Mendocino County Today: Thursday, September 11, 2014

• Local Affairs
• Lions & Bears
• Police Reports
• Catch of the Day
• AVHC Letters & Questions
• This Land Is Mine
• Think Day
• NPR's New Boss
• County Budget Celebration
• Jackson Forest Updates

WHY IS MENDOCINO COUNTY so disengaged from local public affairs? Why the lack of interest?

HUMBOLDT COUNTY, whose demographics are much like Mendo's, boast at least six passionate local blogs devoted almost exclusively to local affairs — LostCoastOutpost, RedheadedBlackBelt, Humboldt Herald, the North Coast Journal’s “Blogthing,” Fred’s Humboldt Blog, and the KMUD radio news blog.

ON-LINE LOCAL commentary? Mendo has almost none, while the comments posted on the Humboldt blogs are extensive, lively, and sometimes even witty. Local politics and events get a thorough airing. Here? Silence.

RADIO COVERAGE: In Humboldt County you have KMUD, a genuinely local community radio station that makes local public affairs a priority. They even cover the Mendocino County Board of Supervisors on a regular basis and, we understand, have more Mendo subscribers and listeners than Mendo’s KZYX.

THERE IS ZERO discussion of local matters on Mendo audio. KMUD’s blog brings the reader editorial and news content both written and audio, whereas KZYX’s “blog” has announcements for upcoming bluegrass or celtic music programs.

THE AVA gets a few letters to the editor about local public affairs each week, but letters addressing local matters in the area’s chain papers are few and far between. With such massive disengagement from public affairs, it's no surprise that some truly appalling characters have been elected to local public office, and then re-elected and even re-re-elected. And the dubious public deals that go down in Mendo — the privatization of mental health services, for instance — prompt almost no comment.

VINEYARD OWNER STEVE ALDEN of the Perli Ranch off deep Fish Rock Road between Highway 128 and the Mendocino Coast, has recently posted these wildlife camera photos of his nocturnal visitors:

ON SEPTEMBER 8, 2014 at approximately 9:35 A.M., Deputies from the Mendocino County Sheriff’s Office responded to the 19000 block of Dorffi Road in Fort Bragg in an attempt to locate Donald Bowman, 41, of Fort Bragg who had two felony arrest warrants for violation of probation. Soon after arriving in the area, Deputies located and arrested Bowman without incident. Incident to that arrest, Deputies searched Bowman and found he was in possession of two glass methamphetamine pipes and a small clear plastic bag containing a white crystalline substance. The substance field-tested presumptive positive for amphetamine and had a gross field weight of 0.7 grams. Bowman was transported to the Mendocino County Jail where he was booked on open charges of possession of a controlled substance, possession of drug paraphernalia and violation of probation. Bowman was also booked on the two no-bail arrest warrants.

* * *

ON SEPTEMBER -09-2014 at 8:00 AM, Mendocino County Sheriff's Deputies along with the Mendocino County Sheriff's Office SWAT Team served a search warrant at a property in the 40000 block of Roseman Creek Road in Gualala, California. The search warrant was obtained as a result of a traffic stop in Gualala in August 2014, where a subject was arrested for being an ex-felon in possession of a loaded firearm (Press Release 2014-22271). During the service of the search warrant an outdoor commercial marijuana growing operation with 94 marijuana plants was located. Taken into custody without incident was Mark George, 56, of Townsend, Delaware, charged with Marijuana Cultivation and Possession of Marijuana for sale. George was booked into the Mendocino County Jail where he was to be held in lieu of $25,000.00 bail. Also taken into custody without incident was Timothy Lepore, 36, of Gualala, charged with Marijuana Cultivation, Possession of Marijuana for sale and a Felony Probation Violation. Lepore was booked into the Mendocino County Jail where he was to be held on a No-Bail status.

* * *

CATCH OF THE DAY, September 10, 2014

MICHAEL FOXWORTH, Ukiah. Probation revocation.

JOSHUA HANOVER, Covelo. Probation revocation.

BRANDON HANSON, Ukiah. Lewd/Lascivious acts upon a child under 14, possession of meth/drug paraphernalia.

RICHARD JOHNSON, Hopland. DUI with priors. (Frequent flyer.)

VERNON KNAPP, Willits. Probation revocation. (Frequent flyer.)

TIMOTHY LEPORE, Gualala. Pot cultivation, processing, sale.

DANIEL LONG, Ukiah. DUI, driving on suspended license.

