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Council votes to reduce transit fares
bus
Turlock and county residents can ride for free on all fixed-route and commuter buses during the month of December.

The Turlock City Council on Tuesday approved a resolution which will reduce transit fares ahead of a scheduled rate increase, benefitting a wide range of bus riders from students to seniors. 

In February 2020, Council approved a Short-Range Transit Plan with recommended service changes and a revised passenger fare structure resolution for both the fixed bus route and Dial-a-Ride. These fare increases were recommended by City staff despite concerns about their impact on ridership due to a state-mandated Fare Recovery Ratio, which required transit to generate a fixed percentage of its operating costs in revenue. 

For the fixed bus route this percentage was 20%, and for Dial-a-Ride it was 10%. 

These fare increases were delayed when bus fares were waived due to COVID-19 in April 2020. As the City and other regional transit partners prepared to resume fare collection in October 2020, Council decided to reduce the newly-adopted fares through June 30 of this year and then extended the reductions further through Sept. 30. 

The reductions were further extended so that City staff could examine the ramifications of Assembly Bill 149, which was signed into law by Gov. Gavin Newsom on July 16 and greatly reduces the strain of fare recoveries on transit agencies.

“The most significant change for Turlock is that we can use our federal transit grant funds as local revenue for the purpose of meeting our fare recovery standards,” Transit Manager Wayne York told the Council on Tuesday. “It’s been a huge controlling factor — no more. The City is now free to establish fare policies, service levels and even offer new services without worrying about penalties for meeting an arbitrary percentage.”

York added that the new legislation would have a positive impact on the City’s ability to deliver transit services to the community.

“As your transit manager, it’s difficult to overstate how important and significant this change is for us,” York said. “It’s critically needed, it’s decades overdue and it’s going to allow us to do some exciting things moving forward, including what we’re proposing tonight.”

Instead of implementing fare increases and service reductions in an effort to achieve an arbitrary FRR standard, both of which hurt ridership, the City can now allocate resources to programs and projects that build ridership based on local needs. The City can also consider, for the first time in many years, hiring additional staff to support the large workload of the Transit Division, helping deliver on programmed projects, improve compliance and oversight with federal and state requirements, and support succession planning efforts. 

Thanks to this legislative change, the Council voted to adopt a new fare structure which will not feature increases, waives fares for children 18 and under (thus eliminating the need for student passes), eliminates single trip passes by reducing all-day passes to a more affordable level and provides significant Dial-a-Ride reductions for ADA passengers and seniors. York hopes that the free fare for children will decrease transit stigma by encouraging riders to start at a younger age.  

Now, rather than the increased fare of $4, all-day passes will cost $2 and $1 for the discounted rate. A 31-day will cost $30 instead of $60 with the discounted rate at $15 instead of $30. 

For Dial-a-Ride and ADA Paratransit riders, rides in Zone 1 for seniors and ADA riders will be $1 while rides in Zones 2 & 3 for the general public will be $2.50. For students in grades K-6 going to and from school, the fare will be $2.50. Dial-a-Ride will also provide free transit to and from COVID vaccination sites. 

Councilmember Nicole Larson asked York if Stanislaus State students would still be able to ride Turlock Transit for free – a partnership which ended when the university campus closed. According to York, conversations are ongoing with the Stanislaus Regional Transit Authority for a partnership which will allow college students to ride transit throughout the county for free. 

The new, revised fare structure will go into effect Oct. 1 instead of the rate increases which were previously scheduled to take place. According to York, Turlock is the first in Stanislaus County to reduce its transit rates.

 

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.