July 2009 Archives

New chief of Memorial shares his concerns about impact of new Sutter hospital

During a meeting with The Press Democrat Editorial Board Tuesday, Kevin Klockenga, the new CEO of Memorial Hospital in Santa Rosa, said he was concerned that more of Sonoma County's uninsured and underinsured patients could end up at Memorial if Sutter is allowed to build a 70-bed hospital near Wells Fargo Center.

But how is that possible if Sutter is now operating at an average of 66 patients a day without, as Sutter CEO Mike Cohill contends, impacting other community hospitals? Sutter contends it is, in effect, already operating as a 70-bed hospital.

Klockenga (pronounced "Clock-en-gay") was careful in his answer to give credit to Sutter for caring for its share of the uninsured in the community, but here in a nutshell is what he had to say. The key is to look at Sutter's plans to drop medical/surgery beds from 91 to 20 and its proposal to reduce ICU beds from 16 to eight.  While it's true that Sutter's average number of patients has dropped to less than 70, its average for medical/surgery beds is around 41 patients per day now, which means Sutter is preparing to build a hospital that only meets half its needs in that area.

The reason that is significant to the issue of uninsured patients is that last-minute, emergency surgeries are more likely to involve uninsured patients, mainly because those without health insurance tend to let a health problem advance to a critical stage before seeking help through an emergency room. Those with insurance tend to be the ones who have scheduled surgeries. And if a block of Sutter's beds are taken up by scheduled (insured) patients, those last-minute emergency (likely uninsured) cases may have to be diverted to other hospitals (such as Memorial.)

As it is, Memorial already takes care of half of Sonoma County's uninsured patients. Sutter has the next biggest share, while the communithy hospitals and Kaiser make up the rest.

In addition, Klockenga told us that in recent months Memorial "has seen a significant and steady increase in the number of uninsured patients." Part of this is a result of our archaic system of tying health insurance to employment. Lose your job and your child loses his doctor.

Finally, Klockenga also was skeptical about Sutter's plans to use perinatal beds as a backup when medical/surgical beds are taken. "Show me any hospitals that do that on a regular basis," Klockinga asked. "It seems good in concept, but it doesn't work very well. I've tried it."

Klockenga, formerly chief operating officer at Memorial, was appointed as interim chief after former lead George Perez stepped down in September. He was officially named as CEO in early March. Prior to coming to Sonoma County, he worked for three years as chief operating officer for Catholic Health Care West's two hospitals in Bakersfield.

- Paul Gullixson

There's no question that California has big budget problems, but so far no one has suggested selling the state Capitol.

In Arizona, that idea was just put back on the table by the Republican majority of the state legislature. Faced with what they describe as their worst fiscal crisis in a generation, legislative leaders endorsed a lease-buy back scheme for the buildings used by the state Senate and the state House of Representatives plus several other state properties.

Gov. Jan Brewer, also a Republican, vetoed the idea once, but may have it delivered to her again soon.

The sale would generate an estimated $735 million to help eliminate a $3.4 billion deficit. To buy the buildings back, the state would make lease payments of about $1.2 billion over 20 years.

That beats budget cuts, GOP leaders told the Arizona Republic.

"What are our choices?" asked John McComish, the House Republican leader. "We could cut more, or we could raise taxes more. Borrowing over the long term, we think, is better for the people, better for the economy."

So much for fiscal conservatives ...

-- Jim Sweeney

Haven't had enough of the Michael Jackson circus? Try his thrill rides.

Not that we want to draw attention or attendance from our Sonoma County fair which began this week, but news is circulating quickly - for reasons that escape me - that three rides that were once at Michael Jackson's Neverland Ranch will be at the State Fair in Sacramento next month.

The State Fair's carnival operator, Butler Amusements, has confirmed that it bought five rides from Jackson's Neverland ranch. Three are expected to be at this summer's California State Fair from Aug. 21 to Sept. 7.

But North Coast residents will likely get an advance look at least a couple of these rides. Before the State Fair, Butler Amusements also will be operating the carnival at the Lake County Fair Aug. 3 to 6 and the Redwood Empire Fair in Ukiah Aug. 6 to 9th.

One of the Jackson acquisitions is called the "Wave Swinger' which is one of those rides with swings on a carousel. Another is called "The Balloon Samba," which simulates riding in a hot air balloon. I didn't make this up. 

OK, that's all I've got for the Michael Jackson report today.

- Paul Gullixson

The Washington Post parachuted into Mendocino County for a look at the backlash against pot growers that culminated last fall in passage of Measure B, which rolled back the liberal pot rules approved by voters eight years before.

Karl Vick, a Los Angeles-based correspondent and the Post's former Istanbul bureau chief, offers some good history, an easy read and a terrific kicker quote from beleaguered District Attorney Meredith Lintott: "Quite frankly, I might benefit from a card. This is a high-stress job. It would probably do me good to go home and smoke some pot in the evening."

Me, I prefer scotch.

