TDH Expansion Progresses; Public Presentations Urged

Tulare - Project team members for Tulare District Hospital's $120 million expansion report they are on schedule to get construction plans to the state by the end of September or in early October.

Once the documents are in the hands of the Office of Statewide Health Planning and Development (OSHPD), they will undergo a review that could last as long as 18 months, said Mike McGuire, project manager with Harris and Associates.

Construction of the four-story tower is expected to begin in early 2010 and finish by mid-2012.

McGuire and architect George Christiansen met with OSHPD officials in Sacramento two week ago. “They were very impressed we were as far along as we are,” said Christiansen, who reported about 30 percent of the design work is completed.

Members of the Tulare Local Health District's Hospital Bond Oversight Committee, charged with making sure proceeds from an $85 million bond sale are spent as promised, urged the project team last week to visit service clubs to present the latest expansion renderings and discuss the progress that has been made.

“It's good public relations,” committee Chairman Bill Postlewaite said.

New CEO

Dr. Parmod Kumar, chairman of the Tulare Local HealthCare District board, liked the idea and also suggested sending the hospital's new Chief Executive Officer Shawn Bolouki along to introduce him to the community. It was suggested they begin making the service club circuit in mid-April, giving the new administrator time to get settled.

Bolouki, who attended the Feb. 27 hospital board meeting and officially began his job this week, has experience in bringing new hospitals into operation.

In 1986 he was involved in the commissioning of a $500 million, 1,200-bed hospital in Germany, where he earned a master's degree in hospital engineering, he said. He later was involved in the design review and commissioning of the hospital for the University of California, San Diego.

McGuire told the Bond Oversight Committee last week the hospital:

• Will send representatives to the Tulare City School District board's March 11 meeting with revised traffic plans that call for only the partial closure of Terrace Street—between Cherry and Auburn avenues—to create a safe entry for ambulance traffic and the realignment of Gem Street. Postlewaite, who accompanied hospital officials to a recent meeting with school district officials, reported “they're pretty excited about cleaning up that corner of Terrace and Gem.”

• Is expected to apply to the city this month for a conditional use permit and height variance for the project, which will include a helicopter pad on the roof of the tower.

• The hospital district also must to do an environmental impact report that looks at noise, traffic, parking, air pollution and other issues and circulate the draft for public comment before the board adopts it.

Helicopter Pad

The $120 million anticipated cost for the expansion—which anticipates inflation—is more than the voter-approved $85 million bond issue and the hospital's $20 million pledge will cover.

Since the district won't spend all the bond money at once, interest earnings are expected to cover part of the $15 million difference.

Kumar told the Bond Oversight Committee in January two alternate building plans exist should the hospital's financial position call for them. One, he said, would build only a pharmacy shell—allowing for its full construction in the future—for an estimated $8 million savings and the other would shell the entire fourth floor, which would save about $20 million.

During the discussion last week, talk turned to the helicopter pad proposed for the roof.

“It's on our value engineering list and can be removed,” McGuire told the committee. He said the pad is expected to cost $500,000. Christiansen, who was not at the meeting, said later the savings would be greater than that if the additional roof reinforcement, which a helipad requires, were not done.

Committee members Laurie Tiesiera and Linda Wilbourn strongly urged the team to keep the helipad in the plans, contending the ability to quickly send patients off to major trauma centers in Fresno or other areas of the state would make patients more willing to use the hospital.

Other members agreed. “It will be used,” Mary Dlugonski said.

“As a physician, I think the helipad is very important,” Kumar said, adding that the hospital should apply to the Federal Aviation Administration for permission to use the pad for inbound traffic as well as outbound.

In the event of a freeway accident or other emergency, Kumar said “our community people should have the option to come right here,” because Tulare District always has a surgeon on call.

McGuire said allowing both inbound and outbound flights would not add costs to the project and was just a matter of amending the FAA application.

Rising Costs

While housing costs drop, project team members say hospital construction costs continue to rise an average of about 8 percent a year, which is one reason they are working hard to keep the project on schedule.

“It has little to do with building housing,” Christiansen said.

Bolouki agreed, noting hospital construction costs in 1996 amounted to about $1 million per bed as opposed to $2.5 million today.

