services contract for at least 2.5 years, while undertaking a more deliberate, data-driven planning process to evaluate any potential transition to a non-exclusive EMS system.

The Board’s decision to slow the process, maintain stability, and require thoughtful planning reflects that message – and reflects the power of physician advocacy. This outcome did not happen by accident. It happened because ACCMA has the credibility, relationships, and resources to engage effectively with local decision-makers. That capacity exists because you support us through membership.

At every level – local, state, and federal – ACCMA serves as your voice. We translate your frontline clinical experience into policy advocacy that decision-makers can understand and act on. When it matters most, we show up.

ACCMA Comments on Proposed Federal Regulations Restricting Gender-Affirming care

The Alameda-Contra Costa Medical Association (ACCMA) has submitted formal comments opposing two proposed federal regulations that would restrict access to certain pharmaceutical and surgical gender-affirming care services for children and adolescents. 

One proposal would prohibit hospitals from participating in the Medicare and Medicaid programs if they provide specified puberty-blocking medications, cross-sex hormones, and gender-affirming surgical procedures to patients under age 19. The second proposal would prohibit federal matching funds under Medicaid and CHIP for those same pharmaceutical and surgical interventions when furnished to individuals under age 19. 

ACCMA’s comments primarily focused on the following areas: 

• Government interference in clinical decision-making: Both proposed rules use federal participation requirements or funding conditions to categorically prohibit specific medical treatments, substituting federal policy judgments for individualized physician-led clinical decision-making.
• Misuse of regulatory and funding mechanisms: The Conditions of Participation framework and Medicaid/CHIP funding structure are traditionally intended to ensure safety, quality, and program integrity, not to dictate the permissibility of particular medical interventions absent demonstrated systemic failures. 
• Evidence and patient outcomes: Peer-reviewed studies indicate that gender-affirming care is associated with improved mental health outcomes for transgender adolescents, while surgical interventions in minors are rare and subject to rigorous safeguards. Categorical prohibitions do not reflect the current evidence base. 
• Precedent and professional autonomy: Allowing federal authorities to prohibit specific medical services through participation or funding restrictions sets a broader precedent that could extend political interference into other areas of medical practice, undermining the physician–patient relationship and professional autonomy. 

We recognize that ACCMA members hold a range of personal and professional views on gender-affirming care, and the Association does not presume unanimity on these issues. What unites us is a shared and longstanding professional principle that the practice of medicine should be governed by clinical judgment, scientific evidence, and the physician–patient relationship – not by ideological or political mandates imposed through federal financing policy. 

The public comment period for both proposals is open through February 17, 2026. Members who wish to review the proposed regulations or submit comments in their individual capacity consistent with their own professional judgment may do so at: 

• Medicare Conditions of Participation proposal: https://www.federalregister.gov/documents/2025/12/19/2025-23465/medicare-and-medicaid-programs-hospital-condition-of-participation-prohibiting-sex-rejecting  
• Medicaid/CHIP funding proposal: https://www.federalregister.gov/documents/2025/12/19/2025-23464/medicaid-program-prohibition-on-federal-medicaid-and-childrens-health-insurance-program-funding-for  

Questions or concerns may be directed to accma@accma.org.  

Member of the Month: Dr. Pauline Huynh, MD

ACCMA is proud to recognize Dr. Pauline Huynh, an exceptionally active Resident member from the Kaiser Permanente Northern California Otolaryngology residency program. Dr. Huynh has demonstrated strong leadership through her service on ACCMA committees, including Health Equity and Community Health and the District IX delegation, as well as through multiple leadership roles within the American Medical Association (AMA). She previously served as Chair of the AMA Resident and Fellow Section and currently serves on the AMA Board of Trustees. Her leadership and advocacy have also been recognized by the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS). 

After completing medical school on the East Coast, Dr. Huynh chose to continue her training on the West Coast, where she values the region’s diversity and advocates for policies advancing health equity. She will complete her residency at Kaiser Permanente Oakland Medical Center in 2026 and then begin fellowship training in laryngology at Oregon Health & Science University. 

Thank you, Dr. Huynh, for your outstanding leadership, dedicated service, and continued commitment to advancing health equity. 

