UnGovr Transcript
iHow this transcript is madeUnGovr transcribes the official recording with automated speech-to-text, separates speakers by voice, and matches voices to the seated roster. Names and attributions are AI estimates and may contain errors.Verify any quote yourself: click anywhere in the transcript and the official video jumps to that exact moment, so you can check any quote against the recording.0:20 – 0:2922 turns
All right, good morning ladies and gentlemen. We're going to get started I'm gonna call to order this meeting of the Ventura County Board of Supervisors for August 18th 2026. Madam Clerk please call the roll.
Roll call, called by Unidentified speaker 2
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Thank you, Sheriff. I'd now like to start our item number four which is our moment of inspiration. This is an employee spotlight this month and we are honored to once again recognize an employee who really stands out. We had the honor of recognizing this same deputy sheriff back in May and really making an enormous impact in the county particularly in the district too. We've got a video for this so I'm gonna ask the clerk to cue up the video first Thank you.
Sergeant Dylan Alvarez is really what we always hope that we will develop and get within law enforcement. He had lived experiences as a child, saw there was a gap in services that were being provided and really knew from the very beginning that he wanted to make a difference. Dylan deserves this recognition among anybody I can think of that has done this work working in special enforcement in particular. He's in the sweet spot where he needs to be. He is working directly with his gang community He's working with former gang members, trying to get these kids down a better path. Formerly I
was from the local gang in the area and some years later I run into Sergeant Alvarez and you know from that moment he was jaw dropped that I was who I was and presented an opportunity to come together to make an impact
Having an opportunity to work as a deputy in Special Enforcement Unit and work with gang members. I came across and met Marcos Aviles, who is now the president and founder of Mando. At the time Marcos was involved in a local street gang. Marcos after going away and doing some time at the California Youth Authority just by chance I happened to run into Marcos at a local shopping center. I didn't even recognize him because he had just made such a change in his life. He looked clean cut and he recognized me and approached me And wanted to thank me for making a difference and working with him as he was a younger kid that was in need of some help. And actually let me know that the work we did helped him come to a realization and see a bigger picture, that there's more to life than the gang involvement.
When I made
a phone call, and I knew that he was there for me, and to hear somebody At one point we were in opposition to one another, kind of like a rival in the streets. To hear him say I love you brother, I got your back for me that meant
the world. He cares about this community. He cares about the people we serve. He sees the value in all of them even when they're doing things they're not supposed to do. Even when they're breaking the law he can see the good in them And he's trying to bring that out. I mean, I can't
ask for anything more out of my people than that. The badge around my neck represents protecting people that don't always have a voice or the means to stand up and protect themselves. If I could share one message with the community, I would want people to know that we're out here because we care. I work with so many amazing people that can do whatever they wanted to do with their lives but we chose this calling to work with people and make a difference because we truly care and wanna see our communities succeed and thrive.
Hey Dylan, congratulations on being selected for this award. What you're doing to try and change systemic problems with the folks that we have that are in gangs and what they've gone through in their trauma and their families and really trying to put it all together makes a huge difference. I appreciate it as your sheriff and certainly as a member of this community as well. You're doing great work. Keep it up!
You know, you never let me feel anything less than belief in me. And I want you to know that I truly admire you and honestly man from the bottom of my heart, man, I love you
brother. Please join me in recognizing Sergeant Dylan Alvarez. I do want to say thank you for allowing us to recognize you and to honor you today because I know you're not that type of person that seeks this out. So, thank you for allowing us to do this and see if you want to make a few quick remarks and the sheriff as well.
I just want to say I'm honored to be here this morning. I appreciate you all. Thank you so much. Yeah.
Thank you Sergeant.
Man of many words. So Chair Gorrell, Board of Supervisors, Dr. Johnson I know this is a moment of inspiration but you know I'm an elected official and you gave me a microphone so I'm going to take a moment. One I want to thank Dylan again for being really the best part of the Sheriff's Office and representing what we strive to have in all of our employees that are engaging with our community. You know we don't see the community as our enemy. Our community we are here to support Protect and defend in any way we can. And so being able to take kids who have had a rough go, who may not have had the best example or who are making bad decisions and having somebody who can be an advocate for them in partnering with other folks to bring them together and help make better choices to get him down a better path is better for everybody in our community.
So I want to thank Sergeant Alvarez for all that he does. We're blessed to have him in this organization, blessed to have him in Thousand Oaks in particular for you Chair Guerrero And I know he's going to continue doing great things for us all. Thank you all for the time this morning.
Yeah, thank you for making the county family so proud and congratulations thanks. This is item number five. We're going to
move to item number five, that's an agenda review. Are there any Levine Act disclosures by members of the Board of Supervisors?
No.
All right and before we go to the agenda review I do want to make a note and that is the esteemed Jeffrey Barnes our Assistant County Council is stepping in to represent County Council's office and we're grateful and I do want to also set for the record the fact that almost half of the people on the dais today are named Jeffrey And that's probably some kind of Jeffrey record. So I just wanted to make that notation into the archives.
Madam CEO, please agenda review.
Thank you Mr. Chair. Good morning supervisors staff and all in attendance today. The agenda review for August 18th 2026 is as follows Item 28 public works agency waterworks district adoption of a resolution revising the rules and regulations of Ventura County Water Works districts number 1 Moore Park, 16 Piru 17 Bell Canyon 19 Somis and 38 Lake Sherwood. One public comment letter has been submitted Item 36, Public Works Agency Water Works Districts. Public hearing regarding proposed increases to monthly sewer service charges, reclaimed water rates and reclaimed water service charges. Four additional protest letters and two public comment letters have been submitted. And lastly item 37, Health Care Agency. Public hearing regarding Ventura County Medical Service model options for the Santa Clara River Valley.
Six public comment letters have been submitted. Thank you Mr. Chair this concludes agenda review.
Thank you, Dr. Johnson. Is there a motion to adopt the agenda as described?
Roll-call vote Moved by Levier · Seconded by Vianey Lopez approve the agenda is modified and
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Agenda Discussionitems moved / continued / pulled, click to expand
Can you mark me as a yes, my computer is not. It's a little slow.
Can you mark me as the yes as well? Mine is in the same.
Might have to take a roll call vote I don't think it's working for any of us.
All right all in favor please say aye. Aye. Any opposed or abstentions? Hearing none that passes unanimously thank you.
Thank you very
much.
Moving to agenda item number six that's a consent agenda items 9 through 33 are there any
public comments on the consent agenda?
Thank you Chair Garrell. We do have one member of the public who wishes to speak on item number 17 Leticia Austin please proceed to the podium and you will have three minutes to give your comment
0:29 – 0:349 turns
Good morning, chair and members of the board. My name is Leticia Austin public and government relations manager at the Port of Wynieme I'm here this morning to express strong support for item number 17 on the agenda. We appreciate Dr. Savette Johnson providing letters of support to all nominated census tracts in the county including their track number ending in 4305 which contains critical economic transportation And defense related assets within both the city of Port Hueneme and the City of Oxnard. This includes the port of Hueneme and naval base Ventura County whose strategic co-location enables significant regional benefits from strengthened goods movement efficiency to advance innovation, economic competitiveness, and national security readiness.
The census track ending in 4715 also plays a vital role in regional freight mobility. It includes Wainimi Road, identified by the Ventura County Freight Corridor Study as both a primary port intermodal connector and a designated multimodal heavy freight corridor This route provides essential access between the port, Navy Base Ventura County, the US 101 and key agriculture and industrial sectors across Port Wyniemea and Oxnard.
Both census tracks are experiencing rising demands for processing facilities, value added services, logistics capacity and innovation oriented development. These trends have led to increased investment interest and property acquisition that bolster local revenues and strengthen the region's supply chain infrastructure. Securing Opportunity Zone 2.0 designations for these areas will help attract crucial long-term private investment. This capital will accelerate local infrastructure improvements, spur green energy and logistics innovation, and create sustainable high paying jobs for our local workforce.
Furthermore, authorizing letters of support for neighboring tracks ensures we take a collaborative regional approach to economic growth and the Port of Wainimi stands in full partnership with the county on this initiative. We strongly echo the CEO's recommendation and ask for your unanimous vote in favor of item number 17. Thank you.
Thank you for your comment. That concludes a public comment for consent agenda.
Yeah, thank you very much. Thank you for those remarks and we always welcome input from our port. Yes Supervisor Long?
Yes to make a comment on number 17. Thank you for the Port of Wainimi for all the support and business that you drive through Ventura County but I also wanted to make sure that we note on the unknown which is ending on 5002 that's Nylan Acres in the auto center area The state says it's recommended which I appreciate because anything we can do to bring opportunities to our county is really important. So I want to say thank you and support this item also on 15, we're continually working on homelessness in Santa Clara River Valley and just want to say thank you to the city of Santa Paula Thank you supervisor any other comments on the consent agenda or actions by members of
Item 6 has been motion to approve by Supervisor Parvin, seconded by Supervisor Long and passes unanimously. Thank you.
Great thank you let's bring up item number 7 that's the minutes of the county and special districts and see if there is any comment on that. There is a first and a second.
Roll-call vote Passed Moved by Vianey Lopez · Seconded by Matt LaVere approve has been
Show transcript
Thank you. Now
let's move to agenda item number eight, that's general public comments on items not on the agenda. Madam Clerk can you please read the advisement and are there any public comments today?
Thank you, Chair Gray. We currently have 11 speakers signed up in our queue and then just as a reminder to members of the public who wish to address the board today with public comments on any agenda item please visit VenturaCounty.gov forward slash BOS comment for participation information and instructions. For in-person public comment please check in with the deputy clerk at the entrance of the boardroom If you wish to make comments, you must be in the boardroom or if you're participating remotely. You must be connected to the meeting via zoom or telephone before the close of the public comment period for that agenda item request to make public comments on an agenda item will be accepted until the public comment period for each agenda item is complete.
For our remote participants please accept a prompt to be promoted and unmute your mic when it's your turn to speak and for all public comments. The in-person speakers present in the board room will be called upon first followed by remote participants At the discretion of the chair, general public comment regarding county related matters that are not listed on the agenda but are within the subject matter jurisdiction of the board may be moved to the end of the meeting.
And I will call your name in threes for our in-person public comment please proceed to the podium when your name is called. Our first speaker will be Steve Gemma followed by Wade Pereira and Rob Brajender. Mr. Gemma?
0:34 – 0:407 turns
Thank you. My name is Steven Gama and I'm a current member with the City Council of Port Hueneme. Last night we had an inspiration, and we focused on the thousands and thousands of youth engagements that occur in the city of Port Hueneme. And one thing that we've learned is that when you engage with youth early and often it really makes for a stronger community. So hats off to your inspiration today I feel like we're on the same page.
I'm here as a member of the V C Animal Services Commission and I want to express my sadness for Bruce and the victims of that long story. I also want to express my sadness for the cancellation of this Thursday's meeting due to safety concerns. And this is the second time a VC Animal Services meeting has been canceled because of safety concerns, and as a commissioner on the board, I would like a little more information. What are those safety concerns? I feel completely safe here in the county of Ventura. We have police officers here and I think public meetings all come with a little bit of safety concerns. And I know that we address those when we prepare and when we come to meetings. And so, I'm just looking for a little more information as to why the VC Animal Services meeting was canceled.
We have important work to do. The animal shelter is at capacity. We're struggling to make better decisions to reduce the number of animals in our care and to get out there to the communities to do Newton's neuter and spade operation with their mobile unit and you know I just feel like it really hurts the mission of the commission when we cancel meetings and so perhaps we could get more information out to the members of the Commission and that's it thank you.
Thank you
Thank you for your comment. Our next speaker is going to be Wade Pereira, followed by Rob Bragenser and Brenna Diaz. Wade? We have a Wade Pereira not seeing any will go to our next speaker. Rob Bragenser followed by Breanna Diaz and Nadia Melgoza. Mr. Bragenser.
Good morning. I'm Rob Bragganser. As many of you may remember, I addressed you during the contract negotiations between SEIU 721 and this body about a year ago. I would like to thank you for unanimously approving that contract. Unfortunately there are still some outstanding parts of those negotiations and I am here today to bring forth one of those, the reclassification of the office systems coordinator series.
I won't put any of you on the spot and ask if you know what an office systems coordinator is. And we're going to call that OSC from now on because one thing that both SEIU and the county agree on is that it needs to be reclassified, both a new name and a better job description. In fact, the term the county used to describe the classification is archaic And the term that I use is extinct.
Let me tell you how we, the OSCs define our work. We're the information technology professionals that work and support all of the county's agencies except the Information Technology Department. That is, we do all the IT that takes place outside of IT services. However, we are not allowed to call ourselves IT professionals. And class and comp says that we cannot.
And they say the fault is yours. Now, of course they don't use those words what they say is that at some point in time this body. And then no one seems to remember what that point was made a decision that only I T professionals who work within the I T services agency can be treated as I T professionals entitled and follow comparable rules that were set forth for IT professionals by the California Labor Relations Board.
Believe me, I understand that none of you were a part of those decisions. They took place quite awhile ago before any of you were on the board but when you make a great decision And your past as you get to live off of that when your past has made a bad decision. That is yours to work on part of the SEIU contract negotiations team has met a few times with us Anna Ford Robert Avalo at the beginning of these negotiations we asked that we be treated like our counterparts.
