Federal Request Derails Hospital Bond Sale
Another Attempt Planned for Fall

Tulare - Tulare Local HealthCare District's sale of $70 million in general obligation bonds was derailed Aug. 12 when the low-bidder withdrew a purchase offer after the hospital disclosed it had received a request for documents from a federal regulatory agency.

The purchase offer from Raymond James Investments was based on information the hospital provided prior to the July 15 bond sale date. When the documents request was made on July 24, hospital officials decided they needed to inform the buyer even though legally what they could say was very limited, hospital attorney Kris Pederson said.

The request came from the U.S. Health and Human Services Department and the hospital cannot disclose any more information than that, Pederson said.

“As soon as we are able to do so, we'll do so,” she said at a special board meeting called last Thursday to discuss the bond sale and “pending litigation,” which she later said was related to the regulatory agency's request.

“I don't want the public to perceive this as a crisis, because it is not,” Chief Executive Officer Shawn Bolouki said. The audience Thursday included Bill Postlewaite and Lynn Dredge, co-chair of the citizens bond oversight committee, hospital board candidates Sherrie Bell and Skip Barwick and Rita Woodard, the county's auditor, tax collector and treasurer.

During a 60-minute public discussion, the board decided to follow the advice of bond consultant Gary Hicks and attempt a $20 million bond sale later this year when more information will likely be available to potential buyers.

Early Sale

Voters approved an $85 million general obligation bond in 2005 to construct a new hospital tower in 2012. The district sold $15 million worth of bonds last year and had not planned to sell the remainder until next year.

But with interest rates dropping and construction and equipment costs continuing to soar, hospital trustees decided earlier this year to sell all the remaining bonds, a move designed to allow the hospital to realize greater interest earnings and Chief Executive Officer Shawn Bolouki to lock up steel, infrastructure and equipment costs before they rise any higher.

A $20 million sale will still allow Bolouki to accomplish his goal, Hicks said.
When board Chairman Dr. Parmod Kumar asked Postlewaite, a former schools superintendent, and Dredge, a former city manager, if they had questions about the discussion, both expressed concern.

“There's something about this I don't understand, but I don't think you can help me with this,” Postlewaite said, indicating he understood that legal limitations were involved.

“Whatever is interfering with that [sale] concerns me,” Dredge said.

Bolouki tried to reassure them.

“We believe at this time it [the request from the regulatory agency] is not even going to impact the ratings of the bonds,” he said.

If the hospital can secure the same A3 rating from Moody's Investor Service as before, then that will be an indication the information request is not material to the bond sale, Bolouki said.

Hospital officials called a special meeting on the bonds because the county of Tulare needed to know immediately what the district's plans were because the Board of Supervisors will set the tax rate this month.

“I have to be very thankful to county officials because they were flexible,” Bolouki said.

Lucy Reimche

Hospital officials cannot disclose information about the U.S. Health and Human Services Department's request for information, but it is possible it is related to former Chief Financial Officer Lucy Reimche's allegations against the hospital district.

In her lawsuit filed in August 2007, against the district and former Chief Executive Officer Bob Montion, Reimche made several allegations that would appear to fall under the domain of the investigatory arm of the Health and Human Services Department.

She has, for example, alleged:

· The hospital entered into lease agreements with physicians for office space at less than fair market value, knowing the practice was illegal.

· Gifts, benefits and remunerations were provided to physicians and others by the hospital in violation of various federal regulations which prohibit such gifts of public funds.

· Pharmacy records were not in compliance with federal regulations and the department was not billing Medicare correctly.

The hospital district and Montion have denied the allegations.

While the hospital district has offered to settle that case for $600,000, Reimche has refused to sign a settlement agreement.

A recent filing by her attorney indicates she is doing so because she believes the agreement would prohibit her from assisting the U.S. government in a “qui tam” case to recover taxpayer money the hospital allegedly obtained by unlawful Medicare billing practices.

“Qui Tam” is short for a Latin phrase that means “who as well for the king as well for himself sues in this matter.”

An employment law Web site indicates “Qui Tam” cases are commonly called “whistleblower” actions and they are brought by private citizens who sue on behalf of the federal government and receive a portion of any money recovered.

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TDH Expects to Open Second Clinic Monday

Tulare - Tulare District Hospital expects to have two walk-in health clinics in operation by next Monday, a move officials hope will reduce the number of non-emergency cases seen in the hospital's emergency room.

The first clinic opened Monday on the corner of Gem Street and Terrace Avenue across the street from Garden School. The 1,600-square-foot building has six examination rooms and will be staffed from 8 a.m. to 5 p.m. Mondays through Fridays by a medical assistant and Carol Thiele, clinical director for the rural health clinics and a family nurse practitioner.

The other clinic is at 874 Cherry Street and is expected to open next Monday with a physician assistant providing services during the same hours as the Gem Street clinic, Thiele said.

With just under 5,000-square-feet and 11 examination rooms, the hospital anticipates adding a second physician assistant to the Cherry clinic in a few months as the volume grows.

