Saturday, August 29, 2009

Jazz in the Pines

OK, who's trying to sneak into the Harry Pickens performance?

Charlie McPherson (left) and Daniel Jackson (right). Do great saxophonists tell jokes during a performance?

On a hot Saturday afternoon, how many dads take their kids to a jazz festival?

Finally, it didn't take Idyllwild Fire Commissioner-elect Chip Schelly (right) long to receive his first lecture on how to improve the fire department.

Morning ashes

I received this from a friend this morning, right after I returned from the morning briefing. It was at zero six hundred hours! Wasn't bad — it was an opportunity to see a sunrise. I haven't done that since I was in school and didn't go to sleep until noon.

So I offer this through from my friend, Star:


Ashes fill the August sky, like snow flakes falling upon the rooftops of mortals who are too fond of living close to the ground. The streets and plazas abound with mortals who view the spectacle of smoke and ash and fears and prayers in the dramatic play of the theater of their collective lives.

The smoke glows red, preventing the light of a billion stars.

I thought of the spring that follows this procession of days…and I foresaw the first green sprig to rise up out of the blackened soil. A sprig of a life force that cannot be suppressed by flood or fire or calamity imposed by men or gods or galaxies. Be it the emergence of the humble dandelion or the epiphany of the sacred lotus, somehow I know that all of the science and myth and religious truths declare that from the seed of this one sprig can engender all of other life…. and you… and me… and all of our dreams that, at the same time, are wild and wonderful as the August fire.

A.Star August 29, 2009 6am

Friday, August 28, 2009

FS fire restrictions and road closures

Additional Fire Restrictions and Road Closures on the San Jacinto Ranger District

Due to fire activity, and to protect public health and safety, effective immediately, San Jacinto Ranger District officials are implementing additional fire restrictions preventing wood and charcoal fires across the entire district, including developed sites.

Additionally, three forest access roads will be closed in the northwest portion of the district, including the San Jacinto Truck Trail (5S07), the Control Road (5S06), and the Indian Mountain Truck Trail (4S21). The road closures prohibit public entry and will last until the current fire conditions subside.

For further information about the closure or fires currently burning on the San Bernardino National Forest, contact the Fire Information Center at (909) 383-5688.

Thursday, August 27, 2009

Cottonwood Fire photos

Photos by Jenny Kirchner

MDP advice to Idyllwild & Pine Cove residents

Photo courtesy of Emily Kaulitz

At this time we have no more current information than is available via the Town Crier or WNKI or observers on various points around the area (Inspiriation Point, above Pine Crest, the outer area of Poppet Flats, etc.) who are reporting what they’re seeing.

What INancy Layton, MDP president, asks each of you to do WHO ARE ABLE, please print out this list and visit each of your neighbors, letting me know the following information:

1) There is a fire burning east-north-east of Cranston Station at the bottom of the Hill as you approach Hemet.
2) The USFS is in charge of this fire and is releasing information as they can.
3) Two sources of current information are the Town Crier Website’s Breaking News and WNKI (1610-AM)
4) IF THEY DON’T ALREADY HAVE THEIR “GO BOX” READY, NOW IS THE TIME. Likewise, get any animals they might need to evacuate confined and able to move them quickly should the evacuation order come.
5) AT THIS TIME, WE HAVE NO ORDERS TO EVACUATE IDYLLWILD, PINE COVE, OR MOUNTAIN CENTER, but it is still a good time to begin preparing.
6) If the vehicle they’re going to use for evacuation does not have a full tank of fuel, go fill it now! Vehicles that break down because they’re out of fuel along an evacuation route will be pushed out of the way so as to not impede the progress of the others along the route.
7) MDP is on the job.

Cottonwood Fire Pix

Doris Lombard, Mountain Center, has generously shared these photos which are in sequence as the Cottonwood Fire grew in size.