The problem was they said if that's what you want then the answer is no and we will stop these negotiations. We cannot give you that. We have not moved forward, we've been working on this for about six months and we need to be treated the same as our counterparts.
Thank you Mr. Bragginger for your comment. You've used your time.
I urge you to treat people that do the same work.
Thank you Mr. Bragginger for your comment. You've used your time. Yeah thank you. Just as a reminder, there is a clock on the podium so it's helpful if you kind of follow along with the clock and then they don't have to cut you off. Our next speaker is going to be Brianna Diaz followed by Nadia Malgoza and Carson Acosta.
0:40 – 0:488 turns
Good morning, my name is Briana Diaz. I work for the Health Care Agency Referral Department. I have only been with the county for seven months but this time has been enough time to see the inequality and unfairness that many employees have experienced for years. We're not asking for special treatment we're asking for fair wages equal treatment and respect for the work that we do.
County employees work hard to serve our community and our pay should reflect our responsibilities and dedication. I may be new, but I do not need years of experience to recognize when something is unfair. It is time for the county to listen to its employees and take action. We do the work we serve the community and we deserve fair wages and fair treatment. We need your board to direct the CEO to negotiate and fix the problem so that county workers are compensated fairly for experience and ability. Thank you.
Thank you for your comment. Our next speaker is going to be Nadia Malgoza followed by Carson Acosta and Viviana Avalar
Good morning, my name is Nadia and I've been working at the health care agency about eight plus years. I don't have a personal speech but I just want to pretty much say that we do have inequities. I worked long enough and I do consider myself a very hardworking employee for the County of Ventura in the community that we work for And it's unfortunate that we have to oversee a lot of employees that are under us, that have got that race.
And they continue to ask us a lot of questions and it's unfortunate that we don't have that pay increase for it. It's unfortunate has gotten a lot attention throughout the departments which is unfairly because I'm a very team player and it's been very challenging personally to take that at home because it does bring you down where are we able to grow here. I always thought the county was the best employee I could work for to give my knowledge, my expertise, my care for the people here in the community and it has kind of put that aside because of what's going on So I just think it's very unfairly and I am trying to speak for everybody, not just myself but everybody and also the community that we work for.
With that said, we need your board, the board to direct the CEO to negotiate and fix the problem so that county workers are compensated fairly to their experience and ability. Thank you so much. Thank
you. Thank you for your comment. Our next speaker is going to be Carson Acosta followed by Viviana Avalar and Joe Harten. Carson?
Thank you Chair Gorel, members of the board. My name is Carson Ocosa and I have the honor of representing over 5,000 union members across Ventura County. After our last contract we were proud to negotiate an agreement that raised wages for thousands of Ventura County workers. And this contract was historic in that it made it a little easier to live and work in Ventura County but our work is not done. We now face a situation where internal inequities have resulted in an office assistant making more than their supervisor. A medical office assistant making more than a referral coordinator, and a case aid making less than an office assistant position that they promoted from. These internal inequities are not fair. They do not represent the skills, abilities, and experience of county workers.
It's a problem that must be fixed. We are ready to negotiate a fix to this problem. We want to work with the county to find a long-term solution, but we need your help today. We are asking your board to direct the CEO to negotiate a fix to this problem so that County workers are compensated fairly for their experience and ability. Thank you.
Thank you for your comment. Our next speaker is going to be Viviana Abelard filed by Joe Hawthorne and Tara viado Viviana.
Good morning, my name is Viviana Velar and I'm a community health worker from California Children's Services. CCS is a state-mandated program providing diagnostic and treatment services medical case management and physical and occupational therapy services to clients from birth to age 21 with CCS eligible medical complex conditions some qualifying conditions include diabetes kidney disease hearing or vision loss muscle disorders and cancer Community health workers work closely with public health nurses to provide case coordination for clients. We're comprised of eight ongoing case management teams and one intake team. Each team manages an average of 570 cases, and the intake team receives roughly 240 referrals per month. We're often the first point of contact for individuals and families needing healthcare services helping identify barriers and assisting with access to care and resources.
Community health workers play a crucial role in our healthcare system and work tirelessly to ensure the well-being of our community. We build trust, advocate for underserved clients and help bridge gaps in healthcare access. We have the skills and knowledge to determine program eligibility and use critical thinking skills when working with complex medical conditions. We advocate for CCS client needs during multidisciplinary care team meetings We work with families to eliminate barriers to care and ensure that they have access to appropriate resources. We also provide verbal interpretation and written translation when needed. Additionally, CCS community health workers became DHCS ambassadors in 2022 reaching out in culturally and linguistically appropriate ways to Medi-Cal beneficiaries to ensure the continuance of their coverage.
These are just some of our responsibilities. Before the market-based adjustment, our pay reflected the specialized skills training and dedication our roles require. We were paid above the minimum salary because the county recognized the complexity and responsibility of our work. However when SB 525 was implemented, our salaries were not adjusted. Our responsibilities didn't shrink. Our impact on the community didn't shrink. We're asking the board to correct this unintended consequence by restoring the salary differential. This adjustment would ensure our pay once again reflects the commitment, skill and heart we bring to Ventura County every day. We are dedicated and resilient staff with deep compassion for our community and we feel very strongly that restoring the appropriate salary level for community health workers is justified and necessary.
Thank you.
Thank you for your comment. Our next speaker is going to be Joe Hawthorne followed by Tara Viado and Anna Wilson. Joe?
0:48 – 0:566 turns
Good morning board, thank you. My name is Joe Hathen I've been working for the county since 1994 and that's 32 years. I was looking forward to my retirement pretty soon and imagine how excited I was when two years ago I got the opportunity to promote from medical office assistant to referral coordinator. And then this contract happened And we were overlooked, and now the position that I promoted from is making more money than I am.
And it seems unfair because it's more responsibilities and more work. And we need your board to direct the CEO to negotiate and fix this problem so that county workers are compensated fairly for their experience and ability. Thank you.
Thank you for your comment. Our next speaker is going to be Tara Viado, followed by Anna Wilson and Manuel Andrade.
Hi, good morning. My name is Tara Viado and I am a case aid for children and family services but we go by field-based case aid because we are out in the field. I've been working for the county for the last 11 years and this is my co-worker. My name is Jacqueline Amos and I have been working for the county for about 15 years And we're going to speak on the inequities as well.
We understand and respect that clerical staff play an important role, and this is not about saying one position is more important than another but our concern is that the duties working conditions level of independence and responsibilities case aids are significantly different and we do not feel our compensation reflects those differences As a field-based case aid, we manage caseloads and work independently in the community often without security or another staff member present. We enter homes hospitals treatment facilities correctional facilities and other unpredictable environments.
We may work with individuals who are under the influence have criminal or violent histories gang affiliations or varying mental health diagnoses creating situations where personal safety can be a concern Our responsibilities include transporting parents and youth, including youth with significant behavioral or medical needs. Facilitating home visits and family time, participating in family time meetings, assisting with placement and family finding, serving court documents, and when necessary providing court testimony.
We are also trained as we also train and mentor new employees and may travel out of state to help maintain family connections. Our workload and responsibilities continue to increase with the possibility of three court ordered visits per week, we will have even more direct contact with families While managing caseloads and additional field responsibilities. There is also a significant concern regarding the change in historical pay relationship between case aid 2 and office assistant 3 historically case aid twos were compensated at higher levels than office assistant threes In 2024, KSAID topped out at $27.64 per hour compared with $2701 of Office Assistant 3s. Following SB 525 increases, KSAID 2s will now top out at $36.62 while Office Assistant 3s will top out at $39.91.
This results in Office Assistant 3's eventually topping out $3.29 higher than a KSAID 2. Despite the substantial differences in field-based responsibilities. We take pride in the work that we do and serving children and families, and we're simply asking that the board to direct the CEO to negotiate and fix this problem so that the county workers are compensated fairly for their experience and abilities. Thank you.
Our next speaker is going to be Anna Wilson followed by Manuel Andrade and Abigail Cervantes.
Good morning. I'm a little nervous here, this is the first time speaking in front of you. Thank you for taking the time to hear all of us. I would like to highlight the wage discrepancies affecting the medical billing specialists and clerical supervisors. I have worked for the county for 16 years in behavioral health and M.A. Biller III Medical billing specialists perform specialized duties including patient accounts, billing corrections insurance company requirements payments reimbursements communications with patients and with insurance companies.
Versus what a claims examiner might do because they're dealing with one just applying a contract which would be the Ventura County health care plan where as billers we have to deal with Medi-Cal Medicare We have to know all that we Billing specialists have received the smallest initial adjustment 1.57 followed by an increase of 7.54 and 8.7 throughout this contract. By comparison, claims examiners received an initial adjustment of 20.28 a 2% memorandum adjustment and additional increases of 9.52, 2.5 and 8 .7 Office assistance received an additional adjustment of 19.94 to 1.5 adjustments in addition 9.52 and 8.7.
We as billers do the job of both claims examiners and of office assistance, and as everyone else has indicated we are now sitting at the lower rung For clerical supervisors, they're facing an additional wage comparison problem. Their current hourly wages are approximately $24.26 to $33.94 for level 1, $26.67 to $37.35 for level 2 and $29.38 to $41.15 for a level 3 clerical supervisor.
Clerical Supervisors begin. Clerical Supervisor 1's begin at the new 25 minimum for all three classifications office assistance would earn up to 42.90 exceeding clerical supervisor 3 by $1.75 an hour most significantly medical claims examiners would exceed clerical supervisor threes by 7.76 per hour Clerical supervisors have a greater responsibility because they oversee clerical employees, assign review work, train staff, evaluate performance and work overflow. And ensure that department standards are met.
We need your support we need your board to support to direct the CEO to negotiate fix this problem and so that the county workers are compensated fairly for their experience and ability. Thank you for your time,
thank you. Our next speaker is going to be Manuel Andrade followed by Abigail Cervantes and Christopher Palma.
0:56 – 1:028 turns
Good morning, members of the board. My name is Manuel Andrade. I'm a food service supervisor for the Sheriff's Department and the Tadroy Jail. I am responsible for approximately 14 employees. We cook for approximately 200 sheriffs and staff members 700 inmates were responsible to order You name it. When I came to this, to the county, I always seek for higher positions be better for my family and everybody else now me and my colleagues we find out Our cooks get close to 29% raise. We got 3.5% raise, so we making less than the cooks. So now my situation and I'm pretty sure my colleagues are the same is to demote ourselves to make more money for our retire or stay in the position that we are making less money.
I'm asking you guys please direct the CEO to negotiate something that is fair for us, okay? And so what I have to say. Thank you very much for your attention. Thank
you for
your comment.
Our next speaker is going to be Abigail Cervantes followed by Christopher Palma and Rick Cortez
Good morning So good morning Board of Supervisors. Thank you for giving me the opportunity to speak today on behalf of the employees in our department and many of the other departments that were left out of the wage increase. I want to begin by saying that I truly love my job as a referral coordinator, I take great pride in helping our patients navigate their health care needs and ensuring they receive the care and expertise they deserve. The work we do matters because we ultimately are helping people take care of their health and well-being That is why it's so difficult to stand here today and talk about how our department and others have been affected by being excluded from the recent wage increase.
I want to make it clear that we are genuinely happy for our departments or the other departments and employees who did receive an increase. We understand how important those raises are, and we're happy that our co-workers are benefiting from those wages. Our concern is that many of us also working hard carry significant responsibilities and contribute every day to the success have been left behind.
When employees see other departments receiving meaningful wage increases while their own department receives nothing, it creates a feeling of inequity and that feeling goes beyond a paycheck. It affects morale motivation and how employees feel about their values within the organization. The impact has been felt throughout our office dynamic. Employees are discouraged, some feel overlooked and unappreciated.
When I interviewed for my position as a referral coordinator lead, I distinctly remember sharing that one of my goals was to eventually retire with county I believe this was an organization where employees would build a career, feel valued and know that their hard work matters. Unfortunately being excluded has changed how many of us feel as a referral coordinator leader it has been incredibly disheartening to watch the morale and drive within our department steadily decline.
Our team works tirelessly to support our patients often while managing having workloads and additional responsibilities. We continue to do our jobs because we care about the people we serve, but we also need a feel that our organization we work for cares about us. I want to emphasize that our dedication to our patients has not changed. We will continue to show continue to advocate for our patients But loving our jobs and caring about patients should not mean that we have to accept feeling undervalued as employees.
The exclusion of multiple departments from the SB 525 increase has affected morale across our workforce. We're asking our leadership to recognize that impact and understand that fair compensation is also an important part of maintaining a motivated, dedicated, and valued workforce. Thank you.
Thank you for your comment. Our next speaker is going to be Christopher Palma followed by Rick Cortez, Wade Pereira and then Mona Rodriguez who's joining us on Zoom. Christopher please proceed.
Hi good morning chair board and staff my name is Christopher Palma I've been with the county seven years. I'm a client benefit specialist lead uh and a 721 member and a union steward as well As you've heard from a lot of my colleagues and members here, the refusal to bargain and fix these problems. The inequities that we have is causing a lot of strife, a lot of animosity and distrust within us. And as I hope you know there has been a large retention problem within us and it's only going to exacerbate the problem.
We do need the board to direct the CEO to meet with us, to negotiate and fix the problem so that the county workers are compensated fairly for their experience and ability. And I'm here to present the board with over 500 petition signatures from members affected by the classifications directly including everybody that you heard from here today. Thank you. Thank you
for your comment. Our next speaker is going to be Rick Cortez followed by Wade Pereira and Mona Rodriguez Rick Cortez.
