Hospital Board Challengers:
It's Not About Bob

Tulare - When Drs. Prem Kamboj and Lonnie Smith filed nomination papers for the Tulare Local HealthCare District board, rumors began to fly almost immediately that they wanted to oust Chief Executive Officer Bob Montion.

Kamboj and Smith, who face incumbents LeRoy Trippel and Victor Gonzalez in the Nov. 7 election, say they are running not to fire Montion but because they want to be involved in planning the new hospital.

“Bob is a real good friend of mine,” Smith said. “I've never had a problem with Bob. I'm not running to get rid of Bob. I'm even going to his birthday party.”

Dr. Prem Kamboj admits he and Montion don't always see eye-to-eye and have had disagreements related to the Tulare Community Health Clinic, which is unaffiliated with the hospital, but said firing him is not on his agenda. Montion serves on the health clinic's board and Kamboj provides pediatric services to the clinic.

“Whenever he and I have worked together as a team, we have done very productive things,” said Kamboj.

“It's not about Montion,” Kamboj said. “It's about the hospital. Dr. Smith and I gave him our word very clearly: We are running to establish a center of excellence.”

They also made it clear, Kamboj added, they have no intention of being a “rubber stamp” for the administration. “Some of the current members are rubber stamps and never ask questions,” he said, declining to publicly zero in on any particular members.

The incumbents in this race are board Chairman LeRoy Trippel, who has served 18 years, and board treasurer Victor Gonzalez, who is completing his first four-year term.

Trippel and Gonzalez said they are proud of the board's accomplishments, including the building of Evolutions Fitness and Rehabilitation Center, creation of the Tulare Pharmacy and other steps taken to meet the needs of the community while keeping the hospital fiscally sound.

“We've accomplished a lot and we've had wonderful support from the community,” Gonzalez said, citing the overwhelming approval of the hospital's $85 million bond measure as validation of the direction the board is going.

The incumbents said they are eager to participate in the planning of the new hospital and in the joint venture development of a medical office/surgery complex next to Evolutions.

“It's going to be a very important period of time for the hospital,” Trippel said.

Gonzalez: “Are you kidding?”

Gonzalez, chief investigator for the Tulare County Public Defender, said he was puzzled by Kamboj' assertion some board members are “rubber stamps” for the administration.

“We question Bob all the time,” he said. “We question the administration closely and we look at the bottom line … Rubber stamping? Are you kidding? I'm an investigator.”

In addition to attending board and committee meetings, Gonzalez said he talks with other employees frequently and visits the Emergency Department and other areas of the hospital to get a first-hand look at what is happening.

He also attends one training conference a year and recently went to Washington D.C. with a department head to accept and review the terms of a $375,000 grant for the hospital's mobile clinic and to find out what other grants might be available, he said.

Gonzalez is particular proud of how the board has addressed the nursing shortage.

“Eleven of our own employees will graduate from nursing school in December and start to work as registered nurses in our hospital,” he said, adding nine other employees will graduate the following year. The hospital has also begun a licensed vocational nursing program with the idea that those graduating will later go on to get their RN degree.

Kamboj: ER needs attention now

Kamboj said the biggest complaint he hears about Tulare District is its emergency room and the board should have done more before now to address the problem.

“This ER is the same size as when I walked into this hospital in 1978,” he said, maintaining that if the board had expanded the ER into the medical records area years ago when it was proposed, it would have been triple the size without incurring too much cost.

He said the board cannot wait six years, which is the amount of time it is expected to take to build the new hospital, to give the public better facilities and should take steps now to enlarge the existing ER.

“I doubt it would cost that much,” he said.

Expanding the existing ER would take just as long as building a new one because of state requirements and the cost would be “tremendous,” Trippel said.

The hospital has added four more ER beds and expanded the waiting area in the past two years to try to address the problems.

“I haven't had any complaints about the ER [since the remodel],” Trippel said. “We also get a lot of complimentary remarks about people's experiences. It's not going to be perfect, but it's pretty good.”

Smith: Wants in on the ground level

Smith said he started thinking about running for the hospital board a year ago because he wanted to be in “on the ground level” in planning the new hospital.

Before moving to Tulare in 1994, Smith was head of the Ear Nose and Throat Department at San Bernardino County Medical Center, where a new hospital was being planned. “Some of the things I learned there, I'd like to give back to the community,” he said.

Smith said he is tired of his patients asking to go to Kaweah Delta District Hospital. “We need to find a way to bring 42 percent of the community back [to Tulare District], he said.