-- Jim Sweeney

In his weekend column, Charles Krauthammer unloaded on the health care reform plans put forth by congressional Democrats and the White House for failing to control rising costs. And on that point, he's right. But Krauthammer's solution doesn't stand up to scrutiny. Like many of his fellow physicians, Krauthammer blames malpractice lawsuits and the cost of malpractice insurance for costly medical care.

Slap a limit on malpractice judgments, he says, and you rein in the costs.

Krauthammer needs to visit California. The Golden State has had the nation's toughest cap on malpractice awards for some 30 years, courtesy of legislation sponsored by Barry Keene, a Democrat who represented Sonoma County in the state Senate and Assembly.

Under his measure, known as MICRA, jury awards are limited to $250,000 for pain-and-suffering - the ambiguous, subjective and costly portion of malpractice lawsuits that Krauthammer calls "jackpot justice."

Trial lawyers hate the California law, doctors love it and malpractice lawsuits are rare in California. And health insurance is cheaper here than in states that don't limit lawsuits, right? Sorry, Charles.

Limits on lawsuits might be a good idea, though MICRA ought to be adjusted for inflation. But there's no evidence in California that limiting legal judgments reduces the cost of health care.

-- Jim Sweeney

Adventures in an Odyssey - Day 6 - Bismarck, N.D. to Detroit Lakes, Minn - 243 miles

The last time I was in Bismarck, N.D. was during the summer of 1989. I arrived determined to hop a freight car. This had been one of my ambitions, and I had finally reached the time and place in life to give it a try.

At the time, I was on another extended odyssey through the nation, although without a car. In fact, all I had in the world was contained in one small black backpack. Being so possession-free was liberating, I remind myself now. This was my "Equinox of youth tour," in recognition of my having turned 29 and having reached a restless stage in life and career.

 After having visited a friend in Duluth, Minn., I hitchhiked across Minnesota and half of North Dakota. I remember my last ride was with a man about my age who had just gotten out of the service and was driving to Oregon in a pickup loaded down with everything he owned. He was on his way to marry his girlfriend and had made his own suit for the wedding.

He thought I was crazy as he dropped me off late one evening near the rail station in Bismarck, and we parted ways. We exchanged addresses, but I lost his when my backpack was stolen a month later in San Francisco. He was a nice guy. It would have been nice to find out how things turned out for him.

He would have been amused that I indeed ended up riding a rail car, but it was not quite the experience I had envisoned. These things never are. As it turned out, that area was one of the major rail hubs of the nation, as I had been told. But the hub is not in Bismarck. "You gotta go to Mandan," some guy at the rail station told me that night.
"How do I get there," I asked.
"You can either get back on the highway and head west, or you can follow the tracks until you cross the river. You can't miss it."
Given my limited options, I set off down the tracks.

It so happens that near Bismarck is Fort Abraham Lincoln, where Lt. Col. George Armstrong Custer and the 7th Calvary rode out on their way to Little Big Horn. That is to say this area has a rich history of ill-fated expeditions, of which mine was one.

Following the tracks was a fine idea until the surroundings grew darker, the banks on each side grew steeper and I started to get farther from any noise or lights. And then I came to "the river," that is the Missouri River. The tracks crossed the Missouri via an expansive tressel which, I was to discover, didn't have a walk way on either side.

As turning back was no option given the late hour, I began to cross that long stretch of dark tracks, carefully stepping on each creosote-soaked rail tie while keeping a close eye on the long drop to black water below. As I recall, there were metal bars - part of the tressel - to hold onto for extra security, but it slowed my progress.

As these things happen, I was about half way across when I first heard the train whistle - not from behind me a la "Stand By Me," but coming from ahead of me. My heart raced as I picked up speed, stepping on each tie with care but haste bordering on panic. Again the whistle blew, this time seeming louder.

Soon I was sprinting as much as I dared, knowing there was no room for me and a train on this tressel. It was hard to know which of my options presented the most risk - running too fast or not fast enough. This was going to be close.

I held my breath the last 20 feet and, heralded by one more blast of the whistle, I reached the far side of the river and descended the rocky slope with a landslide. Sweat poured from my brow.

As I sucked air, I waited to hear a roar on the tracks above me, but nothing happened. A short while later the whistle blew again, but still no train.

I went back up the bank and continued my journey. A few hundred yards farther, the track took a slow, wide turn around the bend and when I completed the turn, there was the train, sitting on the tracks, not moving, amid dozens of other trains within the great Mandan freight yard.

At that point, it was about 2 a.m and given I could not find a car ready to roll West (the biggest challenge in catching a freight train at night is figuring out which end of those endless lines of cars has the engine, if there's one to be found at all) I settled down atop a large stack of rail ties where I couldn't be seen and fell asleep.

Then it started to rain.

The quick end to this story is that I finally caught a rail car, a "grainer," heading west. These have small platforms on each end that will support a rider, but riders are pretty easy to spot. Open box cars just weren't to be found, so I rode this grainer for about 20 miles before it stopped and showed not signs of moving on.

Wet, cold, sleepy and hungry, I hopped off, made my way back to the highway and, in the middle of a downpour, caught a ride with a guy driving a bakery truck who drove me as far as New Salem, home of Lucy, the world's largest fiberglass holstein.

