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May 7, 2014     Feather River Bulletin
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uulletln, tecoro, rrogresslve, teporer Wednesday, May 7, 2014 1111 COMMUNITY PERSPECTIVE Rural residents shouldn't be marginalized for health care Plumas County residents are once again experiencing decision makers' preference for larger urban communities when it comes to their health care. Last year, it was Eastern Plumas Health Care's battle to keep their skilled nursing facilities open in the face of cuts that would unfairly affect small, rural communities. This year, the hit is being felt by the new Medi-Ca! enrollees. In both cases, the promise of "access to care" seems hollow -- and it points to a prejudice against our rural communities that sets a dangerous precedent. Rural counties such as Plumas have recently been require d to shift to Medi-Cal Managed Care. Managed Care is handled by two plans in Plumas County -- Anthem Blue Cross and California Health and Wellness. The new plans have absorbed WHERE I STAND LINDA SATCHWELL PUBLIC RELATIONS COORDINATOR EASTERN PLUMAS HEALTH CARE Healthy Families and Path to Health patients. This, along with the higher allowable income for enrollment, means an increase of 2 million MMC enrollees in California. The shift to managed care combined with the sheer number of enrollees is causing serious access issues for patients, especially in rural counties like Plumas. Our local doctors are having trouble finding specialists for their patients who will take the new Medi-Cal plans. And the specialists who do accept patients are often a long distance away. We are a two-insurance-provider county as well, which means that patients might expect to go to a specialist they've seen before under the old Medi-Cal only to be told that provider isn't in their new network. One EPHC patient in need of spine surgery was given a specialist appointment at USC in Los Angeles. This nine-hour trip for a low-income patient who ". needs spine surgery is about as mind-boggling as the state's assertions during last year's skilled nursing battle. At that time, the state claimed there was "adequate access" to skilled nursing facilities for EPHC's SNF residents should the facilities close. The facilities that the Department of Health Care Services paired EPHC with were as far away as Thousand Oaks, also nine hours away. In urban areas, however, adequate access is usually defined as 30 miles or 45 minutes maximum. This isn't a small disparity. Rural areas are typically lower income than their urban counterparts. They have a higher unemployment rate, higher mortality rate, higher percentage of elderly residents ... and the list goes on. They have fewer doctors per capita, and fewer specialists. In short, they need more, but they often get much less. Legislation in California, not surprisingly, favors urban areas. Legislators want to get re-elected and they want to please the special interest groups that support them. Rural areas don't have a lot of leverage -- they don't have huge numbers, lots of money or influential lobbies. When it comes to rurals, we hope that those who make decisions affecting our lives will do the right thing, we try to embarrass them into doing the right thing, and when we can, we figure out a way to force them to do the right thing. When it came to the skilled nursing fight, we pointed out that coupling rural counties that had a similar bed rate (dollar amount) might sound logical, but while it allowed the state to arrive at the desired conclusion -- adequate access -- it in fact was not logical. We cited a number of federal and state accepted standards (we used those set by the Center for Medicare/Medicaid Services and the Office of Statewide Health Planning and Development) that showed their conclusions were unacceptable. When these discrepancies were brought to the attention of certain people at the Department of Health Care Services there was, unbelievably, an open ear and a change of heart. But, rest assured, it was a battle, and if we hadn't fought it ourselves we would likely have lost our skilled nursing facilities. Now, our Medi-Cal patients are suffering a similar state of unfairness and neglect. They are also facing greatly increased denials on medications they're used to receiving under their previous plans. Further, independent local pharmacists like Mike Kibble and Kevin Goss are taking such a huge hit in reduced reimbursement from the two managed Medi-Cal providers that they're talking about the possibility of having to close their doors. That would leave one chain pharmacy, Rite Aid, in Quincy, to serve the entire county. Again, imagine a patient who is ill and needs medication right away being faced with a drive of 40 - 50 minutes -- that is, if he has a car that can make the drive, and if he See Health, page 13B Feather River College provides services to Indian Valley Evolving from K-12 districts, California community colleges still share many traits with local schools, including a defined service area for offering educational programs. Feather River College officially serves Plumas County, which, in turn, provides the tax base for college operations along with locally elected officials in charge of the overall trusteeship for the district. Because of this, FRC strives to provide higher education services and opportunities to all residents of Plumas County. One of the WHERE I STAND DR KEVIN TRUTNA SUPERINTENDENT/PRESIDENT FEATHER RIVER COLLEGE board of trustees objectives for the superintendent/president in 2013-14 is to focus on outreach activities to local communities served by FRC. In the fall semester, the FRC board met with invited community leaders in Portola, and in March, a similar meeting was held in Greenville with over 30 invited community educational leaders from throughout Indian Valley. FRC is proud to serve the entire Plumas