Tulare District is a good hospital but people's first impression of it often comes in the emergency room, he said. “They think if it's a bad experience there, the hospital has to be bad. … I want to help deliver a class one emergency room.”

Like Kamboj, he said more should have been done sooner to improve the existing ER. “Not enough has changed.”

Trippel and Gonzalez have said they don't think three doctors should serve on the board (Dr. Parmod Kumar is already a member), but Smith said he wants to serve as a citizen on the board.

“I pay my bills by being a physician, but I'm also a citizen of the community,” he said.

His current position as Chief of Staff already allows him to raise concerns of the physicians, he said.

Trippel: Financial expertise important

Trippel has 37 years of banking experience, a fact he considers an important asset he brings to the board.

“I think the hospital requires financial expertise,” he said. “It doesn't take long in a facility like that and you can run through a lot of money. I think management skills are important.”

The board's role, however, is not to get involved in the day-to-day activities of the hospital, he said. “If you get involved, you're going to do nothing but throw a wrench into the operations.”

The hospital has $21 million in cash reserves, which were built up in the past 10 years, and also has made good strides in the areas of patient and employee satisfaction in the past two, Trippel said.

The board veteran said he doesn't think three doctors should serve on the board. “One is an adequate number,” he said. “I would rather see people there from a variety of experiences.”

Physicians at the hospital have a chance every day to communicate with the hospital administration and they are also welcomed to attend board meetings, Trippel said.

“The very fact they're doctors give them a tremendous amount of control within the hospital,” he said.

---

Former Coach Battles Rare Disease

Tulare - Delbert Jones, a recently retired Tulare Union High School teacher and coach is battling a rare disease and his colleagues and friends are planning a major fund raiser at the Nov. 3 Bell Game to help him pay for experimental treatment at the City of Hope.

Jones, 56, head football coach for 11 of his 29 years at Tulare Union, had been sick for eight months when doctors confirmed last November that he suffers from scleroderma, a rare, progressive disease that involves overproduction of collagen which causes the skin and connective tissue to harden.

About 150,000 Americans have the disease, which doctors classify into different subsets, according to the Mayo Clinic's web site. Jones has diffuse cutaneous systemic sclerosis, which affects blood vessels and major organs in addition to the skin.

“Unfortunately, it's the worse kind,” Jones said. “It's a strange disease.”

His first symptoms appeared in March 2005 and today he has no flexibility in any of his joints, including his jaw.

“It's difficult to eat and talk,” he said. “I have to have a walker and I can't go very far. I've had a power chair on order. I'm just stuck in the house.” He retired in June because of the illness.

Jones has tried chemotherapy, which softens the skin in some cases but it did not help.

Doctors at UCLA said he is a good candidate for an autologus stem cell transplant, an experimental treatment that the City of Hope in Duarte offers.

“They extract stem cells from his own body and freeze them,” said his wife Mary Jones, who has taken a leave from her teaching at Live Oak Middle School to care for her husband. “When they get enough, they put them back in and that's supposed to soften the tissue.”

He was taking tests and completing other steps necessary for the transplant when his kidneys began to fail. “We're kind of leveled out right now and waiting for them to heal themselves and get better,” Del Jones said.

The procedure has been used in Europe for a while and doctors here have had successes with the treatment, but insurance companies still consider it experimental and will not cover the estimated $200,000 transplant cost, the Joneses said.

Colleagues and friends have been raising money to help. Their latest endeavor is Ring the Victory Bell for Del, a tri-tip barbecue dinner at the annual football game between Tulare Union and Tulare Western. Tickets are $10 each and available at home games or by calling Tulare Union, 686-4761, or Tulare Western: 686-8751.

“We've had such great friends and families helping and taking good care of us,” Del Jones said. “Just so many people have stepped up.”

The couple has two grown children, Cynthia, who is married and a missionary in El Salvador, and Brett, a graduate of the U.S. Naval Academy who is training to be a pilot.

---

Meridian Interested in Developing Library Property

Tulare - Meridian Property Company, which at one time had plans to build an 11-acre professional and medical office complex at Mooney and Prosperity, is now looking at the Pine Avenue downtown corridor and the possibility of entering into a joint venture with the city that could result in a professional office complex and new library.

The San Ramon-based company was scheduled to ask the City Council this week for an exclusive right to negotiate to develop the city-owned block bordered by Cross and Pine avenues and M and L streets, where the city had planned to build a new library.