1:02 – 1:077 turns
Now for something completely different, I always walk in in the middle of something going on last time I was here thank you for having me I said that you two I was gonna make a t-shirt of you because I was so actually proud that the that you were moving forward with all of the implements of planning and building and safety I was going to wear that t-shirt but it's kind of tight and I went to an 80s party in it.
It got cut off, and I don't want you to unsee that. I'm talking about two things. One is interpretation There's no way around the fact that rules and written words need to be interpreted. It's the spirit of the interpreter that most often citizens are left with, and there's no place we can go for that spirit That spirit, it comes from you and your directives to planning and to building and safety. And without that clear throughput of understanding they are left with themselves often and I don't want to berate anybody but I think something could be done to strengthen that spirit.
So often we've been unfortunate to have said no a lot, and we have to prove our case instead of the other way around. They're not looking for answers. They're not looking to help. They're looking to say no. Secondly, and moving on from that I'm hoping you guys can add to the agricultural amendments a thing that Los Angeles and Santa Barbara is doing. And that's allowing existing buildings on ag land to be used as facilities for weddings or get togethers or whatever that might be through a CUP. And Santa Barbara actually does it without a CUP.
I think that would be a strong way of leading ag, giving it another revenue stream instead of leading up to the market which we know is kind of horrible right now. Thank you for your time.
Hi, good morning
everybody. Can you hear me?
Yes we can hear you please proceed. I feel like as a community health worker we deserve an adjustment in pay because the work we do is essential to the health and well-being of our communities. We are often the bridge between patients families healthcare providers and important community resources every day we build trust educate advocate solve problems and support people through some of their most difficult moments This work requires compensation, knowledge, responsibility and dedications. We are not simply helping people we are helping improve health outcomes and making healthcare more accessible. A pay adjustment will recognize the growing responsibility and value of our work.
It would also help attract and retrain experienced community health workers who have developed a strong relationship and trust within the communities they serve. We are asking for a fair compensation And reflects the importance of what we contribute. Investing in our community health workers is an investment in healthier people, stronger communities and stronger healthcare system. We deserve to be compensated accordingly. Thank you for your time.
Thank you for your comment. Chair Gurrell that concludes a public comment for this item thank you
All right, thank you. I just want to say thanks to all the public speakers today and before we
move on to the next agenda item just say that we are discussing this later and will continue to discuss this with our executive staff. We do have a lot of respect and gratitude for our frontline service providers and many of those represented by SEIU 721 so thank y'all for being here today and giving your remarks I think there are a lot of unintended consequences associated with SB 525 and the fallout is not just affecting this county, but all 58 counties across the state. And we're all trying the best we can to take care of our folks. So thank you for your remarks today and will continue to move on.
I'd like to now call item number 34. It's an item being presented by Supervisor Matt LeVere. Thank you.
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Okay, thank you chair. This item came as a result I was having with Our district attorney Eric Nazarenko and Eric if you want to come up. You know, I was asking Eric if he had any thoughts about naming the Ventura Family Justice Center which was kind of the flagship family justice center in the community really provided a foundation for the future family justice centers which are coming to Oxnard into East County and in that conversation with Eric we kind of realized there was an obvious choice and that was Naming the Ventura Family Justice Center after the distinguished life and career of Judge Colleen Toy White. And so Eric, I know we didn't talk. So I don't want to steal anything that you're going to say. Do you maybe want to start and I'll follow up?
I don' t want to take your speech.
I want to begin Chair Gorel members of the Board of Supervisors CEO Dr. Johnson thank you for the opportunity to say a few words on behalf of the late Honorable Judge Colleen Toy White her widower is here with us Art Bliss. I'm going to invite him to say a few words. I am also joined by Chief Deputy Brent Nybecker while she's no longer with us Her legacy lives on in so many ways.
Chair Gorrell, I know you and I have been before her in her court. It lives on through the individualized specialized courts that she has championed. Elder abuse, domestic violence, drug court, mental health court. She really was able to provide compassion and expertise to victims as well as those who were in the throes of addiction suffering from mental illness and who needed individualized assistance and help so what more fitting tribute is there than naming the Family Justice Center here in Ventura on her behalf? Art would you like to say a few words
Good morning. My name is Art Bliss and it was my good fortune to have been married to Toye. It's been five years since her passing. And we remember every day, we miss her. Her legacy continues with the specialty court she developed reflecting her philosophy of rehabilitation rather than incarceration. I'm sure she would be thrilled. Her family can't be here and so it's false to me to represent her but thank you for your consideration and this honor.
Yeah, I mean Eric hit it on the head in terms of her impact on the community and the impact she had on our justice system locally. Taken as a whole it was a 41 year distinguished career in Ventura County 18 years with the district attorney's office including 10 as the chief assistant and then a 23-year career on the bench and what she was able to accomplish our district attorney just noted Supervisor Long.
Thank you so much. Such a special project and such a special woman, I just want to say thank you what a great idea to do this we talked about it at the Family Justice Foundation's fundraiser hope event and the whole crowd was just almost in tears it was just such a powerful event and um I just want to say thank you for bringing this forward Supervisor LaVere and Eric really do appreciate it thank you.
Thank you supervisor Thank you for doing this. I just want to add that there as a practitioner, you had judges that you wanted to appear before and then you had judges that you hope not to appear before. And then there was the third category which is judges that you just genuinely loved. You know? You just wanted a hug because they were such good people and you wanted to as it, you know, young attorney wanted to emulate them So Judge Toye White was one of those people for sure, just an amazing human being and left us too early.
And I couldn't be prouder to press yes on today's vote so thank you for bringing this forward Mr. District Attorney and Supervisor LaVere. Thank you Chair.
Roll-call vote Passed Moved by Levier · Seconded by Kelly Long approve the recommended action
Show transcript
Thank you
all. All right is now a good time Madam CEO to
move on to agenda item 35 recognition of county employees wonderful so we're gonna take up item 35 at this time And turn it over to doctor Johnson. And miss keys
thank you Mister chair we appreciate the time. As our employees fell and will be recognizing continuous service recognition today we have 25 individuals with 253035 years. This keys will kick off this presentation. I'm going to hand over to you
1:13 – 1:187 turns
Thank you so much. Good morning Chair Guerrero, members of the Board, CEO Dr. Johnson and the illustrious ACO Jeff Berg. I figured I had missed that over all these times over two years so i'm making up for it before you leave. All right um I am Danielle Keys your County HR Director and I am excited and pleased on behalf of your board to present 25 County of Ventura employees to be recognized for reaching continuous service milestones of 25, 30 and 35 years during the first quarter of 2026. So for those of you that are being recognized we will display your photo and say a few words about you. And honorees when your name is called please come forward to receive your certificate and stay in the front so we can take a group photo at the conclusion of the presentation.
So with that, I will get started myself and CEO Dr. Johnson will alternate your recognitions so we will start with Christopher Acebo for 25 years with the probation agency. And Chris joined the Ventura County Probation Agency in 2000, advancing through several roles before becoming a senior deputy probation officer in 2022. He has earned multiple awards and contributed significantly to agency programs and staff training while he couldn't be here today we do want to take a moment to just congratulate you Chris on 25 years of dedicated service.
Next we'll recognize Tony Avalos, Equipment Operator 3. Tony began in roads and transportation, advanced to equipment operator roles in watershed protection and now serves as Equipment Operator 3 helping develop junior staff while continuing to grow professionally and contribute positively to public works. Congratulations on 25 years of outstanding dedication and public service
Next we'll recognize Shana Decker for 25 years with the Probation Agency. Shayna has served with the Ventura County Probation Agency since 2001, progressing to supervising deputy probation officer in 2022. She is experienced across juvenile and adult divisions as a respected instructor and has earned multiple leadership and teamwork awards. Congratulations Shayna on 25 years of service!
Next we'll recognize Sophia Esparza, 25 years Child Support Services Specialist III. Sophia began at DCSS as an office assistant in 2000 and became a case manager in 2001. Over 25 years she has embraced ongoing learning and adapted to evolving systems, finding her work consistently rewarding and engaging. Congratulations on 25 years of outstanding dedication and public service Sophia!
Next we will recognize Nadine Fish for 25 years with the probation agency. Nadine, a Ventura native began with the Ventura County Probation Agency as a student volunteer and now serves as division manager. Her career includes broad experiences across juvenile and adult services providing extensive operational and leadership experience. Thank you Nadine for your 25 years of service. Congratulations.
Next we'll recognize Magda Flores, 25 years Child Welfare Supervisor. Magda's years of dedicated service reflect steady clinical expertise, consistent support for her team and a lasting commitment to improving outcomes for the children and families she serves. Congratulations on 25 years of outstanding dedication in public service.
Next, we will recognize Jose Hernandez for 25 years with the Public Works Agency. Jose began his County of Ventura career in 2001 as a maintenance worker and advanced to equipment operator 4. He has served multiple districts since 2013 contributing greatly to public operations. He enjoys hiking the beach and time with his family. Congratulations Jose on 25 years of service.
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Next, we're honored to recognize Katherine Jones 25 years staff services specialist one. Catherine is a dedicated public works professional with over 25 years of service beginning as a student worker. She spent 20 years supporting watershed administration and since 2016 has provided oversight for Fox Canyon's groundwater extraction reporting operations. Congratulations on 25 years, Catherine!
Next we'll recognize Sonia Lopez for 25 years with the Department of Child Support Services. Sonia began her county career in 2000 with the probation agency before joining Child Support Services in 2001. She advanced to supervisory roles and has long supported, trained and guided caseworkers who assist families throughout Ventura County. Congratulations Sonia on 25 years of service.
Next we'd like to honor Alex Matthews, 25 years Surveyor 3 Alex began his county career in 1989 as a student worker before returning to public works as a Surveyor 3. He reviews maps and project documents, supports operations and earned a 2026 Gold Challenge coin for contributions to the Boundary Explorer application. Congratulations on 25 years, Alex!
Next, we recognize Rosa Menchaca for 25 years with the Human Services Agency. Rosa has served Ventura County for 25 years with professionalism and care administering CalFresh, Medi-Cal and CalWORKs programs. She values her work and is honored to positively support individuals and families throughout the community. Congratulations Rosa on 25 years of service!
Next we'd like to recognize Amado Mejares, 25 years Public Works Maintenance Worker 3. Aminoh has served the County of Ventura since 2001, beginning in agriculture weights and measures before joining public works in 2008. As a longtime Sataquoi District Maintenance Worker he is known for reliability and strong daily support to his team. Congratulations on 25 years of outstanding dedication and public service!
Next we will recognize Lou Negrete for 25 years with the Public Works Agency. Lou spent 22 years advancing through roads and transportation before becoming PWA Superintendent in 2022. He now leads the Moorpark Operations Yard, focusing on improving efficiencies and accountability to support Public Works mission and service to Eastern Ventura County. Congratulations Lou on 25 years of dedicated service!
Next we'd like to honor Kathleen O'Keefe, 25 years Deputy Director. Kathleen of Ventura Native has built her career in the Auditor's Office progressing from Finance Analyst to Fiscal Manager and now Chief Deputy Auditor Controller. She is also a wife, mother and proud grandmother. Congratulations on 25 years of service!
Next, we're honored to recognize Manny Romero for 25 years with the Public Works Agency. Manny began as a maintenance worker three and advanced through equipment operator and supervisor roles to become West County Superintendent. His dedication and leadership have positively supported public works operations and our entire community. Congratulations, Manny on 25 years of service.
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Next we'd like to recognize Shelly Sussman, 25 years Manager RMA Services 2 Planning. Shelly began her county career in Public Works Solid Waste Management Division and has spent the last 20 years in the Resource Management Agency Planning Division, contributing to projects involving housing, natural resource protection and a County's General Plan update. Congratulations Shelly on 25 years of outstanding service!
Next, we will recognize George Toth-Fayol for 25 years with the Health Care Agency. George has provided 25 years of dedicated service as an occupational therapist, advancing his expertise through ongoing education and teaching. His specialized skills and commitment to clients make him a trusted valued member of the Penfield team. Congratulations, George on 25 years of dedicated service.
And next we'll recognize Stan Ziegler, Fire Captain 25 years. Stan helped establish the Junior Fire Academy, has served on the Hazardous Incident Response Team since 2007, worked as public information officer during major incidents and has contributed to several instructional programs throughout his career. Thank you and congratulations Stan on 25 years of outstanding service!
Now our highlights will be transitioning to 30 years of service. We'll start by recognizing Paul Rodriguez with the Ventura County Sheriff's Office. Senior Deputy Rodriguez began his county career in 1996 with the Probation Agency before joining the Sheriff's Office in 1999. Over the years he has served in patrol, schools, investigations and training and is currently assigned to the Ojai Valley Station. Congratulations Senior Deputy Rodriguez for 30 years of service!
Next we'd like to recognize Yolanda Ruiz, 30 years. Yolanda has served in Tura County for 30 years, advancing to Fiscal Specialist 3 in GSA. She oversees key billing functions, supports system updates and projects and brings decades of experience beginning as a student aide. She enjoys travel reading and gardening. Congratulations Yolanda on 30 years of outstanding public service!
