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Planning puts new spin on sign regulations
Sign Ordinance
City staff find enforcing ordinances against sign spinners difficult as they are mobile and easily replaced. - photo by BROOKE BORBA / The Journal

What may be considered normal advertisement to some local business owners may actually be a city code violation. Many businesses don't realize that there are a large percentage of signs throughout the City of Turlock that are or will soon be considered illegal, including sign spinners, flags and banners.
At Thursday's Turlock Planning Commission meeting, Deputy Director of Developmental Services Debbie Whitmore hosted an informational workshop on restructuring the current sign ordinance to fit local needs. Whitmore and the Planning Commission have been using the City of Rancho Cucamonga's sign ordinance as an example after recommendations by the Turlock Chamber of Commerce.
Though a sign regulation reform is in process, local business representatives are nowhere to be found, leaving the task in the commissioners' hands to decide to the city's new sign ordinance.
"We want businesses to give us their feedback," said Planning Vice Chair Soraya Fregosi. "I don't feel as if we are shooting in the dark, but there is an absence here that needs to be filled."
The workshop highlighted signs that are commonly seen on city streets, such as temporary signs, mobile signs, promotional signs, and issues with regulation enforcement. Common seen advertisements, such as sign spinners, A-frames, and feather signs are currently considered dangerous and are illegal.
Newly appointed commissioner Alice Pollard related a story in which hand held signs raised up by sticks would be fashioned into spears once a melee had broken out. Shortly after hearing this story, the commissioners considered no longer allowing these types of signs. Spinner signs were also discussed as being extremely hazardous to individuals.
"Sign spinners often do things that don't make a lot of sense," said Whitmore. "They can create dangerous situations in order to gain attention of passing motorists. They are typically located at the front of the property, city sidewalks, and detract from permanent signage on buildings. One of the issues may be is it fair to allow this type of signage when a wall signage must be paid for? Right now, we have people not complying with the current ordinance, and a number of businesses are doing it."
Most cities currently prohibit commercial signs in the public right of way or are largely limited due to fears about infringing on free speech. Exceptions are generally made for community activities, such as a Christmas Parade for public purpose.
Rancho Cucamonga's sign ordinance is similar to Turlock's existing ordinance but includes more in depth standards, design guidelines, and does not allow any commercial items in the public right of way. These proposals may turn into procedures in the near future.
"We are open to suggestions, but they must always come prepared with rational standards," said Whitmore.
Also on Thursday, the Planning Commission:
• Unanimously approved the 2012 General Plan Implementation Report, which requires that an annual report on the Implementation of the General Plan be submitted to the legislative body.
• Approved the proposed 2013/2014 Public Works Projects as in conformance with the Turlock General Plan.
• Authorized the applicant of the Conditional Use Permit 13-01 (Days Inn Multi-Tenant Sign) to push back his public hearing for May 2.
• Supported Deanna Davenport of Hughson's 20th Century Arts and Crafts Club, and her wish to recycle election boards for the Hughson High School Art Department.
• Sworn in Alice Pollard as the newest Planning Commissioner.
• Recognized Victor Pedroza with a plaque commemorating his long held position as a Planning Commissioner.

 

 

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.