By allowing ads to appear on this site, you support the local businesses who, in turn, support great journalism.
County to take over HOME Consortium following Council vote
Avena Bella
HUD conducted an audit of the City of Turlock’s Community Development Block Grant (CDBG) and HOME Investment Partnerships Program (HOME) management, which includes funds for low-income housing projects like Avena Bella (Journal file photo).
ANGELINA MARTIN
Turlock Journal
Published: Feb 2, 2022, 4:07 AM

Although local service leaders and community members called in to last Tuesday’s City Council meeting to ask that no changes be made to the program, Turlock will no longer serve as lead entity of the joint HOME Consortium with Stanislaus County.

In a split vote, with Councilmembers Nicole Larson and Andrew Nosrati dissenting, the Council voted to reassign the lead entity of the program to Stanislaus County while Turlock remains a member city over the next three years — with the caveat that a shorter time frame be explored for the renewal agreement and that City staff assess the downsides and financial risk of the choice.

With renewal of the program taking place in three-year terms, the City needed to make a decision on whether or not to remain the lead entity by March 1 for the next term beginning Oct. 1. The City Council had three other options in addition to its choice to name Stanislaus County the lead entity, including disbanding the City of Turlock/Stanislaus County HOME Consortium, applying as a single Participating Jurisdiction or leaving the program as is and continuing as the lead entity.

During the meeting, Angela Freitas of the Stanislaus County Planning Department told the Council the County’s preference is to have Turlock continue to act as lead entity, though the organization is “ready to take over…if necessary.” She explained that Turlock possesses more expertise and stronger staffing capacity than the County, making it the better choice to run the program.

“If the County takes over as lead entity, it will essentially be building a program for the ground up…Given the expansion of HUD funds that have come into our community to address COVID in the last couple of years, now is not the best time from a staffing perspective to be building a new program and we do hope that Turlock will take that into consideration this evening when making the decision,” Freitas said. 

The City of Turlock/Stanislaus County HOME Consortium was formed between the two jurisdictions in 1999, allowing them to qualify for State HOME funds as an entitled entity rather than apply for the money on their own, since the process was becoming more competitive. The HOME Consortium allows for an annual direct allocation of grant funding, eliminating the need for the jurisdictions to compete for State funding.

When the HOME Consortium was formed, the City of Turlock was named lead entity which authorized it to act as the representative for implementation and administration of the funding. Since the program’s first year, the City of Turlock and the Stanislaus Urban County (including Ceres, Hughson, Newman, Oakdale, Patterson, Riverbank, Waterford and unincorporated areas) have received approximately $26.9 million in total grant allocations, with Turlock receiving about 28% of that, or $7,657,095. 

In Turlock, HOME funds have been used for First Time Home Buyer loans and property acquisition for senior, low-income households, transitional, domestic violence victims and homeless affordable housing units.

In addition to receiving a portion of the allocated grant amount to fund the program’s administrative services, which last year totaled nearly $127,000, serving as the HOME Consortium’s lead entity also meant Turlock was able to retain and use uncommitted funds from other consortium members, which in the past have been used to fund low-income housing projects like Avena Bella.

Maris Sturtevant, a retired United Samaritans Foundation employee who founded the Daily Bread lunch truck program and works closely with the local homeless population, also called into the meeting to ask that Turlock remain lead entity. 

“This was such an innovative idea that put Turlock on the map for low-income families and providing sustainable income to nonprofits. It’s a win-win situation,” Sturtevant said. “...Let’s keep Turlock as leaders in the surrounding areas and in an upward movement in Stanislaus County.”

USF Executive Director Linda Murphy-Julien also called into the meeting to ask the Council, “Why change something that is working and is valuable?”

With last Tuesday’s decision to forfeit the lead entity title, the City will still be able to receive funds as a HOME Consortium member, but will no longer have access to the additional funds it did as lead. As a result, the City will either have to make up the about $100,000 in administrative funds currently used to pay one Housing staff member or cut the position altogether. 

Additionally, Turlock still remains responsible for undisbursed HOME Consortium funds, any outstanding projects initiated under the current and previous HOME Consortium agreements and for all long-term responsibilities of the HOME program, such as project monitoring, loan management, payment processing, etc. The outstanding projects that would remain as Turlock’s long-term responsibility include 54 unpaid First Time Home Buyer Loans, 126 projects within Turlock and 278 projects in member cities.

Nosrati opposed the decision, calling the opportunity to remain as lead entity a “no-brainer” and didn’t understand why Vice Mayor Pam Franco requested for City staff to evaluate the program. 

“...I’ve noticed over time that there have been a lot of errors out of this department on their staff reports, and I believe that it is not paying for itself,” Franco explained, stating that she received staff reports which state Turlock is the only consortium member to have utilized the funding in recent years. “If we’re supposed to be doing this for the County, why is Turlock one of the only recipients of the money?...I’m really concerned about the disorganization of this department. The numbers are different, the numbers have come to Council meetings incorrectly and it seems that Turlock gets the benefit of all the projects and the rest of the County doesn’t.”

Larson took issue with Franco having access to reports that the rest of the Council did not.

“If the idea is that this department is not run adequately to your standards, I would need to see specifics as to why other than, ‘Some of these numbers don’t line up,’ at this point in the meeting when the vote is about to be taken,” Larson said. “...We’re literally declining free money and free administrative support to administer these programs.”

Franco also went on to say that low-income housing projects like Avena Bella have people from other cities living in them, so it’s not fair to people in Turlock.

“We have people from Patterson who now live in Avena Bella, taking up low-income housing that could have been for a Turlock citizen,” she said. 

Nosrati argued that remaining the lead entity was important because he believes the City doesn’t have a reliable policy in place to address the housing affordability crisis, noting that most developers building in Turlock are constructing homes with out-of-reach prices.

“...We are just disregarding the public’s input, disregarding servicing our low-income community without any clear direction or understanding,” Nosrati said. 

“No we are not, we are not doing anything more than taking our management of it and giving it back to the County where it belongs,” Franco responded. 
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.