There I spotted a Greyhound bus sign at a service station, a sight so glorious to me that to this day I own a Greyhound sign of my own.

How do we begin to explain these kinds of misadventures to our kids especially when we don't entirely understand ourselves how we got into them in the first place? I don't know. But I chose to keep my past adventures mostly to myself as we cruised past Lucy the cow and Mandan and finally crossed the Missouri River. Off in the distance I could see the dark tressel, looking no more welcoming than it was 20 years earlier.

"Twenty years from now you will be more disappointed by the things you didn't do than by the ones you did do," Mark Twain once wrote. "So throw off the bowlines, sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover."

Yes, there are even adventures to be had in places like Bismarck, North Dakota, even if they're ones you would prefer to keep to yourself.

By mid-afternoon, we reached Detroit Lakes, where the wedding party, family and friends had been invited to spend the day by Pelican Lake. The family of my brother-in-law's fiance, Heather, had a place there. We spent the afternoon swimming, fishing and swatting mosquitos. It was a true Midwest experience.

I thought it was remarkable that when we pulled up we had traveled just two miles shy of 2,000 miles at that point. Not everyone I met that day was as impressed with this fact, but I told them anyway.

They usually resulted in an exchange of travel stories, a great ice-breaker for weddings. Traveling is America's great common denominator - we've all got a tale.

- Paul Gullixson

Day 5 - Madison Campground, Yellowstone to Bismarck, N.D.: 630 miles

Today was our longest haul yet, and it got off to a slow start as we missed by nearly an hour our goal of getting out out campsite by 8 a.m. and then spent longer than expected at  Mammoth Hot Springs where the kids got certified for their junior ranger badges. As we sat out in front of the Albright Visitors Center - in the heart of historic Fort Yellowstone, build and occupied by the U.S. Army when it protected the park until World War I -  we heard the high-pitched cry of elk from a nearby hill. It was a haunting but memorable wail from the last wildlife we would see in Yellowstone.

We then headed out through Roosevelt Arch and followed the Yellowstone River through Gardiner, Montana on up to Livingston where we caught Interstate 90 heading east. The blue ribbon of the Yellowstone kept us company for a good portion of the day. We finally parted ways just before the North Dakota border at the Montana town of Glendive, Montana, home of the somewhat-famous Makoshika Dinosaur Museum, which showcases fossils, sculptures and casts of dinosaurs around the world. (Adults $5, kids $3.)

It's clear that to many people I-90 is not just the name of the main west-east route through Montana, it's the speed limit as well. There's just something about the long flat highways of Big Sky country that make you feel small and slow. Nevertheless, we averaged 80 mph, stayed mostly in the slow lane, and made good time as the kids read, worked on activity books, sang songs and were at times completely goofy.

I also had time to contemplate why men don't mind being behind the wheel on long trips like this. In fact, we prefer it. For one, it's one of the few times that we allow ourselves to sit and relax - and even talk a little - without feeling a sense of needing to be doing something else. When you're driving, you are making progress, so it's one of those rare occasions when we don't see talking as being an obstacle to progress. Women will never understand this.

Second, and I bet most men would agree to this if you twisted an arm, there's something in us that wants to be leading the wagon train, to be the guy sitting high in the saddle with the Winchester at our side, riding point, scouting the way, making sure we're headed in the right direction. It's one of the reasons we like to wear hats when we drive and never like to ask for directions. Did you ever see John Wayne ask for directions or check a AAA guide for a place for dinner? Not on your life.

It's amazing what a guy thinks about as he drives an overloaded mini-van across flat states - amazing and a little embarassing.

Our goal was to be in Bismarck before the hotel pool closed at 11 p.m. Indoor pools with high waterslides are very popular in Bismarck and the kids were besides themselves with anticipation. So I was very proud of myself when we made up time and pulled into Bismarck at 10 p.m. - proud that is until I discovered that we had crossed a time zone and was now in Central Standard Time, meaning it was actually 11 p.m. The guy at the hotel desk at the Ramkota Best Western took pity on us and let the kids swim in the pool for a while if they didn't make noise.

They made noise anyway, but fortunately, kept it to a dull roar.
We fell asleep shortly after midnight, thankful to be in a real bed. Thankful to be in Bismarck.  

- Paul Gullixson 

Every state budget seems to have provisions with little obvious relationship to, well, the state budget. This year was no exception. Here are a couple school-related items culled from an e-mail distributed to Republican legislators:

-- The state high school exit exam, an important measurement of school accountability, will continue for most students. You may recall that legislative Democrats proposed to eliminate the exam (a multiple-choice test measuring 10th grade English and math skills), claiming it would save money. "It sounds kind of cute but it works," Assemblywoman Noreen Evans, D-Santa Rosa, said at the time.

Under the deal cut this week, special education students will be exempted from the test for at least a year.

The issue has divided parents in special education programs, with some arguing that their children are able to meet the same standard as other students, while others point to data showing special education students fail at a higher rate.

-- The district-of-choice program also will be retained, according to the e-mail sent Tuesday by state Senate GOP leader Dennis Hollingsworth.

