Contra Costa Times: Without help, death for Doctors Medical Center is only a matter of time
The hospital providing emergency room services to West Contra Costa's neediest patients is on life support, and without outside financial help, it won't survive past the spring.
It's time for Doctors Medical Center officials to begin preparing for what seems an inevitable shutdown. It's time for Kaiser to brace for an onslaught of emergency patients at its Richmond facility.
It's time for leaders at John Muir Health, officially a nonprofit organization, to look in the mirror and ask how they can live with themselves.
John Muir's Walnut Creek facility holds the lucrative contract as the county's designated trauma center. With that should come a social responsibility to help more needy portions of the county.
Absent a bailout, Doctors will run out of cash sometime between March and May, current projections show. No one should be surprised by this.
In 2011, the West Contra Costa Healthcare District, which operates the hospital, sought and received voter approval for a $47-per-house tax increase.
We backed Measure J, but warned that district and hospital officials needed to move quickly to restructure the operation and find a way to keep it going. Back then, it was clear that, even with the tax money, the district would go broke in 2014.
The projection then was this summer. Declining hospital inpatient volume has shortened its life expectancy a few months. But emergency room visits have not declined. And that should be great cause for concern.
The inpatient visits will probably be absorbed by nearby hospitals in a somewhat orderly manner. But the lack of an emergency room at Doctors will create a chaotic situation. Most residents in distress will go to the next nearest facility.
Kaiser, which is not designed to take in patients who are not enrolled in one of its plans, will have no choice but to provide care to all emergency patients showing up at its door. That's the law.
To a lesser extent, Sutter's Alta Bates Summit Medical Center in Berkeley is in the same boat. So, while John Muir has a moral obligation to assist, it's in Kaiser's and Sutter's financial interests to help out, too.
Whatever aid they do provide would probably be only stopgap. In which case Doctors Medical Center cannot continue on its own. That's clear. It must find a new permanent source of funding or a larger hospital to absorb it. Given Doctors' high level of uninsured and poorly insured patients, that will not be easy.
But without emergency resuscitation, death is certain. It's only a matter of time.
The Fresno Bee: Fresno County coroner should be appointed
The Fresno County Board of Supervisors is serving the public's interest by taking a hard look at the elected coroner-public administrator's position with changes in mind for 2015.
Unimaginable as it is, candidates for the job aren't required to have even the most basic of medical qualifications. They only have to be registered to vote in the county.
This creates a scenario in which a coroner with no background in medicine can overrule the findings of a forensic pathologist in determining cause of death. Unfortunately, the best overhaul of the position—switching to a medical examiner-coroner appointed by the Board of Supervisors—wasn't on Monday's agenda.
Supervisors instead will choose between keeping the current system or assigning the coroner's duties to the sheriff and the public administrator's duties to the district attorney.
The rationale cited by supervisors favoring a sheriff-coroner is that the county will save money and the public will receive better service. An analysis by County Administrative Officer John Navarrette, however, pegs potential savings at just $50,105 in the first year.
Interestingly, Navarrette's report states: "The Coroner has yet to make the facility a Forensic Regional Center; the Sheriff has the desire and the resources to make that facility into the regional center for which it was designed.
"The county does have a state-of-the-art coroner's facility adjacent to the Juvenile Justice Campus. In fact, the quality of the building's design and the technology inside is among the reasons why the county should appoint a medical examiner instead of reverting to the sheriff-coroner system that was in place until 1978. That facility will attract a top-flight medical examiner—something that isn't likely to happen if the medical examiner has to report to a publicly elected sheriff.
In addition, Sheriff Margaret Mims has plenty on her plate in maintaining public safety and running the jail—both difficult tasks. She also is highly involved in implementing Assembly Bill AB 109, the realignment of the state's prison system in which more persons convicted of crimes serve time locally. And she is seeking $80 million in state funding to replace the 66-year-old south annex jail—a bid we endorse.
The Fresno County Grand Jury last month completed its investigation of the coroner's position and concluded: "Ultimately, we feel that Fresno County should adopt the appointed Medical Examiner-Coroner model in place in the Counties of Los Angeles, San Diego, Ventura and San Francisco. This is the most professional way to structure the coroner's office function. Fresno County has achieved a size (and) stature, and has the facilities to attract and support a full-fledged Medical Examiner in the near future."
We concur with the grand jury.
Marin Independent Journal: Shifting gears in Marin County planning process
After months of study and debate, a special county-selected citizens committee has come up with more than 60 ideas for cutting red tape in the county's planning process.
