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Kaweah Delta Shuts Down
Exeter Memorial Hospital

Exeter - The board of directors of Kaweah Delta Health Care District has approved a plan to eliminate several subsidized services, close the Exeter campus, and improve hospital revenue. Lindsay Mann, CEO, notes that the changes are an immediate response to recent financial challenges, and part of a long term strategy to ensure Kaweah Delta's financial health and ability to meet core health care needs.

Memorial Hospital at Exeter has been a site for primarily SubAcute and Skilled Nursing (SNF) inpatient services, as well as a rural health clinic. Skilled nursing, diagnostic and therapeutic services will be discontinued at the Exeter campus. The outpatient clinic of San Juan Health Center will be discontinued under Kaweah Delta Health Care District. Kaweah Delta is planning to transition this service to a provider with clinic expertise. SubAcute services will be provided at the Community Health Care campus in Visalia, where similar services are provided in the Transitional Care Unit. January 31, 2002 is the target date for patient transition to be complete.

Memorial Hospital at Exeter and San Juan Health Center joined Kaweah Delta Care District in August, 1998. Memorial Hospital was within weeks of closing its doors. Like many rural hospitals located across the country, MHE has not been able to sustain positive financial performance. Low reimbursement rates have primarily stunted the hospital's ability to compensate for rising expenses.

"The health care staff at Memorial Hospital at Exeter and San Juan Health Center are true professionals and have contributed greatly to the health and welfare of the Exeter community. The decision to close MHE and San Juan was not an easy one, but necessary. We now turn our immediate attention to transitioning those patients into other health care settings," said Lindsay Mann, CEO of Kaweah Delta Health Care District.

Many of the nursing and other clinical staff at Memorial Hospital at Exeter will be able to transition to available clinical positions within Kaweah Delta Health Care District.

Memorial Hospital at Exeter consists of eighty beds with fourteen dedicated to acute care patients, twenty-four dedicated to skilled nursing patients, and forty-two beds available for subacute patients. Memorial Hospital served the Exeter community for fifty-one years. San Juan Health Center is a rural health care clinic that treats patients on an outpatient basis.

Other District services slated for closure are the Alzheimer's Day Care Center; the Mobile Clinic; patient transportation services; and the Parish Nursing Program. Many administrative departments will be trimmed to effect further cost reductions. "Kaweah Delta has an excellent reputation for quality services and sound financial management," says CEO Mann. "As health care reimbursement declines and competition for that reimbursement increases, it is incumbent upon us to take steps necessary to ensure the availability of core services in the District.


Plan For Big Shopping Center Filed

Visalia - The City of Visalia has released the draft Environmental Impact Report for a regional shopping center south of Packwood Creek - the historical development line on South Mooney Blvd.

The long awaited project lays out five adjacent major retail centers amounting to over 1 million sq. ft. to be phased in over a number of years. The project proposed by Monterey developer Don Orosco (DBO Development) will have a comment period for 45 days as local citizens can review the plan.

The first of what is expected to be a number of public hearings on the project is scheduled for December 10th at 7 p.m. at the Planning Commission.

"We tried to address the impacts we thought would be brought up ahead of time," says Orosco including worries about traffic and the impact on the rest of Mooney retail space.

"There is about 1 million sq. ft. of retail space looking to locate in Visalia - stores who are not already here," says Orosco. In addition he says he is working on a new Target store for Visalia - named Greatland that will be about 153,000 sq. ft. "As part of the deal we have agreed to buy the existing 92,000 sq. ft. Target store and re-lease it," says Orosco responding to concerns that this new shopping center would prompt more empty stores on the Mooney strip.

One prospect Orosco says he's not working with is Costco, who has an existing store on Mooney just north of the creek. In recent days House 2 Home has announced it would close their big former Home Base store they lease at the center next to Costco making it possible if not likely that Costco could stay where they are and expand next door.

However, the project layout in the EIR continues to have a 148,000 sq. ft. footprint for a store the size of a new Costco if the big warehouse retailer decides to jump the creek. Costco had considered an alternative site to relocate in the past few years including plans to move to Demaree and Caldwell - shot down by the city council. The city's top retail tax generator, the issue of where Costco locates and rumors of its changing intentions have been fuel for city watchers. Threats that the company would pick up and move to Tulare are not considered credible, however.

