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Bulletin, Record, Progressive, Reporter Wednesday, May 2, 2012 11B COMMUNITY PERSPECTIVE Hospital can .become "dream" facility WHERE I STAND DOUG LAFFERTY CHIEF EXECUTIVE OFFICER PLUMAS DISTRICT HOSPITAL As I promised at the April 5 Plumas District Hospital (PDH) board of directors meeting, I am taking steps to ensure that information on a new facilities plan is present- ed openly and continuously as the proposal moves for- ward. Since the initial project proposal in 2008, much has changed, and the challenge before us is to determine if we can move forward with a fiscally responsible plan. In the late 1990s, California implemented severe and com- plex construction expecta- tions on all acute-care hospi- tals. The seismic restrictions were developed by the Legisla- ture and administered by the Office of Statewide Planning and Health Development. These initial guidelines were based on large territory geographical information and required that all seismic up- grades be completed by 2003. The requirements were so re- strictive that the cost for re- construction, new construc- tion and/or seismic upgrades measured well into the bil- lions of dollars, and the ma- jority of California hospitals fell outside of the guidelines. An extension was thenmade taking the compliance date to 2013 and then eventually to 2030 and beyond. The situation for Plumas District Hospital is no excep- tion. In 2005, when PDH be- gan planning to meet the stringent state seismic regu- lations in place at the time, the board and administration were basically "stuck be- tween a rock and a hard place." They were tasked with bringing a 50-year-old facility, already in need of upgrades, into compliance by 2013 or face state penalties or possible forced closure. The resulting building plan, projected to cost over $20 million, called for a complete hospital replacement that consisted of a two-story facility housing a new emer- gency department and two new operating rooms on the first floor with all new inpa- tient beds on the second floor. Under today's seismic stan- dards several major rules have been changed that per- mit modifications to the ini- tial PDH plan. Seismic testing for California hospitals now works from site-specific infor- mation rather than large territory geographical infor- mation. The new site-specific testing criteria have deter- mined that seismic risk for PDH is significantly lower than was determined under earlier state rules. With some additional upgrades such as facility sprinklers, anchoring and strapping on movable equipment, PDH will meet seismic compliance standards until 2030 and potentially beyond. Despite the relaxed seismic regulations, PDH remains an aging facility in need of up- grades. The initial plans for replacement were appropri- ate for the time, and would continue to be ideal,' if funds were available. Recognizing the state of the local economy, current seismic standards and specific needs of the 50- year-old facility, an alternate plan is being recommended. The new proposal includes both a new addition, as well as renovation of the existing building. The single-story ad- dition will house a new five- room emergency department and new surgery department with two operating rooms. The existing building will re- ceive seismic upgrades to ex- tend its life beyond the 2030 timeline; upgrades to the in- patient rooms to transform them to private rooms and up- date the appearance; remodel- ing the existing laboratory, respiratory and radiology de- partments; a relocated hospi- tal entrance to Bucks Lake Road; and, renovation of the exterior of the existing hospi- tal to tie it into the addition. This potentially can be ac- complished for $9 - 10 million. At current assessed property values, a $50 flat assessment per $103,000 of assessed proper- ty value is estimated to cover approximately $4 to $4.5 mil- lion. PDH would have to cover the remaining cost of the pro- ject from hospital operations. Funding would come from a 30- year fLxed interest rate loan from the USDA. Today's cost of borrowing is at 3.38 percent in- terest, approximately half the rate of the original interest estimate. While there are significant changes under this scenario from the original, those changes should in no way re- flect on past administration, boards or decisions. Hospital construction is an ever- changing field driven by fi- nances, state regulations and interest rates -- not to men- tion the ever-changing field of medicine. What was de- signed in the past was well done, but the market has sim- ply changed, requiring the hospital to shift and adjust with the market. The new proposal takes into consideration the long-term needs of the hospital and com- munity, the current economic environment within which See PDH, page 12B International Doula Month recognizes birth assistants WHERE I STAND SUSIE WILSON CERTIFIED DOULA. CBI CERTIFIED LACTATION EDUCATION COUNSELOR "If a doula were a drug, it would be unethical not to use it." --Dr. John Kennell, M.D. If you're like many people, you're asking yourself: What is a doula, actually? Doula (doo-lah) is an an- cient Greek word, meaning a specifically trained female servant whose job was to serve the lady of the house during her pregnancy, labor, birth and postpartum period. Her role was help ensure a healthy labor and delivery, and to support the baby's transition t6ifeoUtside the womb. Today, a doula is a profes- sionally trained childbirth as- sistant who offers physical, emotional and informational support to a mother and her partner during the pregnancy, labor, birth and postpartum period. She is often referred to as the "mother to the mother" (and sometimes the grand- mother, partner and other rel- atives and friends who are present at the birth). The doula movement began in the United States nearly 30 years ago with the formation of Doulas of North America, (DONA) a networking and doula