County region. While it is not financially possible to establish a college center in every town, there are significant outreach activities and educational opportunities offered throughout the county. Due to this emphasis on outreach communications, FRC has now produced a specific report to the residents of Indian Valley. The first question FRC tried to answer in this community-specific report was: How many local students attend FRC? Since fall 2009, students who listed a permanent address from Indian Valley in the 95934, 95947 or 95983 ZIP codes took between 195 and 291 courses on the Quincy campus every semester. For example, in the current spring 2014 semester, Indian Valley residents enrolled in 225 distinct courses on campus (some students took multiple courses, so it is not a headcount). This equates to an average of 15 full-time students each taking a full load of 15 units each semester. Indian Valley area students signed up for an additional 24 courses offered online and 16 students enrolled in a special program such as veterans, EOPS, CalWORKS or Disabled Students Programs and Services. The enrollments remained steady each semester without large increases or decreases, showing that residents are driving to Quincy to take between 195 and 291 courses every semester with between 24 to 72 additional courses taken online every semester. On the average, this equates to about 20 full-time Indian Valley students taking a full college course load each semester split between campus offerings and online classes. The impact of Indian Valley residents on the FRC campus is significant. Funded by FRC student fees, a monthly average of 455 riders used Plumas Transit from the FRC campus to/from the Chester and Indian Valley areas. This is in addition to those who rode to campus in individual vehicles. Besides the enrollment patterns and figures, the Feather River College Report See FRC, page 13B do!. Md."" r Guidelines for Letters All letters must contain an address 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 3p.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 dmcdonald@plumasnews.com. t Editor's note: With the local primary election scheduled for June 3, Feather Publishing will not print election-related letters in the May 28 paper unless they are a rebuttal to a May 21 letter. Feather Publishing will not print letters about candidates that we consider to be too personal or in poor taste. We reserve the right to edit letters to remove personal comments or unsubstantiated claims. Change of direction needed As I walked toward the Graeagle Fire Hall on the evening of April 24, I was unsure of what lay ahead at the candidate's forum. Was I entering a vitriol confrontation with gladiators throwing sulfuric acid on each other or just making caustic remarks as they.used their arts of war to destroy the character of the other? I came from Portola not to participate in a war of ideals but out of concern for the future of Plumas County. District 5, which includes Graeagle and parts of Quincy, is a district of prosperity for most of its residents. Other districts are not so fortunate. As I approached, I was greeted by Lee Anne Schramel. She personified the goddess Venus. In reality, she is the President of the League of Women Voters. She was setting the tone of the evening. Margaret Goodard gave the audience a brief history of the hundred-year-old organization which remained a group of non-partisan reformers. She then moderated the meeting with a strict format. The League of Women Voters are to be commended for their dedication to our political system and the need for informed voters. They realized the power of the vote and the importance of electing the most qualified candidates to office. We now see the number of women who have become our leaders and decision-makers. Plumas County is in need of a change of direction from just a goal of a balanced budget and a "hold it, don't spend it approach." We need to sustain more families like that of the Jon Kennedy family. We need to create good jobs for an economic recovery. Voters need to select the best candidate to get this job done. We need to work together. Larry F. Douglas Portola Informed decisions As our country heads into another round of elections, it is crucial that we elect individuals who are worthy of leadership. Taking on the responsibilities of an elected official requires dedication and commitment. Our elected representatives are given access to volumes of information. Some of it is based on science and research; some of it comes from historical records or results of past legislative actions; some of it comes from nonpolitical fact finding groups and political analysts who project possible outcomes of proposed legislation; some of it comes from interest groups who have personal agendas; all of it must be embraced to provide effective leadership. The polarization within our current political climate has clouded the vision of many politicians. Common sense and objectivity is often second to ideology. Compromise has become a lost practice. Information is sought selectively. Our political leaders are becoming increasingly vulnerable to making decisions based on incomplete, distorted, inadequate information. This trend has undermined our Democratic process. Decisions that are made too hastily with too little actual understanding of an issue will affect all of us. Our state, our nation, our world is faced with problems of unprecedented proportion. If our nation is to effectively deal with the problems of today and tomorrow, our legislators must be knowledgeable, forward thinking, objective, and concerned about all of their constituents. They also need to represent the future generations who will inherit this Earth. It is up to the voters to make sure that they elect such leaders. Before we voters cast our ballots, we should educate ourselves. We should check on a politician's past