State Cutback Means $1.5 Million TDH Loss

Tulare - Tulare Local HealthCare District officials have learned recent action by the Legislature and Governor will mean an estimated $1.5 million loss in Medi-Cal revenues.

The news of Medi-Cal reimbursement cutbacks comes at a time when the hospital district's operations budget is in the red and the district is embarking on a $120 million hospital expansion that will require a substantial amount of money beyond the $85-plus million that a voter-approved bond sale will generate.

The state's decision to cut inpatient and outpatient fee reimbursements by 10 percent is going to hit other Tulare County hospitals hard as well. Kaweah Delta Hospital District in Visalia is expected to take a $6 million hit and Sierra View District Hospital a $3.4 million cut.

“It is not good news for the hospitals in the state of California,” interim Chief Financial Officer John Church told the Tulare hospital board on April 23.

News from the national front is not much better. The President's proposed budget would continue the four-year downward trend in the hospital's Medicare margin through 2012.

In 2003, Medicare revenues were about $1 million ahead of costs. While reimbursements are still expected to exceed costs this year by $133,493, they are projected to fall short of actual costs in future years.

Red Ink

Church told trustees the reductions in Medi-Cal and Medicare reimbursements are “substantial,” especially in light of losses in the district's operations budget.

The last year the district made money from operations was in 2005, but various factors, including a loss of physicians and the related drop in the number of patients, have pushed operations into the red since then, Church said. He told the board the year-to-date loss is $1.3 million.

While the hospital district's operations budgets have been in the red for more than two years, the overall budgets, which factor in property tax, investment and other revenues, have been in the black, Church said.

With the hospital facing a $15 million to $25 million shortfall in funds for the expansion, it needs to be making a profit from operations just as other hospitals in the area are doing, Church said.

“We should be making between $2 million and $4 million dollars,” he said.

Chief Executive Officer Shawn Bolouki, on the job for two months, said cost containment measures and efficiencies will be needed to get a “reasonable profit margin.”

Based on his experience, he said a 4 to 6 percent profit margin would be reasonable, but added the board will have to decide that.

The hospital board began taking measures late in 2007 that they hope will eventually help put operations into the black.

Rural Clinics

Members voted to open a series of rural health clinics, which are still in the planning stage. Bolouki said the district will apply to the state for a license, which could take six to seven months to process.

The district could begin to operate a clinic before then, if it were willing to delay reimbursement for services, he said.

He cautioned that while the clinics might help the hospital's bottom line and provide better service for the community, there will be a lag time before a positive impact is seen on the budget.

Hospital directors last November also convinced a Fresno urology group to open a South Valley office in Tulare, offering a $400,000 income guarantee. The group opened its doors in March.

The vote was 3-2 with opposing board members wanting more information about how the guarantee might affect the budget.

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Tulare Nail Artist on Road with ‘Rock Star’

Tulare - Studio 115's Melissa Garcia has captured the imagination of not only her clients but of a company that is sending the Tulare nail artist to national and international beauty expositions to teach others a unique technique she calls Rock Star.

Garcia became an international educator and a senior mentor for Young Nails last April and her creativity is becoming well known as she travels and her work is referenced by others.

The December issue of “Nails” magazine, for example, featured her Rock Star nails on the cover and included a story on the technique, which involves embedding Mylar and confetti into nails using acrylic and gel to create a long-lasting, three-dimensional, stained glass effect.

“It's the bling that people get addicted to,” Garcia said. “It's a lot of fun. It makes your job not routine.”

Garcia recently opened Rock Starz, a nail supply business, in a room at Studio 115, 520 East King Ave., where she features the Young Nails products that she has been using for the past three years. She is the Central California distributor for the company as well as an educator.

Garcia teaches other nail artists how to use Young Nails products to quickly create the three-dimensional designs and increase their earnings.

“It more than doubles your income,” she said. While she charges $45 for a regular pedicure, the Rock Starz treatment is an additional $60.

Garcia said she began using the Young Nails products because she liked the fact the gel colors never change and “it wears so well.”

She also appreciated the flexibility of the products, which allows her to give nails a very natural or use her imagination and give them an artsy look.

“I can even put a picture of somebody in a nail,” she said.