Orosco says he has firm deals with Lowe's - the nation's number two home improvement store chain - and Best Buy - the top U.S. electronics store - for the first phase of the new shopping center on the east side of Mooney. "We'll have other new stores - mid-size anchors at that center," says Orosco.

The shopping center plan is being filed only days after the Visalia city council election and will now become the new council's top profile political hot potato.

Opponents fear the loss of stores who could relocate to the new center south of the development line. Some, like former mayor Greg Collins, believe there are spaces that could be filled on the existing Mooney strip.

Newly vacant stores in town just this past year have been Montgomery Ward, Save Mart, Heilig Myers Furniture, Home Base (now House 2 Home) and Lumberjack putting some 350,000 sq. ft. of space back on the open market. In addition rival developers including Dave Paynter say they want to develop within the current city boundary (at the old Sin City) - a process that tends to be more expensive than building on open ag land but furthers the city's growth policies. Critics point to the effect new stores at one end of town have on the rest of the town's retail investments wanting it not to be like Fresno.

But others say that land owners south of the creek have waited decades for their chance to develop and that criteria have been met allowing this long time "retail reserve" area to be filled.

The project - the South Packwood Creek Specific Plan - is located on a 130 acre site on both the east and west side of Mooney Blvd. - all ag land currently. The development would occur in two phases according to the plan, with almost 77 acres being developed first with 678,000 sq. ft. This first phase would require 3,125 parking stalls. The remaining 53 acres are to the east of the first phase - not further south on Mooney. The property is owned by the Freitas, Sprague and Kasbergen families.

Key to managing the traffic concerns would be the construction of two new east-west streets, Cameron Ave. and Ave. 272 - Visalia Parkway.

The plan says that Mooney Blvd south of the Packwood Creek bridge would be widened to 6 lanes to allow turns and the bridge itself widened.

As part of the EIR a market study has been prepared that demonstrates the need of the new retail stores and suggesting that there won't be a "long term deterioration of the viability of Visalia's existing commercial areas." That study done by Economic Research Associates updated in July 2001 concludes that this project "will perpetuate Visalia's dominance in the regional retail market."

The time table for a decision by the city council would be early Spring. The current city council has been cautious but approving of the Orosco's effort underway for the past year and a half. Mr. Orosco has visited an lobbied all the members of the council and says Visalia has "a great team"to lead the city over the next four years.

Just how great they think the town's largest retail project ever is - we shall see. One million sq. ft. would be the size of two Visalia Malls side-by-side.


Red Ink At Kaweah Delta

Visalia - Kaweah Delta hospital has instituted a hiring freeze for non clinical positions as a result of poor numbers coming out of their financial reports released recently.

The healthcare district lost $200,000 in the first quarter of the fiscal year putting them $2.44 million behind where they thought they would be at this time according to their budget projections, says Lindsay Mann CEO. However, worried that losses might hurt the hospital's bond ratings are unlikely to happen. A memo from finance chief Gary Herbst earlier this month urged the district to cut expenses and accelerate revenue to meet a November 30 deadline from Moody's - the bond rating service.

Hurting the health care district's bottom line is payment on existing bills are taking more than 4 months to be paid with a goal to reduce that number to two months by the end of this coming January.

On October 19 CEO Lindsay Mann ordered a hiring freeze of the non clinical personnel noting that if losses continue "this is a sure strategy for financial distress."

Finance chief Gary Herbst says the district's bond rating could be affected because Moody's "A" rating requires more cash on hand than the district is showing right now. "The district has relied on cash reserves to fund expansion and capital expenditures thereby depleting cash reserves in a period of rising operating costs," says a November 7 memo from Herbst.

The red ink puts some pressure on the board at their November 27 meeting to cut some of the unprofitable businesses and services that the district has supported over the years, says Mann - a projection the district was already considering after they lost the battle to stop construction of a proposed private surgical hospital in Visalia that will be up and running in a few years. Mann says the board is looking at both short term and long term at some services they may no longer be able to afford. Mann had told the Visalia council that surgical services help subsidize other community services that might be beneficial to the community but that the district may not be able to afford if they lost a high percentage of that business. But now some cuts may be coming far sooner than expected. Last year at this time the district had a net income of $881,000 compared to the $200,000 loss this quarter.

A "Financial Strategy" offered to the board includes eliminating product lines/services which are not profitable and not likely to become so, not unique in providing service to the community and district from the ability to focus on the healthcare district's "core business."