Next, we'll recognize Adolfo Valdivia for 30 years with the Human Services Agency. Adolfo is marking 30 years of service contributing to technology improvements and providing strong support across the agency. His long-standing commitment to high quality service and collaboration is greatly appreciated. Congratulations Adolf on 30 years!
And now we're
moving to the next here of 35 years of continuous service. There you go starting us off is Sylvia Campos, 35 years. Sylvia has dedicated 35 years to Ventura County, serving with integrity and excellence. Her work across multiple agencies has strengthened public service and positively supported residents, colleagues, and the broader community. Congratulations, Sylvia on 35 years of dedicated public service!
Next we will recognize Maricela Cortez for 35 years with the Health Care Agency. Maricela is recognized for many years of dedicated service, providing compassionate care and helping train more than 1,500 resident physicians. Her commitment to patient care and education has shaped generations of clinicians and strengthened the agency's service to the community. Congratulations, Maricela, for 35 years of dedicated service!
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Next it's my honor to recognize Nerissa Martinez, 35 years Office Assistant 4. I used to work with Nerissa in a clinic. Was it Simi Valley? Ventura. I worked at so many clinics over there, I couldn't remember which one but she's amazing. So Nerissa is recognized for 35 years of service including 26 years with Ventura County Behavioral Health. Her deep knowledge and steady commitment have made her a valued part of the organization and its work in supporting the community. Congratulations Nerissa on 35 years of outstanding service!
And our final recognee is Lorena Rosas for 35 years with the Department of Child Support Services. Lorena has built a dedicated career at VCDCSS, serving in roles that support Ventura County families financial stability. She values strong collaboration with customers co-workers management and partner agencies. Congratulations Lorena on 35 outstanding years of dedication.
To date, the careers of these 25 dedicated individuals represents a total of 680 years of county service. Can we give them another round of applause? I had a moment doing this recognition and I'm like if you look to your left or your right just like five more years and you guys can be back up here getting another award. So stick with it. We want to take a moment to congratulate all of you and also thank our board for recognizing these amazing county employees and the substantial impact they make to our community in the work we do every day.
If I could have all of you stay right where you are, we're going to take a group photo and once again congratulations.
All right, for those watching at home we're gonna go take a break and go into closed session and we will wait for County Council to make an announcement related to that. We're gonna adjourn in this closed session.
I can make the announcement.
Okay.
We'll go into closed sessions for items 40 41 and 42 there are no expected announcements coming out of closed session thank you
All right, thank you Madam CEO.
2:04 – 2:041 turns
Testing 1, 2 testing.
2:35 – 2:4014 turns
Okay, good afternoon everyone. Good morning still actually. Ventura County Board of Supervisors will reconvene there's an announcement by county council.
Thank you, Chair Gorel. The Board of Supervisors having met in closed session today there is no reportable action except as related to agenda item 42 in which the board has by a 5-0 vote authorized the initiation of litigation in one case. The lawsuit defendants and the other particular shall be disclosed to any person upon inquiry after the lawsuit is filed
That's
all.
Thank you, Mr. County Council Board is going to move now to agenda item 36 This is a public hearing regarding the proposed increases to monthly charges I'm gonna open the public hearing on this and ask for a presentation by
mr. Chan. Thank you Thank You. Good morning, sir. Girl board members dr. Johnson. I'm Paul chain director for water and sanitation department Item 36 we're proposing a two-year sewage and reclaimed water rates increase for Water Works District 1 Moore Park at 30% for fiscal year 26 to 27, 23% for FY27 to 28. There are 9,680 sewer customers and 25 reclaimed water customers.
Our main public engagement effort was through the Prop 218 process where we released a Prop 218 on 2 July allowing 45 days for public comments For District 1 specifically, we reached out to two customers who were identified as fixed income elderly and also disadvantaged. So therefore we provided them direct communication with some nonprofit organizations that could help support them financially.
And there are 26 protests received. Of the 26 protests, two were concerned about the fixed income where we basically communicated with them directly. Nine were concerned with economic pressure and 15 had no reasons listed. A bit more about the wastewater and reclaimed water system at Moore Park. We can process roughly 5 million gallons per day, we can produce 1.5 million gallons per day of reclaimed water. There are 107 miles of sewage pipelines, 7 miles of reclaimed water pipelines, 3 point miles of forest mains and 4 lift stations.
The reason why I'm talking to you about this is because our collection systems over 50 years old We need the recapitalization requirements and following the 2023 sewer spill, we have updated our sewage management plan which we're now cleaning and inspecting all 107 miles of sewer lines every three years. And in addition to that, we're aggressively pursuing outside funding which included 6.5 million in the UV disinfection and also pump station one project. And also we pursued a 1% annual percentage rate loan for the California Energy Commission along with the tax credit for the PV plants that would deviate some of the demand for energy costs that continue to escalate.
Without anything else I'm ready to answer any questions you might have.
All right, thank you Mr. Chan. Madam Clerk are there any public comments on this agenda item?
Thank you Chair Gorrell there are no requests to speak for this item.
Okay thank you. Any questions by the board for Mr. Chan or Public Works? Supervisor Parvin
Yes, 26 protest letters. I certainly can understand their frustration especially with those types of increases 30% the first year and 23%. I also understand the reason why over the past 10 years there was only increases in five of those ten years so it's like a catch up would you say you agree with that statement?
Absolutely ma'am. In addition to that, for the last 10 years our expense have outpaced our revenue so therefore we're running in the red for the last ten years
There was a lot of really good questions by the residents that are significantly impacted. I appreciate the questions, I ask the same questions and we also have this citizens advisory committee that really got a lot of answers to the question is it's just that how do you predict or how can you tell the public I mean, these are substantial increases. So how do you sort of tell the public how to budget for something like this? Or how do you avoid it going forward where it's such a significant amount?
Yes, ma'am and I appreciate that question. And we did consider that in addition to that, we were actually trying to spread that out as far as we can. And the two year time period is that's why it's a two year rate increase instead of just one to ensure that we could spread the pain a little bit.
It's a pain, that's for sure. Yes, I apologize. We'll see that.
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Thank you any other questions or comments from the board If none, then I'm going to close the Public hearing and just say that I appreciate all your work on this. I know particularly in the two water works districts in my district You you and the entire public works team have been very diligent in getting public feedback and empowering Comments and listening and adjusting over time and ultimately coming back with this I know that you're also been very aggressive trying to identify ways to bring down state and federal grants that could help with some of our infrastructure requirements. So, I want to thank you Mr. Chan and Mr. Strakoulos.
Is there a motion?
I'll move approval.
We have a first and second.
Roll-call vote Passed Moved by Janice S. Parvin · Seconded by Kelly Long approve staff recommendations has been
Show transcript
Thank you everybody let's shift now to agenda item number 37. 37 is public hearing pursuant to the Belizean Act regarding Ventura County Medical Services Spanish interpreters are provided for this today knowing that I would ask everyone including myself to recognize that there is interpretation And that we should probably speak a little slower to give them the opportunity to do the interpretation. There is a public announcement that we're going to make right now, would you like to do that please? Thank you.
Good morning. This meeting will be simultaneously interpreted from English to Spanish. To listen to the interpretation inside this room, please go to the reception that is outside of this room and take your reception devices. If you are listening in Zoom, please step off your screen, select the interpretation icon and choose your favorite language. lo que prefieran uno u otro pero tienen que seleccionar un canal para que escuchen todo. Si quieren hacer un comentario público con el uso del intérprete, por favor hablen de forma lenta para que sus comentarios puedan ser interpretados para la junta.
Good morning, this meeting agenda is being interpreted simultaneously from English into Spanish and Spanish into English. To hear the interpretation from inside this room please check with the staff at the table right outside these chambers. They will give you a listening device. If you are listening in Zoom, please go to the bottom of your screen, select the icon of interpretation and select your preferred language. Even if you are bilingual, you must select one language so that you can hear the entire meeting.
If you'd like to make a public comment, please use the services of the interpreter speaking slowly and clearly so that your comments can be Related to the board. Thank you.
All right Thank You madam interpreter I'm gonna open the public hearing and Call for a presentation Thank you
Thank You mr. Chair So as you all know, we're here to talk about the future of health care services in the Santa Clara Valley and the different service models brought forth by our consultant with Health Management Associates. Mr. John Friedman I want to make a couple of points of clarity just before we get started first that this discussion does not look at sighting of a new location so it's not looking at where the location This discussion does not take that into account.
Additionally, I want to make clear that if any entity or organization approaches the county saying that they want to partner or collaborate. We are open to engaging meeting with them walking through the nuances And engaging council as well to help us understand if there is a feasible path forward. We actually have a conversation scheduled for the end of this month with the entity, and we will come back to this board publicly to share what we have learned in any possible path forward with any entity or organization that would approach.
Lastly, there were many public comment letters that went in and I read each and every one of them. And our auditor controller was kind enough to just provide some clarity about some of the comments regarding property taxes and general fund dollars. So in the year 2526 from the city of Fillmore, there was 25.12% contributed to the County General Fund And for the city of Santa Paula for the same time frame. It was about 19.72% that went towards the county general fund from property taxes.
So with that clarity, if you have questions, the auditor controller would be happy to help. You can contact the auditor's office but with that I'll pass it over to Mr Friedman for your presentation. Thank you.
Thank you. Thank you Dr Johnson chair Garel members of the board. I'm going to walk through a number of slides here Thank you. I'm going to provide some introductions and background about the Santa Clara River Valley, the hospital and community and patient profile, and then outline the different service model options in the financial projections in our recommendation.
The goal of this presentation and the work that we've developed is how to develop a sustainable health care program for the county in the Santa Clara River Valley. That was based on a series of board discussions that happened in actually many time periods back, but most recently in November of last year and in February of this year. We've developed three service model options for consideration here. One is a hospital replacement which is option one which is a 24-7 emergency department we call that the micro hospital A expanded medical office building, expanded access care center which is a very robust urgent care with diagnostic and laboratory and pharmacy capability. And then option three is an urgent care which you'll see pieces of this in later slides.
Before we get into this more deeply, I think it's very important to cover some terminology because when we consider healthcare access there are many different dimensions of healthcare access. It's not all one thing. One way to look at it is the acuity or the severity of the illness of patients They're low acuity, which we're very familiar with are things like common colds minor injuries rashes etc that can be handled in after set after our settings emergency rooms but they're often.
can be solved in routine care, what we call outpatient or ambulatory care settings. There's also moderate acuity types of care where there needs quick evaluation and tests done monitoring basic treatment and often a transfer to another facility. Those are people who might have rising risk Might need deeper evaluation, stabilization, etc. And then there's the high acuity which are serious life-threatening types of health needs that often require an emergency department a hospital care trauma care or into our transfer to another facility it's important to level set on that because The programs we're talking about, these are not just one-to-one replacements. There's different sets of needs as you look at the healthcare portfolio of the residents in this community.
There's ambulatory needs, there are inpatient needs and there is urgent and emergent needs in this community. Also need to step back and look at the health care context was the county is operating for the last 12 to 15 years. We've had tremendous success in California reduce excuse me reducing the number of uninsured from roughly 14% in 2013 to 5% in 2014. That gain is on the cusp of being reversed in California due to federal actions that make the Affordable Care Act less robust It's harder to obtain insurance under the reforms in H.R. 1 and the Medicaid component of H. R1 is going to have a series of factors that make eligibility and retaining eligibility principally work requirements and more frequent eligibility checks That's likely to cause an erosion in coverage and our uninsured rates are likely to increase.
In addition, there are provider payment reductions on the horizon for Medicaid providers called for under HR 1 that will hit in late 27 and early 28. Cumulatively, you've heard a presentation on this back in November of 25. Cumulatively the impacts of HR 1 are about $400 million through fiscal year 2030-31 that doesn't all occur in one event it's a series of actions enrollment erosion as well as provider rate reductions that are occurring In addition, you are all keenly aware that the county has an obligation to be the provider of last resort for indigent care just not the same as Medi-Cal coverage. It's a narrower scope but as people lose access to Medi-Cal The county's obligation to be the provider of last resort for under section 17,000 is also on your horizon here.
So you have a series of very difficult and tumultuous fiscal challenges in maintaining your health system that are in front of you. I touched on HR 1. This is a timeline of key events that have occurred over the last year. HR 1, I mentioned it changes eligibility and might increase indigent care obligation of the county. It's on the upper left. In November, we presented a report to you on the impacts of HR 1. You also considered future care and whether to continue to make further capital investments into the Santa Paula Hospital to meet seismic standard deadlines there. And you instructed the agency and HMA your consultants to come back with looking at the health needs in the community profile, the utilization profile which I'll touch on in slides.
We did that also in a more focused presentation in February of this year. You also asked for community meetings to occur those are listed here on this slide and which brings us to today, which is a Billinson hearing, which is a state law requirement on changes or reductions to County Health Services. That's what you're doing today and to consider the policy and economic factors for a new service model direction for the Santa Clara River Valley.
Many of you know this far more detailed than I do. This is, in a nutshell, the history of the Santa Paula Hospital from when it opened in 1963. We noted when the seismic requirements are on the lower right 1994 that are affecting all hospitals in multiple waves, multiple time waves across the state since 1994. The financial challenges and 2003 in bankruptcy of the hospital, the county purchasing it in 2005 and reopening it in 2006. And having continued financial challenges in running the facility and having to make service reductions to the facility in 2004 which involves birthing an obstetric service being closed And then in 2005, November not electing to pursue further seismic upgrades into the facility.
