By allowing ads to appear on this site, you support the local businesses who, in turn, support great journalism.
City prepares for water rate increases
Placeholder Image
Cara Hallam
Updated: Dec 13, 2013, 11:32 PM
Published: Dec 13, 2013, 11:33 PM

As California continues to face diminishing groundwater, the City of Turlock will soon have to take measures of its own to keep the precious resource flowing.

In the last City Council meeting of the year on Tuesday, Turlock Municipal Services Director Michael Cooke shared with the council members that the City will be looking to water rate increases over the next five years – a turn that the City has been expecting for some time as groundwater continues to become scarcer.

“It’s not cheap,” said Cooke on Tuesday while discussing the City’s water conditions. “All the cheap water is gone, unfortunately.”

Although the purpose of the discussion on Tuesday was to not approve any water rate increases as of yet, the Council was tasked with establishing a hearing date for the item on March 25, 2014 prior to their consideration of a series of water rate increases. The rate increases would also have to make it through a protest election before the Council could make such a decision.

According to Cooke, the City is looking to approve six rate increases over the span of five fiscal years for Turlock residents.

“We do need to take action one way or another,” said Councilman Steven Nascimento. “Water has been very cheap, but like Mike said, all the cheap water is gone. It certainly won’t be popular, but I think that the residents are expecting it. We have no other options if we want keep water running and flowing.”

While rate increases for a groundwater only system is not ideal, the rate increases are expected to be fairly modest in comparison to the rates necessary for a surface water supply. City staff is recommending that the Council utilize the groundwater only system as the preferred alternative at this time, given that an agreement has yet to be reached with the Turlock Irrigation District for the Regional Surface Water Supply Project.

“We are going to continue pursuing the Regional Surface Water Supply Project,” said Cooke. “It is the best option for our long term future for sustainable water supply and further economic development.”

The City also says that staff is continuing to pursue participation with the Stanislaus Regional Water Authority for the RSWSP and are continually negotiating with TID to supply water for the project.

However, should the RSWSP proceed, Cooke says that the rates will then have to be increased significantly, following a second round of notifications and protest elections – perhaps only 18 to 24 months from now, he shared.

Due to the current structural deficit in the Water Enterprise Fund, City staff says that it is imperative for the Council to not delay rate increases any longer.

“RSWSP rate increases may be needed in 18 to 24 months,” said Cooke. “But we’re not asking for all of this at this time.”

The Council is expected to adopt a rate implementation schedule no later than July 1, 2014 for the first rate increase, January 2015 for the second rate increase, and then every Jan. 1 thereafter. The Council could alternatively opt to elect a larger initial rate increase in July 2014 and allow delay for the subsequent rate increase until January 2016.

Over the past four months, staff have completed an analysis on the detailed cost comparisons of either keeping a groundwater only system versus a groundwater and surface water system, the long-term costs of upgrading the City’s groundwater supply system should the City not proceed with the surface water project, revisions to the capital cost estimates for the surface water supply project – particularly the various facilities that would be needed to interconnect the surface water with the existing groundwater system – and the continued negotiations on the surface water project between TID and the Stanislaus Regional Water Authority.

According to City staff, although the negotiations with TID have been “productive” it has become apparent that an agreement will not be reached in the near future. Having found this, staff has recommended that the rate increases necessary for the construction of the RSWSP be delayed until the project has reached a more advanced stage.

Although the significant increases for the construction of the project are not needed at this time, the City says that a series of modest rate increases are still needed to improve the Water Enterprise Fund’s financial deficit, while also making improvements to the City’s existing groundwater system.

“We do need to make some capital improvements if we are going to continue using the groundwater only system for a couple more years,” said Cooke. “The groundwater situation in our area is a challenge.”

Cooke says that even with the groundwater only system, customer bills will still require increases to fund capital improvements, such as wellhead treatment.

While rate increases are certainly in the near future for Turlock residents, Cooke says that the incremental cost of the surface water project compared to a groundwater only system are not as significant as initially projected.

For instance, by 2023, it is estimated that the average monthly single family bill will be approximately $12.45 higher using a surface water and groundwater system, compared to a groundwater only system.

Diminishing water resources continue to plague the entire state, however, as a recent study by UC Irvine using NASA data found that the aquifer in the San Joaquin Valley is being over-drafted by 800 billion gallons per year. Due to increased agricultural pumping in the eastern part of the region, the aquifer has declined over 100 feet, having a significant impact on groundwater flows in the Central Valley region.

Although the City Council will not meet for the remainder of 2013, it is expected that the issue of water rate increases for Turlock residents will be continually discussed when the Council reconvenes in January.
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.
Published: Apr 2, 2025, 4:48 AM

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.