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Council approves residential road project list
Construction expected to begin summer 2020
roads Alaska
This section of Alaska Street is one of the over 20 sections of residential roadways on the City Council-approved project list (CANDY PADILLA/The Journal).

Work will be done to repair a number of residential roads in Turlock when the weather once again turns hot, as the Turlock City Council voted on Tuesday to move forward with a project selection strategy that places an increased focus on neighborhood roadways.

The Council voted 4-1 — with Council member Nicole Larson dissenting — to move to a road strategy that utilizes a funding breakdown of 60 percent for residential roads, 20 percent for collector roads and 20 percent for arterial road classifications. The City of Turlock receives approximately $4.7 million annually for road rehabilitation projects from Measure L (countywide road tax), SB1 (state transportation funds), gas tax and federal and/or state grants.

In the past, the majority of road funding was used for work on main thoroughfares — such as West Main Street — because the City could leverage its own funds to get federal or state funding for the project as well. This strategy, however, didn’t leave any funding for work on neighborhood roads.

While the Council was in agreement that a new strategy was needed that focuses more on residential roads, Larson was not sold on how the list of projects that will be tackled first was created.

City staff used information from StreetSaver, a pavement maintenance computer program, to identify road projects under the 60/20/20 funding guideline. StreetSaver evaluates the available funding and applies the most economical treatments for the lifecycle of the pavement system. Preserving roads with a higher Pavement Condition Index (PCI) for a low cost per square foot is much more effective than reconstructing a road section with a low PCI for a high cost per square foot, according to Interim Development Services Director/City Engineer Nathan Bray. Because of this methodology, some of the City’s worst streets were not identified by the program for the projects list.

“I want to make sure that we can use all the data available to us so that we can try to, if we can, accomplish those residential roads that aren’t going to be subject to the feasibility and the best way to stretch our dollar compared to the ones that will,” said Larson.

Larson wanted to delay a vote on a project list until information could be presented on what roads City crews spend the most time on filling pot holes, as well as having another workshop to seek public input.

Other Council members thought the process of how the project list was made could be improved on, but decided to vote to approve the projects as presented so that the City could move forward with the process of putting bids out for project design work and contractors with the goal of a summer 2020 construction timeline.

“I’m looking at… 26 roads in Turlock that we could possibly have worked on in the first year. To me that’s a win, win, win. I think you guys did a pretty good job here and I kinda hate to see us push it down any further. I want to get it going. Let’s get on it and move on,” said Vice Mayor Gil Esquer.

While the City Council is moving forward with the approved project list and funding strategy, they agreed to continue discussion on possible new funding sources for roadway projects and using more “human data” when compiling a list of projects for future years.

The approved project list for 2019-20:

Project 1: Colorado Avenue (Marshall to East), Bell Street (Marshall to East), Sycamore Street (Minaret to Bell); Merritt Street (Minaret to Bell), Oak Street (Marshall to Cooper), Cahill Street (Rose to Oak) and Pioneer Avenue (Wakefield to Main) for a total estimated cost of $1.45 million.

Project 2: Rice Avenue (Hawkeye to Riviera), Riviera Way (Rockford to Denair), Piedmont Avenue (Denair to Rohrer), Clemson Court (Baylor to end of the cul-de-sac), Tuolumne Drive (Geer to Temple), Annhurst Avenue (Tuolumne to Minnesota), Greenboro Street (Tuolumne to Minnesota), Tammi Way (Dawn to Robbin), Robbin Way (Sherri to Tammi) and Olive Avenue (Tornell to Minnesota) for an estimated total cost of $1 million.

Project 3: Alaska Street (Flower to Main), West Avenue (Park to Main), Florence Street (West Avenue to Grant), Sunnyside Drive (Vermont to Spruce), Orange Street (Castor to South) and 9th Street (F to Elmwood) for a total cost of $1.13 million.

Project 4: Golden State Boulevard — from Geer to Canal, Hawkeye to Walnut and Tuolumne to Monte Vista Avenue — for an estimated total cost of $1.03 million.

 

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.