MEVLIN MARTINEZ, Ukiah. Possession of meth.

DAVID MILLER, Santa Barbara. Drunk in public.

STACEY MODDRELLE, Willits. Drunk in public. (Frequent flyer.)

RICHARD SCHRAMM, Nice. DUI.

DAVID SHEARER, Ukiah. Court order violation, failure to appear.

MARK SOGOIAN, Red Bluff. Burglary.

JENNIFER TINSLEY, Ukiah. Possession of meth, resisting arrest, escaping. (Frequent flyer.)

JONATHAN YOUNG, Willits. Threats to commit crimes resulting in death or great bodily harm, evading a police officer, probation revocation.

AVHC LETTERS and QUESTIONS (for directors and patient/public)

Assembled by Gene Herr

On September 2nd, Diane Paget asked

“What if the Clinic Board were to resign tomorrow, would we have a group of people ready to step in and govern the Clinic the way we would like to see it governed? Maybe some of you are already working quietly on this. If not, maybe it is time to do it. It is not going to be easy to find people with the skills, willing to make the commitment and take the chance that the Clinic might not keep its federal funding under their guidance.”

She raises good questions for the community and for directors.

On September 3rd the Board of Directors of the AVHC Corporation wrote to the Anderson Valley Advertiser:

“The paper has printed a number of letters from community members who have concerns and observations about the Anderson Valley Health Center and the care received by patients there. Unfortunately, many of these letters have promulgated significant misinformation. Additionally, a number of people attending the Health Center’s Board of Directors meeting on August 25, who expressed their concern for Dr. Apfel, repeated much of the misinformation that has been published. Although we cannot always comment on particular points, we can make general statements that we hope will alleviate some of the concerns.

Many people have expressed their strong support for Dr. Mark Apfel and the patient care he has been providing at the Health Center for many years. The Board completely agrees. Dr. Apfel has been skillful and dedicated in serving his patients. The Board respects Dr. Apfel and the care he gives patients. We are not trying to fire him. We want Dr. Apfel to continue to serve his patients at the Health Center.

Dr. Apfel is not retiring at this time. The current plan is for him to be working 20 hours per week in patient care and an additional 6 hours per week on projects that will enhance patient care. He will continue to receive full benefits.

There are many rural communities throughout the country that have been unsuccessful in finding a family practice physician to replace a retiring doctor. Those clinics have either had to close their doors or severely limit their hours of operation. Anderson Valley Health Center has been proactive in planning for obvious eventualities and working to ensure a high level of patient care. We competed with other clinics and hospitals in California for Dr. Logan McGhan’s services, and we are honored that he has chosen us. Dr. McGhan’s services were secured by the combined efforts of the management team, the AVHC Board, and Dr. Apfel.

There have been bumps along the road of this transition. I’m sure I speak for the entire staff and Board when I say that we look forward to successfully completing this process. The members of the Board are all long-standing members of the Anderson Valley community who are committed to a strong, locally managed Health Center that is fiscally sound, legally accredited, and that delivers quality, affordable patient care. If there can be said to be a bright spot amid the turmoil, it is the recognition that our community cares about Dr. Apfel and the continuation of the excellent medical care delivered by the staff of the Health Center. It is the Board’s mission to ensure that tradition carries on.

Ric Bonner, President; Lynne Sawyer, JR Collins, Gaile Wakeman, Eric Labowitz, Wally Hopkins, Sandy Parker”

* * *

What just happened to us in the past year?

Very Visible Failures in Personnel Management:

In the past year Community relations with the AVHC have been largely motivated by outrage at two apparently gratuitous personnel actions, the ugly firing of dental clinic administrator Kathy Corral and the equally ugly reassignment of physician and clinic medical officer Mark Apfel. The same period has seen the collapse of the shared management model of center administration, supposedly a pre-requisite for our operations grants [from the Bureau of Primary Health Care of the US Health Resources and Services Administration].

Director’s Report:

In May, Agee submitted a report [largely overlooked by the community due to anger over the personnel issues] to directors outlining historic and continuing difficulties in AVHC operations and management. She discussed the continued failure of the clinic to satisfy the feds on operational issues, restrictions on availability of funds, problems with the dispensary, and continued failure of the Board’s quality improvement and performance improvement committees to arrive at agreement or a plan forward on correction of issues.