Monday, August 24, 2009

More headlines

The headline police are active today and they aren't nitpicking our small local bretheren. These come from the "Grey Lady" herself! It's early in the morning, but my favorite aunt often took her medicine early in the day, too.

Both of these stories detail a tragic and deadly event. In no way, am I spoofing the untimely and unexpected loss of a loved one. Death ripples out across families and communities. While we know we will eventually share this procedure, we are rarely conscious of its proximity.

Nevertheless, the writers of these headlines produced an ambiguous statement. That's my target. And believe me writing a headline is often harder than writing the story because of the space limitation!

Friday, August 21, 2009

Bad nurses!! Good Physicians!

The Valley Health System directors say they don’t want to sell the district, but their creditors are forcing them to take this position. But keep in mind many creditors are the local physicians.

Well, if you sell something don’t you try to maximize the gain? Most of the VHS directors said, that is not their objective. They have a commitment to keep the hospital open. They want what’s best for the community.

They listened to the creditors about first a “dual track” than the focus on a sale of the assets. In July, they agreed to give the local docs an exclusive right to negotiate for 90 days.

During the discussion, one of the physicians arguing for the exclusivity explained that one of his children had won the Riverside Spelling Bee while attending Hemet High School. This proof of his commitment to the community because he could have sent his child to private school.

So is the gift a spelling bee champ worth the insider’s track on a multi-million dollar hospital deal?

Here’s what those same creditors have to say about the hospital’s finances.

  • “The District’s historical indicators from FY 2006 through FY 2009 demonstrate a steady decline in financial and operational performance”
  • “Acute inpatient volumes at the Hemet and Menifee hospitals have been steadily declining for many years”
  • From FY 2008 to FY 2009, the District acute inpatient discharges fell significantly — 13.3 % at Hemet Valley and 9.8 % at Menifee Valley

Ask yourself who controls which hospital you might go to? Does you doctor recommend a facility or do you get on line and research it?

Have patient volumes been declining because VHS doesn’t have enough bargains! how about an appendectomy and gall bladder laparoscopy for one price! Or half off a caesarian section!

Patient volumes are in the hands of doctors who have been sending patients to other hospitals, forcing a bargain basement sell-off, but with little capability to keep the doors open after they buy.

The July volume at Hemet Medical Center were slightly worse than June while Menifee showed improvement it is about 1/3 the size of Hemet.

  • The picture is no brighter for the District's consolidated outpatient service lines. On a consolidated basis, outpatient surgeries declined 20 %
  • Inpatient surgeries decreased by 14.3 % in the past year.

If patient volumes have been declining for more than two years, why will they change now? Steven Wade. Attorney for Physicians for Healthy Hospitals, says the local docs now realize their incomes may be at risk if the hospital closes.

"A precipitous drop in both inpatient and outpatient surgeries gives me cause for grave concern," says Martin L. Cohen, financial adviser for the bondholders.

He also opines that the district and certain members of the medical staff are battling for control of the hospital revenue streams and ability to determine which physicians have local privileges.

Notice nobody asks about the patients, but staff, nurses and aid staffing has been significantly reduced in the past two months. Must be their fault patients don’t come to VHS. Doctors spend long hours treating patients, too bad they don't get paid. so many are near homeless.

VHS Director Vinay Rao summarized the situation for the board when they gave the doctors the exclusivity agreement.
"We are community leaders. Our charge is to community … an important part of community is the physicians. We have criteria."

Well have you seen the criteria, have the leaders felt like sharing with you? But they gave the criteria to PHH.

Even Judge Peter Carroll, the bankruptcy judge, asked Gary Klausen, the VHS bankruptcy attorney, if PHH had the financial ability to close if the hospital were sold in the vicinity of "fair market value". Klausen had to reply, "not yet! There is some internal interest and some external, but no ability to close sale yet."

Thursday, August 13, 2009

Is PHS better for VHS than PHH?

