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Turlock to seek grant for additional firefighters
Turlock firefighters
The City Council approved the Turlock Fire Department applying for a federal grant to hire nine new firefighters (Photo courtesy of TFD).

Turlock Fire officials want to add nine more firefighters to their ranks to more efficiently respond to calls.

This week the department asked the city council for permission to apply for a federal grant that would provide just under $3.1 million to fully fund the hiring of nine additional firefighters for three years.

Chief Andrew Hunter went before the council on Tuesday and made the case for pursuing the Staffing for Adequate Fire and Emergency Response (SAFER) grant that would help TFD achieve minimum staffing standards, starting in fiscal year 2024-25.

The council approved the request by a 4-1 margin, with councilmember Kevin Bixel (District 1) casting the lone dissenting vote.

The department operates with four engine companies staffed with three firefighters and one battalion chief, totaling 13 personnel on duty each day. 

“Earlier, I mentioned the need for increased staffing levels within the city of Turlock to adequately respond to fires. And the No. 1 thing mentioned at that time was 16 bodies,” Hunter told the council. “Currently, within the city of Turlock we have 13 bodies that arrive at a fire. To make up that difference, that’s where we take advantage of the opportunity that we have with our partners and we call additional companies or fire resources down into to Turlock to assist with that response to help us meet that minimum standard. That’s great for getting that total count on scene, but where we come up short is the time that it takes for them to get here. Fires can grow very quickly; there’s also the chance that a second call could come in. So, as we look for opportunities to see how we can address this need, the SAFER grant is one of them.”

Typically, the grants are awarded between July and September. If awarded the grant, Hunter would come before the council again and ask that the members vote to accept it.

Councilmember Cassandra Abram (District 3) mentioned that a study conducted by Folsom-based consulting firm Citygate Associates recommended that TFD staff a fifth company to better handle simultaneous emergency calls. Abram wanted to know how the nine potential new firefighters might fit into that scenario.

“Let’s say today we magically had the money to staff a fifth company,” said Hunter. “We still need bodies to fill those positions. We need trained people that are adequately prepared to assume the role of captain and engineer to supervise the company and to drive and operate the equipment. What this grant does is puts us in a better position and gives us three years to prepare for a potential opportunity to staff a fifth company.”

The program is administered over a three-year period through a Federal Emergency Management Agency (FEMA) contribution of $3,089,880 toward salaries and benefits annually over that period. That excludes overtime costs and personal protective equipment, which Hunter said would cost the city about $85,000, but could be expected to last 10 years if properly maintained. At the conclusion of the grant’s life, if the city chooses to retain the nine firefighters, the city would then responsible for salaries, overtime costs, and benefits moving forward. 

“At the conclusion of the grant, there is no requirement the city maintain personnel,” said Hunter. “But we don’t want to offer employees positions within the city if we don’t have some reasonable expectation that we might able to retain them at that time. There are a lot of variables between now and three years from now.”

Abram also pointed out that if nine firefighters are added, it is not the long-term expectation to continue with four-person companies, but rather return to a three-person companies.

“The biggest advantage for a city of Turlock’s size is to have more companies that can go to a call, as opposed to more people on (fewer) companies that can go to a call,” said Hunter. “If we don’t apply for this grant or if it’s not awarded, we’re still going to face the same problem in the future if we do have funds to staff another company. We’re still going to need to train up personnel to take on those leadership responsibilities. The SAFER grant is a big part in subsidizing that process.”

Bixel explained his problem with pursuing the grant.

“Personnel is the highest expense we incur as a city,” said Bixel. “It’s salaries, it’s retirement, it’s benefits. And I think we have to be mindful about what free money will cost us in the long run.

“I don’t hear people concerned about their fire department getting to their fire. I do hear from people who are concerned about the first response to a life-saving emergency. I know that the biggest percentage of the fire department’s calls are emergency-medical in nature. I personally feel that’s where we need to be directing our funds and increasing our level of service. And I would like to see that be part of this discussion before I would be able to support it.”

 

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.