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City Council begins redevelopment agency shut down
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On Feb. 1, the redevelopment era came to an end.
On Tuesday, the Turlock City Council will oversee an agenda dominated by preparing for a world without a redevelopment agency, culminating in holding their first-ever meeting as an RDA Successor Agency.
During the 2011 state budget negotiations, legislators looked to balance the state budget by forcing redevelopment agencies to either close, or pay large fees to the state each year. The required payments were found to be illegal by the State Supreme Court, leaving agencies with only one option - to shut down.
The law provided for a new agency to replace the outgoing redevelopment agency - a "Successor Agency." The Turlock City Council previously decided the City of Turlock would serve as the successor agency to the Turlock RDA - a new legal entity which holds liabilities separately from the city or former RDA - but on Tuesday will finalize that decision.
The successor agency will make payments on debts and collect loans, rents and other revenue on behalf of the former redevelopment agency. But the successor agency will not be allowed to bond for further revenues, or take on new projects; the agency will solely be tasked with winding down Turlock's existing RDA, with an aim to eventually disband once all debts have been paid and existing projects completed.
The Turlock Successor Agency is expected to have the Turlock City Council serve as its board of directors, with the mayor serving as the chair, and vice mayor as vice chair. The city manager will serve as executive director, city clerk as secretary, and city treasurer as finance officer.
Then, meeting as the successor agency for the first time, the agency is expected to create the fund needed to collect tax revenues from the county auditor-controller to pay existing debts, adopt a payment schedule for those debts, and authorize the successor agency to invest in the State Treasurer's Local Agency Investment Fund.

On Tuesday, the Turlock City Council is also expected to:
• Hold a reception, from 6 p.m. to 7 p.m., in honor of new Turlock Police Chief Rob Jackson. He will be sworn in as chief at the beginning of the regular, 7 p.m. council meeting.
• Issue a proclamation in honor of Dave Young, the interim police chief, whose tenure as chief will end Tuesday. Young's interim term will have stretched from July 30, 2011 through Feb. 14.
• Approve rehabilitating Golden State Boulevard, from Crane Street to the city limits, and West Main Street from 700 feet west of Tegner to just east of Kilroy Road. Pavement will be repaired, broken curb, gutter, and sidewalk will be replaced, ADA compliant access ramps will be installed, and drainage at the corner of Golden State Boulevard and Marshall Street will be improved.
Work will be performed by George Reed Inc., of Modesto. The $985,484 cost will be financed through a combination of federal grants and gas tax revenues.
• Consider upgrading the city's security card access system in City Hall and in Fire Station 1 and 2. Additionally, a new cardlock system would be installed at the wastewater treatment facility, corporation yard, and transit building
The work, to cost $146,846, would see all City of Turlock buildings use the same cardlock system as the new Public Safety Facility. The cost was included in the fiscal year 2011-2012 budget.
• Approve advertising for construction proposals for a multi-million dollar expansion to Turlock's wastewater treatment facility. The upgrade would be funded through a state loan.
• Appoint Aaron Hackler to the Turlock Mosquito Abatement District board. The board has had a vacancy since former board president Milt Richards left Turlock to take a job in Canada.
• Hear a presentation on the Central San Joaquin Valley Risk Management Authority.

 

 

Costa, Gray propose congressional bill to address critical physician shortage in rural areas
Costa and Gray
San Joaquin Valley congressional members Rep. Jim Costa, D-Fresno, left, and Rep. Adam Gray, D-Merced, are shown discussing their bill H.R. 2106 in a virtual press conference on Tuesday.

BY TIM SHEEHAN

CV Journalism Collaborative

Two San Joaquin Valley congressional representatives have introduced a bill that could help address the vast shortage of doctors in the region, particularly in underserved areas. 

Rep. Jim Costa, D-Fresno, and Rep. Adam Gray, D-Merced, say the Medical Education Act would, if passed, establish a program of grants to support expanded medical education programs in underserved areas of the nation.

The Valley could be one of the key areas that would benefit from the legislation. California has about 90 primary care doctors per 100,000 residents statewide, the federal Health Resources & Services Administration reported in November 2024. 

That’s more than the ratio in some states, and less than some others. The nationwide ratio is about 84 doctors per 100,000 residents.

But in the San Joaquin Valley, home to about 4.3 million people, doctors are much more scarce – about 47 primary care physicians per 100,000 residents, according to Dr. Tom Utecht, chief medical officer at the Fresno-based Community Health System.

That number is “a little over half of what is necessary to take care of a population,” Utecht said Tuesday in a video press conference. “We have the lowest physicians-per-capita rate in all of California, in the San Joaquin Valley.”