These are excerpts from the presentation in November, showing what are the seismic needs of the hospital. They're roughly $36 million of capital improvements and deferred maintenance obligations into the facility plus an annual ongoing operating cost of about $10 million here. There was also consideration of a new medical office building, some of which are incorporated into what is known as option two in this report here. And this would be the financial obligation to the county roughly $40 million estimated costs of doing the new hospital and the medical office building at that time.
This is a slide on the current footprint of the Ventura County Medical portfolio in the Santa Clara River Valley. On the far left are the ambulatory clinics in Santa Paula and in Fillmore, you can see the patients and number of visits. You can see the behavioral health footprint as well, the hospital in the third column and the public health program in the fourth column.
And this is a pictorial display of where those locations are in the Santa Clara River Valley. We also included some other locations of the Clinica's location since this is primarily a safety net planning exercise for the county, other safety net provider being The Clinicas and also the CMH program in their urgent care location. Now I'm gonna turn to utilization and this gets to the different types of needs, the different types of concerns of access. So we think about inpatient care, outpatient care and urgent and emergency care.
We looked at all of the hospital admissions from people who reside in the Santa Clara River Valley. This is a distribution of the hospitals that serve all of those residents in 2024. So out of all the hospital admissions coming from residents in the Santa Clara River Valley, 23% were admitted to Santa Paula Hospital. 24% were admitted to Ventura County Medical Center and 53% went to other facilities which are listed on the bottom right here CMH St. John's Henry Mayo Los Robles Children's Hospital Los Angeles UCLA Keck Why is that? That could be a skill match, that can be a service need. That can be an artifact of coverage and provider networks. It can be an artifact of referral pathways that are designed in certain types of health coverage here.
So the takeaway here is not all inpatient care is for the community in the Santa Clara River Valley, is solved by the Santa Paula Hospital or the Ventura County Medical Center. People get care in many different locations, in many different places both within the county and outside the county. This is simply a descriptor. You've seen this slide in the past, which is some of this is also capability differences.
Ventura County Medical Center is a much more robust facility in terms of its service portfolio and just comparatively you can see the narrower service portfolio at Santa Paula Hospital It's important to note that, you know, Ventura County Medical Center also doesn't provide cardiac service. So this doesn't reflect there are certain services that the Ventura County medical system is not robust in and other providers in the community have to solve for that access challenge within our community.
Now this slide is now looking at the emergency department and the volume that's in the emergency department, which are reflected in the blue bars at the bottom. This is how much volume occurs in the Santa Paula Hospital on an annual basis Roughly 15,000 visits per year. And the blue line, excuse me, the green line above the blue is of that volume how many got admitted? What's the proportion of patients that got admitted from that volume and you can see it's roughly 5.5%. It is a declining volume That number for the county, I believe is 14% and statewide is roughly 11%. So this is an indication somewhat of the service availability at the hospital. It's also an indication of the mixture of the types of patients that are in that blue bar And how many of them require admission?
It tends to be a lower acuity type of patient load that's in that hospital comparatively. Now let me speak more specifically about acuity. There is a scoring system called the Emergency Severity Index to grade the condition of a patient at entry into hospital emergency department, the EMS This system also uses this same type of grading model. And you can see at the very top, immediate life-threatening on the far right, you can see those are cardiac arrests, life threatening allergic reactions, severe respiratory distress. You can see the next level down is emergent high risk requires multiple and complex resources and it requires an emergency room. Those first two rows require an emergency room chest pain, suicidal ideation, severe sepsis.
That's somebody has to be in an emergency room the next levels down it gets a little fuzzy and I'd like to it's important to view this chart not as a layer cake In practice, it's a marble cake. These are far more nuanced here. Somebody can end up in Level 3 who is urgent and stable, can be seen in an emergency room but may need to be admitted. On the other hand, they could also be seen in urgent care and they may not need to be admitted. They can be returned to their home or to another location here. So those are things like abdominal pain, dislocated shoulder, high fever with cough, mild dehydration And then you can see the less urgent level four, which are minor lacerations, required stitches, urinary tract infection symptoms. And then level five, which are non-urgent, which often are seen in urgent care sometimes seen in emergency departments as well but those are things like medication refills, suture removal, minor colds et cetera.
So it's important to think of this framework when we consider the next slide. This is the Santa Paula Hospital Emergency Department acuity from 23 to 25. So it's that same grading schedule, and it's the distribution of patients that are across that grading scale. You can see that under 1% are immediate life-threatening needed to be seen at that hospital, about 10% are emergent and high risk. And then the next two categories 48% and 38% are in this urgent and stable need.
Could they be seen in an emergency department going forward? Yes. Can they be seen in other settings such as an urgent care? Yes Those are things. It's not a direct one-to-one, can't say this for every single case. That's why I said it's not a layer cake, it's a marble cake. Each patient has to be evaluated here so that we're not trying to slot every single individual into a specific location here.
Now we're looking at the community profile and this is a distribution of the three communities in Santa Clara River Valley. And you can see the median household income on the first three bars here compared to Ventura County, and you can see that Santa Paula has a higher proportion of lower-income Households which correlate with the county's obligation as a safety net provider here and then at the table down below we've highlighted the number of residents living in poverty in Santa Paula Fillmore Peru.
Contrasted to the countywide right there. So this provides an important reminder of why the county needs to continue to have health service investment in the Santa Clara River Valley. Now we're going to look to the patients in the community. This is survey information I did provide in February, this points to the different type of access which is access to routine care and ambulatory care regular doctors visits and specialty visits here You can see on the dark blue bars are the Santa Clara River Valley residents and on the light blue bar are the countywide statistics. So you can see that community has tendency to higher level of diabetes, higher level of asthma And then on the right and you can say preventive screenings here.
The community lags in preventive screenings for routine checkups mammograms colorectal cancer cervical cancer screening and cholesterol test history those point toward The need to consider chronic disease, chronic disease which are the dimensions that shorten lifespan. That shorten longevity and you need to get in front of those by routine access to ambulatory care.
So what does this tell us? That Santa Paula serves a younger predominantly Hispanic Latino population with larger households in economic and higher economic insecurity. 90% of the emergency room visits are low to moderate acuity. It's important to note that EMS today bypasses Santa Paula for severe trauma and nearly all life-threatening conditions when they're picked up in the field. Not all volume in the emergency room is brought by EMS, some of it is walk-in.
Residents use hospitals outside the valley due to specialty needs, referral patterns and insurance networks. And preventive care rates lagging against county averages representing the needs for pointing us toward ambulatory care access and patient education here. The ED utilization is low, but it does point to the need for rapid access to stabilization diagnostics and transfer pathways that expanded urgent moderate acuity care can help fill identified gaps from out migration for routine and moderate acuity needs. And that we would like to have a model that supports multi-generational, culturally rich community while trying to mitigate transportation and coverage barriers. Continued Ventura County presence in the healthcare system there. So we've designed three options for consideration A micro hospital, which is a scaled down hospital with an emergency department and observation beds.
It would provide a 24-7 operation. An expanded access care center with a higher capability with on site imaging laboratory and pharmacy services. And option three outpatient clinic offering extended daytime and evening care hours. I didn't prepare a slide on this, but we've analyzed when the Santa Paula Hospital emergency room volume occurs. There is a pretty substantial amount of care that occurs after the working hours that's in that emergency room And that pointed us to the need to have expanded after hours care. It does have a tendency to drop off significantly from midnight forward here, so it's really this after hours here. So what I'd like to outline for you here is this is more detail about these three options. I touched on 24-7 care for the micro hospital.
It would be the broadest array of inpatient and outpatient emergency services It would be the highest capital and operating costs, and I have a slide on that. It would require a county operating subsidy because of the negative margin that would occur in the facility. And it's the most complex to finance permit staff and sustain and we take roughly six to eight years to open.
The other two options are not a hospital They have expanded capabilities, as I touched on with imaging and laboratory and pharmacy services in option two. It would provide a wide array of urgent care and diagnostic services. It's a lower capital cost than a hospital, and in our modeling it would project have a positive margin in the first five years And it requires roughly three to five years to open. It is not a hospital building, it's not built to seismic requirements built much more closer to office building requirements that's why it can be done faster the cost will be lower associated with that and similarly in option three which is extended hours would not be as robust as option two with imaging and diagnostic capability We do project however it would have a negative operating margin and that has to do with idiosyncrasies in healthcare finance, Medi-Cal finance.
They are not in a linear manner that the lower intensity service why would that be cost money versus the higher intensity service which would be profitable there? That's a different discussion that I can elaborate on at a different time But similar to option two, it would be a quicker build of roughly three to four years to open. So here's some more specifics on the micro hospital.
Three slides here on each option we project that would incur a $73 million operating loss over five years It would require approximately $100 to $121 million of investment and would take six to eight years to build. It would be a 24-7 capability, and it would serve as an EMS receiving facility so that ambulance can take a patient to this location. I'm going to skip ahead here.
The option two, which the expanded access center we projected that would have a $5.4 million Positive margin over five years would be $35 to $40 million of a capital investment, three to five years of construction. And you can see the hours there. There's two pieces to this. It's consolidation of the existing footprint of the ambulatory program in the Santa Paula area And it's the expansion of a robust urgent care on top of that there, but it could not accept EMS runs. That's an artifact of state law that EMS transport can only go to a licensed emergency room. Can't drop me off at another type of location.
And then option three, as I mentioned we projected would have a negative margin of roughly $5 million over five years. Would cost about nine to $16 million of capital investment and take three to four years to build lower acuity not as robust as option two and similarly could not accept EMS transports. So here's some comparison of those three options side by side.
Here you can see the projected operating margin in the middle row, the capital investment requirement, operating times on the bottom there. Importantly none of these numbers factor in the economic value of the property of where the hospital is today. We felt that we needed to do that analysis independent of what may happen with the land and the building today, that exists today.
Also point out that if option one is selected we would also need to develop a very detailed transition plan because there might be a gap in time between when the hospital might close, because of state requirements there and when a new hospital would open. It's an unsettled area about whether you could file plans and whether the state would grant relief and can continue to operation that's a possibility or whether there will be a gap ED service between the old hospital and the new hospital.
This chart tries to plot those acuity factors which are on the far left, those those acuity levels one two three four five and in the blue column those are the services settings today where people where residents get care Today, if you're a level one acuity immediate life threatening some of that occurs at Santa Paula Hospital. Most of it occurs at Ventura County Medical Center and other trauma centers and other EDs where that would occur in the future options. You can see the level two emergent risk here I'm gonna try this Here is emergent risk. Here, people get care today at Santa Paula Hospital, Ventura County Medical Center and other EDs.
In the future they could get care in the micro hospital, VCMC and other EDS. And these two options it would only be at VCMC and other EDS. You can see the level three people who are urgent and stable They currently get received care at Santa Paula Hospital. They could receive care at the micro hospital. And in option two, some of them could be seen at the Expanded Access Care Center. Not all, it's a gray area. There's many different conditions within this here and VCMC and other emergency departments.
And option three, many people who are in this category would not be seen at the urgent care and would need to be seen at VCMC and other emergency departments. And then you can see the other category less urgent There, roughly 38% could be seen at the micro hospital, the expanded access center and in urgent care. Here. Bear with me a moment. So where does this leave us?
Since reopening the hospital, the county has faced ongoing challenges in sustaining financially viable hospital operations and resulting in net losses of roughly seven and a half upwards of $15 million annually that's historically subsidized by the county. The financial pressures and the investments needed to comply with state seismic requirements, competitive market dynamics and the anticipated $400 million funding challenge in front of the system are bearing down on your county. Here see a very difficult set of challenges in front of you in maintaining your safety net.
We outlined the three options about the future service models that could be developed for the Santa Clara River Valley, a hospital, a medical office building and expanded access center or a smaller urgent care expansion. Our assessment, HMA's assessment is that the hospital would provide, the micro-hospital would provide an emergency department and limited observation care. However it would require the highest capital investment incur significant operating costs and negative revenue margins and require the most complex staffing and regulatory structure.
And then Santa Clara River Valley and Santa Paula Hospital utilization patterns in our judgment don't clearly demonstrate a broad need for a 24-7 facility there. There's no doubt the community would benefit from a 24-7 emergency department, But the challenge in front of the county is balancing access, of which there's many different dimensions of access. Inpatient care, emergency care, routine care, ambulatory care and the finances of the county.
And because of that, we recommend option two because it would best align with the observed needs in the utilization patterns of the Santa Clara River Valley residents. This best balances costs while matching most of the volume at the current Santa Paula ED and improving the ambulatory care array in the Santa Clara River Valley. It also aligns with community needs to strengthen access to primary preventative care And making sure that there's reliable access to primary care, preventive screenings, chronic disease management, et cetera here.
I'd be happy to take your questions.
3:18 – 3:248 turns
Thank you Mr. Friedman. It's my intention now to go to public comment. How many speakers do we have Madam Clerk?
Thank You Chancellor. We currently have 38 speakers in our queue
Okay. I'd like to do two minutes per speaker and just a quick admonition for those that intend to participate in this section of today's agenda, for those that have signs we would just ask you to keep the signs down so the people behind you can see if you'd like to hold your sign up you're welcome to do so but we would ask you to do that in the back of the room So again, please keep your sign down unless you want to hold it up. And if you do want to hold it up We'd ask you to go to the back of the room and the second admonition is just please no audible responses To any of the speakers or any of the comments made? You're welcome to give thumbs up and thumbs down or jazz hands If you support what's being stated But we just asked you not to respond with any boos or claps either way because we don't want to damper public input and public speaking for those that might beyond any side of this issue or frankly any issue where we have public speakers.