certification organiza- tion founded by Penny Simkin. Simkin, author and co-author of many notable books on pregnancy and postpartum care, and regular contributor to publications such as the acclaimed Lamaze blog Science and Sensibility, is still considered to be one of the foremost doulas in the world. : " " " Since that beginning, there are now many different groups certifying pre- and p0st-natal doulas, childbirth educators and lactation consultants. What does a doula do? A doula is educated in the physiology and psychology of labor, birth and the post- partum period. She will: --Assist the woman and her partner in preparing for the birth, including helping them research options for de- livery, pain relief, testing and postpartum procedures. Provide emotional and physical comfort and relax- ation measures to the mother during labor. --Support communication between the laboring woman and the obstetrical staff. --Remain with the woman during the labor and after- ward, until the woman is settled and comfortable, regardless of the length or complexity of the birth. -- upport parents chomes, even if they differ from what she might choose. --As needed, a doula will use massage, aromatherapy, acupressure, positioning, breathing and vocalization techniques, music, visualiza- tion and much more to provide the most comfortable experience possible for the mother and partner. A doula may: --Provide support and information for the first few weeks after the family re- turns home, including (if requested) spending the first night or two, or until the new family is settled. --Provide new infant care and breastfeeding informa- tion, run errands, field phone calls, do light housework or meal preparation,'or enter- tain siblings as needed in order to give the new morn and baby time to bond. A doula does not: --Work for the hospital or birth center. She is employed by the pregnant mother as a professional personal mater- nity assistant. --Offer medical advice or treatment in any form. --Interfere with communi- cation between the laboring mother and the obstetrical staff, attempt to intervene or "speak" for the parents regarding their plans or decisions. --Make decisions for the pregnant/laboring/postpartum woman. --"Deliver" the baby. Aside from the obvious benefits of having emotional and physical support during labor and afterward, what are the benefits of having doula support at your birth? A recent Cochrane review of 30 years of studies indicates that women who are supported by a doula or other trained personal birth assistant were: --26 percent less likely to give birth by cesarean section. --41 percent legs:likely I6 give birth with a vacuum extractor or forceps. 28 percent less likely to use any analgesia or anesthesia. --33 percent less likely to be dissatisfied or negatively rate their birth experience (Hodnett, et al., meta- analysis, 2008). Additionally, the study concluded that even at hospitals with quality obstetric nursing staff, the presence of a doula made a difference. "Continuous Iabor support appears to be more effective when it is provided by caregivers who are not employees of an institution (and thus have no obligation to anyone other than the laboring woman) and who have an exclusive focus on this task." To learn more about doula services go to childbirth international.com. To find a doula in your area, go to findadoula.com or ' ii6iiatch.nei. " ' : Susie Wilson is a doula certified by Childbirth International (CBI). She is also a lactation education counselor, certted by UC San Diego. LETTERS r o the EDITOR Guidelines for Letters All letters must contain an ad- dress and a phone number. We publish only one letter per week, per person and only one letter per person, per month regarding the same subject. We do not publish third-party, anonymous, or open letters. Letters must be limited to a maximum of 300 words. The editor will cut any letter in excess of 300 words. The deadline is Friday at 3 p.m. (Deadlines may change due to holidays.) Letters may be taken to any of Feather Publishing's offices, sent via fax to 283-3952, or e-mailed to mail@plumasnews.com. Grace and respect Through much delibera- tion and soul searching, Shawn Montgomery has resigned as Plumas County auditor. As far as the Audi- tor's Office is concerned, we are losing one of the county's greatest assets. Shawn's edu- cation and expertise in government accounting and taxes are phenomenal. Her ability to follow and execute the state and federal requirements has awarded this county with six years of clean and favorable audits and state reporting. The procedures that counties are required to follow are or- dered by the Board of Super- visors and state and federal government. Even though the procedures may be difficult to follow and can be hard to abide by, they are not meant to work against others and are in place for good reasons. The county is required to follow them and they will still be followed long after Shawn has moved on. The county fiscal woes were here long before Shawn was elected Plumas County audi- tor, and unfortunately it appears that they will not get better in the near future. Our office is saddened by her stepping down but we know that the Plumas Uni- fied School District is getting an excellent asset. Over these past six years Shawn has worked her full day and given up her evenings and weekends to make sure the county was in compliance. It is unfortunate that Shawn is receiving negative remarks from individuals that do not truly know her. Shame on those who will not let her leave with the grace and re- spect that she truly deserves. We wish her the very best and we will miss her greatly. The Auditor's Office Linda Williams Sandy Thomas Meghan Ruggieri Elaine Cardoza Clara Molina Pat Bonnett SaY it ain't so Doug LaMalfa and Sam Aanestad, both congressional candidates, took California taxpayers for a free ride ... literally. Dave Palmer, watchdog at noethics.net, investigated