Postlewaite, when asked if he was comfortable that the hospital will be able to build the expansion the community wants, said: “I would never be totally comfortable, but I think they're OK. One can only predict inflation…there are so many unknowns when you've got to plan that far down the road.”

He also expressed strong confidence in interim-Chief Financial Officer John Church. “I think John really knows what he's talking about.”

He also said he is pleased with the plans he has seen. “I think it's going to be a very, very fine facility,” he said.

Postlewaite, emphasizing he was speaking for himself, said he thought the community would support a second smaller bond to build the hospital as designed and to avoid having to put on hold the fourth floor or some other aspect the project.
“If they could get their public relations back in order and show the community that we have this really classy plan here and we're $10 million short or $20 million short, then I think we could probably sell it,” he said. Postlewaite is the former superintendent of the Tulare City School District and under his watch the district was able to convince voters two pass two school tax measures.

Because property values have soared since September 2005, when voters approved the $85 million bond, Postlewaite said the cost of that bond to individual taxpayers has dropped “way below” what was estimated.

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The Max: Good for YSB; Runners Too

Tulare - The Max Choboian Road Race, which raises money for the Tulare Youth Services Bureau, has over three decades become a family affair that includes races, live music, food, a car show and other entertainment.

“It's one of those things that everybody looks forward to and that's very nice for us,” said Mike Leoni, director of Tulare Youth Services Bureau.

His organization uses the proceeds—which range from $10,000 to $15,000 annually — to provide mental health services to uninsured sexually abused children and to support the California Express Track Club. YSB serves about 1,500 children and teen-agers throughout the county annually, Leoni said.

This year's Max, featuring six walk/run races for participants from preschool age through adults, is scheduled for Sunday at the International Agri-Center, 4450 South Laspina St.

Running the Max can benefit the walkers and runners who participate as much as YSB.

Take 18-year-old Joey Barnett. Running the Max for the first time as a junior high school student did not pay off with a medal or ribbon but it was an event that sparked his desire to become a long-distance runner.

“I wasn't very good in other sports,” Barnett said. “When I ran in the Max, it told me there was something for me.”

The Tulare Western High School senior, who is a National Merit Scholarship finalist as well as one of the top 10 cross-country runners in the East Yosemite League, said running has trained him mentally and physically to endure the challenges of life both inside and outside the classroom.

His ability to endure was tested In October 2006, when he was in an automobile accident that damaged his left femur, knee and tore the anterior cruciate ligament, which connects the bones of the knee joint.

Had he not been in such good physical and mental shape prior to the accident, he might not have been able to return to long distance running in spring 2007 as he did, Barnett said.

Jim Luis

Special to this year's event will be a presentation to the family of Jim Luis, an Agri-Center employee who died March 20, shortly after last year's race. He was 58.
“Everyone at the farm show helps us, but this guy went the extra mile,” Leoni said. “He did everything needed to make the race go perfectly. He did it with enthusiasm and a smile. He went out of his way for us.”

The Dennis Wong Memorial Scholarship also will be presented at the race. Wong was a runner involved in the race.

The Max, which organizers report draws between 450 to 550 runners and walkers annually, is named in honor of the late Max Choboian, a Denver Bronco football player who helped launch the event 33 years ago after returning to Tulare to practice real estate. He ran in the first race in 1976 and died in early 1977 after a battle with cancer.

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Tasers Give Officers Another Option

Tulare - Tulare police officers are for the first time carrying electro-shock weapons, which Police Chief Roger Hill said will allow them to confront a violent person without getting hurt.

While introducing the Taser X26 to the City Council recently, Hill stressed this is a “non-lethal” weapon with “no deaths associated with it in and by itself.”

He acknowledged “circumstances beyond our control could come into play,” an apparent reference to reported incidents in which people who were under the influence of drugs or had some other health-risk factor died after receiving the shock.

The Police Department used state Citizen Options for Public Safety (COPS) grant money to buy 75 of the X26 Tasers, which feature laser sighting and cost nearly $75,000.

“One of the benefits is departments have seen a reduction in Workers Compensation involving their police officers,” Hill said.

When the Visalia Police Department started using a Taser weapon “it substantially reduced the number of injured persons and injured officers,” Tulare Police Capt. Wes Hensley said.

When an officer and suspect “go to the ground” fighting, both are more likely to suffer injuries, Hensley said.