While the Valley Health Systems (VHS) directors continue to meet with the local physicians, another offer has been delivered to board President, Dr. William Cherry.

Prime Healthcare Services, Inc (PHS)., Chino, CA, sent a letter of interest in acquiring VHS. Several pages of the letter are shown below. If you are interested in the whole missive, just send an email (no donations necessary).

Actually, Michael Sarrao, vice president and general counsel for PHS, was present at the VHS board meeting on July 27. He told the board then that PHS was interested in the acquisition and would be submitting a letter.

Notice that Thomson - Reuters has designated PHS in the top ten hospital systems in the U.S. that seems like a good organization to run a local hospital.

Universal Health systems submitted a letter of interest about two weeks ago, so the board has at least three groups interested in its assets.

Nevertheless, the directors felt it was in their responsibility to open exclusive negotiations with Physicians for Healthy Hospitals (PHH). The local docs seem to rely on their longevity and the threat of a mass exodus if a firm purchased the VHS assets.

While some physicians may pack and move, it is hard to believe that many will. It is already clear that the valley won’t become a medical wasteland. Businesses will always fill a vacuum where the demand exists. Only a month ago, ADR Associates announced plans for a new hospital in San Jacinto.

If the existing physician corps decides to vacate, a new hospital and equipment should attract a replacement cadre of new and younger physicians.

Since the board has shown no interest in comparing offers and trying to maximize the benefit to the district’s owners — you the voters — we’ll have to wait see the results of the Aug. 18 bankruptcy hearing and the confidential deal being negotiated with the docs.

I have to acknowledge that the founder of PHS is Dr. Prem Reddy, who has been know to be invovled in controversial medical business deals. Nevertheless, PHS has garnered some national recognition.

Thursday, August 6, 2009

Today, John Marshall, Valley Health System legal counsel, forwarded two documents regarding the potential deal and negotiations between VHS and the Physicians for Healthy Hospitals (PHH).

Earlier this week, he responded to our pubic records request letter and charge of a Brown Act violation. Essentially, he argued that the board can establish a special or ad hoc subcommittee to deal with these types of issues. The subcommittee does not have to report as a Brown Act body.

Keep in mind, if that is true, nobody else can be part of that subcommittee including PHH members, otherwise it is opened to the public. I’ll attach his letter tomorrow.

But today, he did send the criteria, which the board will use to evaluate the PHH offer. These are below. Please note, they are dated, July 10.

That is only 11 days after the June 29 board of directors meeting where they collectively decided to pursue the “dual track” of exploring the possibility of selling the hospital as well as continuing to demonstrate improved financial health.

Gee, in 11 days they had already narrowed the “dual track” down to one “tie”.

At the July board meeting, the board agreed to grant PHH an exclusive negotiating position for 90 days. They approved this despite two different parties announcing their interest in the district’s assets.

Days later, a national hospital management firm, Universal Health Services, wrote the board and expressed their interested. I’ve asked for confirmaion of this offer and any others, but haven’t heard from VHS yet.

That’s 3 separate parties besides PHH.

Do you think the directors are meeting their fiduciary responsibility to the district’s constituents? If PHH is the high bidder, VHS could use the additional funds to care for the concerns that might go untouched in PHH’s absence. That’s the typical economist argument for bidding rather than sweetheart deals.

VHS criteria for evaluating what? The dual track was to evaluate the concept of a sale. The first sentence of this document clearly states, VHS is developing criteria to evaluate PHH only. Weeks before the board even voted to do this.

Point number 2 suggests some physicians may have low admissions. Isn't that the issue, the number of patient days is less than estimated? Since some physicians are creditors in the bankruptcy proceedings, how does the public know this sale is not being manipulated behind closed doors?

Point 7 seems important to the public but the board's subcommittee defers it to focus on point 5 — obtain public support and marketing. Wow, our hospital is just like tooth paste or our favorite brand of detergent! Do you think they might offer coupons good for half price surgery or free TV with the purchase of a certain number of hospital nights?