So with that, Madam Clerk let's take the public speakers.
Thank you Chair Garrell and just as a reminder if you wish to make up a public comment on this item if you have not pre-registered please check in with the deputy clerk. If you are participating remotely please visit VenturaCounty.gov forward slash BOS comment for participation information and instructions I will call your names in threes when I call your name please proceed to the podium You have two minutes to give your comment. There is a timer at the podium that you're able to see, that's helpful so I don't have to cut you off after two minutes and we will start with our in-person public comment and then we will transition to our Zoom participants.
So first speaker is going to be Pedro Chavez followed by Cristina Villasenor, Albert Mendez and Jenny Crosswhite. Pedro please proceed to the podium and you will have two minutes to give your comments.
Thank you, I'm deeply troubled by the gradual erosion of Santa Paula Hospital and its expected closure in 2030. We went from the hope of a new medical facility in East Area 1 to uncertainty about whether Santa Paula, Fillmore and Piru will even have access to a local emergency room. This is where we draw the line. Medical emergencies don't wait. When they happen families depend on accessible emergency care close to home. The decisions before you could take that access away from thousands of residents A wise person in this chamber once said that she was proud that the county budget reflected our shared values of our people and communities. So I ask you, what do those values mean if Santa Paula Hospital closes without preserving local emergency care?
Before accepting the outcome, I urge you to think outside the box. I will be emailing you a list of opportunities that I hope that you take into consideration so that we can further the conversation. Since my time is running out these solutions require ganas, the will and determination to make something happen. I am asking you to roll up your sleeves and direct staff to explore every reasonable option there's three before you today however we draw the line on having access to an emergency room I ask you to raise your voices work with legislators bring our communities and institutions to the table explore every reasonable mechanism before deciding that emergency service must disappear from the residents and families in the Santa Clara River Valley.
I leave you with one question where your legacy be taken away emergency services from the people of in the communities of Santa Paula Fillmore in Piru. That's a fundamental question that you have to ponder and ask as you make these tough choices I ask that your choices represent your values. Please protect local emergency medical care in the Santa Clara River Valley. Thank you very much.
Thank you for comment. Our next speaker is going to be Christina Villasenor followed by Albert Mendez and Jenny Crosslight
Good morning Supervisors, thank you for your time. Much like Councilmember Chavez says the people of the Santa Clara River Valley, Santa Paula, Fillmore and Piru have spoken and they want a 24 hour 7 day a week emergency room to stay in the Santa Clara Valley The need is here. It is not leaving, it is not shrinking. In fact, it may be growing. What concerns me is the level two. What concerns me is everything but particularly those level two. The 10% who will be SOL up a creek without a paddle for care for needed critical care in the Santa Clara River Valley How many of them will make that trip out to VCMC or to St. John's?
And how many of this population, without the ability to pay for an ambulance, without the ability to drive themselves, to get a ride and without that health care knowledge of the serious health crisis that may be upon them, how many will choose instead weighing all these barriers and say I'm going to hold tight. I'm going to stay pray figure it out maybe in the morning when it's light when there's transportation and how many of them will make the wrong decision?
As an elected official, I want to share this information with my constituents in Spanish. However the slides from two weeks ago in the Fillmore presentation just came up yesterday less than 24 hours before this meeting. I could not share them with my Spanish-speaking constituents. The recordings from the meeting of Fillmore still haven't been up. I haven't been able to get a hold those recordings to be able to share them widely with the community to get the input I really, really want you Supervisors to consider that we know we make tough decisions, tough financial decisions.
But the Santa Clara River Valley community deserves more. They deserve better. Thank you.
Thank you for your comment. Our next speaker is going to be Albert Mendez followed by Jenny Crosswhite, Mario Rodriguez and Marian Krause.
3:24 – 3:329 turns
Good morning, Chair Garrell, supervisors. Thank you for giving me this opportunity to speak. Today I just want to talk. The seismic and financial challenges facing Santa Paula Hospital are real, but that is not the same thing as saying that closing the hospital without replacing it is the right answer. The County of Ventura's own 2020-2024-2027 strategic plan specifically identifies healthy safety and resilient communities as a strategic priority and establishes a goal to provide equitable and timely access to quality health care mental health and public health services The plan also states plainly that access to quality health care is essential for our community to thrive.
That is where I believe closing Santa Paula Hospital without an acute care replacement conflicts with the county's strategic goals. Yes, the existing hospital faces a 2030 seismic deadline. County documents acknowledge that. The existing facility will no longer be licensed for an acute care under the current circumstances. But the county's own capital improvement program also says it is evaluating this medical need of the Santa Clara River Valley and how to meet those needs in a financially sustainable way.
There is also an important distinction between an emergency department, any smaller urgent care or triage facility. Santa Paula Hospital is a current license general acute care hospital without with emergency services. Stabilizing some seriously ill patients and transferring them to Ventura does not mean the local emergency department is unnecessary. Stabilization itself is emergency medical care, and having the capability close to Santa Paula and Filburn in Piru and the surrounding communities matters.
The county's Healthcare Equity Advisory Council minutes acknowledge both sides of this issue. They say they cite an estimated $25 million in retrofit costs and significant projected financial pressures on the county medical system. But those same minutes acknowledge that the Santa Paula Hospital serves a disproportionately low income population, and the county is considering alternatives including a micro hospital.
Fiscal responsibility matters. In fact, it is the goal of the county strategic plan. But thank you also say thank you for your comments maintain a balanced budget while funding essential services. Mr. Mendoza views your time in a timely health care access and for maintaining and improving dependable public resources serving our diverse communities. So the question
should be how can we afford to keep Thank you very much.
Okay, our next speaker is going to be Jenny Crosswhite followed by Mario Rodriguez and Marion Krause. Please remember you have two minutes to give your time and there is a timer at the podium. Thank you
Thank you good morning. I know that you received a letter on behalf of the city and I'll speak on behalf of myself, I know I've talked to a lot of people I know that look I recognize that you all have a really excruciatingly difficult decision in front of you and at the same time It is vitally important to our community that we have access to the health care that we deserve. Right? We all desire to have a hospital with an ER and a lot of people that I've talked to feel like That the study has been to get to a certain end, and so it's been hard for people to feel like all of the options were fully explored. And so as leaders in our community you're going to hear from a lot of people there's a lot of people here this morning who are going to share their passionate perspectives on why they believe that health care in the Santa Clara Valley is important And so I hope that you'll listen to them.
I know that it will not always be easy, right? And so I think we have to remember that people come with their passion and their perspective and it's also very much something that members of our community feel is a life-and-death issue, right? They really want to know that if they wake up at 2 30 in the morning and they think that they need to go to the ER that they don't have to drive 15, 20, 30, 40 minutes depending where in the Santa Clara Valley they are in order to get to those emergency services. And yes they could call an ambulance but not everyone's going to do that and so it's just something that our members of our community feel really passionate about and so I hope that you will listen to everything they have to say. I recognize that you have a tough decision but this is something that's really important to our community so thank
Thank you for your comment. Our next speaker is going to be Mario Rodriguez followed by Marianne Krause and Chris Espinosa.
Hello Chair and members of the Board. I'm here today to speak about an urgent life critical issue affecting our communities, the need for 24-hour emergency medical access for the residents of Fillmore, Piru, and Santa Paula. The lack of nearby 24 hour care is not just an inconvenience it's more of a life and death situation when someone experiences a heart attack, stroke or serious injury every minute matters. Delaying reaching care and determining survival or long-term recovery.
Our communities include families, seniors and working individuals who may not have ability to travel quickly to an emergency. When life should not determine whether someone lives or dies, or where you live. This is not about convenience this is about saving lives I respectfully urge this board to prioritize the issues and working with health care providers emergency services to establish a sustainable 24-hour emergency medical facility or equivalent access point in our region. Our residents deserve timely reliable emergency care when every second counts thank you for your time and continue serving Ventura County
Thank you for your comment. Our next speaker is going to be Marianne Krause followed by Chris Espinosa and Yesenia Avila.
Good morning. I'm here on behalf of Santa Clara Valley Together. We believe that we need a 24-hour emergency facility in the Santa Clara Valley. The need for hospital is only going to grow as our already approved projects develop and as traffic on the freeway continues. If option two is chosen, we believe that that facility needs to operate on a 24 hour basis And if option two is chosen, even with 24-hour operation more people are going to need to be transported.
Right now their families may take them to the hospital but once they have to leave the valley they need transport. We need a comprehensive way to finance transport for people. We're a low income community and people are afraid to call an ambulance. You can't take away a hospital and then charge them $3,000 for an ambulance ride. I have personal experience with this. Our own nephew had medical debt when he had a severe asthma attack, he did not call an ambulance that he could not afford and he died alone in his apartment.
I have provided you with similar stories in our letter. We cannot have gaps in our emergency services if the new facility, the expanded urgent care with the medical office building cannot be ready when the hospital closes then please use the hospital facility as an urgent care it doesn't have to be retrofitted for that purpose we ask for your consideration thank you
Thank you for your comment. Our next speaker is going to be Chris Espinoza followed by Yesenia Avila and Felix Nunez.
3:32 – 3:396 turns
Good morning Supervisors. Before we decide what health care the Santa Clara River Valley should have tomorrow, we should be clear about where we stand today. We are not starting from a place of equity. Ventura County Public Health's latest Community Health Index gives Santa Paula ZIP Code the highest socioeconomic health needs score of any zip code in Ventura County And if we eliminate the emergency department at the hospital, we will just be adding lack of adequate healthcare infrastructure to a list of myriad health disparities. The consequence of those disparities can be measured in something more important than dollars. In Ventura County Public Health's 2021 analysis life expectancy in Santa Paula was 78.6 years, the lowest in Ventura County.
In Thousand Oaks and Westlake Village, it reached 90.5 years nearly 12 years of life separating two communities in the same county that should trouble every one of us and against that backdrop I believe one principle must be unequivocal Santa Clara River Valley needs quality emergency 24-hour care But preserving a hospital should be the beginning of our ambition, not the end of it. We should maintain hospital-level care without interruption, build the next generation of hospital infrastructure and surround it with primary care, behavioral health, specialty care, diagnostics prevention, senior services, community health workers and a pipeline that trains local residents for healthcare careers here. Because those life expectancy numbers are not inevitable.
Geography should describe where you live, it should not predict how long you live. Imagine a Ventura County where we judge our health care system by whether disparities are actually closing. Whether people can get a doctor when they need and access an emergency room where they live. Where chronic disease is caught earlier and whether a child born in Santa Paula has the same opportunity for a long and healthy life as a child born anywhere else in this county. That is the standard we should set.
Thank you Mr. Espinoza for your comment. Please adhere to the two-minute time so I don't have to cut you off. Thank you. Our next speaker is going to be Yesenia Avila followed by Felix Nunez and Susana Macia Robles.
Well, I was told not to come because it's a waste of my time and it's only three minutes and those minutes don't make a difference but they do well now it's two minutes My name is Yesenia Avila. I'm a registered nurse, a Santa Paula resident, a former Ventura County employee, a community advocate, a Latino town hall member and vice president of a nonprofit but today I'm here as a patient and as a mother. I live just three minutes from the Santa Paula Hospital and those three minutes have made the difference between life and death over the last few years. I have experienced pulmonary emboli, an infarct, a ruptured appendix hemorrhagic Asthmatic attack, kidney stones, brain swelling from influenza, COVID sepsis, hypokalemia from campylobacter intubation with a 45-day stay in the ICU.
Transfer to tertiary care, 12 embolizations, a heart catheter, blood clot removed on several other surgeries. I'm lucky to be alive. As a nurse, I understand how quickly an emergency can turn fatal. Those three minutes mattered, and that's why we need the hospital in Santa Paula. It is the first link of chain of survival and you cannot put a price on that. This is about access and saving lives. Please do not tell us what cannot be done. Show us what can be done. We need a plan. And the Santa Paula residents deserve timely access to lifesaving care and an emergency.
Those few minutes do matter. Thank you.
Thank you for your comment. Our next speaker is going to be Felix Nunez, followed by Susana Macia Robles and Tiffany Leon.
Good morning, Chair Goral, Vice-Chair Lopez, distinguished supervisors, Dr. Johnson. My name is Dr. Felix Nunez and I am the Chief Executive Officer of Gold Coast Health Plan, your local MediCal health plan for Ventura County. Gold Coast Health Plan serves 22,000 members about 10% of which reside in the Santa Clara Valley that amounts to 22, 000 members or approximately 45 percent of the valley population. This includes 48,400 children under the age of 17 Supervisors, with this in mind I respectfully come before you today to fulfill my obligation to advocate for our members and their access to high quality health care services that meaningfully address their healthcare needs.
As you know many of our Santa Clara Valley members face significant barriers that can make traveling farther for care difficult including language barriers limited transportation and work and caregiving responsibilities As a practicing family physician who has served underserved communities for the entirety of my 31-year career, I know that distance on a map does not always tell us whether care is truly accessible. Meaning that a service that is available somewhere in the county may not represent meaningful access if a patient cannot reasonably get there when they need it.