a perk giving legislators a state-subsidized vehicle upon request. Taxpayers pick up 90 percent of the monthly bill and legislators cover the rest. According to Palmer, "Shortly after assuming of- fice in December 2002, D0ug LaMalfa was of the opinion that he was entitled to hose the public by ordering a 2003 Mustang Mach 1 at a cost to the public of $28,957 .... From 2003 through 2008, it cost the taxpayers of California $65,584 to provide Doug LaMaffa with a 'muscle car' to allegedly serve the best in- terests of his constituents .... Doug LaMalfa personally au- thorized the expenditure of $16,258.64 for maintenance on the Mach 1 for the years 2006 and 2007." Aanestad has a similar horror story. Sam purchased a 2003 Ford Expedition for $45,393.91 and a Chrysler 300M in 2007 for $43,780.70. Palmer says, "From 2003 through 2008 the taxpayers were hosed to the tune of $165,286 to provide o1' Sam with luxury rides of his choosing. This comes out to a yearly average of $27,048 a year." Please, gentlemen, say it ain't so. Donna Caldwell Cottonwood Our future Undeniable economies can be made by consolidating small schools but there is a great price to pay when a small town loses its high school; it loses a vibrant focal pointin the community. The accomplishments of our high school youth are a source of civic pride. Without its youth, where is the future of a community? I have been privileged to work with students in the culinary program at Green- ville High School and, while at that campus, I have ob- served dedicated teachers who work diligently to educate our children academ- ically and socially. These teachers have given gener- ously of their talents and their time, staying late at night to prepare for their classes, providing needed materials without reimburse- ment. They deserve our support and gratitude. The students in the culinary program have demonstrated great heart and soul. In 2011, the Greenville High School students entered a statewide competition spon- sored by the California Restaurant Association Edu- cational Foundation and, despite having a smaller team, earned second place honors, finishing just behind a much larger, better funded, urban school team from Southern California. Their accomplishment demon- strates that small schools can perform at a high level. This school spirit is a tribute to Greenville and the com- mitment of its teachers. We need to find creative sources of funding for our schools and allocate those resources wisely. Let us recognize that educating our children has great impor- tance they will become our future. Scan Conry Executive Chef Longboards Bar & Grill Graeagle Nice chunk I amindebted to the email I received that has revealed the fact that Chevron (so named after its scandals under the name of Standard Oil) has been a major factor in keeping our country in its present state of fiscal chaos. Not only has it dodged its federal tax obligations, but it has demanded tax breaks at the local level. It is hard to believe that in addition to not paying any federal taxes in 2009 Chevron got a tax subsidy of $19 million. This, while enjoying record profits since 2008. In 2011, Chevron earned $26.9 billion in profits, the highest annual profits in its 132-year history. Well, the lobbyists and politicians are happy. They have been receiving a nice chunk of the subsidies we taxpayers have been handing Chevron. More than ever, we need election reforms that will stop this kind of corporate abuse. Salvatore Catalano Taylorsville Ranting The survival of Plumas County depends on its ability to develop an environment to sustain local businesses. With training from the League of California Cities and 30 years in business management and ownership I have made a new business to put my nose into issues that impact our county. Some of the locals like Darrel Smith have considered me "out of my mind." The public is allowed to run our mouth off during public comment. The super- visors may consider us "gadflies." We do not yield our sovereignty to them. Smith has made his com- ments before, during and after the Belden music festi- vals. The Board of Super- visors voted unanimously to issue permits over the protests of one individual. They acted as public servants. The BOS have listened to Smith's rantings for the last three years. He has tried to stop a local business from providing a community service. His issues have been investigated and reported back to the BOS. His seffish whining is driving many out of their mind. Dut:ing Portola's Railroad Days attendees park illegally, tres- pass on my property and m leave trash behind without my whining. The Belden Town Resort is a county asset. Their staff have responded to requests for added services and personnel. Their ability to attract musical festivals and even add to their number in these economic times is not only a testimony to a local business but also to our attraction to those living in the Bay Area. At no time did I think that all the partiers to the music festivals in Belden go into Quincy to spend pocketfuls of cash. They help sustain a Belden business and may attract other artisans to the county. They may choose to move to Plumas County if they are not repulsed by Smith's conduct. Larry F. Douglas Portola Let them eat corn A fable for 2012: Did you know you can catch wild pigs by finding a place in the woods and putting corn on the ground? The pigs will find it and begin to come daity to eat the free corn. When they are used to coming every day, you put a fence down one side of the place where they are eating. When they get used to the fence, they begin to eat the corn again and you put up another side of the fence. Continue hntil you have all four gides of the fence in place with a gate in the final side. The pigs, which have become accustomed to the free corn, start to enter through the gate to eat the free corn again. You simply slam the gate shut and suddenly the. wild See Letters, page 12B