The most significant message from the committee is the county needs to improve its customer service, providing clear and helpful instructions to applicants and reducing the time and cost involved in the planning system.
The first takes a change of image, from expectations of a potential ordeal snarled in red tape and rising costs to a road map that is clear and not as hazardous.
This image leads too many residents to avoid the planning process and well-intentioned safety checks, banking on chances they won't get caught and fined.
Anything the county can do to present a helpful image and reduce costly delays would be a step toward persuading residents to follow the rules.
The county Regulatory Improvements Advisory Committee was formed after the controversial withdrawal of George Lucas' proposed Grady Ranch film studio near Lucas Valley. After the county Planning Commission had endorsed Lucas' plan and as it was before county supervisors for approval, the county learned that some state regulatory agencies had not signed off on the plan, even though it had been in the works for years.
By the time the plans were presented to supervisors, all of the approvals should have been in place and factored into Lucas' plan.
Lucas, also citing warnings of a prolonged legal fight with neighbors, withdrew his plan, and with it its promise of hundreds of jobs and much-needed local tax revenue.
Supervisors vowed to reform the planning system so the mistake would not be repeated.
They formed the 12-member advisory committee. Its preliminary report recommends county planning staff work "constructively" with applicants and help detail possible obstacles to approval. That includes a clear "flow chart" for the approval process, with review by numerous local, state and federal agencies often involved in larger projects.
That doesn't mean the public should get short shrift. Their requests for information and ability to comment deserve to be treated with the same customer-friendly approach as afforded builders.
But the goal should be to remove last-minute surprises and, as with Lucas' plan, fingerpointing over who left important loose ends on such an important and well-debated project.
The committee's recommendations cover a variety of planning issues, from creating an "express permitting" process to updating the county's various community plans.
The recommendations will be presented to county supervisors early next year.
It's too late for Lucas' studio proposal, but many of the recommendations may be welcomed by those who find the county planning process a costly and time-consuming hassle, rather than helpful.
U-T San Diego: San Diego avoids new self-inflicted black eye
It's been a rough year for America's Finest City in the court of national public opinion. It wasn't just having Mayor Bob Filner be exposed as a serial groper and then driven from office. Earlier in the summer, there was also the case of Jeff Olson.
The city attorney's office charged the San Diego man with 13 vandalism misdemeanor counts for repeatedly protesting at Bank of America branches with criticism written on the sidewalk in easily removed chalk. Olson refused two plea-bargain deals—one very punitive, one somewhat less so—and stood trial. He was vindicated when the jury found him not guilty, seeing his protest as protected First Amendment speech. But the verdict only came after national media coverage scorned San Diego authorities as persecuting a guy for the sin of criticizing a big bank.
Now San Diego has avoided an encore flap of a similar nature. On Monday, the district attorney's office dismissed its felony vandalism case against Ocean Beach property owner Juvencio Adame for allegedly cutting down several small coastal evergreens known as New Zealand Christmas trees, which can have multiple roots. Adame said he did nothing of the sort, only trimming the trees on city property adjacent to his property to clear the area and reduce its use by the homeless.
The DA's Office said the decision to drop the case and end its prosecution of Adame was prompted by new evidence, including an arborist's report that the trees could grow back to their old dimensions in a few years. We don't think it's cynical to wonder, however, if U-T news coverage of the case over the weekend and the editorial board's inquiry about the case Monday morning might have changed some minds. Aides to DA Bonnie Dumanis said she didn't track this case, one of 1,200 or so vandalism cases her office considers each year.
One way or the other, we are glad this potential self-inflicted black eye isn't going to happen. Yes, there are still some murky questions remaining. But the fact that neighbors interviewed by the U-T depicted Adame as being prosecuted for doing the sort of routine upkeep that the city had failed to do showed where this case was headed—to "The Tonight Show" and "The Jimmy Kimmel Show," where San Diego would have faced fresh floggings.
This city didn't need the grief.
The San Luis Obispo Tribune: Don't shut out Salvation Army's drive
Like Santa Claus and Christmas trees, the Salvation Army's red kettles are a holiday tradition, as well as a powerful fundraising tool.
Locally, kettle campaigns raise tens of thousands of dollars for a charity that's often the last resort for desperate families in need of food, clothing, help with rent and utility bills and other necessities. But as Tribune writer Cynthia Lambert reports today, this year, those efforts are hampered by new restrictions on fundraising at certain locations.
Two shopping centers in San Luis Obispo County—one in Arroyo Grande and another in Paso Robles—no longer allow Salvation Army to set up kettles outside of stores.