During a recent trip to Ireland, she spent two days at a beauty expo and then several more teaching Young Nails' educators in Dublin her technique. She is heading for New York this week and will be on her way to Greece in three weeks.

Her travels have allowed her to see what other nail artists around the world are doing and to share the latest style with her clients here. While attending the Dublin expo last year, for example, she met nail artists from Moscow who did stiletto shaped nails, which she loves to do using Young Nails acrylic forms.

“The Russians are such awesome nail artists,” Garcia said, adding she will be going to Moscow in July to receive training.

Garcia, who grew up in Albuquerque, New Mex., moved to Tulare at age 17 and graduated from Tulare Western High School. She has been a nail artist for 171/2 years.

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Blood Drive Tuesday Honors Gary Ribeiro

Tulare - Tulare businessman Gary Ribeiro has donated blood in the past, but it wasn't until earlier this year, when he was at a low point in his treatment for lung cancer, that he experienced the difference such a giving act can make in the life of another person.

“I really was at a low point and I didn't know if I would live or die,” Ribeiro said, explaining that a second round of cancer treatment had left him anemic and in need of a blood transfusion.

“I was at Kaweah Delta Hospital getting my transfer and I remember being so grateful someone took time to give blood,” he said. “I prayed for them and I still do.”

The Tulare Community Blood Drive, set for 3 to 7 p.m. Tuesday at the Tulare Senior Center, 201 North F St., is being held in honor of Ribeiro, 61, who was born and raised here.

He worked for nine years at Goble-Miller Funeral Home, first as an arranger and then its licensed director, before leaving because of illness. Prior to that job, he had worked a year for the American Cancer Society in Visalia and for more than 20 years in the food service industry in California, Idaho and Texas.

Ribeiro was diagnosed on May 21 of last year with inoperable, stage four lung cancer, which means the disease was in “the most critical stage,” Ribeiro said. “You just try to slow it down the best you can.”

Ribeiro, who went through two rounds of chemotherapy that were unsuccessful, is now participating in a trial program at the University of California, Davis, Medical Center, where he goes for treatment once a week.

“I'm doing much better,” he said. “God's been good to me. I'm just amazed how generous and kind people have been to me.”

He and his wife, Michelle, live in Tulare, where she is director of customer and community relations for J.D. Heiskell. They are the parents of a 16-year-old daughter and a 2 ½-year-old son. He also has two adult sons, ages 28 and 24.

Second Drive

For those who miss Tuesday's blood drive, another opportunity will present itself on Friday at Preferred Outlets at Tulare, 1407 Retherford Drive, where the center's bloodmobile will be on hand from noon until 4 p.m.

Donors will receive a free T-shirt, plus a variety of discounts from Valley businesses for dining, recreation, entertainment, and services.

Donor Requirements

Blood donations take less than one hour to complete. Donors must be in good general health, weigh a minimum of 110 pounds and be at least 17 years old. Senior citizens are encouraged to donate, as there is no upper age limit.

Donors should eat a good meal and drink plenty of water within four hours prior to their donation. Donors can give blood every eight weeks. Photo identification and Social Security number are required at donor registration.

A variety of discount coupons for food, entertainment, recreation and other services will be given to donors.

The Central California Blood Center is the sole provider of blood and blood products for the 31 hospitals in Fresno, Tulare, Madera, Kings and Mariposa Counties and must collect between 5,000 to 6,000 pints of blood a month to meet the needs of our Valley community.

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Orosco Looking for More Downtown Property

Tulare - Chris Orosco of the Orosco Group, which plans to build a shopping center on the southwest corner of Cross Avenue and J Street, has confirmed his company is looking for additional downtown property.

Tulare Joint Union High School District officials said last week the Tulare Redevelopment Agency has approached them about the possibility of acquiring property at 351 North K St., where the Tulare Adult School holds classes. The 20,000-square-foot building was originally a Safeway supermarket, which closed in the early 1980s.

Redevelopment officials indicated a developer on the west side of J Street (which is Orosco) wanted to mirror the project on the east side, Adult School director Marie Pinto told high school trustees.

“I don't think you want to close the door on anything like that,” trustee Adrian Holguin said. Other board members agreed and gave administrators permission to enter into discussions with the city.

