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AV Health Center Capital Campaign Goes Public

Many Advertiser readers know the Health Center Capital Campaign “Heartbeat of The Valley” raising monies to expand the facility’s offices has moved from the “silent” to the open phase. Last month the whole community received in the mail the formal announcement from the HC’s Executive Director Chloe Guazzone, English on one side of the letter, Spanish on the other.

As of this week the expansion is nearing completion and all concerned, staff and contractor, hope the ribbon cut-cutting and medical services grand opening will be in early September. HC staff anticipates with relief the end of the care provider/patient traffic congestion the new space will provide. Many of you who are long-term patients at The Clinic can speak to the experience yourselves. I recollect sitting inside the doorway of the narrow, too small lab last year having a blood sample taken as other staff pushed past the nurse doing the extraction, while two other caregivers were bumping into one another looking for some medical item on the lab workbench. Or a few minutes later sitting in a tiny exam room with a RN wielding her stethoscope in search of my heartbeat, another staffer bursts into our work space, clipboard in hand, looking for an empty one for her patient, the distraction forcing the nurse to begin the heart rate evaluation all over again.

On another visit occasion one Thursday noon last year I arrived at The Clinic for another blood pressure remediation appointment a few minutes early, my habit. Thursday mornings at eleven is the time for the medical team weekly staff meeting- to identify and reconcile medical transaction management problems that have arisen. As I approached the appointments desk, I saw in the area behind ten or so staff standing in what appeared to be a magic fire pow-wow circle engaged in conversation I couldn’t hear. There was Mark Apfel in his faded Hawaii red/yellow hibiscus shirt, Dr. Rochat in formal green gown, Chloe, Cindy Arabanovella, other medics all in earnest conversation. It was five minutes before one of the two receptionists noticed me standing outside the glass partition. Issue: there was no other space available in the current clinic for the weekly staff meeting.

For perspective let me remind you that the endless need for more service space my previous articles describe is the consequence of Phranklin and Mark Apfel’s forty six years ago vision of providing primary healthcare to the Anderson Valley community, and their and other colleagues’ mission to continue expanding the range of service programs available to us. Chloe’s campaign contribution solicitation letter to the community reports “75% of the community relies on AVHC for their regular healthcare,” which means there are 37 full and part-time employees in the current building seeing an average of 45 patients per day, often attended by family members. A very dense work environment, not quite as dense as a bee hive though.

And so arrives soon the new addition, the structure on the east end of the existing one, two stories facing toward Highway 128 and the Rickard Ranch subdivision ridge east of the 128 Freeway, affectionately known as Cheesecake Estates. The expansion, some 4,700 square feet, is dedicated mostly to administrative offices, a luncheon room/rest area, patient records storage, and IT service office/computer hardware room. The architect for the new building is local resident Steve Wood, the contractor Ric Cupples, born and raised in Anderson Valley. Ric’s wife, Jane, was the volunteer first receptionist at the Clinic’s earliest offices, the abandoned Spenard Building in downtown Boonville. The addition, Chloe reports, was estimated to cost about $1.5 million. To date in the “silent” phase our community has contributed around $1.4 million. Your reporter, also an experienced construction budgeter, is pretty sure the $100,00 Chloe says remains to be raised, won’t cover all the costs, building, utilities, furniture, medical and other equipment, and so on needed to open the doors.

Last month I interviewed architect Steve Wood about his participation as apprentice to Ron Verdier, designer of the last expansion in 2002, and how his own addition design intends to relieve the human traffic congestion in the current space. I also contacted retired Medical Director Mark Apfel last week about his recollections of work life in the clinical beehive over almost forty years.

Steve and I sat on the veranda outside his office in the Boonville Weintraub commercial/office complex early one afternoon, and he explored his recollections of that first expansion back in 2001-4. The original 1983 building was about 2,700 square feet. Over twenty three years later the services and patient base had simply outstripped the available space. There was no longer room to include the available dental, chiropractory and mental health services, to support administrative activities, or a functioning reception area. It was also time to include an emergency services area and ambulance docking space. Executive Director Judith Dolan, RN, and Ron Gester, leader of the volunteer Anderson Valley Ambulance Service, were key contributors to the design planning process.