Dispensary Operations Terminated:

The dispensing of all prescription medications was stopped suddenly, June 3rd, “following a decision made by the clinical staff”. The reason given was a lack of full and complete compliance with applicable federal and state regulations.

AVHC Shared Management Team Quits:

Three of the key AVHC management team, Chief Executive Officer Diane Agee, Chief Financial Officer Dave Turner and Chief Operating Officer Lucresha Renteria decided that they could no longer work as employees of the AVHC under the shared services agreements with the three other Mendocino county Health Centers participating. These decisions “were based upon on-­going compliance issues with the dispensary operations, and federal program requirements for an active and effective performance improvement program and concerns related to liability and risk in clinical operations raised in a recent clinical audit.”

Federal Grant:
“We were notified by the federal Health Resources and Services Administration (HRSA) on May 27th that the AVHC was approved for a 3 year project period from June 1, 2014 through May 31, 2017. The grant is for community and migrant/seasonal worker health programs and totals $756,951 per year. This is the longest grant period that can be awarded and was issued with no restrictions or special requirements. This is the best possible outcome for the AVHC and reflects the hard work and diligence of the staff and management who oversaw the October 2013 HRSA site visit and audit, the implementation of corrective actions to resolve prior deficiencies (unrelated to the current issues) and the grant proposal document.”

New Personnel:

The shared management model team resigned at the beginning of June. The board has filled Diane Agee’s executive director’s job with an in-house transfer of Physician’s Assistant Shannon Spiller (her work at the school program and wellness programs to be covered by newly hired RN Michelle Ambrois ), hired accountant Judith Waterman, owner of Ukiah-based Price Waterman, (a firm which currently handles AVHC bookkeeping ? and accounting,) to replace Dave Turner as “financial officer—when needed”, and filled Lucretia Renteria’s operating officer’s job with an in-house transfer of business manager Faviola Cornejo, with no one seemingly named to pick up Cornejo’s previous responsibilities.

New hired Doctor Logan McGhan began seeing patients in August. He is a recent graduate of the UC San Francisco – Fresno Medical Education Program and did his residency in Family and Community Medicine. He is bilingual in Spanish and has volunteered, worked and studied in various locations in Mexico.

The biggest personnel change is the hiring of clinic consultant David Gorchoff MD, as medical director. It is difficult to see how this position fits in the organizational structure of the clinic. Technically he will be working under the direction of Spiller. Gorchoff will not see patients. He will direct the clinic and supervise the medical personnel but not medical assistants or dental assistants however, who will be supervised by Cornejo. Gorchoff came to the clinic in March, hired as a consultant to outline changes needed for AVHC to become “FTCA deeming status” compliant, a status which would save the clinic some $20,000 annually in liability insurance. His initial report (according to Agee) outlined 8 key clinical/dispensary deficiencies” and is “under review by the AVHC performance improvement committee (which has made no public report on the matter).

Gorchoff was hired as Chief Medical Officer, replacing Apfel effective July 8, 2014. “He will be leading the efforts to implement programs and practices to help support the delivery of quality care and to insure continued federal funding. These include: strengthening our Quality Improvement program; improving clinical work to support quality and efficiency; working with our IT vendor to improve the usage of our electronic health record system to facilitate efficient and thorough utilization by staff ; moving AVHC toward becoming certified as a Patient Centered Medical Home by the NCQA, which is a multi-year process; develop policies and practices which will allow AVHC to apply for FTCA deeming (federal professional liability coverage) in May of 2015; working with other clinical leadership and providers to re-engineer and eventually reopen the dispensary operation.”

Where does this leave the community?

Answers which can only come from Mark:

Is the offer of the Board for hours, salary, benefits, work assignment sufficient for you to be willing to remain at AVHC? Are you satisfied that you will be able to work with the new administrative structure? Does the present medical and administrative staff provide you with enough support to work effectively?

Answers which can only come from the Board:

The Board’s letter above cites much misinformation about the clinic circulating in the community. It ignores its primary function to inform the community about the policies, operations, finances, and future of the Anderson Valley Health Center.

Shared Management left overs: Diane Agee claimed that the initial operations grant from the Feds required a shared service management agreement and full exploration of merger with one or all of the other community health centers [participating were Redwood Coast Medical Services; Mendocino Coast Clinics and Mendocino Community Health Clinics, Inc.]

Does the board intend to merge any or all functions with other health centers?

Does the Board have any intention of selling the clinic building, or leasing it to any other health center?