“What we plan to do is primary care for all ages at both sites,” Thiele said, adding the goal is to get the clinics ups and running for 12 hours a day, six days a week.
Because the Cherry location is so big, the hospital may add a specialty service to the site in the future, said Viktoria Meyers, vice president for business development.
The number of people who use Tulare District's ER for non-emergencies has resulted at times in long waits for care and complaints from the community.

“My hope is this is going to help us in the emergency room,” said Chief Executive Officer Shawn Bolouki, who in September is also replacing the group that currently provides ER physicians to address other types of complaints.

The Tulare Local HealthCare District board of directors approved the idea of opening a series of rural health clinics in November 2006 with the expectation the move would not only have a positive impact on the ER but would also improve the hospital's financial position.

Consultant Kelly Hohenbrink from TCA Partners told the board the hospital could see a $100,000 revenue gain in the first year of clinic operations in large part because Medi-Cal provides larger reimbursements for patients who get non-emergency care in a rural health clinic as opposed to the emergency room.

Bob Kelley, who was the hospital's interim chief executive officer at the time, said that when he was at Madera Community the hospital opened an outpatient clinic and added $500,000 to $750,000 to the bottom line.

The new clinics, however, won't initially cover their costs because they do not have the necessary rural health clinic designation from the state and will get lower reimbursements as a result.

“You have to be up and running before the [state] survey date,” Thiele said.

Tulare District Hospital expects to have two walk-in health clinics in operation by next Monday, a move officials hope will reduce the number of non-emergency cases seen in the hospital's emergency room.

The first clinic opened Monday on the corner of Gem Street and Terrace Avenue across the street from Garden School. The 1,600-square-foot building has six examination rooms and will be staffed from 8 a.m. to 5 p.m. Mondays through Fridays by a medical assistant and Carol Thiele, clinical director for the rural health clinics and a family nurse practitioner.

The other clinic is at 874 Cherry Street and is expected to open next Monday with a physician assistant providing services during the same hours as the Gem Street clinic, Thiele said.

With just under 5,000-square-feet and 11 examination rooms, the hospital anticipates adding a second physician assistant to the Cherry clinic in a few months as the volume grows.

“What we plan to do is primary care for all ages at both sites,” Thiele said, adding the goal is to get the clinics ups and running for 12 hours a day, six days a week.
Because the Cherry location is so big, the hospital may add a specialty service to the site in the future, said Viktoria Meyers, vice president for business development.
The number of people who use Tulare District's ER for non-emergencies has resulted at times in long waits for care and complaints from the community.

“My hope is this is going to help us in the emergency room,” said Chief Executive Officer Shawn Bolouki, who in September is also replacing the group that currently provides ER physicians to address other types of complaints.

The Tulare Local HealthCare District board of directors approved the idea of opening a series of rural health clinics in November 2006 with the expectation the move would not only have a positive impact on the ER but would also improve the hospital's financial position.

Consultant Kelly Hohenbrink from TCA Partners told the board the hospital could see a $100,000 revenue gain in the first year of clinic operations in large part because Medi-Cal provides larger reimbursements for patients who get non-emergency care in a rural health clinic as opposed to the emergency room.

Bob Kelley, who was the hospital's interim chief executive officer at the time, said that when he was at Madera Community the hospital opened an outpatient clinic and added $500,000 to $750,000 to the bottom line.

The new clinics, however, won't initially cover their costs because they do not have the necessary rural health clinic designation from the state and will get lower reimbursements as a result.

“You have to be up and running before the [state] survey date,” Thiele said.

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Garbage Problem Puts
Salvation Army in Bind

Tulare - The problem with people dumping off junk outside the Tulare Salvation Army has worsened to the point the Army's Fresno Adult Rehabilitation Center will stop sending a truck twice weekly to pick up the unusable items.

This means the Tulare Corps, which has tried to make people aware it is not a drop-off point for discards, will have to find another way to handle the increasing amount of garbage local residents dump on its property at night.

“I'm at a total loss as to how to handle the situation, because Tulare has always operated with just volunteers,” said Capt. David Scott, who operates the Tulare Corps with his wife, Capt. Ruth Scott. “I don't have a truck, I don't have employees and I don't have a budget to pay dump fees.”

If he has to hire an employee with benefits, that would mean $24,000 to $25,000 a year less in direct services that the Tulare Corps can provide to the working poor, Scott said.

Scott is unable physically to load and haul away the garbage himself. “I can't do the lifting anymore,” he said.

The amount of junk left outside the Army office has grown dramatically, probably because of the foreclosures and evictions that are the results of a weakened economy, he said.

The dumping problem in Tulare and other Valley cities is eating away at the non-profit organization's funds for its regional residential drug and alcohol treatment facilities in Fresno, Scott said.

“The problem is so bad that the Army's dump bill was $40,000 last year — that's for Fresno and Tulare counties,” he said.

While some people may be dropping off usable items, by time the Army opens at 314 East San Joaquin Ave. each morning most of those are gone and what is left is garbage, including old carpets and furniture “you wouldn't let your dog sleep on,” Scott said. “That stuff has to go straight to the dump.”