The Tasers function in either a stun mode, where the officer must get close enough to touch a person, or in a dart mode, which is most effective from a distance of 15 to 20 feet, Hensley said.

When used in dart mode, two barbed projectiles connected to the weapon by high voltage insulated copper wire are shot into an assailant, delivering 50,000 volts of electricity for five seconds.

“Five seconds is a very long time,” Sgt. David Frost said. Frost was shot with a Taser when he and Cpl. James Haney were trained on the weapon by representatives of Taser International, the manufacturer.

Safety Precautions

The Tasers Tulare police have are bright yellow—a color intentionally selected to distinguish it from an officer's gun. “The older design of the Taser looked and felt like a department-issue firearm,” Hensley said.

The Tasers are carried on the opposite side of an officer's firearm, so he or she will have to cross draw. “It will take an actual intent of the brain, not a reaction,” Hill said.

The department wants to avoid having a situation such as the one that occurred in Madera when an officer in a struggle drew her firearm instead of the Taser and shot a suspect.

In that case, Hensley said, the Taser and her gun were holstered on the same side of her body.

Although widely used in law enforcement, some people have raised questions about the safety of electro-shock weapons such as the Taser. Amnesty International, for example, reported that since 2001, more than 290 people in the U.S. and Canada have died after the weapons were used.

The U.S. Justice Department, as a result, is reviewing the deaths of more than 100 people to determine whether electric weapons played a significant role.

The Tulare City Council approved the purchase of the Police Department's Tasers upon recommendation of a grant advisory committee, which included representatives from Tulare County Superior Court, the District Attorney's Office, Tulare City School District, Salvation Army and the Police Department.

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Off-Duty Bus Driver Saves Child's Life

Tulare - Kristin Schakel would have normally taken her daughters, Kyndall, 3 ½, and Preslee, 2 ½, to Applebee's Restaurant last Tuesday but decided this time to go to Chili's instead. She said she's glad she did.

Kyndall took a bite of a chicken tender and then looked as if she were going to vomit, her mother said. “But then she grabbed her neck and I knew what was wrong. I started the Heimlich on her, but I wasn't doing it right,” she said.
“I was screaming…she was not getting any air anymore and her eyes rolled back…”

Linda Van, a 20-year veteran bus driver in the Tulare City School District who is trained in CPR and the Heimlich maneuver, but never had a need to use it, was luckily sitting nearby.

When Van realized what was happening, she grabbed the child from her mother and performed the Heimlich in a new manner, which she had learned in a recent training.
“It worked because that chicken came right out and it was the biggest piece of chicken I ever saw,” Schakel said. “Linda is our angel. I don't know what I would have done without her.”

Van said she was alerted something was wrong when she heard a commotion and then a woman yelling, “No she's not, no she's not.” At first she thought it was an argument, but quickly realized the woman's young daughter was choking and not breathing.

“The mother had her, holding her and trying to do the Heimlich maneuver. Her (child's) eyes were staring straight ahead,” recalled Van. “She (the child) wasn't OK. Her skin was white and she was limp. The mother began yelling ‘call 911, call 911.'”

Van quickly went to the table and tried the Heimlich maneuver and as she did the maneuver and was pulling the girl off of her bench seat, the girl spit out the piece of chicken and began to breathe once again.

“It came right out. She starting breathing. She starting crying and saying, Mommy, Mommy.”

Tulare City firefighters arrived about five minutes later, said Van, but by then the little girl was already eating again.

Not only had Van been trained in CPR, but she went through recertification in January. “It's a good thing to know. You just never know,” she said.

“I felt good because I saved her life. By the time paramedics got there it would have been too late. No one else was helping her,” said Van.

She said the little girl's mother, Kristin Schakel, told her, “Thank God, Thank God. You're my angel. You saved my baby.”

She said the mother kept repeating that and repeated it again when she showed up at the district's bus barn on Thursday with her two daughters to thank her again. This time they brought a card and all of the staff, including several from the district office, came out to join in the celebration.

Tulare City Schools Supt. John Beck said Van will be recognized by the school board at its March 11 meeting.

Asked what happened that day, little Kyndall said simply, “She saved my life.”

A couple days later when Kristin asked Kyndall where she wanted to eat, she announced: “I want to go back to Chile's, but I don't want chicken.”

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