In Arroyo Grande, the ban on soliciting donations affects not only Salvation Army, but also scouting groups and other nonprofits that go to high-volume shopping centers for candy and cookie sales and other fundraisers. (The company that manages the Paso Robles center could not be reached for comment on its policy.)
For the Salvation Army, this is a serious financial blow; the three kettle locations affected—Walmart and Albertsons in Arroyo Grande and Vons in Paso Robles—collectively generate as much as $35,000 per season in kettle donations.
A representative of Santa Barbara-based Investec Management Corp., which manages the Arroyo Grande shopping center, says the company is enforcing an existing "no soliciting" clause in contracts because tenants complained that some solicitors—not Salvation Army—were bothering customers with their aggressive tactics.
The property manager suggested that Salvation Army supporters mail in donations instead, or that Walmart allow the bell ringers inside that store.
Certainly, those are options. But the reason the Salvation Army kettle campaign is an effective technique is immediacy and convenience. No need to find a stamp, or an address or to write out a check. Simply drop a donation in the kettle and the donation is made.
As for moving the kettles and bell ringers inside, there would be less visibility, and that could involve legal obligations that individual stores aren't willing to assume. And frankly, some "sales tactics"—ringing bells, singing carols—are not suited to indoor venues.
We believe the simplest solution is to stick to what's worked in the past: Allow bell ringers to set up kettles on outdoor walkways and allow other nonprofits—Girl Scouts, Camp Fire, etc.—to carry on with their fundraisers as well.
To guard against overzealous solicitors, why not write up guidelines that nonprofits must follow? Make it clear that if they violate the rules, they will be banned.
We strongly urge property managers and owners to reverse course and allow fundraising to continue—with limits.
In this season of giving, permit Salvation Army to carry on its long tradition of providing a safety net for community members in need.
Santa Maria Times: Setting rules for everyone
It might seem intuitive that Santa Barbara County residents—who sit atop a huge oil and gas supply—would be given an opportunity to make their feelings known about hydraulic fracturing, one process used to extract that oil and gas.
And local citizens will have just such an opportunity—if they are willing to travel to Bakersfield or Ventura, neither of which is in Santa Barbara County, to make their views known at state-sponsored scoping hearings.
Frankly, not holding hearings somewhere on the Central Coast is not much of a surprise, for two reasons. First, bureaucratic decisions are rarely intuitive. Second, state officials overseeing oil and gas regulations pretty much know what kind of public reception to expect in Santa Barbara County.
This county has a long, turbulent history with gas and oil operations, and an equally extensive reputation as being opposed to any new development.
That legacy is unfortunate in some ways, because the oil industry has made great progress in recent years refining methods and procedures for safely extracting oil and gas.
Still, even with the sometimes-toxic public opposition to anything even loosely connected to the oil industry, you'd think officials of the California Department of Conservation could have arranged one local hearing on the contents and intentions of an environmental impact report on so-called "oil and gas well stimulation activities," more commonly known as hydraulic fracturing, or "fracking."
The state has chosen five host cities for hearings this month and next, with Bakersfield and Ventura being the closest. The other sites are Oakland, Sacramento and Long Beach.
However, because we have ready access to the internet superhighway, local citizens wishing to express their views on proposed fracking regulations can do so by going to: http://www.conservation.cal.gov and finding the appropriate places to click.
The state's proposed fracking rules were made public in mid-November, and purport to "strike a balance between strong safeguards, and ensuring that California's oil and gas industry can remain strong and competitive ...."
This month and all of 2014 will be devoted to vetting the proposal, with a final plan by January 2015.
It should be a very lively debate. Fracking involves blasting a mix of chemicals and water into underground rock formations, blowing them apart so the oil and gas can be extracted. Proponents say it is the key to America becoming more energy independent. Critics are convinced fracking is a public health hazard.
As with most high-profile disputes, the truth probably lies somewhere between those two extremes.
The major problem now is that fracking is, and has been virtually unregulated. The proposed new rules at least require oil companies to disclose the chemicals used in the process, and to notify owners of neighboring properties when a fracking operation is proposed.
There are no current fracking operations in Santa Barbara County, nor are any being proposed. But the fact that this region is at the lower end of the oil-rich Monterey shale plume and its wealth of oil and gas deposits more than suggests that the Central Coast will be high on the oil industry's list of future drilling priorities.
We need to think carefully about this, especially as it seems this nation will rely on oil for years to come. Unstable political situations in other oil-rich regions of the planet point to the need for America to become more self-reliant. Still, we don't want to destroy an environment that is part of the coastal California franchise.
At least one of those scoping hearings should have been held here.