The 16-year-old program allows parents to move their children to other school districts without first asking for permission from school boards in both districts. For districts that declare themselves districts-of-choice, they must take students on a first-come, first-serve basis regardless of special needs or language barriers.

We raised the issue in an editorial after a bill to extend the program passed the state Senate unanimously before getting bottled up by Democratic opposition last month in an Assembly committee.

Many of the side deals cut to pass state budgets past couldn't survive the light of day (and some of those may still be skulking about this week). These two issues, however, should have turned out exactly the same had they settled on their merits.

-- Jim Sweeney

Adventures in an Odyssey: Day 4 - Old Faithful is upstaged, twice

The best kept secret about Old Faithful is that it's more faithful than punctual. Park rangers only "predict" when it will blow. When it actually does can vary from 10 to 20 minutes either way. The kids found this out the hard way as we sat and sat and sat along with hundreds of other people complaining in multiple languages watching hole in the ground puff like a tea kettle.

"OK, now I'm bored," said Christopher.
"Are you sure you have the time right?" Tamara asked.
"Daddy, I'm thirsty," said Clara.
At one point I considered giving up and going in search of ice cream. But then I thought better of myself. I couldn't hold my head up as a true American car trip guy if I didn't at least make my family watch Old Faithful.

"You know as soon as we walk away and give up our seats, it will go off," I said. "I think there's a saying about how a watched geyser never boils."
Just then, some waves of water started shooting and steam started to billow.
"Here it goes!" I said.
Tamara grabbed the camera.
"I think this is it" shouted Clara.
And with that, the churning came to an abrupt halt.
"Was that it?" asked Christopher.
"That wasn't very exciting," said Clara.
Somebody behind us shouted, "We want our money back,"
People laughed.
It went on like this for an eternity - maybe another 15 minutes.

Patience is not a virtue of the modern family. We don't deal with the term "approximately" well. Either something comes on at 2:20 p.m. or it doesn't. And if it doesn't, you do the only thing that comes natural nowadays - you call the cable company and complain.

I encouraged the kids to think about what they would write in their journal. This had been an eventful day. We woke up to thick layer of frost all over our campsite. The wish dish towel I left out had turned cardboard stiff. As we sat eating our breakfast, Clara looked up with big eyes and announced, "There's something other there," she said pointing to trees between our campsite and the Madison River. "It's big and it's brown and it's moving!"

I turned and spotted a ground squirrel scurrying off into the brush. I was about to explain this "big" creature to my daughter when the trees parted and a large elk came bounding through, turning its head slowly like a T-Rex.

"Whoa," I heard Christopher call.
"I told ya," said Clara.

As I thought about all the wildlife that we had seen - from nesting bald eagles near the West Yellowstone entrance to the herd of bison all over the Lower Geyser Basin - it occurred to me that Yellowstone, a place the size of Rhode Island, is America's Jurassic Park. Not only does it look like something out of Land of the Lost, it's a place where the public can watch and interact in a natural setting with some of our planet's most bizarre and majestic animals like moose. Sometimes people interact stupidly and end up losing their hats and cameras fleeing from charging bison. But if people didn't do that on occasion, park rangers wouldn't have anything to talk about during the winter months. So we all have a vital role to play here in Yellowstone.

As we continued to talk about things like this, a geyser began erupting off in the distance. It reached impressive heights.
"Which one is that?" Tamara asked.
"I think that's Beehive Geyser," I said. "Looks like a steam engine coming around the corner, doesn't it?"
"Wow," said Christopher. "I wish we were over there."
"Yeah, I wish we were over there," said Clara.
"We could start walking over there now," said Tamara.
"It will probably stop soon," I said. "Besides, Old Faithful is going to go off any moment."

Five minutes later, neither event had occurred.

"If we had started walking, we would be there," said Christopher.
"Yeah, we would be there by now." said Clara.
A short while later, Beehive stopped. But soon after another geyser went off farther to the west with an even more impressive spray.

"Which one is that?" asked Tamara.
I looked at the map. 

"I think that's Grand Geyser," I said. "It's the tallest predictable geyser in the world. It erupts only ever seven to 15 hours."
We watched in silence.

"I think we're in the wrong spot," Tamara said.
"I think you're right," I said.

When Old Faithful finally went off, the kids cheered - and 2.5 minutes later it was over. We all applauded. I like that people applaud an act of nature. Of course, when you wait as long as we did, your always applaud and the tell all of your friends it was "spectacular."

(But decide for yourself. Old Faithful now has its own Webcam.) Don't tell my kids they could have watched this from home.)

TIP FOR PARENTS: If you're going to a National Park with kids, pick up a form for the kids to earn Junior Ranger badges. They're usually available in the Visitors Center. Children usually are asked to attend a ranger program, complete some activity pages, pick up some trash, etc. And then when they're checked out by a ranger, they're sworn in and given a Junior Ranger badge for that particular park. The ones from Yellowstone are made of cloth and are the nicest. Our kids earned four or five of theses badges by the end of our car trip. It keeps them busy. They learn a thing or two. And, if you're lucky, it will distract them long enough to get past the souvenir shops without spending a fortune. 