Those plans were dashed, at least temporarily, when California voters failed to pass a state library construction bond measure in June, which would have provided the city with $6.9 million to build a 26,462-square-foot replacement for its existing North F Street library.

Redevelopment Director Bob Nance is recommending the council approve a 180-day exclusive right to negotiate with an option to extend talks 60 days if both sides agree. And if the City Council does not want to tie up the city's property for six months, Nance said it could put out a request for proposals to see what the interest is.

“We're going to be really happy to march in the direction the council wants to go,” City Manager Darrel Pyle said.

“We've had a handful of developers who have had interest in developing the property,” Pyle said.

“These guys [Meridian] said they'd like to spend time [working on a proposal] and they're going to be into this thing for a big chunk of money by the end of the day,” he said. “They would hate to do the study and have you sell it to somebody else 30 days later.”

Just how a joint venture with the city could work is something the study would explore.

One possibility is Meridian would build the library on city land at no cost to the city and then lease it to the city at or below market rate, Pyle said.

“And in the end, we'd own it,” he said. “We're trying to avoid putting $8 million up front for a new library.”

One scenario Meridian has discussed would have the developer build part of its medical office complex on the city block with the library and purchase about half of the block immediately to the west, where Betty Brite Cleaners is, for the remaining part, Library Director Michael Stowell said.

Nance said Meridian is also offering to work with the city on expanding the Tulare Santa Fe Trail through the downtown and provide public parking. The review would also determine the long-term potential of building a housing development on land behind the National Guard Armory pond.

The city's existing Pine Avenue plan call for a ponding basin behind the Armory, but Nance said it is possible the large ponding area the city is considering building west of the Union Pacific Railroad tracks downtown could eliminate the need for the smaller one.

Eric Schueler, acquisition manager for Meridian, said the company is well-aware of the Tulare Local Health Care District's plans to joint venture with a developer to build a medical office complex/surgery center adjacent to Evolutions on East Prosperity Avenue.

“We talked to the hospital about building on its site and we then went down the road and talked to two other people,” Schueler said.

“As we go through the process, we'll really get into analyzing the market and how big the market is,” he said. The company has built medical offices in Hanford, Clovis, Fresno and other Valley communities.

Meridian has not a done joint public/private sector projects before, Schueler said.

“We're researching the types of approval we'll need through the state,” he said. “We believe this will be just another building. We're at the very beginning of talking. It's so preliminary at this point.”

Mayor Richard Ortega said before this week's meeting he initially thought a 180-day agreement with Meridian was too long, but company officials said they needed that amount of time to do their studies.

“These people are pretty big developers and they really want to have a shot at it,” Ortega said.

---

Council Challengers Want More Police Officers

Tulare - Unlike four years ago when they had no opposition, Mayor Richard Ortega and Councilman David Macedo face two challengers in the Nov. 7 election.

They are Derek Thomas, 41, a state correctional officer who made an unsuccessful bid for a council seat two years ago, and Randy Dennis, 36, a former Tulare city firefighter who is an engineer with the Fresno Fire Department.

Even though the City Council has approved 14 new police positions in the past 19 months, public safety is still an issue with the challengers.

“Crime hasn't gone down enough as far as I'm concerned,” Thomas said.

Dennis concedes the council has done a lot in the area of public safety, but said more needs to be done because “people don't feel safe yet.”

Ortega, who has served five years on the council, and Macedo, an eight-year veteran, said their re-election bids reflect a desire to provide City Manager Darrel Pyle and the city's many other new employees with experienced council leadership.

“The overriding factor was I really felt I owed it to our new city manager,” Ortega said. If neither he nor Macedo is re-elected, Pyle will be working with four council members who have two or fewer years of experience.

Dennis: Time for a Change

The two council incumbents seeking re-election have done a “decent” job, but “it might be time for a change,” Dennis said. “You need different personalities on the council. Eight years or six yearsthat's a long time to be in a position.”

He is running at the urging of city employees who trust him and think he will give them a voice on the council, he said.

“There is some concern [among employees], yes there is,” Dennis said. “They feel there are ramifications if they talk to City Council members. There's only a few they would talk to. Carlton [Jones] is one of them.”

Like Jones, Dennis left the Tulare Fire Department because he disagreed with the way promotions were handled, but he said “that's not a main reason why I'm running.”

More needs to be done for public safety, including: installing more street lights; putting in a grade separation at the Union Pacific Railroad track, so there is a way to get across town when trains are passing; and hiring more police officers, he said.

He supports building a new library and likes the concept of working with private developers who would include a new library as part of their project.