What are our obligations under the shared management model now?

There is a prerequisite that the Feds pre-approve any change in the position of executive director. Did they approve Spiller’s appointment?

What are the duties of Agee, Turner, Renteria, now serving until the end of February 2015 as “volunteer consultants”?

What is the significance of the February 2015 date?

Do they have positions descriptions?

Who pays them, how much?

How and where is their compensation reported for tax purposes?

Are any of the shared services still operational, i.e. any of our personnel working with other clinics, any portion of our grant funding work done at other clinics, any consulting still available from any of their employees, e.g. pharmacists?

Do the three former officers retain any of our files and passwords and access links to other agencies such as banks, accounts, or the Feds’ grant people and management?

Grants, Operational: Is there any threat to, or condition, on any of our grants?

Who is in charge of dealing with the Feds on existing grant compliance?

Who is in charge of policy development which deals with requirements for new grants or extension of existing grants?

Please describe the programs for which grants were received: community health care; seasonal agricultural workers health care.

Please outline the scope of the programs, what and how much the grants fund for each goal?

Please describe the additional grant received for outreach under the Affordable Care Act: how much, for how many years, what results?

How do you determine whether grant goals are community needs- driven or grants- driven?

Plans for the Future:

According to Agee’s report Fed compliance reviewers noted in October of 2013 (as a “not met” compliance standard) the Board needs to pursue a “more robust” strategic plan and engage with other community health centers to “assess the consolidation/merger options.”

The Board met in June with a professional facilitator to discuss strategic planning. There has been no report of any results of this meeting, nor of any intentions to provide the community with specific plans for what it says are its goals: continued operation and development of “a strong, locally managed Health Center that is fiscally sound, legally accredited, and that delivers quality, affordable patient care”.

Does the Board recognize the need for community involvement in a successful Health Center program?

How does it suggest that the community might help?

Which directors’ terms expire in December?

What is the status of the student director whose term expired at the end of August?

Is the Board interested in recruiting new directors who could help with finances, fiduciary responsibilities, governance and management, staff recruitment, IT systems, future planning?

What are your procedures for recruiting directors?

Is the Board interested in involving community members in supporting roles, such as committees to assist with finances, fiduciary responsibilities, governance and management, staff recruitment, IT systems, future planning?

How might community members best volunteer for such a service?

And last (for now) why does the Board not use the web site to inform the community by: keeping information current and complete (including all staff), publishing the Articles of Incorporation, the current and previous year’s budgets, the budget vs. actuals reports monthly, the written reports of all officers (Director, Operations, Medical) standing committees minutes, the members of standing committees.) And an announcement of availability of the audit report for public review would also be welcome.

THIS LAND IS MINE by Nina Paley

http://vimeo.com/50531435

THE RESPONSE to World Arnold Day, July 30, was underwhelming. Only a few imaginative luminaries were able to comprehend the intent. But next year, World Arnold Day will grow in popularity, no doubt. The next New Holiday is tentatively titled Think Day. Think Day will occur every September 10th, which happens to be today. On Think Day, people will be encouraged to use their heads before leaping into hazardous ventures at the instigation of political shysters. Think Day will help people resist the blizzard of bathetic rhetoric and bloody-shirt waving that happens on September 11, which our rulers have titled "Patriot Day". Self-styled patriots may wish to use their brains in advance of our next leap into the 1400-year old intra-islamic civil war as we gear up again to take another punch at the tar baby. Yours, Biro

SAME OLD, SAME OLD

Subject: New NPR Boss: 'We're Going to Be Talking About Brands That Matter a Little Bit More'

SUPES & CEO CONGRATULATE SELVES for simply doing their job, declare, “County Budget is Something to Celebrate”