While proceeds from the sale of usable items in Salvation Army thrift shops help keep treatment centers going, costs related to disposing of garbage reduce earnings, he said.

“It cuts down the numbers of people we can serve and the ones we serve are the ones who have not made it anywhere else and need it the most,” he said

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Jeweler Celebrates 25 Years in Tulare

Tulare - Many years ago, Harvey Willis opened a fortune cookie that read: “You will succeed at a business of your own.” The Tulare native has done just that and is celebrating 25 years as owner/operator of Willis Jewelers, 218 South K St.

Willis had an open house for Tulare Chamber of Commerce and Tulare Improvement Program (TIP) members last Friday followed by a customer and community appreciation celebration that included music and giveaways Saturday.
“I have a lot of admiration for Harvey,” TIP coordinator Jerry Magoon said. “He minds his own business and he takes care of his business. He's an outstanding jeweler and he does that carefully. He's the only one left in downtown.”

With the face of downtown changing over the years to include many more commercial offices, Willis' store is one of the oldest retail businesses in downtown. Asked why he has stayed in the downtown, he answers with one word — “roots.”

While he likes the downtown, Willis admits “it's a real big concern” now. A glance across the street from Willis' beautifully remodeled and appointed store tells at least part of the story.

More than two years after a devastating fire destroyed the California Office Liquidator's building, the lot sits vacant as the owners wait for an out-of-town landlord to shore up her empty building so they can build.

'Promising'

Despite this, Willis, who has attended brainstorming workshops on the future of downtown, still calls the area “promising.”

Through the years he has put considerable effort not only into his craft but into his building as well, remodeling it twice since he purchased it in 1991. These were rather daunting efforts. The first go around, for example, involved removal of five roofs or 7 ½ tons of material.

For Willis, who subscribes to the philosophy that “success is planning on succeeding,” the efforts were worth his investment and have contributed to his success.

“After I remodeled in 1999, I got on my soapbox and tried to explain this to other people,” Willis said. “All the money I put into the remodel…I got it all back in the first year,” Willis said. “People want to go where it's new, fresh and exciting. That's why big boxes always remodel.”

Willis first job in the jewelry business was right after he graduated from Tulare Western High School in 1975.

He took a temporary job at Houston's Jewelers in Visalia and ended up staying more than seven years, getting the hands-on experience he needed to strike out on his own in August 1983.

“I had the opportunity to become a watchmaker, but that was not enough creativity for me,” he said.

“I'd been fascinated with jewelry — it's construction — for a long time,” he said, explaining that designing and creating jewelry for customers is one of the most enjoyable parts of his job.

When a customer receives the piece, likes it and wears it proudly, that makes him very happy and often results in another customer.

“When that takes place, you know you've succeeded,” Willis said.

Willis said he held the weekend celebrations because he really wanted to thank customers and the community, including jewelers who have referred people to him when they have retired, for supporting him all these years.

Willis is also the proud father of two daughters, Bethany, who just completed her training as a physician assistant, and Leslie, who rebuilds jets on the A-10 Warthog aircraft. Both are married with children.

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Free Leadership, Advocacy
Training Available to Tulare Parents

Tulare - Tulare is one of only three Tulare County communities where parents will have the opportunity to receive leadership and advocacy training this school year.
Funded by a state grant awarded to the Tulare County Child Abuse Prevention Council and hosted by the Tulare Family Resource Center, the Parent Institute Leadership Training is free to parents.

The sessions will begin Sept. 3, and continue to be held from 10 to 11:30 a.m. on the first and third Wednesdays of the month through June 3. Classes will meet at the activity center at Tulare Community Church, 1820 North Gem St. Classes will be held in Cutler and Woodlake on the same days.

“This is for parents with children of all ages,” said Patricia Pullen, program coordinator and facilitator who is a certified parent educator for the Parents Helping Parents and The Incredible Years programs.

Leadership is not reserved only for those with a college degree or who have “something else special going on in their lives,” said the Rev. Larry Dodson, director of the host resource center.

“This teaches everybody how to become an effective leader — to know their rights and how to express their concerns,” Dodson said. “To me, it's real important that parents learn how to advocate for their children in school.”

Pullen said advocacy on behalf of children can involve a wide-variety of issues in schools and elsewhere in the community.

“Maybe it's getting a stop sign at a particular intersection — whatever cause is important to them that affects families and children,” she said.

Training will also include instruction in how to work with the news media and “how they are able to draw attention to their cause,” she said.

The classes also involve setting a good foundation for the parent-child relationship, Pullen said.

Parents will look at their own personality profiles —t heir strengths and weaknesses — and learn about communications and setting limits, she said.

“Many parents are being ordered to attend parenting classes,” Dodson said. “That's a big deal right now in this county and a lot of that is a lack of understanding, education about their roles as parents.”

Parents who complete the training will be awarded certificates, Pullen said.

Information: To register or get more information about Parent Leadership Institute Training in Tulare, contact Patricia Pullen at 622-1853 or patrcia@synchronyofvisalia.com.

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