That is why the system of health care delivery you decide to move forward with for the Santa Clara Valley should consider preserving meaningful access to high quality healthcare through the people who live in this vulnerable region of the county. It should ensure that people get can get care, get the right care at the right time in a place that's reasonably easily accessible. Each of these options being presented should be reviewed carefully to determine what they would mean for this community, not as abstract concepts but in the day-to-day lives of a member of a community that is already experiencing significant barriers to accessing care.
Will these options give residents of the Santa Clara Valley timely access to care? Will there be sufficient primary and specialty care? Will they be able to receive diagnostic services and treatment for chronic conditions close to home? And when the hospital level of care is needed, will transportation and referral systems work efficiently? Those questions are especially important for our 22,000 Santa Clara Valley members and the 2,500 who will be transitioning to fee-for-service on January 1st. We also need to look beyond individual services and consider the entire continuum of care that includes primary and specialty care, behavioral health, diagnostic testing, radiology, pharmacy, hospital services, and urgent and emergency care.
Even if the new solution looks different from the healthcare system that exists there today, for Medi-Cal members in the broader community, the outcome must retain meaningful and timely access to high quality care and services. Thank you so much.
Thank you for your comment. Our next speaker is going to be Susana Macias Robles followed by Tiffany Leon and Marissa Garcia. And I'd just like to ask the members who are speaking to please speak slowly for our translators. Thank you.
3:39 – 3:457 turns
Good morning, my name is Susana Macias Robles. I work at Ventura County Medical Center. I've been their nurse for 38 years. We are facing a pivotal point that will affect our livelihood of our patients in our communities and we care for each one every day. For years the future of Santa Paula Hospital has been at a point of contention where the health care agency is gambling with the lives of our farm workers, undocumented and marginalized communities who sustain our local economy.
We all have heard multiple stories personal stories my personal story is of my godmother My godmother had a heart attack in the middle of the night, she told her husband. My arm's hurting. He was 92, let's drive you up to Santa Paula Hospital. They stabilized her. They saved her life. She was at CMH and she was saved because as soon as she got to CMH, she went into cardiac arrest and then she would rush to the OR and ended up getting stents and saving her life. To this day, she is with us.
So I plead with you that the Santa Clara River Valley has always and prior speakers have spoken that they have, that we have less access and our lifespans are reduced. So I leave you today that I ask you to remember that you are our safety net and do not pull that safety net away from us. Thank you.
Thank you. Our next speaker is going to be Tiffany Leon followed by Marissa Garcia and Miranda Miller.
Hello, my name is Tiffany Rose Leon and I work at Santa Paula Hospital in the MedSurgTally DOU department. Santa Paula hospital is deeply personal to me. I was born in the hospital and my family has deep roots in the Santa Paula community after working there for over nine years. I've seen firsthand how important this hospital is to the people who call Santa Paula home The Ventura Health Care Agency has shown they have no shame in requesting funding from the county's general fund for outsourcing employment. However, when it comes to finding solutions to our health care challenges you are quick to invest in consultants and administrative promotions while ignoring the needs of my community.
When we are facing a life expectancy gap of nearly 10 years between residents of Santa Clara Valley and the rest of the county, we cannot afford to overlook the health care needs of the most vulnerable. We demand those needs be prioritized. Take a stand with my community and do right by my people you represent. For me this is not simply a workplace, this is part of my family, my history, and my community. I ask that you recognize the importance of preserving and investing in Santa Paula Hospital and healthcare services It provides to the people who depend on it. And since I have a little bit more time, I just want to add that please consider your grandchild, your wife, your husband, your children because when you vote for any other option than the full running hospital, that means 10 years less on my life and my family and my community.
Thank you.
Thank you for your comment. Our next speaker is going to be Marissa Garcia followed by Miranda Miller and Sophie Roman.
Good morning, I'm a resident of Santa Paula. Access to health care in the Santa Clara River Valley is not a luxury it's a necessity. Santa Paula Hospital Services serves Santa Paula, Fillmore, Piru our surrounding communities We are predominantly Latino, hardworking community, farm workers, small business owners, employees, parents, grandparents who all contribute every day to the strength and economy of Ventura County.
I also want to address that the statistics being presented, that were presented today. We have to ask why those numbers are what they are when hospital services are reduced or downgraded naturally fewer people can use the hospital for those services we cannot reduce services and then use the resulting lower utilization numbers as justifications for taking even more health care away This is personal for me. My grandson has a trach and counts on a ventilator. If something happens to him, minutes matter. I cannot accept that families like mine may have to travel farther to Ventura or Oxnard before receiving critical emergency care. Closing a hospital does not eliminate emergencies it redirects them putting additional pressure on other hospitals and increasing travel time for our families Santa Paula, Fillmore and Piru matter.
Our valley needs hospital. Whatever solution moves forward must provide emergency assessment stabilization triage and critical care when minutes matter. We expect our county leaders to protect health care access and to the Santa Clarita River Valley, invest in our community and maintain a hospital. Our families can depend on and our community deserves nothing less. So thank you for your time. And please take in consideration we need a hospital. There are no other options. Thank you.
Thank you.
Thank you for your comment. Our next speaker is going to be Miranda Miller followed by Sophie Roman and Thomas Figueroa Miranda. Okay, not seeing Miranda so we will go to Sophie Roman followed by Thomas Figueroa and Amalia Ochoa.
3:45 – 3:5124 turns
Hello. Okay, so I find it very fitting that you cut our time to express what we need and you're also cutting our time to get emergency services. So I'm going to cry. It's vital that we get 24 hours emergency hospital strokes cardiac issues asthma and other issues other people have brought up require immediate care this population Me, my population may be low income but we're hardworking people who support our families.
Many who are agricultural workers and we ask them to sacrifice their bodies and deny their care this is so messed up I find this to be systemic racism because this would not be happening in your backyard. I guarantee you guys would be fighting so hard to keep a hospital near where you live, near where your family lives. This is so so messed up also just because we need preventive care doesn't mean we don't need an emergency department We need both.
We need emergency services as our population grows and expands, and also with the changes of the law of the HR 1 whatever it's called your presentation didn't take into account the new buildings that they have so you're not taking all the statistics into account I think everyone else has said everything and when you told the people to speak slower for the Translators, I think it's so perfect as to how you're handling this whole situation with the hospital. You're asking us to shorten our time. You're asking us to shorten our lives and if this hurts your feelings today, I don't care because you don't care about our lives. You don't care about people who look like me and your decisions say that. You could say otherwise. Your words can say anything but your actions are saying dying.
So thank you.
Thank you for your comments Sophie. Our next speaker is going to be Tomas Figueroa followed by Amalia Ochoa and Dr. Gabino Aguirre.
Members of the board, CEO Johnson and county staff my name is Tomas Figueroa I'm a political coordinator for SCIU Local 721 in the Tri-Counties region We're here today because we have strong concerns regarding the closure of the Santa Paula Hospital without the immediate plan for how health care services will be maintained in the Santa Clara Valley. We represent the hardworking members at the Santa Paula Hospital who put their lives on the line every day during the COVID pandemic and continue to serve a vital part of the healthcare safety net in the region.
We also represent thousands of members and their families who live and work in the region, who would be directly impacted by the hospital's closure. And with the rapid increase in population from new developments in Santa Paula, Fillmore and Piru. The healthcare needs are increasing. Labor is a key stakeholder in Santa Paula Hospital. Our members demand a seat at the table when the future of this hospital's being decided. Unfortunately, the CEO has not engaged labor at any point in the discussion to the CEO, the hardworking men and women who serve this community are an afterthought.
We understand that difficult decisions need to be made regarding the future of this hospital. No one understands us more than our members who serve the Berry community at the hospital does too. This is why we need to be part of the process from the beginning, not merely informed after decisions have been made. Thanks.
Thank you for your comment. Our next speaker is going to be Amalia Echola followed by Dr. Gabino Aguirre and Richard Redman.
Buenos dias. Mi nombre es Amalia Ochoa.
We're gonna get a translator for you and double your time.
Fix the timer, Brennan. Good morning, my name is Amalia Ochoa. I am a community leader and an activist with
cause.
I think all of you know this story
about
what happened to my
husband.
My husband in Santa Paula used
the emergency services three times
He was in intensive care because of pneumonia. My husband's no longer
with us,
but I represent him. I am his voice and the voice of many patients
that
are in Santa Paula.
Santa Paula is a community Like
you heard, very poor without medical services. We have an urgent care but we
need
emergency services with doctors, nurses.
My community
3:51 – 3:5616 turns
Sorry, let's be honest. All of
us. We
don't have a lot of ambulances. You know
that.
What are you going to solve this in case of an emergency? We had earthquakes, fires, floods. I have so many grandchildren and great-grandchildren. I don't want them to die.
I don't want my daughters to die
You're saying that everything has to do with money. What about the lives of a community? What about the life of my children? What about the lives of my family members, doesn't that count? I'm so sorry but somebody has to tell you the truth. Every single one of you won't be able to sleep tonight because every single life lost I am so sorry. You have children, you have family members.
You would not want to be in the problem of Santa Paula and the Valley of Santa Clara. Be responsible for once in your life, be honest. I
can't tell you anything else. Thank
you.
Thank you for your comment, Molly. Our next speaker is going to be Dr. Gabino Aguirre followed by Richard Redmond and Elvia Hernandez.
Good morning, chair members of the board so that. So here we are again another gathering to consider the tragedy facing residents in the Santa Clara Valley and our struggle for critical medical services. This is a critical issue for us as you have seen and the clock is ticking not only on the hospital but it's also ticking on our 55,000 plus residents and I would ask this group Raise your hand if you're willing to give up 10 years of your life.
I didn't think so. The county has the data as it's been already listed by several speakers, but Santa Paula we've been in this survival mode for quite a long time and all they've got we've gotten from you are promises that have changed over time beyond these promises we've heard from you that quote we really can't afford to provide you with what we're providing In other communities and also you don't have a client base that can justify this county expenditure. What we've actually seen is the dismantling over time of a system that has been assigned a low priority an institution neglect which is has been structurally placed on our valley in this dangerous predicament for us. We're witnessing managed decline for us it's about life and death, it's not only about each of our residents giving up 10 years but you're asking the Santa Clara the Santa Paula community to give up collectively a loss of 317 740 life years once again You're asking the Santa Paula community to collectively give up, lose 317,740 life years.
You've continued to blame us for the cause of our condition. We did not create this problem. It is through your inaction, lack of political will and waffling that this has been allowed to continue. The closure and non-replacement of hospital facilities represent an abandonment of a local community. Thank you.
Our next speaker is going to be Richard Rudman followed by Elvia Hernandez and Maria Cornell.
Good morning board my name is Richard Rudman I'm a resident of Santa Paula some might say that you are confronted with the choice between the lesser of three evils In my opinion, you should consider a fourth option that might be a synthesis of parts of Option 1 and 2 along with 24-hour 7 day a week service and a transportation strategy as my friend Mary talked about.
You are deciding a critical component of the existential existence of the Santa Clara Valley's population. Please remember that we who live, work and vote in Santa Clara Valley are hoping you will do the right thing by us. Thank you.
Thank you for your comment. Our next speaker is going to be Elvia Hernandez followed by Maria Cornell and Robert Good morning or
afternoon everyone. I know
this is such a hard decision for all of you
3:57 – 4:0831 turns
I could see some of your faces, you're suffering because of what is happening. But the Valley of Santa Clara has been forever forgotten
for so many reasons in so many areas
We have here the voice of almost 2,000 people that
signed
for a good resolution.
Take
into account all of these signatures so we can have good medical service
for you to make a good decision For
all of these people, we are their voices for all of them in this valley. We should think three to five years on a short term and what happens next? Please take us into account. Thank you. Thank
you.
Thank you for your comment. Our next speaker is going to be Maria Coronel, followed by Robert Bagdazian and Oscar Gonzalez.
Good morning. Sorry, good afternoon. My name is Maria Coronel. I am a member of the community of St. Paula. And a member of the Promotoras y Promotores Foundation. I'm here representing the community of Santa Paula.
Our
community is so, so disillusioned with what is happening to the hospital. When they were notified of the closure of the hospital, the elderly always say what's going to happen to us? Where are we gonna go if we have the need of an emergency? So it's so important that something for our community does
exist.
I'm talking about the elderly because they're more vulnerable,
children
And I can give you my own experience because my son, I took my son just for checkup. And during the checkup the doctor said take him to the hospital immediately. It was his appendix if he had not reached the hospital I would not have been able to make it to Ventura. So, as a mother and as a member of this community and our organization, I plead with you to consider the needs of our community.
And thank you so very much. And I believe that every single one of us here is because we're interested in our community. Thank you so very much. Thank you.
Thank you for your comment. Our next speaker is going to be Robert Bagdazian, followed by Oscar Gonzalez and James Mason. We have Robert? Okay. Okay, thank you. So our next speaker then will be Oscar Gonzalez followed by James Mason and Maria Robles.
Oscar
okay. Thank you for the opportunity to address the board and looking at the presentation this in the presentation this morning there was one element that was missing from the report and that's the actual consequences on the people who live in the Santa Clara River Valley How many years are they going to lose on life expectancy. How many deaths are going to happen? They're going to happen.