- Paul Gullixson 

Sunday column: How 2 parents, 2 kids and 1 minivan survived 5,216 miles in 17 days

Adventures in an Odyssey: Day 1

Adventures in an Odyssey: Day 2

Day 3 - Ashton to West Yellowstone via Squirrel Meadows, Wyoming - 106 miles

So why did we stop in Ashton, Idaho, of all places? Mainly to visit an old friend located 24 miles east of here in an aspen grove tucked under the Teton Mountains. It's a two-story cabin made of lodgepole pine in a place called Squirrel Meadows. My father, uncle and I - and friends - built it. This was my first time back in 16 years.

The cabin's now owned by the U.S. Forest Service. The windows are boarded up. At one time it was considered the best-built cabin in 50 miles in any direction. But a friend in town tells me the Forest Service doesn't let anyone stay there. Locals don't understand it. Neither do I. What a waste.

(Through Google Maps, I actually found a satellite shot of the cabin, the pole barn and meadow. Take a look.  Click here.)

Here's the cabin's history abbreviated: 1. We lease 5 acres for 100 years to build it. 2. Owner dies suddenly. 3. New owner doesn't want to honor lease so he buys us out. 4. New owner makes land swap - involving all 1,000 acres of Squirrel Meadows - with Forest Service in exchange for property elsewhere to expand a ski resort. 5. We use part of settlement money to lease rustic old cabin closer to Ashton, so we can continue visiting Ashton area for another 10 years until my father and uncle can't make it anymore. We give up the lease in 1993.

But despite everything that has happened, the cabin looked pretty good, although we couldn't get very close. My family and I had taken the long drive along a dirt and gravel road to get there, but much to the chagrin of my kids, a locked gate prevented us from driving out to the property itself. We had to settle for looking at it from a quarter-mile away from the reclamation road that winds from Flagg Ranch (located between Yellowstone and Grand Teton National Park) to Ashton. Long ago, this road was used for dog sled races. Now it's used mostly by rangers, campers and, in the fall, locals looking for fire wood.

So I stood on the side of the road, looking at the lupine and Indian paint brush blooming like it was still spring, and told the kids stories of my summers in Squirrel Meadows. Stories about  shucking logs on hot summer days, and taking long cool drinks of fresh water out of Boone Creek with a ladel we hung on a barbed wire fence; of sleeping in a special bunk out in the pole barn with our dog Tasha; of seeing snow in June and the Northern Lights in August; of the "swan lady" who came to study the endangered trumpeter swans at nearby Indian Lake; and of my brother Brent and I riding our dirt bike all over the meadow, pretending we were Steve McQueen in The Great Escape. This land was our great escape.

I scanned across the meadow at our cabin one more time before getting back in the van and taking off. The wind was starting to pick up. "I wish we could go there," said Christopher, looking out with me.
I put my hand on his head. "Me, too," I said. "Maybe some day."

We then headed for Yellowstone.

(Side story: The rustic cabin we leased from 1983 to 1993 was later coverted into a bed and breakfast inn and resort, and this is where we stayed the night before. It's now called Squirrel Creek Guest Ranch and Inn. Here's the link. They've done some amazing things with this old property, but the rustic charm remains. If you're ever up in this part of the country, I recommend a couple of days here if you have the time. Tell the Hossners I sent you.) 

Final note: In all my years up there, I never saw a trumpter swan at Indian Lake. I spent plenty of evenings writing in my journal on the banks of those lilly-pad covered waters, but I never saw one. This time we did, however. Two of them in fact, at the far end of the lake. Maybe that says something about how far these swans have come back. At one time, fewer than 100 of them existed in the lower 48 states.

That night we camped at Madison Campground in Yellowstone where a heavy wind tore a hole in our rain fly. We grilled hamburgers over the campfire and cooked corn in their husks and potatoes in aluminum foil befoe heading for bed. That night it was so cold we slept hundled together with layers of clothing. I had forgotten that in this part of the world June could be summer - or it can still be winter. You never know.
It was great to be back.

- Paul Gullixson

Sutter chief calls comment in Press Democrat ad Sunday "outrageous and irresponsible."

Sutter Medical Center CEO Mike Cohill is clearly heated about a full-page ad that appeared in Sunday's Press Democrat. The ad, titled "An open letter to the Sonoma County Board of Supervisors and our community," appealed to supervisors to reject the preliminary analysis done so far on Sutter's plans to build a 70-bed, $175 million hospital near the Wells Fargo Center and do more extensive studies on the plan's overall impact on health care in the region. The ad, on page A8, was signed by board members and executives from all the other local hospitals (except Kaiser) including Memorial, Palm Drive, Healdsburg, Petaluma Valley Hospital, Petaluma Health Care District and Sonoma Valley Health Care District. Even the CEO of the Mendocino Coast District Hospital signed on.

It was timed to appear before supervisors hosted a public workshop today on the proposed hospital.

In his introductory comments at this morning's hearing before a standing-room-only crowd, Cohill said most of the criticisms in the ad of Sutter's hospital plan were "outside the scope of the health care access agreement" between the county and Sutter. (This is the agreement that allowed Sutter to take over the former Community Hospital with the promise to continue to provide care in the community, particularly to low-income and government-insured patients.)