“I don't think we can fund it ourselves,” he said. “I don't think the citizens want more taxes or another bond.”

Dennis gives high marks to the new city manager.

“He's real receptive and I think he's going to do the city a great job … He listens to you. He doesn't talk down to you. I think it's kind of nice.”

Thomas: Crime Statistics “Frightening”

While official crime statistics for the first five months of 2006 show a dramatic decrease, Thomas said he has tracked reports in Tulare's daily newspaper for the past nine months and finds the totals “frightening.”

Instead of hiring twice the number of officers Police Chief Roger Hill requested in early 2005, the council should have hired 18, three times as many, he said.

“It's better to have something and not need it than to need it and not have it,” he said.

While calling for more officers, Thomas said he would make sure the city had the money to pay for the new positions first. He criticized the City Council for approving new police positions before obtaining voter approval for a sales tax increase.

Thomas also accused the council of “constantly pulling money from reserves” and repaying the general fund account. “I remember two years ago when I was running for council the city had $5 million in reserves,” he said.

Once the books are final for the 2005-06 fiscal year that ended June 30, city officials said they expect to have $8.6 million in reserves. The council has indicated a willingness to use about $2.6 million of that to finance major projects.

Thomas said that until the city hires more police officers and is certain it has enough water, electricity and sewer capacity to serve more people, it should slow down the growth.

“I applaud the growth that we're experiencing, but there're a lot of issues that come with it,” he said.

The number of homeless people has increased over the past two years and the community needs to address that problem, Thomas said.

He said he has no opinion about the new city manager.

Macedo: Grade Separation Priority

Macedo initially thought serving eight years on the council was enough but he said his constituents urged him to run and he also wanted to provide the city manager and other new employees with continuity in leadership, he said.

“I think the hiring of Darrel Pyle was just an awesome decision of the City Council,” he said. “He is a magician at finding funding sources for projects.”

Well-known as a fiscal conservation, Macedo stepped somewhat out of character in early 2005 when he voted to dip into city reserves to hire a dozen new police officers. The council then did not have a plan for paying the salaries in future fiscal years.

“I knew throughout my tenure we had found dollars to do things we wanted, not that we needed, and by golly we would find money for what's needed,” Macedo said.

A few months later, voters overwhelmingly supported Measure I, a half-cent sales tax increase.

“That was a mandate from the people,” he said. “We want our public safety strong and we want our streets fixed. Those are the things local governments owe their constituents.”

Building a new library is not a priority with Macedo, but constructing a grade separation at the Union Pacific Railroad track to allow east/west traffic to flow unhindered is.

“We've talked about this since I was a little boy and now I'm 45 years old,” he said.

Macedo said he is proud the council has promoted economic growth, provided more services and increased the general fund reserves kept for emergencies.

“I'd like to feel I had a positive role in that,” he said.

The auctioneer and owner of the Tulare Sales Yard was first elected to the council in 1998.

Ortega: More jobs needed

Ortega said the City Council has done many things right during the past five years and he wants to serve another term to support Pyle and help oversee development of Pine Avenue, where the Atchison, Topeka and Santa Fe Railroad line use to run, and the rest of downtown.

A strong proponent of revitalizing downtown, Ortega has called for new residential housing in the area and a library built on the city-owned block on the southeast corner of Cross Avenue and M Street. “But it's going to have to make sense in terms of financing it,” he said.

He applauded council actions increasing the utility users' tax to pay for road repairs and convincing voters to pass a sales tax increase to pay for more police officers, firefighters and road improvements.

“One of the other great decisions was our selection of the city manager [Pyle],” Ortega said. “He has lived up to our expectations and then some. He's very astute in financing and balancing our budget.”

Asked about Thomas' criticism pertaining to the council spending city reserves, Ortega said: “Our reserves are still in good shape.”

The city has seen significant retail and residential growth in the past four years, but needs more large industrial parcels to attract companies that will bring more jobs to the area, he said, adding the council will address that issue when it adopts a new general land use plan.

“You don't want to be caught short [of vacant industrial land] like we are right now,” he said.

He said he also wants to continued redevelopment of west Tulare, where uninhabitable homes are being replaced with newer one. A hands-on supporter of Habitat for Humanity, Ortega said he definitely wants to encourage more city involvement with Habitat and Self-Help Enterprises. Both help families who could not otherwise own their own homes build them.

There is a domino effect in neighborhoods where these projects occur, he said. “They really improve.”

