A Message from Your 2026 President: Catherine Gutfreund, MD

[Photo: Dr. Gutfreund & SMLMA Executive Director, Wendy Davies, attend SFMMS 2026 Gala event.]

Dear Colleagues: Spring brings with it both renewal and resolve — and as your medical association, SMLMA enters this season with both in full supply. From Sacramento to our own county boardrooms, the work of organized medicine is making a real difference for our patients, our practices, and our communities.

I want to personally encourage every physician in our tri-county region to join SMLMA and the California Medical Association at Legislative Advocacy Day in Sacramento on Wednesday, April 8th. There is no more direct way to make your voice heard than walking the halls of the Capitol alongside your colleagues and speaking face-to-face with the legislators who represent us. Look for registration details below and plan to join us.

Thanks to the protections secured through Proposition 35, the existing MCO tax remains in effect at its current level through December 31, 2026. We are actively working with the Department of Health Care Services (DHCS) on a path forward for 2027 and beyond, within the constraints imposed by HR-1.

On reimbursement: CMA has recommended — and DHCS has agreed — to deliver the 2026 Medi-Cal rate increases for primary and specialty care through supplemental payments, effective July 1, 2026. These rate increases have been submitted to CMS for federal approval. This is a meaningful step forward for physicians who serve Medi-Cal patients in our region.

The longer fight continues. CMA and SMLMA remain committed to working with Congress to reverse the harmful provider tax provisions of HR-1 and restore the healthcare funding our communities depend on. This may require sustained effort through and beyond the November 2026 election — and we are prepared for that.

Many of our physicians are witnessing a troubling pattern firsthand: immigrant and farmworker patients — a significant and longstanding part of our tri-county community — are increasingly avoiding care out of fear. Across California, mobile health clinics serving agricultural workers have seen dramatic drops in patient visits. Here in Sonoma, Mendocino, and Lake Counties, where vineyard and agricultural workers have long faced higher rates of diabetes, hypertension, and limited access to routine care, the consequences of delayed or avoided treatment are serious and predictable. Patients who don't come in today become more complex, more costly, and more vulnerable tomorrow. SMLMA will continue to stand for a healthcare environment where every patient in our region feels safe seeking the care they need.

The Sonoma County Board of Supervisors has awarded $12.4 million in Measure O and state funding to expand mental health and homeless services across our county. This investment will support school-based mental health care, youth and family services, crisis response teams, and housing supports — precisely the community infrastructure that complements the clinical care our physicians provide every day.

This is our community making good on its values. When patients have stable housing, crisis support, and mental health services, they are better able to engage with their medical care. We applaud this investment and look forward to the partnerships it will strengthen.

Thank you for the exceptional care you bring to this region every day. SMLMA is here to support you — in the clinic, in the Capitol, and in the community.

With gratitude,

Catherine Gutfreund, MD

President, Sonoma-Mendocino Lake Medical Association