Introduced last month, the Medical Education Act is something of a placeholder for the time being until the Congressional Research Service can weigh in with financial estimates of what is needed in different parts of the country, Costa said. 

A companion version was introduced in March in the U.S. Senate by Sen. Tim Kaine, D-West Virginia, and Sen. Alex Padilla, D-Los Angeles.

At this point, the legislation does not specify how much money will ultimately be sought or how grants would be structured.

Costa said the shortage of doctors in the region “is combined with language barriers, cultural barriers and distances … and that would really go for rural parts of our country regardless where folks live.”

“If you live in rural areas, it’s just more difficult to have access to good quality health care,” he added.

Costa said the legislation, if it can survive a Republican-controlled House and Senate and a Republican president, “would be transformative because it would invest expanded resources to minority-serving institutions and colleges located in rural and underserved areas to establish schools of medicine and osteopathic medicine.”

The bill would also create an avenue for more historically Black colleges and universities, as well as Hispanic-serving institutions, to establish medical education programs, Costa said.

Gray noted that when he was in the state Legislature, he and colleagues “worked to get hundreds of millions of dollars in funding to expand the UC Merced campus, to ultimately secure the funding to put the first medical education building up on campus.”

Gray added that the UC San Francisco’s medical education program in Fresno “is an important part of creating the (medical) workforce of the future for the valley, but more importantly, solving this access to care issue that plagues Valley communities.”

At UC Merced, director of medical education Dr. Margo Vener said there has been a surge of interest in the university’s program that funnels students through an undergraduate program for their bachelor of science degree through a medical school degree in collaboration with UC San Francisco.

“All the students that we are enrolling are from the Valley and for the Valley, because they want to really make a difference in promoting health in their communities,” Vener said. That, she added, is likely to eventually translate to those would-be doctors to stay in the Valley to practice medicine.

“The data suggests that two factors really strongly influence where physicians stay to practice,” Vener said. “One of them is where they’re from, which, of course, is why we’re recruiting students from the Valley for the Valley just to stay (and) be doctors for their community. And the other factor is where you went to residency. Those are the two biggest drivers.”

That’s something that was underscored by Dr. Kenny Banh, assistant dean of undergraduate education at UCSF Fresno. “Regional campuses such as UC Merced and UCSF Fresno not only grow doctors, but they take those doctors, physicians and medical students from their communities in the region, and train them in those regions to go back to be physicians in those areas,” he said.

While the costs of the Costa-Gray legislation are yet to be determined, Banh said there are also costs associated with doing nothing to expand medical education.

“There’s health care costs, regardless of how we work it, if we don’t invest in having an adequate supply of physicians,” Banh said. “There’s a cost on the human that can’t access care” and doesn’t get to a doctor until a condition is not treatable “or with significantly worse morbidity and mortality outcomes.”

“And that cost is borne by health systems taxpayers, one way or the other,” Banh added.

But even if the Costa-Gray bill were to pass in this congressional session, the payoff of home-grown medical schools producing a bumper crop of physicians in the Valley or other deprived parts of the country would be years down the road.

“I think it’s really important to understand why we need to invest now for our future, because it takes so darn long” for a student to go from being a college freshman to a practicing doctor, surgeon or specialist, UC Merced’s Vener said. 

After a four-year bachelor’s degree, a student must then complete four years of medical school, which in turn is followed by a residency of three to five years.

“Then often people will do a fellowship to become, for example, a cardiologist or a gastroenterologist or something like that,” she added.

“If you start investing in just one student now, it’s going to take such a long time before they really are there to take care of you at that moment when you need them to be your gastroenterologist, your cardiologist, your emergency physician, or, dare I say, your family doctor,” Vener said.

That, she said, is why it’s also necessary to expand residency programs that can attract would-be physicians into the region in hopes that they will remain once they complete their training. “We need those doctors now, and that’s why this effort is important,” Vener said, “because this is what will both inspire people to stay, but also inspire people to really come and embrace the communities and serve them.”

In a related development, state Assemblymember Esmeralda Soria, D-Fresno, recently introduced a bill for the University of California system to develop a comprehensive funding plan for expanding the current SJV Prime+ BS-to-MD partnership between UC San Francisco and UC Merced, with the goal of transitioning the program to a fully independent medical school operated by UC Merced.

“We have seen firsthand the impacts of medical workforce shortages throughout the Central Valley,” Soria said in a prepared statement. “AB 58 would help ensure the Legislature is equipped with the information needed to secure appropriate funding for the medical education provided for our community at UC Merced.”

— Tim Sheehan is the Health Care Reporting Fellow at the nonprofit Central Valley Journalism Collaborative. The fellowship is supported by a grant from the Fresno State Institute for Media and Public Trust. Contact Sheehan at tim@cvlocaljournalism.org.