Ensuring Safe Access to Medical Care for All Patients

The Alameda-Contra Costa Medical Association (ACCMA) is deeply concerned by reports out of Minneapolis and around the U.S. of immigration enforcement actions that interfere with the delivery of medical care and contribute to fear, trauma, and avoidance of health care services among patients and communities. Our foremost obligations as physicians are to protect patient health, preserve the integrity of the physician-patient relationship, and ensure that individuals can seek medically necessary care without fear of harm, detention, or reprisal.

Previously adopted ACCMA policy affirms that access to affordable, quality health care should be available to all persons, regardless of immigration status, and that immigration enforcement should be ethical, compassionate, and carried out in ways that minimize psychological and physical harm. Consistent with California Medical Association (CMA) policy, ACCMA opposes the use of clinical settings or patient medical information for immigration enforcement purposes and rejects practices that undermine trust in the health care system or deter patients from seeking care.

ACCMA urges law enforcement agencies to conduct immigration enforcement activities in a manner consistent with established legal standards, professional norms, and public health considerations. Enforcement actions should respect due process, minimize trauma, and preserve the integrity of health care settings.  Enforcement actions should not interfere with the delivery of medical care, compromise patient confidentiality, or create conditions that deter individuals from seeking necessary health services. Health care is a human right, and health care spaces should be safe for everyone.

In California, state law reflects these principles. Recent statutory changes strengthen protections for patient confidentiality and limit immigration enforcement access in health care settings, reinforcing the importance of maintaining health care environments that are safe, lawful, and focused on patient care. ACCMA encourages physicians and medical practices to remain informed about these protections and to uphold policies that prioritize patient wellbeing, continuity of care, and public health. Click here for guidance and information.

Updated Guidance: Responding to Immigration Enforcement in Health Care Settings

Updated Guidance: Responding to Immigration Enforcement in Health Care Settings

ACCMA has updated its guidance for physicians and medical practices responding to immigration enforcement activity in health care settings to reflect changes in California law enacted in 2025 (SB 81). The updated guidance builds on our prior recommendations and clarifies new legal protections and requirements affecting clinical practices. Read the guidance here. 

The updated guidance includes:

• Clearer limits on when and how patient immigration-related information may be documented or disclosed, consistent with new state confidentiality protections
• Updated standards for responding to warrants, subpoenas, and court orders, including which legal orders require compliance
• New requirements for designating nonpublic areas of health care facilities and limiting immigration enforcement access to those areas
• Clarified staff roles and escalation procedures when immigration enforcement officers request access to patients, facilities, or records
• Continued emphasis on trauma-informed care and the health impacts of detention and family separation

ACCMA encourages practices to review the updated guidance and ensure internal protocols and staff training reflect these changes. Please contact ACCMA with any questions or requests for additional information.

ACCMA Member of the Month: Dr. Arthur Chen, MD

ACCMA Member of the Month: Dr. Arthur Chen, MD  

ACCMA is proud to recognize Dr. Arthur Chen for his longstanding service to patients, public health, and organized medicine. A dedicated ACCMA leader, he has served on the Council, as President and Delegation Chair, and on numerous committees. His impact also includes roles as Alameda County Public Health Officer, Medical Director of Alameda Alliance for Health, and physician leader at Asian Health Services, advancing equitable care for underserved communities. A committed mentor, Dr. Chen is the 2025 Joseph F. Boyle, MD ECPS Young at Heart Award recipient for his enduring support of future physician leaders. 

Thank you, Dr. Chen, for your extraordinary leadership and advocacy!  

Federal Changes to Childhood Vaccine Recommendations and California Guidance

Yesterday, federal health officials announced immediate changes to the Centers for Disease Control and Prevention (CDC) childhood immunization schedule, reducing the number of diseases for which vaccines are routinely recommended for all children from 17 to 11. Under the revised federal schedule, several vaccines—including hepatitis A, hepatitis B, influenza, RSV, rotavirus, meningococcal disease, and COVID-19—are now recommended only for certain high-risk children or after consultation with a health care provider, rather than universally. The changes were issued without the traditional evidence-based review process conducted by independent federal vaccine advisory committees and have drawn strong concern from public health and pediatric experts nationwide.

It is important to note that vaccination mandates and coverage policies are determined at the state level. In California, evidence-based vaccine guidance issued by the California Department of Public Health (CDPH) remains in effect.