But Cohill called attention to one particularly paragraph in the ad that said, "A hospital half the size of Sutter's existing facility would result in the redistribution of patients who are uninsured or underinsured, potentially jeopardizing other hospitals and their ability to continue serving all comers . . . "

"This is an outrageous and irresponsible statement by the non-profit hospitals . . .  that paid for this ad," Cohill said. He noted that all local hospitals "have an obligation to care" for the community's patients. Furthermore, he noted that Sutter has been handling about 63 patients per day this year, meaning Sutter is already operating as essentially a 70-bed hospital "without adversely effecting other hospitals."

A county analysis has pointed out that Sutter's plans would leave the region with a shortage of medical/surgical beds and intensive care beds by 2014, within a year after the hospital's projected opening. Expect this to remain the central issue surrounding whether Sutter's plans get the green light.

On that note, it looked like about half of the members of the audience were wearing green stickers that read "Yes! Greenlight the new hospital." I stayed long enough to hear the first six members of the public testify, and all were in support of Sutter's plans.

- Paul Gullixson

Back from the grave

On Wednesday, we published an editorial criticizing legislative Democrats for killing California's district of choice program, which allows school districts to accept any and all comers without forcing parents to plead for permission.

The program is 16 years old and a bill to renew it permanently sailed through the Senate without a single no vote and the Assembly Education Committee on a 6-1 vote, but was defeated on a party-line vote in the Assembly Appropriations Committee two weeks ago.

Since then, advocates of the program have helped generate public attention, including several news stories and editorials around the state. On Wednesday, the bill, sponsored by state Sen. Gloria Romero, D-Los Angeles, and cosponsored by Assemblyman Jared Huffman, D-San Rafael, among others, was brought back for reconsideration and passed the committee on a 9-3 vote. What changed? Not much, except that instead of a permanent renewal, the bill restores the program for seven years.

It will be interesting to see if the renewed support fades away when the bill gets to the Assembly floor.

-- Jim Sweeney

Day 1

Day 2 - Winnemucca to Ashton, Idaho - 504 miles.

Lesson No. 1: When you call a motel and ask about pool hours be sure to ask if the pool is actually open. They may not volunteer this information. Such was our experience at the Days Inn in Winnemucca, where we ended up with two kids in swimsuits staring at a pool that was closed due to a missing part. Water, as it turned out, would be the theme of the day.

Tip: For some reason, Winnemucca is home to a significant Basque population and each years hosts a Basque Festival around the first weekend in June. I know because one year my brother-in-law and I stopped at the popular Griddle Restaurant on Winnemucca Boulevard, where, in the middle of our omelettes, clowns in small cars started passing by our window. I feared we had fallen into some music video until we found it was the annual festival parade. Couldn't leave until it was over, which is just as well. We had nothing better to do.

We pulled out of town (just south of mountains known as the Santa Rosa Range) and made good time through the desert on I-80. Oddly, there was lots of standing water out  among the sagebrush, which reminded me that I forgot to check our sprinkler system before we left. Listened to Creedence Clearwater Revival as we counted boxcars and talked about what it would be like to live in the middle of a flat world near towns with names like Battle Mountain and Deeth.

At Wells, we discovered that our new, soft-sided ice chest, strategically located in the center of our Odyssey, was leaking, forcing us to clear out the nest of stuffed animals, books, and sundry items the kids had formed at their feet. Christopher's journal was a total loss. Fortunately, it was empty but for one page. I told him we would get him a new one. He asked if he could get some pizza instead. 

Afterward, we headed north on Highway 93 through Jackpot and ran into a squall as we crossed into Idaho. Lightning, thunder, downpour - the works. It was at that point that Tamara discovered we had left the itinerary of our trip including phone numbers and directions to each of our places, on the counter in the kitchen. When it rains it pours.

Tip No. 2: We stopped at Massacre Rocks State Park on the banks of the Snake River west of Pocatello. Despite the name, it's a geologic wonderworld with a (free) frontier museum/visitors center where the kids were invited to, among other things, pet a snake. The place gets its name from a narrow passage between rock formations where travelers on the Oregon Trail had to go single file and feared an ambush. We learned that those on the trail averaged between 4 and 20 miles a day. Given our pace for the afternoon, I was envious.

We finally reached our destination - the Squirrel Creek Guest Ranch and Inn in Ashton -around 10:30 p.m. on a chilly, wet evening. We were supposed to camp, but fortunately, they had a small (heated) cabin available with two queen beds made of lodgepole pine available for $85. We took it.

As we cranked the heat and prepared for bed, I looked at a map and realized that we had pretty much traveled backwards along the California and Oregon Trail for most of the day. In fact, Massacre Rocks was the dividing point for westward traveling parties, with some going northwest toward the Columbia River and others moving southwest along the Humboldt River, past a place called Winnemucca.

Those migrants gave their life savings - and sometimes their lives - to travel 2,000 miles over the course of many months to a new future out West. Today, we covered about 25 percent of that journey in seven hours, and our only casualty was an unfinished journal.