Orosco said his request to the Redevelopment Agency did not zero in only on the Adult School property, but was a general inquiry as to availability of other properties in the area.

Redevelopment Director Bob Nance said the agency has been approached by several developers over the past year about the Adult School property and Orosco was the most recent one.

“It has been pointed out that as a site that could hold a higher density,” Nance said.
“First and foremost, the Adult School has to remain downtown … and be able to expand to meet the changing market needs,” he said.

Three Options

Pinto told the board Nance identified three ways that the Adult School could transition to another downtown building without disrupting the school's programs. The options include:
• Finding an existing building that the developer could remodel for the Adult School.
• Finding vacant property, where the developer could build a new Adult School.
• Staying on the current property but have the developer build a new school on another portion of the site before tearing down the existing building.

“We haven't given any considerations to any of those options,” Orosco said. “Our interest has been very broad.”

The Orosco Group and the Redevelopment Agency continue to work on a development and disposition agreement that would pave the way for sale of the former Union Pacific Railroad property on Cross and J to the Monterey-based group.

“We expect to have the agreement finalized within the next 60 days,” Orosco said, adding the document will spell out a construction schedule.

His company is working with an anchor and is “pretty close” to signing a ground lease for the site, he said.

Meanwhile, Nance said the city is working with Union Pacific and the former lease holder to determine who is responsible for cleaning up the 700 to 1,000 cubic feet of contaminated soil at the site, where a fuel tank was buried.

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SOPAS to Honor Lucia Noia, Other Portuguese-Americans

Tulare - Lucia Noia will become the third person and first woman to be inducted into the Society of Portuguese American Student's (SOPAS) Hall of Fame on Friday during the annual Most Valuable Portuguese-American Awards.

“We feel she is a role model for she came as an adult from Portugal to the US and has, through education, built a very successful company,” SOPAS advisor Diniz Borges said. “At the same time, she has always stayed in touch with the Portuguese-American community.”

Noia has been part of the Portuguese-American community for more than 35 years. She was in Portuguese radio broadcasting for 25 years, where she took an active role in defending workers’ rights, Borges said.

She earned bachelor's and master's degrees while she was working and doing the Portuguese radio show and then started a group of homes and a school for the mental and physically challenged.

She is the co-host of a Portuguese television show on Channel 49 called “Os Portugueses No Vale” and does programs on health issues and information for senior citizens.

Noia has been an active member of the Portuguese-American fraternal organizations and involved with many Portuguese-American cultural events. She was a collaborator of a literary symposium, “Filaments of the Atlantic Heritage,” that was organized and held in Tulare for 12 years.

She also has received entrepreneurship and philanthropic awards.

Students from the Tulare Union and Tulare Western SOPAS Club will honor Noia and several others at 7:30 p.m. at the Tulare Community Auditorium. Admission is free and the public is invited. A reception will be held in Pride Park on the Tulare Union High School campus following the ceremony. Traditional Portuguese sweets will be served.

Information: 686-4761 or d.borges@comcast.net

Other community Portuguese-American members and organizations to be honored are:
• Lino Pimentel: Businessperson of the Year
• Manuel & Sam Sousa of Tipton: Dairymen of the Year
• Mary-Carmen Pereira: Teacher of the Year
• TDES: Portuguese-American Organization of the Year
• José Carlos and Filomena Rocha: Volunteers of the Year
• Tom Karr: Honorary Portuguese-American of the Year
• Anthony LX Bettencourt: Inspiration of the Year

The event will honor many Portuguese-language students and club officers.
Among them:

Frankie Pimentel, Tulare Union, and Brenda Vilarreal, Tulare Western, Portuguese I Students of the Year; Jordan Cardoza, Union, and Andrew Borges, Western, Portuguese II Students of the Year; Vanessa Gomes, Union, and Garret Soares, Western, Portuguese III Students of the Year. Josh Avila: Portuguese IV-Honors Student of the Year; Kristen Godinho: Portuguese V Student of the Year; Tim Fonseca: Portuguese Language and Culture Student of the Year; Amanda Brasil, Union, and Monica Silveira, Western, SOPAS Officers of the Year.

Mat and Chris Parreira, Union, and Sandra Leonardo, Western, will be honored as S.O.P.A.S. Alumni of the Year.

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