VHS Criteria for negotiating sale to PHH



July 10, 2009

The Ad Hoc Committee has developed the following criteria as a starting point for discussion regarding the possible financial commitment of members of the physician community to a potential sale of assets of this Health Care District:
1. It is imperative that PHH identify/contact a credible, easily recognizable partner to move forward with any acquisition process. The reasons are twofold: physician unity is critical to the success of any proposal and the Board of Directors must have a high level of confidence that such proposal will be looked upon with favor by the district electorate.
2. Mindful of legal restrictions, PHH is encouraged to make certain physicians with high admission rates support the project and are willing participants. (Needs to be re-worked with assistance from our legal counsel as to how this should be presented). I understand it is a potential mine field and must be constructed/crafted with care.)
3. PHH must submit to the Ad Hoc Committee a business plan which addresses the major issues facing the district, i.e., revenue and operations. PHH must be able to outline how it will address these issues with specificity and a reasonable timeline for accomplishment.
4. Full disclosure of financing plan must be provided. On this issue, transparency is critical, especially to the electorate. Anything less will not and cannot be accepted by the Board of Directors of VHS.
5. Initially, PHH must be able to demonstrate its ability to obtain community support for its proposal. How will this purchase be marketed to the general public, and what level of funding has been established to support a marketing blitz are questions requiring a satisfactory response.

6. What, if any, assets of Valley Health System are off the table.
7. Commitment to maintain community-based hospital--Hemet and Menifee.
8. Retention of Hospital District model.

Breakfast amigos

Here's a little behind the scenes view of the Town Crier. Many of you know, at least the names, of the editorial staff, Marshall and I write most the stories, and Becky is the editor.

But to sprew our thoughts out to the world requires the help of 8 more people. I won't reveal names since they are behind the scenes (maybe they don't exist).

We're actually a pretty good team. We laugh and joke, really it's not that evil here. But eating is our speciality. We'll celebrate birthdays, several times a year, just for the cake, ice cream and beer.

Sometimes one of our most special people will bring donuts in the morning so that our coffee tastes better. But today, the morning cuisine was (honest) tortilla strips and guacamole dip. So if you think some of the stories don't meet past standards, imagine dipping tortilla strips with guacamole in your coffee.

Maybe that would work on St Pat's day, green (baby food green) coffee! But in the middle of August, it takes a strong stomach, but that's your TC staff, willing to do the difficult to keep the news coming.

Of course, the other side (a good reporter gets both sides) argues that this is healthy grains and fruit, perfect to start the day. Huh? I prefer liquid grains and crunchy fruit.

I admit I miss the chocolate donuts with coconut, but I'm still reading the Web. There will be other mornings. But Marshall claims he has stomach contractions (don't ask, I know what you're thinking, shame) and nausea; yet he's still here punching the keyboard too. Dedication!

So that's how the day goes. But we're all still friends even though the tortilla strips were substituted for the donuts.

Wednesday, August 5, 2009

It's huge!! Tank no 11

Steve Erler, Fern Valley Water District general manager, gave me a tour of tank no. 11 today. So I took some photos. It's huge. the diameter is 176 feet, that's nearly 2/3 the length of a football field. The volume is 3 million gallons.

The crew, Jim Nutter and Bob Sims, were cleaning the tank floor. The photo to the right with Jim and Bob gives you a sense of scale.

Below, you get a sense of how huge it is. It's like an auditorium inside. Steve has a fan blowing out of one side trying to dry the walls. He met with a representative of the coating producer, the company that did the work and the inspector.

Steve has plans to ensure the water passes the oder and taste tests efore refilling the tank and connecting it to the distribution system.

But you can see how huge it is. That's what I kept saying. Last week, when he drained it, you understand why some below were surprised by the unexpected appearance of the babbling brook behind their residence.