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Community Clinic Association of Los Angeles County

Affiliate Application

All applicants for affiliate are subject to approval by the CCALAC Board of Directors.
An Affiliate has no voting privileges, and may not participate in the Policy Advisory Group.

Categories & Fees

Nonprofit Providers – $1,200

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Includes: Participation in one (1) CCALAC work group or roundtable.
May participate in other work groups or roundtables for additional fees. (see below).

Other Nonprofits – $1,000

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Includes: May participate in other work groups or roundtables for additional fees. (see below).

For-Profit Corporations – $10,000

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Includes: May participate in other work groups or roundtables for additional fees. (see below).

Individuals – $500

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Includes: May participate in other work groups or roundtables for additional fees. (see below).

Students – $100

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Includes: May participate in other work groups or roundtables for additional fees. (see below).

Before You Start

If you are applying as an organization, please be sure you have the following documents ready before you start this application:

  • Federal Tax ID Number (if applicable)
  • Articles of Incorporation
  • Federal Tax Exemption as 501(c)3 (if applicable)
  • Most recent IRS form 990 (if applicable)
  • Lists of your Board of Directors, with officers noted
  • Bylaws
  • Electronic copy of logo

Affiliate Application


Work Groups and Roundtables

All applicants for affiliate are subject to approval by the CCALAC Board of Directors. An Affiliate has no voting privileges, and may not participate in the Policy Advisory Group.

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Work Group/Roundtable Description Fee
Behavioral Health Roundtable Bi-Monthly Meeting of staff who provide mental health services $200
Chief Financial Officer Roundtable Bi-monthly meetings of Chief Financial Officers to discuss pertinent issues (e.g. Prospective Payment Systems, Alternative Payment Methology) $200
Chief Operating Officer Roundtable Bi-monthly meeting of Chief Operating officers to discuss clinic operations issues and identify best practices to be shared. $200
Clinical Advisory Group Monthly meetings of physicians and nurse leaders to discuss strategies to improve clinical practice and the care delivery system. The CAG is a standing committee of the CCALAC membership and provides reports at the Members’ Meetings. $300
Dental Roundtable Bi-monthly meetings of dental staff $200
Development Discussion Group Quarterly meeting that incorporates discussions on marketing, fundraising, grant writing and communications. $100
eClinicalWorks User Group Monthly meeting that serves as a forum for discussing training, negotiation, and collaboration between CCALAC members and eCW. $3,300
Emergency Preparedness Work Group Bi-monthly meetings of clinical staff responsible for emergency preparedness activities. Emergency Preparedness work group requires program enrollment, contact Dana James for more information
Health Information Technology Roundtable Monthly meeting of CIOs, IT staff, and Health IT staff that provides peer support around current and relevant IT and Health IT topics, including EHR implementation, IT policies & procedures, etc. $300
Human Resources Roundtable Bi-month meeting of Human Resource staff to focus on workforce issues currently facing clinics; including job satisfaction, recruitment, training, and retention. $200
NextGen User Group Monthly meeting that serves as a forum for discussing training, negotiation, and collaboration between participating CCALAC members and NextGen. $3,300
Nursing Leadership Roundtable Montly meeting of the directors of nursing. $300
Pharmacy Work Group Bi-monthly meeting of pharmacy/dispensary leadership from Member clinics. Topics include issues such as smoking cessation, bulk medication, replenishment program and patient assistance programs. $200