It was an enjoyable excursion down memory lane sitting with Mark Apfel in his Greenwood Ridge home backyard garden on a serious spring afternoon last week. Mark is a compelling story-teller, quite good with facts and more important their historic meaning. In about an hour, never mind the side reminiscences about other local characters and adventures, he had spun a valuable recital of the Anderson Valley Health Center’s migration from its first office in the downtown Boonville Spenard building to its own space on Airport Drive next to Anderson Valley High School.
By 1980, his founder cousin Phranklin, Mark, in fact the whole staff realized the downtown walk-in office couldn’t support in its small, physically fragile space the increasing daily patient visits and medical services, never mind mitigate the building’s sanitary condition. Together staff began exploring the possibilities for outright office ownership, and with support from knowledgeable community members, began investigating affordable locations, building design, governmental grant possibilities, and local fund-raising activity.
The property site for the first Health Center-owned building is where the current offices and new extension sit today, two acres west of the AV High School ball fields. The AV School Board had a genuine interest in having the facility nearby as it could provide proximately more medical support for the students and staff than could the sole school nurse. So it leased the building site to the Health Center at a modest rent for a number of years before selling it for a nominal price around 1990. A talented architect Harry Jordan, rusticating here in the Valley while still practicing his craft in the Bay Area, drew up a set of building plans capturing the current medical service's space needs and the construction limitations inherent in the Health Center’s financial position. What Harry designed was a rectangular chicken shed style window-walled passive solar structure facing south on a cement pad still embedded in a small part of the current building’s footprint.
First site problem arising was the inability of the soil structure to sustain a viable waste water septic system. Hence one still sees today an above-ground dirt mounded leech field running east and west along the Health Center parking area, an interesting piece of landscaping. For the rest of the design Harry laid out an entrance about where the current one is; inside was waiting room sitting area (doubling as the Health Center Board of Trustees meeting room). Across this space near the back wall was the reception desk, about eight feet long. The rest of the floor plan captured facing as they do today four exam rooms, an emergency procedure room, a real lab and an x-ray room. Total floor space was about 2,700 square feet. The contractor was a Santa Rosa firm notable for small office space construction whose name Mark doesn’t recall, though he remembers local builder John Burroughs did some of the subcontract work.
Next was the construction financing matter. This is where Administrator Terry Anderson’s inherent energy and skills shone brightly. Terry and her husband Jim had moved to The Valley from Sacramento, where she had had experience as a small business office manager, but she also was an intuitive financial planner, fearless but frugal. It was Terry’s relentless reconnaissance that found the financing. Mark and Peggy relate. AV Health Center received a loan of around $350,000 from the US Department of Agriculture. Simultaneously Health Center staff launched a fund raising campaign up and down Anderson Valley. At a time before the arrival of the more wealthy winery and vineyard owner community (Roederer, 1983) Mark recollects they were able to raise about $30,000 in that first drive.
The Health Center staff and friends were also skilled at celebrating their achievements, receptionist Jane Cupples reported to me, and there was a boisterous party to memorializing laying the building cornerstone. The ribbon-cutting celebrating the grand opening was at the end of the year 1983, another cause for a party including staff and community, and the building’s doors opened that December. What Jane Cupples remembers about those early days in the new facility was the relief and comfort staff felt being able to do their medical work in a healthy environment designed specifically to support the profession’s mission to “do no harm.” A lot different from the constant worry about structural weaknesses in ceilings, windows, floors, plumbing and electrical failures, and general sanitariness of the downtown Spenard building.
Everyone part of the in-town offices made the move to Airport Drive, including Phranklin, Peggy Miniclier, FNP, Judy Nelson, RN, Annie Stenerson, lab technician, and Jane Clow (now Cupples) and Maria Reynoso, receptionists and bookkeepers. Mark retired early this year, though he still provides occasional back-up support for vacationing staff. Maria stayed on staff for 42 years, Jane Cupples retired in 1990, Peggy Miniclier in 2007, Judy Nelson five years ago. Not long after the new building opening Phranklin decamped to Ukiah to explore another pioneering primary healthcare for the unserved project, and Mark became a full-time staff member and Medical Director.
A growing patient community and added healthcare programs had contributed to making the old Boonville slum site inoperable. And the availability of a purpose-built office space and more programs continued the growth of patient portfolios representing all pieces of the Anderson Valley community, particularly older people, less wealthy locals and immigrant Mexicans. New programs included WIC (Women with Infant Children), a US government funded program supporting women in pregnancy and early child development health care, particularly important for poor families with no prior access to professional pre-natal and post-birth support. Judy Nelson, RN, began visiting the AV school system weekly to identify common childhood illnesses, the poxes, flus, asthma, diabetes, etc. And to continue support of the mission of affordable medical care the pharmacy also made the migration from the old Spenard building to the new offices.
The rest of the Health Center-owned medical facility story follows the path I’ve described here and in my previous article. The patient base continued to increase, particularly among the growing immigrant Mexican vineyard worker community; managing the business side of low cost medical services for the growing customer base became increasingly challenging; state funding became more unpredictable in the 1990s because of urban governor Pete Wilson’s disregard for California’s rural medical care needs. Tragically the talented, caring Administrator Terry Anderson died in 1999 after a heroic battle with cancer.
Her replacement, a recently arrived local resident, retired RN Judith Dolan, was a timely addition to the Health Center staff and mission. Judith had not only extensive medical practice experience; she also had done medical administrative work, the vital, thankless task of patient information management supporting appointments, diagnostics, billing, filing, etc., without which a growing primary care walk-in clinic can’t survive.
And soon enough the Anderson Valley Health Center’s contribution to the health and wellness of the local community was putting strain on the space required to provide for the waxing daily appointment schedule. Sometimes every seat in the waiting room area was occupied, people stood in corners, under the portico outside the front door, or in their cars. No fun on a rainy day in January for a family with two sick kids and a worried husband and wife.
Thank you to Mark Apfel, Peggy Miniclier, Jane Cupples, Eric Labowitz for your assistance writing this article.
(Next Episode: The Health Center in the 21st century: Growth and another building campaign.)