Ortega, 74, is a retired dairyman and served 17 years on the Tulare Joint Union High School board of trustees before he was appointed to the council in 2001 to complete the term of the late Reatha Retherford.

---

101-Year-Old Tulare Resident Finds 'Promised Land’

Tulare - When A.J. Spencer was riding his scooter downtown a few months ago, the 101-year-old Tulare resident thought he saw a good-looking new hotel under construction.

Little did Spencer know that, thanks to the efforts of friends, he would later move out of the South K Street trailer park where he lived and into what was actually the Salvation Army's new Silvercrest apartment complex for low-income senior citizens.

He was the 23rd person to move into Silvercrest, a fact that holds significance for him because of his fondness for Psalm 23 which proclaims, “The Lord is my shepherd.”

He remarks often on the goodness of God as he talks about how Chris and Chrissy Beck and Richard and Georgia Montgomery encouraged him to move from his trailer, helped him find the documents he needed to qualify for Silvercrest and furnished his new home.

Moving into the apartment was like arriving at the Promised Land, he said.

“When I left the trailer house, I left everything there,” he said. “The table was set. I didn't have to bring nothing. I've met some beautiful people. I feel so perfectly safe here.”

Spencer may not have moved in with many of his old possessions, but he arrived with an amazing number of memories lodged in his nearly 102-year-old brain. (His birthday is Oct. 9.)

He can recall when a Dr. Lokey drove the first car into Creek County, Okla., where his mother raised her six boys and six girls after his father died. “What a day that was!” Spencer said.

“What a week that was!” Spencer said.

Lokey normally rode a mule through the countryside when making house calls, he said, so not even the animals knew what to think when they heard the “popping and snorting and carrying on” of the contraption he rode into the area that day.

“A lot of those old hens didn't know they had wings to fly,” he said. “Dogs that would kill a bear ran into the house.”

The people were no better. “Everyone was afraid of it,” he said. “Everyone was.”

Spencer worked hard most of his life, even as a child.

“When I was too little to plow, I was looking after the calves and cutting sprouts,” he said. “The older I got, the bigger the work.” As a teenager and then adult, he helped construct railroad lines, homes, universities, prisons and other projects.

When he married Verna Cleveland in 1930, he said he was unaware of the depression but that changed a short time later when the work that had been so plentiful during World War I and immediately afterwards suddenly dried up.

“And here I had a brand new wife,” Spencer said. He ended up finding work in Phoenix after a search that took him from Oklahoma to Texas and then Arizona.

“God is such a good God,” he said. “I got there [in Phoenix] on a Friday night and went to work on a Sunday night.” His wife joined him six weeks later.

He later moved to California, where he hoed potatoes in Arvin, had a shoe-shine business in Fresno and worked on construction jobs throughout the state.

He kept hearing about Tulare and in the 1940s moved here. He eventually built a two-bedroom home on an S Street lot that he bought for $300.

He moved back to Arizona when his beloved wife became sick, returning 18 years later in 1999 to bury her in Tulare District Cemetery. He returned in 2000 to set up house in a little trailer, which he later replaced with a little larger one.

“Then I met my 'children,'” he said, referring to the Becks.

That friendship was born in Oct. 2004, when Chris Beck read a story about Spencer in which the then 100-year-old man said he liked to fish but couldn't find anyone to take him.

Beck found Spencer's name in the telephone book and invited him to go fishing at Lake Kaweah.

“We fished, fished, fished and fished,” Spencer said with broad smile on his face.

He has taken other trips with Chris Beck and Richard Montgomery, including one to Rocky Hill.

“I've never saw nothing as beautiful as this valley from Rocky Hill,” he said.

When he's not riding his scooter about town, Spencer is likely at home reading the Bible.

“That's my life,” he said. “There's so many books in here [the Bible]. I love them all.”

Asked about his health, Spencer said: “Everything in the world is wrong with me; I just don't let it happen.”

He starts each day, he said, by cooking himself a “tiny” breakfast that consists of two eggs, four slices of bacon, a bowl of cereal, jelly and a couple of biscuits.

“I like to do a lot of sopping,” he said, explaining he puts Ribbon Cane Syrup on his biscuits, along with the butter.

Spencer is excited about his new home and was happy to learn Silvercrest has an area where residents can garden, a hobby he enjoyed many years ago when he had a plot of ground available.

“We're living in a brand new world,” he said. “I'm going to have me a garden. Yes, Siree.”

Chrissy Beck smiled. “You couldn't find a better place for A.J,” she said.

---