Already the district has eliminated more than $430,000 recently in budget expenses for this fiscal year that include:

• Eliminate Parish Nursing Program - $80,000

• Discontinue Valley Fever Research Funding - $120,000

• Pro-Youth - In kind, not cash funding - $60,000

• Reduce TV Marketing - $75,000

• Bone and Joint Center PA don't hire - $100,000.

Subsidized services include: Skilled Nursing (TCU/TRC), Community Outreach, Community Benefits, Diabetic Clinic, Bone and Joint Center, Clinics, Hospice, Adult Day Health, Adolescent Crisis Unit, Quail Park Wellness, Boys and Girls Club, Pain Program, Family Recovery Center.

The largest category is skilled nursing which includes the Memorial Hospital operation in Exeter Memorial Hospital showed a $315,000 loss in their first quarter up from a $40,000 loss for the same quarter last year. The district has lost money on Exeter Memorial every year they have owned it.

The board will hold a meeting November 27 to discuss finances and facilities as well, says Lindsay Mann.

The hospital has put a planned expansion of the hard pressed emergency room on hold while it waited to sort out its long term facilities strategy. Already the study of facilities has been underway for some two years informally and more formally for the past year.

Kaweah Delta's Emergency Department handles more than 50,000 visitors per year, making it one of the busiest emergency departments in a hospital its size in California.

There was some bad news this week on the city help to assist Kaweah Delta with a downtown expansion. Mayor Don Landers reported he got an email last week from the city's lobbyist that a $6 million request to Congress to build a new parking garage adjacent Kaweah Delta's campus had been turned down. However, the Downtown PBID group offered $625,000 it has budgeted as a down payment for such a structure.

While some services at Kaweah are losing money, the highly regarded cardiac services are more than $3 million in revenue over budget although the expenses are $813,000 over budget as well.

The hospital has trouble growing heart surgery much more because of a lack of nurses for critical care beds, however. But, the outcome for high risk patients aren't always positive since Tulare County has a high rate of diabetes, congestive heart failure and cardiovascular disease, a report says. Non-invasive cardiology is up 10% and the cath lab has seen a 20% increase. Planning for a new heart center with TDH and Hanford Community is underway, says Lindsay Mann resulting in plans for a major new center being built downtown.


Visalia Picks First Hispanic Mayor

Visalia - In 2002 Visalia will celebrate 150 years of its history. Leading the community in 2002 will be the town's first Hispanic mayor - Jesus Gamboa - elected here by a 4-0 vote of his fellow council members this week. Council member Wendy Rudy did not attend the council swearing in ceremony due to a death in the family.

The list of Visalia mayors over the years is long and distinguished. But it contains no mayors with Spanish surnames. And so the election was a big deal signaling to the world a coming of age in town that after all had US troops stationed here during the Civil War because of its large contingent of Southern sympathizers.

"When I first came here many years ago I never thought I would see this day," says former farmworker Manuel Hernandez. "There was so much prejudice." Hernandez is now Gamboa's mentor - the elder statesman of the northside.

"Now we are very proud," even though it "took more than 100 plus years."

Gamboa too worked in the fields and today is a top official with Proteus - the valley-wide job training agency.

As the town's current vice mayor, Gamboa was in line to take the gavel from current mayor Don Landers by tradition. Landers wasn't about to break that tradition being the first to nominate the 48 year old council member who just won reelection a few weeks ago.

Supporter Victor Moheno says the whole thing "happened naturally." Moheno believes Gamboa's tenure will benefit all of Visalia. "I'm a Visalian of Hispanic descent" emphasizes Gamboa.

Visalia of course is not the same small trading post built 150 years ago. The population has swelled to near 100,000 and its ethnic mix has changed as well over the years. Visalia today is around 36% Hispanic - more than double what it was in 1980 (see chart).

Visalia like Tulare County itself if far more Hispanic today than just a few years ago. Today Tulare County is around 51% Hispanic. In the 1980 Census Tulare County was under 30% Hispanic. Visalia's ethnic mix continues to have White's in the majority.

A Census study found that around 40% of the foreign born population entered the U.S. since 1990 and another 28% came since 1980.