“After five years of fiscal instability, the County’s financial status is on the mend. Today, on the second day of the FY2014-15 budget hearings, the Board of Supervisors voted 5–0 to approve the final budget submitted by the Chief Executive Officer. According to Mendocino County Board of Supervisors Chair, John Pinches, ‘This is not only a budget to adopt; it is a budget to celebrate. This budget includes something for everyone.’ CEO Carmel J. Angelo outlined her final budget recommendations within the framework of the Board’s current goals of Fiscal Stability, Financial Sustainability, and Organizational Development. The County has been struggling to mitigate a deficit and balance the annual budget for the past few years. Ms. Angelo told the BOS, ‘With the adoption of today’s final budget, the County will have a $10M General Reserve, establish a $1.5M Pension Gap Reserve and recognize the good work of our employees with one-time supplemental payments.’ Employees in the SEIU bargaining group will receive a one-time payment of $1200, in return for a one year contract. According to Ms. Angelo, ‘while the County is not able to restore the 10% wage concession employees took over the past few years, this is a positive first step in the process of giving back to our employees.’ Additionally, County employees will benefit from the $1.5M allocation to establish a Pension Gap Reserve to ensure the County is able to meet its pension obligations to past, current, and future employees of Mendocino County. Other highlights of the approved FY 2014/15 Final Budget include an allocation of $1M for corrective maintenance on our County roads; paying off the Teeter Plan Debt which had grown to $11M in 2009; and maintaining a $500,000 contingency fund for unanticipated expenses that may occur during the fiscal year. According to Deputy CEO Heidi Dunham, ‘This budget is balanced, innovative, fair, and most importantly, it indicates we have entered a period of fiscal stability for the first time in several years.’ The final budget resolution is scheduled to be adopted, as a matter of process on September 23, 2014. Budget materials are available on the County website, Executive Office page at: http://www.co.mendocino.ca.us/administration/BoardWorkshops.htm.” — Carmel J. Angelo Chief Executive Officer

JACKSON DEMONSTRATION STATE FOREST Campground and Firewood Area Closure and Mushroom Permit Update

Fort Bragg– California Department of Forestry and Fire Protection (CAL FIRE) Mendocino Unit is preparing for the Fall season at Jackson Demonstration State Forest (JDSF) by announcing changes in the mushroom permit program as well as scheduling seasonal campground, road and firewood area closures.

Mushroom Permits: All individuals collecting mushrooms on JDSF must have a permit. Permits are issued for a 12-month period (July 1– June 30) annually from the JDSF Fort Bragg office. A new permit process has been established to enhance resource protection measures. There is a single annual fee of $20.00 for an individual permit. The permit entitles the permittee to gather mushrooms on JDSF for either commercial or personal use with no daily collection limit. Special Use permits for educational institutions may be arranged by contacting staff.

Campground Closure: The seasonal closure of JDSF campgrounds is scheduled for Monday, September 29, 2014. Wet weather could require the closure of the campgrounds sooner. If you have any questions about the status of the campgrounds, please contact our office.

Firewood Area Closure: The designated area for firewood cutting will also close on September 29, or first significant rain, whichever occurs first. After the closure, all firewood cutting on the Forest is prohibited.

Seasonal Road Closures: Effective on Wednesday October 15, 2014, except as noted below, all State Forest roads within Jackson Demonstration State Forest will be closed to unauthorized public vehicular traffic in accordance with Sections 1431 and 1438, Title 14, California Code of Regulations. The road closure prohibits the use of all unauthorized motorized vehicles, including motorcycles and ATVs. Roads may still be used for hiking, bicycling, and horseback riding. It is always unlawful to operate unlicensed vehicles (including off-road vehicles with or without green stickers) on State Forest roads. Off-road travel with motorized vehicles is not permitted on the State Forest.

This is a seasonal closure that protects forest roads from damage during wet weather. Please do not drive on roads that are wet and have soft surfaces, even if they are not formally closed. Road and stream damage can occur from rutting and erosion. It is not safe to drive on roads with slippery surfaces. Please help us protect your forest resources.

EXCEPTIONS - ROADS THAT WILL STAY OPEN:

The following roads will generally remain open throughout the winter, but may be closed periodically without further notice depending on road and weather conditions:

Road 100 (closed at the property line at the north end)

Road 130 (closed at Road 1000 at the north end)

Road 200

Road 250 (closed at Road 1000 at the north end)

Road 350 (only as far as the Egg Collection Station/Camp One Day Use Area)

Road 500

Road 700 to Mendocino Woodlands State Park

Roads 800 (to the property line)

Road 810

Road 900 only to Road 810

Information regarding camping and other recreational activities such as mushroom gathering on JDSF is available at the CAL FIRE Fort Bragg office located at 802 North Main Street, Fort Bragg, CA or by calling (707) 964-5674 during the following hours: Monday through Friday from 8-12 & 1-5. Our website is: http://calfire.ca.gov/resource_mgt/resource_mgt_stateforests_jackson.php

Multiple uses of JDSF for a wide variety of activities that benefit the public, the economy and natural resources are what our demonstration forests are all about.

(CalFire Press Release)