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Council reflects on 2013; looks toward water in 2014
Regional versus city road tax talks to continue in new year
Monte Vista roads
Many City Council members predict that roadway improvements will continue to be a hot topic throughout 2014. The improvements being made to Monte Vista Avenue, between Crowell and Geer Roads, are expected to be complete within the coming months. - photo by CARA HALLAM / The Journal
Cara Hallam
Updated: Jan 7, 2014, 8:22 PM
Published: Jan 7, 2014, 8:23 PM

As the Turlock City Council heads into 2014, the general consensus is to keep a strong focus on water.

The council – which has been in negotiation talks with the cities of Ceres and Modesto alongside the Turlock Irrigation District regarding a Regional Surface Water Supply project – has kept a close eye on the diminishing water supply in Turlock and the surrounding region. During the Dec. 10, 2013 council meeting, council members discussed the possibility of increasing water rates over the next five years that would see six rate increases for Turlock residents.

“The biggest issue in 2014 will be water,” said Councilmember Forrest White, who sits on two different committees for surface and recycled water projects. “It’s a big issue and is going to be at the forefront, especially if we continue with the lack of rain…It’s going to get harder and harder with less of a resource, so we need to determine, how do we find new resources?”

White shared that although the City is in continued negotiations with stakeholder groups on the Regional Surface Water Supply project – which he hopes will be culminated this year – an agreement would still place the project five years down the road.

“Since it will still be five years or so until we get a plant going, conservation of water will be key,” said White. “It’s a good idea to make water a real priority. Bumpy roads and potholes are not good either, but you can survive. With water, you have to have an adequate drinking water supply. And if industry is going to survive, you need an adequate water and sewer capacity for them.”

With the City continuing to bring in new industries to the Turlock Regional Industrial Park, White hopes that the anticipated industrial growth in 2014 will have a positive impact on the city’s roadway and water systems.

“It’s going to be dictated by our industrial growth, which will hopefully help everybody,” said White. “If you want to do roads and make improvements in the water, there’s a cost associated with that…We’re in a good growth mode, and better off than a lot of cities. We’ve got the industrial space that people are looking for, which many other cities do not. I really believe that a good economy is going to mean a more positive attitude with the public, and that would lead to them looking for more improved services, and maybe be willing to pay a little bit more for roads or vote on a road tax. A better economy means a better budget, which allows us to address issues like water and roads.”

Councilmember Bill DeHart echoed White’s growing concern with water, stressing the importance of receiving input from the County and various water organizations to help resolve the region’s water problems.

“[The water concern] is far more than agricultural at this point,” said DeHart. “We’re talking about drinking water here in town. “

Reflecting on the improved business development in 2013, DeHart says that he expects continued economic growth within Turlock in 2014.

“There are a lot of things in the works with respect to Monte Vista Crossing, with the Phase 2 of that project,” said DeHart. “There are also quite a number of backfill projects taking place, and a lot of permitting going on, so we’ll continue to see growth throughout the year including more development in the northeast corner.”

Various legislative efforts taking place in Sacramento will have an effect on Turlock as well, said DeHart, as the City continues its partnership with the League of California Cities while keeping a close watch on state developments.

“We need to keep our eyes and ears to the ground with policy,” said DeHart. “They all have some sort of impact on the economic stability of our town and region as well…We have a lot of pokers in the fire, but it is all a function of what the people want. If there is a valuable idea out there, we’re willing to hear it. We don’t have all the answers. We think we have a good feel of what the community wants, but it’s really about what they want us to do and we’re always open to input. Maintaining and improving the quality of life here in Turlock needs to continue to be our priority.”

Council members Steven Nascimento and Amy Bublak both pinpointed roads and water as key issues for the Council in 2014, as both discussed proposed fee increases and tax measures to address growing concerns.

“In Turlock, 2013 was about maintaining our services with generous employees who gave us concessions to assist us in sustaining our financial needs,” said Bublak. “2014 will be a year of proposed fee increases and suggested tax measures to address water, public safety and roadway issues. It is my hope that as these topics arise, the citizens voice their opinions through council members or at the meetings so that the best decisions are made for Turlock.”

In regards to a potential tax measure for roadway improvements, Nascimento said that he believes a regional approach would be best, however, a city-wide tax should still be considered. Mayor John Lazar also shared that the City will continue to have discussions with the Stanislaus County Council of Governments – the regional transportation planning agency – to determine how Turlock will proceed with the conditions of the roadways.

“There are ongoing discussions at the county level of a potential county tax measure, and the City is still entertaining the idea of moving forward with a Turlock-only self-tax measure,” said Nascimento. “Depending on how those conversations go, that’s something that we’ll continue in 2014. A regional approach is preferable, but if we don’t do so on a regional level, the council will have to decide whether we move forward as a community.”   

As the council members reflected on 2013, all could agree that the economy continued to improve, yet still has room for growth.

“Our economy has improved, and Turlock has continued to be a bright spot in the Central Valley in terms of economic recovery,” said Mayor Lazar. “Although we have a long way to go in terms of fully healing, I think that creating the Mayor’s Economic Development Task Force was a great start, and I look forward to continue working with them in 2014 for new opportunities in bringing business to Turlock. We have some great prospects coming to City Hall, talking to city staff. This will be a good year for Turlock economically.”

Although Mayor Lazar noted the improvements in the downtown area, Geer Road and Monte Vista Crossings as signs of continued development and growth and a recovering economy, he shared concerns regarding public safety realignment and the impacts it continues to have on the region as counties become responsible for housing low-level state prison inmates in local county jails.

“I still have concerns with realignment, but I have every confidence in our sheriff to manage properly with prison space,” said Mayor Lazar. “It’s a concern locally because we have seen a higher criminal element because of it. As a City, we’re calling on the Turlock Police Department and residents to be vigilant of that, with programs such as Neighborhood Watch, so that we can know where to place our resources and what areas might need increased surveillance.”

Both Mayor Lazar and Councilmember White recognized and expressed their appreciation for the efforts of the Turlock Gospel Mission, as the non-profit organization prepares to construct a multi-bed homeless shelter in 2014.

“I’m very encouraged by the Turlock Gospel Mission, and their efforts to help our homeless population,” said Mayor Lazar. “They continue to make strides with the help of We Care and other organizations, and it is encouraging to see.”

With the opening of the new Public Safety facility in 2013, Mayor Lazar says that public safety will continue to be a top priority in 2014.

“Opening our public safety facility was a great opportunity for the downtown, the Westside, and public safety in Turlock in general,” said Mayor Lazar. “It’s great for the region, not only for Turlock.”

As Council members Nascimento and White shared, the City is hopeful to announce new businesses and retailers in 2014, as city staff work to land new industries while continuing to work diligently on issuing new business permits. 

“We have a great community,” said Mayor Lazar. “I’m so thankful to be able to serve as Mayor and preside over this, in my view, prosperity...It’s been really exciting.”

 
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.