But clearly Gamboa or any ethnic minority must get support from all sectors and Gamboa has done that, he's the only Democrat on the council even though this is a nonpartisan seat. The council works typically on a consensus basis and Gamboa has learned through 4 years on the council already that consensus building is the name of the game. "I'm a good listener," says Gamboa, one of the reasons why he has the top spot.

As mayor, Gamboa's vote doesn't count anymore than any other member. But the position is more than ceremonial. He will set an agenda at meetings and guide critical discussions - potentially hot button growth issues - over the next few months that will test his leadership.


$8 Mil Dairy Complex Gaining Steam
Largest Instructional Diary Will Make Power From Waste

Tulare - The California Dairy Technology Center - about a year from construction adjacent the University of California Veterinary Medicine Research Center in south Tulare is gaining steam this winter says Jim Cullor who heads the VMTRC.

The dairy tech center is being organized by three partners - the UC system, COS and Tulare High working on a $7 million state-of-the-art 1000 cow instructional dairy beginning next year. Already the group has amassed more than half that amount to build the complex with dairymen and industry support (see chart).

But Cullor says the UC involvement in the project fulfills more than instruction for high school through the Ph.D level. "It also fulfills our research mission and technology transfer obligations" to California industry.

A third component is consumer education, says Cullor, being fulfilled with a $1.2 million grant announced recently from USDA to build a new pavilion at the UC complex on Rd. 112 near Kraft Foods. "The pavilion will be built within a year," predicts Cullor, just north of the veterinary facility bringing a total of more than $8 million in new investment at the public facility.

Also on the 100 acre spread they plan to build the 1000 cow dairy - a typical industry size in the area - complete with milking parlors, barn and free stall housing - what will be the largest instructional dairy in the U.S., says Cullor and quite a contrast to the 50 head dairy COS currently operates.

Once construction begins, the dairy could be in operation a year later, he predicts with donations of cows from dairymen helping to fill the stalls.

Of significant interest to the dairy industry will be state-of-the-art technology to deal with dairy waste complete with methane digester and sales of electricity made on the farm. That's a big subject with dairymen right now because of objections to the pollution problems caused by confined waste. " We expect to make enough electricity to power the entire UC facility and sell some as well," says Cullor. Dairy students will learn all aspects of waste management including "how to sell power into the grid," he says.

Like any good dairy, Cullor says most of the 100 acres will be grown to corn and alfalfa to be used as feed for the animals and a place where waste can be spread. "We want to experiment with all sorts of ways to handle the waste - carrying out our research function," says Cullor setting the standard high for this aspect of the project. "It will have all the bells and whistles," he says.

Another aspect to the work at the UC Center will likely be expansion of the food safety lab at the complex used by CDFA and the industry to monitor animal and food health in California. "We are expanding our surveillance in California agriculture," says Cullor noting this is just one of a few such diagnostic labs that carry on this critical function. Monitoring for animal diseases like foot and mouth and anthrax are just some. Officials are concerned about agro-terrorism as well and this key lab has a function here as well.

Cullor was asked about other food safety question - the use of the growth hormone BST and the monitoring for antibiotic residues in milk. On both scores Cullor says the industry is doing a good job with no tankers found "with residues of antibiotic reaching the market place," he says. Use of the BST growth hormone has leveled off around 20% of the dairymen use it, he says.

Cullor says he looks forward to ambitious plans to expand the World Ag Expo just a mile north the Veterinary Center building sort of an "Ag Epcot" center perhaps. He says the Ag Expo is looking to build a 500 acre - a sort of one-stop location for everything in agriculture including a major visitor component.

"We already get some 2000 visitors a year - many from all over the world," to the UC Veterinary Center, notes Cullor.


Allen Group To Build Downtown Office

Visalia - The Allen Group has agreed to buy a city owned lot on the northwest corner of Acequia and Bridge to build a professional single story office. The site right across the street from the Signature Theater had been marketed to out of town developers for a mixed use multi story option but the small parcel would not pencil out unless the property owners are the users, developers told the city.

Now rather than have the parcel sit much longer, the city has agreed to sell the local group this parcel for $90,000. The city rejected the Allen Group's proposal option to buy the adjacent parcel - 119 S. Bridge - which will remain in city hands.

The parcel has been available for sale for two years since the completion of the adjacent parking garage. Now the entire Acequia frontage from Church up to Bridge will be in the process of developing with the new Comfort Suites hotel now well underway.