As a reminder, CDPH released updated guidance in September 2025 to ensure Californians are protected against COVID-19, influenza, and RSV during the respiratory virus season. This guidance is supported by state law (AB 144), which guarantees access to CDPH-recommended vaccines and screenings and requires coverage by most commercial insurers and Medi-Cal managed care plans.

Key California vaccine recommendations for 2025–26 include:

• COVID-19: Recommended for children 6–23 months; children 2–18 with risk factors or who have never been vaccinated; adults 65+; adults under 65 with risk factors; pregnant and postpartum individuals; and anyone choosing protection.
• Influenza: Recommended for all individuals 6 months and older, with particular emphasis on young children, older adults, and those with medical risk factors.
• RSV: Recommended for infants under 8 months; children 8–19 months with risk factors; pregnant people at 32–36 weeks gestation; adults 75+; and adults 50–74 with risk factors.

Physicians are encouraged to continue relying on CDPH’s evidence-based recommendations, available here:
https://www.cdph.ca.gov/Pages/public-health-for-all/publichealthforall.aspx

Vaccines recommended by CDPH must be covered under AB 144 by most commercial plans and Medi-Cal managed care plans, though coverage may vary for Medicare Advantage or specialized plans. Vaccines remain available through medical practices, pharmacies, and MyTurn.ca.gov.

ACCMA will continue to monitor developments at the federal and state levels and provide timely updates to support your practice and your patients as this situation evolves.

Member of the Month: Dr. Irene Lo

ACCMA Member of the Month: Dr. Irene Lo 

We are proud to recognize Dr. Irene Lo as ACCMA’s Member of the Month for November! A retired surgeon and current Interim CEO of the Contra Costa Health Plan, Dr. Lo has been an ACCMA member for 10 years, most recently serving as President and contributing to numerous committees. 

Volunteering has always been central to her life, and she continues to combine her professional experience with her passion for advocating for patients and the community. Outside of work, Dr. Lo is a dedicated foodie who enjoys discovering new restaurants—recently hosting an ACCMA member-led event at one of her new finds in Walnut Creek. 

Congratulations, Dr. Lo, and thank you for your leadership, service, and ongoing commitment to our community! 

Early Bird Discount Extension: 12/5

This is a quick notice that the 5% early bird discount rate for your 2026 ACCMA/CMA membership renewal has been extended to Friday, December 5th. We encourage you to renew online today at https://www.cmadocs.org/renew so you don’t miss out.

We truly appreciate your continued membership and participation.

Stand by What is Proved

Stand by What Is Proved

Clifford Wong, MD, ACCMA President

It is my honor and privilege to serve as your ACCMA President in the coming year and sustain our Association’s mission: to improve the practice of medicine for the benefit of our patients and the public’s health. Now more than ever, we must be guided by this purpose.

None of us can fully foresee the challenges that lie ahead. A few years ago, could any of us have imagined leading through a global pandemic? And today, could we have imagined the upheaval now threatening our health care system – the erosion of our public safety net, and the growing distrust of evidence-based medical practice?

This past Independence Day, our nation received quite the birthday gift in the form of H.R. 1, the “One Big Beautiful Bill Act.” Beauty may be in the eye of the beholder, but from a health care perspective, this one is aesthetically challenged. The bill enacts deep cuts to Medicaid and the Affordable Care Act – over $1.2 trillion in total – and is the largest rollback of federal health care funding in American history. Ten million people are expected to lose coverage within a decade, including 2.5 million Californians who will lose Medi-Cal and nearly 2 million whose premiums are expected to double.

Compounding these challenges, we find ourselves on the defensive against an unexpected and insidious attack on science. As physicians, we are witnessing the dismantling of our public health infrastructure, research funding cuts, and the replacement of scientific experts with political appointees. Long-settled guidance on vaccines, pasteurization, even Tylenol is being questioned.

Are we about to enter a “Scientific Devolution”? Not if we can help it. The ACCMA will continue to defend evidence-based medicine, advocate for health care access – including reproductive and gender-affirming care – and protect vulnerable populations. We will also continue fighting for prior authorization reform, fair reimbursement, telemedicine permanency, and full implementation of the voter-approved Proposition 35 funding.

This is a critical moment to pay attention, to use our voices to counter misinformation, and to model reason, logic, and faith in science.

Galileo once wrote, “It is surely harmful to souls to make it a heresy to believe what is proved.” Stand by what is proved – and be proud to represent our profession.