I can only imagine how big the country must have looked to those travelers. Nevada, alone, seemed endless to us. 

- Paul Gullixson

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My inner-Swede was just one of the discoveries - good or bad - my family and I made during a just-completed 17-day family car trip across the nation in our Odyssey mini-van. We needed to be in Minnesota for a family wedding at the end of June and decided to take the opportunity to show the kids the heartland of America, as well as some less-essential organs like Barstow.

Final tally: 5216.8 miles, 12 states, seven National Parks, eight nights of camping and about 1,000 rounds of "Take my home country roads," "Born in the U.S.A.," and "City of New Orleans." (You know, the Arlo Guthrie classic, "Good morning, America, how are you . . .")

Here's a quick summary of our travels and some of the things we discovered on the way. If you have stories of your own or suggestions of places we missed, feel free to jump in. 

Day 1: Santa Rosa to Winnemucca, Nevada - Total distance: 401 miles.

I should have known trouble was ahead when Christopher, my 10-year-old, announced in the final hours before depature that he was limiting his nonessentials to "just" three back scratchers, a seven-foot-long green stuffed python and sundry items that filled a backpack - and I said "OK." As long as he and his sister Clara, 6, no longer bothered me about bringing baseball bats, scooters, playground equipment, board games and the family dog, Cody, I was willing to conceed just about anything.

I hoped to be on the road by 1 p.m. so we could be at the Days Inn in Winnemucca in time for the kids to swim in the pool before it closed at 9 p.m. Of course, announcing a departure time is the kiss of death on family car trips, (OK, I'm as much to blame as anyone in taking care of those last-minute things), and we ended up leaving at 4:40 p.m., got stuck in traffic, and didn't pull into Winnemucca until 12:30 p.m.

Everyone fell asleep quickly. I ended up crossing Nevada on a moonless night wondering how one state can have so many highway construction barrels and listening to some guy on a remote radio station talk about how he was a horse in a previous life. He said he knows this because when he goes near horses the mares get amorous and the stallions get hostile.

Where do they find these people? I love car trips..

- Paul Gullixson

One of the talking points in every California budget standoff for at least 20 years has been that high taxes are driving people from the state.

Once in a while, someone even offers a bit of anecdotal evidence.

Finally, we have some hard numbers. Researchers at the Public Policy Institute of California released a study Friday showing that low-income residents are leaving the state at a faster pace than rich residents.

The research doesn't undermine the high-tax argument entirely, but it certainly marginalizes it.

Using data from the U.S. Census and the state Department of Finance for 2004 through 2007, the PPIC study found that poorer residents are twice as likely to leave the state as more affluent residents.

PPIC said  that 1.73 of the state's poorest households (those with annual incomes of $22,000 or less, placing them in the bottom 20 percent) left California for every arrival in that income range.

On the opposite end of the spectrum, 1.16 households in the top quintile (annual incomes of $110,000 or more) left for every upper-income person who arrives. At the very top of the scale (incomes of more than $200,000 a year), 1.09 leave for every arrival.

Obviously, the state's financial picture would be better if the upper-income numbers were less than one, but they're leaving at a far slower pace than poor families.

Where do they go? States without incomes taxes, right?

Three of the five most popular destinations are Texas, Washington and Nevada, all states without personal incomes taxes. But that's true of both lower- and upper-income emigrants, suggesting taxes aren't the only factor. As for states sending immigrants to California, two of the top five (Texas and Washington) have no state income taxes.

-- Jim Sweeney

Paul Stutrud, a Rohnert Park community activist who died last week, was a textbook example of the species city hall gadfly.

To some people, the term is pejorative. But I like gadflies, and I liked Paul Stutrud.

Every city needs someone willing to take the time to drill into its deepest catacombs for evidence of shady deals and unlawful decisions. Gadflies help keep politicians honest, and they can keep reporters from getting lazy.

It was a Santa Rosa City Hall gadfly who blew the whistle on council members collecting pay from the Chamber of Commerce while voting on budgets that included money for the chamber. An LA. City Hall gadfly once handed me the roadmap to expose a sweetheart deal involving the chairman of the redevelopment agency.

An obituary in Tuesday's paper described some of Stutrud's watchdog efforts in Rohnert Park. But one story that bears repeating wasn't included.

In 1996, Rohnert Park levied a property tax to cover the cost of staffing two fire stations around the clock, but the city ignored Proposition 218, an initiative crafted by the Howard Jarvis organization that retroactively required a complicated corporate-style election to raise many municipal taxes.

The issue here isn't the wisdom of Proposition 218. On that, I suspect Stutrud and I might have disagreed.

But Rohnert Park rejected Proposition 218's election mechanism, opting instead to file an unusual lawsuit against its own citizens in a bid to secure court-approval for the tax. Stutrud, who wasn't a lawyer, took up the challenge and argued against the city in court.

Sitting in court that day in 1998, it was clear to me that Stutrud understood Proposition 218 better than the city's lawyer or the judge, who ruled in favor of the city. Stutrud persevered, and a state appeals court unanimously overturned the decision a few months later and ordered the city to refund about $1.1 million in taxes.

