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Water troubles back on City Council agenda
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After a two-month delay, a study which could result in increased water rates is back before the Turlock City Council.
On Tuesday, the Turlock City Council will consider hiring a consultant to conduct a water rate study, which will likely lead to higher rates to counteract large, ongoing deficits.
Council initially considered authorizing the study at its Nov. 13, 2012 meeting. But Councilwoman Amy Bublak requested a vote on the study be delayed until after Steven Nascimento, elected to council on Nov. 6, was seated.
"These are going to be big decisions," Bublak said at the time. "He can't say anything, he's sitting out there (in the audience). I'd recommend that we wait."
Turlock's water revenues have fallen sharply since a state-mandated conversion to metered billing in January 2010. This fiscal year alone, Turlock's water fund is expected to lose $780,000.
City staff recommended Turlock raise rates in 2009, in anticipation of the switch to metered rates, but council members at the time opted to adopt a "wait and see" approach. With two years of data, the costs of metered billing became clear: Turlock's revenues have declined $1.5 million annually.
The deficits can be attributed both to decreased water usage, and lower rates paid by the average consumer. In Turlock, residents now pay $25.54 for 22,000 gallons per month, plus additional charges for usage beyond that mark. By comparison, Modesto residents pay $50.99 for the same amount of water, while Tracy residents pay $71.28.
Raising rates enough to cover the deficit may not be enough. Turlock is in the midst of negotiations to build an $85 million Regional Surface Water Supply Project, a proposed drinking water plant to be operated in partnership with Modesto and Ceres, treating Turlock Irrigation District-controlled water from the Tuolumne River near Hughson. Without the plant, Turlock is projected to overdraw groundwater resources starting in 2018.
Should council approve the rate study, the consultant is expected to return to council with a proposal in three to four months.

On Tuesday, the Turlock City Council is also expected to:
• Consider extending the Turlock Partnership Incentives Program, which offers businesses $1,000 for opening up shop in a vacant storefront and drafting a business plan.
Already, the program is near using up the $15,000 budgeted for the 2012-2013 fiscal year, with 13 participating businesses thus far. The extension would grant another $15,000 to the program.
• Appoint a new Vice Mayor. The vice mayor is selected from among existing council members, serving rotating one-year terms.
Amy Bublak is the current Vice Mayor; based on seniority, either Forrest White or Bill DeHart is likely to be appointed.
• Appoint members to the Turlock Planning Commission, filling two vacancies. Incumbents Jeanine Bean and Soraya Fregosi are likely to be reappointed, though Anoheen Varani, office manager at the Dental Spa, also applied to join.
• Appoint members to the Turlock Parks, Recreation, and Community Programs Commission. Incumbents Mike Dowd and Richard Salinas have applied for reappointment.
A third vacancy, created when Steven Nascimento was elected to the Turlock City Council in November, will likely be filled by Jeremy Rocha, a California State University, Stanislaus student who unsuccessfully ran for Council in 2006 and 2010.
• Appoint Sergio Alvarado to a vacant alternate seat on the Turlock City Arts Commission. Alvarado is a postal service employee who unsuccessfully ran for council in 2012.
• Name council members to serve on The Alliance, the Stanislaus County Council of Governments, the League of California Cities Central Valley Division Executive Committee, the Regional Surface Water Supply Project Advisory Committee, the City of Turlock/Turlock Unified School District Joint Meetings, and the Stanislaus County Economic Development Action Committee.
• Hear staff updates on board, commission, and committee vacancies, and on capital projects and building activity.
The Turlock City Council is scheduled to meet at 7 p.m. Tuesday in the Yosemite Room of Turlock City Hall, 156 S. Broadway.

 

 

 

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.