The contractor for the project was Mike Nonella, Santa Rosa, but born locally, this reporter believes related to a famous Fort Bragg nineteenth century stage coach wagon building family by that name. (I once saw a Nonella vehicle, totally restored, repainted red, orange, blue, green, in a Museum in Danville, East Bay. A sign on its side door announced, “Nonella Stage, Point Arena, Fort Bragg.) The architect Verdier, HC staff and contractor collaborated effectively to come up with a 4000 square foot expansion to the existing building. At the west end facing Boonville International Airport was the ambulance reception, emergency room area, accompanied by a larger bathroom arrangement than what the current building had. In the middle space were four patient examination rooms, the lab, admin and record-keeping offices. Design played an important role in the operation of the medical facility. The south-facing chicken shed roof elevation permitted as much natural light for patience room ambiance, and moveable windows for healthy ventilation. Solar panels on the roof contributed to the passive heating and cooling elements. The east end of the building housed administrative offices and a board and staff meeting room.

Steve also noted that in his apprentice status back then what a valuable experience it was to be part of such a collaborative renovation planning environment between the architect, Judith Dolan, Ron Gester and the contractor Nonella. He then couldn’t resist a story about his bizarre experience working with part of the local community on the current expansion project. He found out he had to get a variance from the Mendocino County Airport Commission in order to build a two story building over 200 feet east of the north/south runway. My ironic first thought was it would take remarkable piloting skill to fly into the building, but then I didn’t know that small but twin-engine jets sometimes land at Boonville International in foggy conditions.

Then last week I visited again with Mark Apfel at his Greenwood Ridge schoolhouse home. Mark regaled me with his recollections of the clinic’s work space problem that has been its ecosystem since the first offices in downtown Boonville. His recollections of those days and experience are captured in the traffic report stories at the beginning of this article. And as Mark’s definition of “retirement” is more like the next chapter in his adventures, we spent most of our time together looking at the two spaces around his house he is planning to plant grapes, likely Syrah and Pinot noir to support his winemaking agenda. I of course was intrusively advising him on “appropriate” vine spacing, trellis structure and irrigation water needs.

The new Clinic addition is closed-in now, and construction is at the endless stage of interior elements completion, down to door fixtures and window trim, lighting and furnishings installation, stairwell railings, and so on. The ground floor main entrance on the building’s east side opens into a spacious reception area similar to the current one, behind which is the enclosed office for the IT services manager. To the reception left is a staff meeting room overlooking the landscaped exterior walkway between the current building front door and parking lot. Also behind the reception desk is the much-needed medical records storage space and includes computer hardware and spare office furnishings. To the reception desk right is a corridor north, first with a public rest room, then the elevator to the second floor, and finally exam rooms on each of its sides, five of them dedicated to mental health counseling, the sixth described on my floor plan as the “Teen center,” at the corridor end north a more private entrance to these health services.

The staircase to the second floor is to the right of the reception/waiting room area and against the east wall opposite the elevator. It spirals circularly and elegantly up to the elevator door and another rest room. To the left and against the south wall is a large break and lunch space that also opens onto a larger open deck supporting the room’s purposes and should also become a lovely outdoor meeting space when the weather cooperates. The north portion of the second floor past the staircase has the same plan layout as the first, six administrative offices distributed on either side of the corridor and leading to an exit staircase down to ground level. The highlight of the second floor, in this reporter’s view, is the lunch room/deck design, and hope I get an invitation to visit this space and look south across the Valley Floor to the old Moonie Ranch and Floyd Johnson’s ranch highlands all the way to Shearing Creek.

Of course, this reporter with fifty years’ experience living in The Valley and observing the evolution of the community and the Health Center wonders for how many years the old building and the new addition will provide enough space for the services it provides. A fun future mapping exercise, but not one likely of accuracy. HC Board Chair Ric Bonner notes the new addition will provide enough service space to increase the daily patient encounter count from 45 people to 64. Yeah! 

Let me close my report by asking each of you readers to consider how much each of us who care about our community and its future can contribute to one of its key local institutions, The Anderson Valley Health Center and its future role in our common health and welfare. 

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