voting record and group affiliations. A person's education and experience will provide information about their interests, accomplishments and knowledge base. The information is available- let's use it to make informed voting decisions! Faith Strailey Quincy Sheriff Hagwood a valuable asset Residents of Plumas County have a valuable asset and friend named Sheriff Greg Hagwood. Recently I contacted the sheriff. My correspondence to him surely expressed concern and even panic about a current county topic. I've written to other officials in the past and never heard back, but our sheriff was back to me in no time. While rea0ing h' response, I felt an imaginary hand pat my shoulder and a voice say, "It's OK, I'm all over it. I know exactly what you are talking about and we are working on it." Our sheriff is not a straight-line thinker. He is very aware of the myriad influences on us in this increasingly complicated world. And accordingly, he acts as your diplomat, communicating citizen concerns to other levels of government and agencies, to attempt to preserve our rights and freedoms. He doesn't have to take that level of concern but he does because he cares for people. So, treat him good. Next thing you know, he'll be running for president or something and we'll be out of a great Sheriff. I recently learned that his son attends Oxford. Which gives credence to the phrase "The apple doesn't fall far from the tree." Thanks Sheriff Hagwood for everything you do. Robert Milne Clio Forest thinning good and essential The fellow who wants us to compost all these pine needles and institute a burn ban needs to do more homework. If composting is such a great idea have the fellow start a private company to gather this vegetation together and compost it. I believe that our pine residue is too volatile and acidic to make compost for any purpose. And burning the pine residue is a little bit of a health problem. It is far better than leaving it and letting it burn in July. The letter writer's solution would be too cost prohibitive for most of our residents anyway. He also had a letter to you saying that forest thinning is about profit. No, it's about forest health. It costs to manage the forests, no matter how you do it. Using forest vegetation to heat schools, offices and other public buildings is a great way to remove the vegetation and to heat the buildings. We should have been doing it for a hundred years. These treatment areas are not decimated; they are about what the forests would look like if it wasn't for European settlement (that's you and I). Most educated Plumas County residents know that forest thinning is not just good for forest health, but necessary for continued sustainability. Forest fires were good for the forests when they used to occur under natural conditions. There are extremely small parcels where the forest is under natural conditions because of human intervention. A majority of forested lands in California are overgrown and overcrowded. Mother Nature will thin out the forests but we will be better off if we manage it with the best science available. Dave Rudolph Wild Land Firefighter, 1969-2001, Retired Portola Just one opinion One mathematics instructor at Portola High School would adapt common sayings to particular situations. When he noticed more conversation than classwork in a corner of the room he'd walk in that direction and casually say, "Well, birds of a feather flunk together." I use that anecdote in response to one letter in last week's edition. That letter seemed to infer that an overwhelming majority of Plumas County residents are opposed to forest thinning, even to provide defensible space, to the burning of debris piles, and to the installation of biomass boilers. I can only guess that almost everyone that this person interacts with on a daffy or weekly basis shares these same opinions. I find this strange because I live in the same county and almost everyone I See Letters, page 13B Contact your elected officials... PLUMAS COUNTY SUPERVISORS - 520 Main Street, Room 309, Quincy, CA 95971; (530) 283-6170; FAX: (530) 283-6288; E-Mail: pcbs@countyofplumas.com. Individual supervisors can also be e-mailed from links on the county website, countyofplumas.com PRESIDENT - Barack Obama, the White House, 1600 Pennsylvania Ave., NW Washington, D.C. 20500. (202) 456-141. Fax: 202-456-2461.  . E-mail: whitehouse.gov/contact / U.S. SENATOR - Dianne Feinstein (D), 331 Hart Senate Office Bldg., Washington, D.C. 20510. (202) 224-3841; FAX: 202-228-3954; TTY/TDD: (202) 224-2501. District Office: One Post Street, Suite 2450, San Francisco, CA 94104; Phone: (415) 393-0707; Fax: (415) 393-0710 Website: feinstein.senate.gov. U.S. SENATOR - Barbara Boxer (D). District Office: 501 1 St., Suite 7-600, Sacramento, CA 95814. (916) 448-2787; FAX (916) 448-2563; OR 112 Hart Bldg., Washington, D.C. 20510. (202) 224-3553. FAX (202) 228-0454. U.S. REPRESENTATIVE, 1ST DIST. - Doug LaMalfa. 506 Cannon HOB, Washington, D.C. 20515. (202) 225-3076. lamalfa.house.gov. DISTRICT OFFICES: 1453 Downer St., Suite #A, Oroville, CA 95965; 2885 Churn Creek R., Suite #C, Redding, CA 96002. 1 STATE SENATOR, 1st DIST. - Ted Gaines. State Capitol, Room 3070, Sacramento, CA 95814. (916) 651-4001, FAX: (916) 324-2680. E1 Dorado Hills Constituent Service Center: 4359 Town Center Boulevard, Suite 112, E1 Dorado Hills, CA 95762. (916) 933-7213, FAX (916) 933-7234; Redding Constituent Service Center:. 1670 Market St., Suite 244, Redding, CA 96001, (530) 225-3142, FAX (530) 225-3143. STATE ASSEMBLYMAN, 1ST DIST. - Brian Dahle, State Capitol, l Room 2174, Sacramento, CA 94249, (916) 319-2001; FAX (916) 319-2103. l District Office, 2080 Hemsted Dr., Ste. #110, Redding, CA 96002; | (530) 223-6300, FAX (530) 223-6737. [(9144 GOVERNOR - Jerry Brown, office of the Governor, State Capitol, Suite 1173, Sacramento, CA 95814. Website: gov.ca.gov/ 5-2841. FAX: (916) 558-3160. 4