Chalk up another one for the gadflies.

-- Jim Sweeney

Healdsburg adopted a new general plan on Monday, and Mayor Eric Ziedrich said the council would act separately on an ordinance governing "formula" businesses. That's the new euphemism for chain stores. The conversation, as reported by Staff Writer Clark Mason, touched on big-box stores and Starbucks. You may recall that Starbucks set off a similar debate in Cotati, which ultimately decided some chains were OK -- as long as they kept to the west side of the highway. Other towns have debated other chains. Calistoga once considered running out Copperfields because it had stores elsewhere, including Petaluma, where the City Council is clearly uncomfortable with any bookstore that might compete with Copperfields.

But in all these debates over chain businesses, I've never heard anyone try to exclude Wells Fargo, Chevron, Bank of America, Exxon or Safeway. So some chains are OK? You know, if they don't sell books or coffee?

Just wondering.

-- Jim Sweeney

Gov. Arnold Schwarzenegger proposes to close about 200 state parks because they don't pay for themselves. Among them are the Sonoma Coast state beaches, Angel Island, Annadel and Armstrong Grove. Others include Hearst Castle, Point Sur and the California State Capitol Museum.

Just how the state plans to keep people off the beach or out of Annadel has yet to be explained. There's also are the obvious questions of liability if anyone is hurt and whether damage from vandalism will cost more than keeping the parks open.

Legislative Democrats offered a potential solution: levying a $15 surcharge on auto license plats and dedicating the revenue to parks. I'm ready to pay that, or to simply pay a few dollars more to use the parks.

It sure makes more sense than closing them (and, yes, I use them regularly so I would be shelling out any fee increase).

The federal government has warned Schwarzenegger that six parks could be seized if the state closes them. They are: Angel Island and Mount Diablo in the Bay Area, Point Sur and Fort Ord Dunes on the Central Coast and Border Field and Point Mugu in Southern California All six were acquired with federal grants that were contingent on perpetual public access to the land.

A letter from the National Park Service also notes that 67 other state parks have received federal funding for various improvements, also contingent on public access. That money could be cut off, though those parks apparently aren't subject to seizure. That list includes several in the North Bay: Sonoma Coast, Salt Point, Annadel, Robert Louis Stevenson, Mount Tamalpais, Olompali, Manchester, Navarro River Redwoods and Russian Gulch.

Further up the coast are Jedediah Smith Redwoods, Humboldt Redwoods, Benbow Lake and Richardson Grove.

Here's betting the final budget deal includes some sort of new fee - with cover for the governor to deny it's a tax - to keep the parks open.

-- Jim Sweeney

North Bay Rep. Lynn Woolsey is usually hand-in-glove with conservation groups, but a deep schism is developing between the Petaluma Democrat and some environmentalists over an oyster farming operation at Point Reyes National Seashore.

Drakes Bay Oyster Company's permit expires in 2012, and the 1,100-acre property that it leases from the National Park Service is scheduled to become protected wilderness at that time. The company, the largest commercial shellfish operation in California, wants the lease extended, and it has been battling with the National Park Service for years.

The Park Service has published reports saying the oyster farm is detrimental to the surrounding area, but a recent review by the National Academy of Sciences found that those conclusions were overstated.

Many conservation groups object to a commercial operation, such as the oyster farm, delaying a wilderness designation.

Woolsey sided with conservation groups last year, writing letters that helped block an attempt to attach a lease extension to the Interior appropriations bill.

Now, however, she is siding with Sen. Dianne Feinstein, who has attached a rider to extend the lease to this year's Interior appropriations bill. Woolsey issued a written statement citing environmental safeguards included in Feinstein's amendment, but conservation groups are lobbying hard against it.

In addition to objections to delaying the wilderness designation for the Drakes Bay area within Point Reyes National Seashore, critics point out that using the congressional appropriations process cuts the public out of any discussion of the merits of extending the oyster farm's lease.

The House version of the bill - which doesn't include the oyster farm lease language - passed last week, so the issue may get hashed out by a conference committee.

-- Jim Sweeney

Common sense tells us that 40 school districts is more than we need in Sonoma County (population 486,000). Practical experience tells us one school district isn't enough for Los Angeles and several surrounding cities (population about 4.5 million).

But who would have guessed there's an even goofier model out there?

Well, leave it to New Jersey, which has two dozen school districts that don't have any schools at all.

According to an Associated Press report, efforts to eliminate the school-less school districts began in 1969. A law finally passed in 2007. Since then, three more districts closed all their schools. Yet another law passed last week to eliminate the no-school districts prior to the 2010 school year.

Perhaps the extra year was granted to allow time for one last reunion ...

In fairness to New Jersey, the U.S. Department of Education says there are almost 300 school districts across the country - including more than 50 each in Maine, Massachusetts and Vermont - that don't bother with schools. (It would be too easy to make a wisecrack here about classes only siphoning money from big-time prep sports machines.)

Perhaps we can take inspiration from the Garden State and root up some of Sonoma County's myriad school districts, then plant them in a more streamlined education system.

And maybe we can take less than 40 years to do it.

-- Jim Sweeney