The city staff report says that the Allen Group plans to build a 5600 sq. ft. office space covering the entire property and paying $3000 per space in parking in-lieu fees on 20 to 30 spaces. This could result in as much as $90,000 in parking in-lieu fees paid by the developer over a five year period. The city is installing a sidewalk.

Currently the Allen Group leases office space in the West America bank building across from city hall west. "We plan to move our office," says Harvey May who heads the commercial division of the Allen Group. Joining the Allen Group will be the TPG Group says principal Charlie Clouse. "We're partners in the project," says Clouse who says the group includes some 20 employees. They lease space at the Rainbo building on North Court. TPG has offices in San Luis Obispo, Fresno and Akron, Ohio. May says look for the building to be completed around this time next year. "We'd still like to make it two story if we can work out the engineering," says May.

Meanwhile the city will retain the corner of Bridge and Main - that rather narrow sliver of land that some have thought should be converted to public space with a kiosk retail user.

While the Allen Group has suggested the sale of their residential real estate development company likely soon, the company will continue its commercial and industrial activity. Headed by Richard Allen, the company has been active in industrial park development and office build-to-suit office projects in central California.


Woodlake Garden Blossoms

by Miles Shuper

Woodlake - The Woodlake Botanical Garden, a longtime dream of University of California Cooperative Extension Farm Advisor Manuel Jimenez, dozens of volunteers and other community leaders is about to take shape.

And probably next spring, or sooner, the ambitious project may be featured in the prestigious Sunset Magazine which already has send a photographer to the area along the levees of Bravo Lake where the garden will bloom. The moving of soil some of it from inside the levee-bound irrigation reservoir for the formation of mounds and pathways could start before the end of the year, according to Jimenez.

A $250,000 grant from the state Department of Transportation will go toward paying for bike paths and curbs and gutters and a parking lot. Pledges from business for materials, labor and technical skills also will play a substantial part in creating a mile -long garden.

"By early next year area residents will have something to actually see and enjoy. The mounds and bike and foot paths hopefully will be in place and some of the trees will be growing," Jimenez said. Even once the major aspects of the garden are completed it will be a perpetual project.

There will be a variety of crops grown including citrus, grapes, fruit trees along with irrigation systems and planting, cultivation and grafting techniques.

The Woodlake Pride Coalition has a long-term lease agreement with the Wutchumna Water District and Union Pacific Railroad for use of the land. The city is also looking for a way to obtain funds to help in a possible future purchase of the land which lies along the north edge of the lake. The site ranges from 75 to 100 feet wide and nearly a mile on the right-of-way of the abandoned rail road line.

There will be three major elements to the garden. Starting on the west edge will be an ornamental garden will dozens of flowers, plants and shrubs. Visitors will travel east into an agricultural section with hundreds of varieties of citrus, vegetable and vines. The eastern edge is scheduled to be developed into a natural habitat area. The whole area, which eventually will total of about 16 acres, will have an awesome background of foothills framing the majestic Sierra Nevada.

Once the road base materials and infrastructures are in place along with the planting mounds and terraces the planting of trees will follow this winter and early spring, Jimenez said.

Although Jimenez and his wife Olga have been working with volunteer youth groups in garden projects for some time, the plans for the Woodlake Botanical Gardens began in earnest about four years ago. City officials and others see it as a potential visitor attraction to the Woodlake community and a source of visitor dollars. It could draw visitors from around the world, especially tour groups interested in seeing first-hand the diversity and abundance of San Joaquin Valley agriculture.

Last month Woodlake Pride, under the Jimenez' leadership, held a field day at the site where more than 500 different cultivars were grown on little more than one acre. Included were 12 types of squash, 20 varieties of egg plant, 50 varieties of peppers, at least 10 varieties of tomatoes, head lettuce and more than 20 varieties of leaf lettuce, a vast collection of herbs, edible flowers, more than 40 oriental vegetables along with scarlet sweet corn and Indian corn, 70 varieties of sun flowers and several water melons including some with flesh which was red, pink yelow, orange and white. Other melons included casaba, crenshaw, canary, honeydew and orange flesh honeydews.

After the event, which also marked the dedication of the Botanical Garden Project, the crops were offered at no charge to local residents. Last year a similar project was done on a nearby site along Bravo Lake. Included in both projects were demonstration of irrigation systems, planting techniquies, pest control and other planting and cultivation techniques.


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November 21, 2001

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