Why isn't that addressed in your report? It's all about finances. It's all about acuteness, but we give us the results how many deaths will result as if we lose an emergency care in Santa Paula that could be figured out get consulted maybe could redress that before he leaves today I note that I have health issues. I've been a insulin-dependent diabetic for 20 years, last year I lost my eyesight.
It gets worse. I was able to regain my eyesight in my right eye. I'm a lawyer, I couldn't read, I had to retire. I came back to work once I regained my eyesight. All I think, all I can think is that when that day comes when I have that stroke And when I have that heart attack, then I have the same access to emergency care that each and every one of you have.
Each and every one of you have access to emergency care. Anything short of that is fundamentally inequitable. I thank you for the opportunity to be heard.
Thank you. Thank you for your comment. Our next speaker is going to be James Mason followed by Maria Robles and Elena Robles. James Mason?
Good afternoon. I want to talk a little bit just about the economic development impact that a hospital and medical center would have on Santa Clara Valley. There's really not a significant economic driver like a hospital what it could do for our communities collectively both from the standpoint of the jobs that are created by that, the network that be created by that and then the ancillary development and type of jobs that be associated with that I recognize this is about service and about, you know, sustainability and funding but also from the economic vitality of the whole county.
This can be an extreme benefit in a driver. One other thing I did want to mention is that as you look at these options, I know it's been kind of stated from the standpoint of the growth that we're seeing within this area Please look at both from the sustainability of the hospital and the expansion possibility of the hospital. What does this valley look like in five years, 10 years, 15 years? And what is your investment now look like and the flexibility to be able to expand that based on the needs of the community in the future?
And the last thing I appreciate the CEO's comments about looking for opportunities for partnership because I think long term It's been said many times, many hands make for light work. We need collaboration, we need cooperation, we need partnerships to make some of these things work and I think the county carrying it on their own know that these communities and there are private sector individuals and companies that are willing to work together to make this happen.
Thank you for your time.
And thank you for your comment. Our next speaker is going to be Maria Robles followed by Elena Robles and then Anna Maria Robles.
Hi, my name is Maria Robles. I'm the youth organizer with One Step a la Vez, a teen center located in Philmar but we serve Santa Paula, Philmar and Piru. I am here today as the voice of the teens, the youth, the community members who are not able to be here at the moment due to an accessibility of the timing and school. We collected 1,034 signatures and responses from our community members asking you to pursue an alternative solution instead of relocating these services to BC.
One of the strongest concerns we heard was importance of continuing the emergency room services and the resources currently being offered at Santa Paula Hospital. These 1,034 signatures represent real people, real stories and those community members that you may see here today. These are parents, grandparents, students, workers, children, nurses who depend for this hospital.
For many people Santa Paula Hospital is more than just a building that they're able to go for easy accessible resources. There are many people who have personal struggles, even myself. You'll hear from my mom who is currently going through home personal struggle that makes this Santa Paula Hospital personal to home. Some of these teens who worked alongside me were even born at this hospital and find it quite important to keep these resources keep on running.
We've heard of all three options Considered here today in Fillmore. Our team strongly urge you guys to choose option one and keep that emergency room hospital open. They find it important to continue to support our community. Please think of the single parents working two jobs, the seniors who live alone and the families who need those emergency care resources as well as transportation of how unaccessible it is to get to Ventura Hospital.
As my mom will talk about her experiences as well as how difficult that is. Thank
you. Thank you for your comment, our next speaker is going to be Elena Robles followed by Anna Maria Robles and Derek Farage. Hello
thank you well first of all I have a recent visit to the hospital to emergency care they found me cancer and thanks to the hospital the nurses doctors they find they Act fast and found what's wrong with me. And in this hospital, thanks to this hospital emergency they revived my mother that now on these days I have her here and thanks to the hospital I had my girl that she was having some problems too so I ask you, you are parents please think on your kids You probably are not from Santa Paula, but we really need urgent care.
Thank you. Thank you.
I would like to request to speak because my health is a jeopardy and I feel like I'm having a heart attack right now. So I ask you to please listen to me so I can leave. Have you? You have signed up?
Yeah. What's your name please?
Cecilia Hernandez-Garcia. I'm going to speak in Spanish.
We'd be happy to grant that and if you could just wait for an interpreter to come down. Yes.
4:08 – 4:1422 turns
Thank you, Lourdes. We're just in the clock and I think you check her
out.
My name is Cecilia Hernandez-Garcia. I work for Ventura County 19 years. I was an activist and leader of the SEIU Union 721 The union chose me to become a representative
of
Becerra and I served three years.
It was my honor, and I was proud to serve.
I was going to run again this year, but because of my health.
I have terminal cancer and I
also have diabetes. I have an average
of
11.8 which is very brutal.
I am also bipolar I have depression and I have suicide ideation sometimes. I
am here to tell you that we shouldn't be here today. This makes no sense. You're risking the lives
of
I want to die knowing that I
fought
for my people.
That's my legacy. I want to die knowing that I fought to the very end for my people. I do not like what ICE is doing to us.
I'm not happy how you can connect with ice to continue to brutalize us. I was attacked by two officers and put in jail for sleeping in a car because I was homeless, and I'm going to sue all of you. I've already started contacting my lawyers. I am constantly being bullied, intimidated, stalked by your police officers. Why? What did I do? What crime did I commit?
Just for sleeping in a car because I'm homeless, that's my crime? I had a police officer tell me yesterday if I call 911 he's going to arrest me. And that was in Santa Paula. How dare you treat a woman who is dying in that way! I tell all of you and I know you Kelly personally. You're all white privileged. You don't know what it's like to be born black or brown or Asian.
You were born with a silver spoon in your hand with so many advantages that we will never So I urge you to take away that race mask or whatever you have because we are all human beings, period. It doesn't matter the color. I love every color of the rainbow. I don't discriminate anyone, everyone. You treat me like worse than a dog. Everywhere I go, I'm told that I'm banned and I can't go. Well, you know one place I will not be banned from? Heaven.
Because God is waiting for me in open arms. You cannot ban me there, you cannot send your guards or your policemen or your dogs there because he will protect me and I'm telling you I will do everything I can in my power to stop you from closing this hospital and that's all I have to tell you.
Okay our next speaker is going to be Ana Maria Robles followed by Derek Farage and Lisa Magallanes
Good afternoon, my name is Ana Maria and I'm a proud member of Santa Paula. I like to think of Santa Paula as the true definition of a small town in all the best ways. A hundred year plus football tradition, classic vintage planes flying in and out over the city, delicious barbecue smoke over Harvard Boulevard for Best Barbecue, and the scenic Santa Paula Punch Bowls.
I like to brag to people that don't know about Santa Paula, oh we're so small. We don't have a Target, we don't have a Walmart, we don't have In-N-Out, we don't have Chick-fil-A and we have like two high schools? I would be so disappointed and so embarrassed to say in the future we actually don't have hospital and no access to emergency services for our community and neighboring towns Community members of the Santa Clara Valley are no strangers to commuting for work, appointments, entertainment and other resources.
We must always consider the 20-40 minute travel to Ventura. Medical emergencies will not care about the commute and will place us at further risk The absolute best part of Santa Paula are, of course, the people. Growing up in Santa Paula you never know... You know someone who knows someone who knows someone else. These connections and support amongst community members is the strength that keeps our community tightly bonded.
Whenever bringing someone new to Santa Paula for the first time Hospital Hill is always a stop. The most beautiful view in the city it's breathtaking. Santa Paula hospital is a beating heart of the city and the people I urge you to consider the impact to any changes in the services to Santa Paula High School, I mean hospital would have to our community. Our patients and community deserve 24-7 access to critical hospitals' services. We ask you make the right choice to stand with our working class communities. The options you've been asked to take into consideration are not choices that will save lives in emergency situations. We need a hospital with emergency services for our neighbors and family. Thank you for your time.
Thank you. Our next speaker is going to be Derek Farage, followed by Lisa Marianas and Jody Armstrong.
4:14 – 4:206 turns
Good afternoon board. Of the options before you, I wholeheartedly support option one. I believe maintaining a hospital and emergency services in the valley would provide the best level of care for the surrounding communities. So while I support option one as an accountant, I recognize the financial constraints may limit the county's final plan. The county cannot spend money it does not have. And the passage of HR 1, which has been the worst legislative action from the federal government in decades, has made an already difficult healthcare budget situation even worse.
Unfortunately, Santa Paula now is going to become another statistic. If option two is the direction the board chooses I respectfully ask for three commitments. First, make the urgent care component available 24 hours a day seven days a week. Medical needs do not operate on a schedule. Second, develop a real and affordable transportation plan. Residents cannot simply be told their emergency care is now in Ventura. Not everyone has reliable affordable transportation and an ambulance ride can create significant financial burden.
And third, establish clear expectations for implementation and regularly report back to the community on the county's progress. I understand circumstances and resources can change and the county needs the flexibility to respond responsibly but the commitments made as part of this transition should have measurable goals reasonable timelines and transparency so both the board and the community can evaluate whether the plan is working as intended. Thank you Thank you.
Thank you for your comment. Our next speaker is going to be Lisa Magallanes followed by Jody Armstrong, Eric and Dr. Veronica Valadez.
Hi there, I work at Santa Paula Hospital in the emergency room. I've been there for the past 10 years. I'm an emergency room nurse and I consider myself a frontline leader for our staff and for the community. I was born there 46 years ago so I'm pretty passionate about keeping Santa Paula with a hospital About a year, it's going to be a year next month. My mom who is from Fillmore she had some chest discomfort and I chose to drive her to the hospital not call an ambulance because I think that's what a lot of our community members do. Not everybody shows up in an ambulance We were able to get her in pretty quick. She ended up being pretty sick, really sick actually. She had to go to the ICU and be transferred out to Ventura, to CMH actually.
And I think that...I'm not sure if I missed it in the statistics, in the data but I saw the admission numbers there was like 15,000 people seen in this hospital last year and then there was like the number of admissions that stayed but I don't know that there was a transfers, how many people get transferred out So as one of the charge nurses, we do a lot of transfers out because we don't have the services that the patients need. So I'm just wondering if there was a number for that.
I'm honored to advocate for the patients who live in Santa Clara Valley. The need for the hospital services is evident and the already ongoing visits we see in our facility every day and night. The lives of our patients depend on the types of services they have access to, to expect them to drive further to receive life-saving care is corrupt and dehumanizing. We fear that lives will be lost We demand justice for our patients and expect ethical treatment for every human being in Ventura County. Thank you. Thank you.
Thank you for your comment. Our next speaker is going to be Jody Armstrong followed by Eric, Dr. Veronica Valadez and Bridget Day.
Hello, I am a ER nurse at Santa Paula Hospital. I proudly came to Santa Paula Hospital a year and a half ago in twenty twenty four before I was a nurse there you eliminated the care and OB services at Santa Paula Hospital since arriving there it seems like the county has given up on us rather than trying to improve and make solutions As someone that works in the ER, we deal with cardiac patients, strokes, anaphylactic people that come into the ER almost daily. I work the night shift and we deal with a lot with very little resources so I just wanted to say it's not going to be if people die, it's going to be when people die.
It's easy for you to say it's a 15-20 minute drive to Ventura but If you've ever done CPR or rode on an ambulance with a patient, like I have one minute. 30 seconds is a long time. We were shocked to see the postings on our hospital entrance. Taking away emergency services will be detrimental to our community. We ask that you make the decision to work with our community, our nurses, our healthcare professionals to come up with a solution that will take into account a continued continuity of care of emergency services and considering if our hospitals in Ventura can accommodate all these people that we are seeing in Santa Paula.
I don't know, like Lisa said, if you guys have taken into account all the people on the daily that we transfer to other hospitals because we can't keep them at our little hospital Thank you for your time. I know it's a very difficult decision, but our community members are worth it and you can't put a price tag on our communities' lives. Thank you.
Thank you for your comment. Our next speaker is going to be Eric followed by Dr. Veronica Valadez, Bridget Day and Sandra Perello. Do we have Eric? Okay. How about Dr. Veronica Valadez followed by Bridget Day?
4:21 – 4:3616 turns
Hello, my name is Dr. Veronica Valadez. I recently bought a home in Santa Paula and as a new resident it's a shame that one of the first things I'm learning is that our beautiful community is facing this injustice under your watch. I'm an educator, a scholar activist And I study and teach exactly how systems produce inequity. Institutional racism and classism are what happens when the ordinary workings of our institutions, our budgets, and our healthcare decisions quietly give less to working-class communities of color and more to wealthier white ones.
There's a difference between being non-racist and being anti-racist. Non-racist means you personally mean no harm, anti-racist means you look for the inequity, you name it and you dismantle it. That takes real leadership, courage and ingenuity and that's what we expect of you. Being non-racist instead of anti-racists does not interrupt injustice, it preserves it and it seems that's exactly what this board intends to do.
Let's be honest, no one would accept this in Thousand Oaks or Camarillo. No one would expect those communities to send their heart attacks and births to another city. For over two decades the Santa Paula Latino Town Hall has done its part. The forums, the hearings, the reopening of the obstetrics unit in 2019 solution after solution has been offered. Our ask is reasonable, retrofit and preserve the hospital we already have.
A good hospital in our community would not only offer our familias an opportunity to survive emergencies. It could also be an economic anchor that lets our young people build a future without leaving home. That's what courageous anti-racist and visionary leadership could build so after everything that has already been done for you and offered this board for this board to not fund our hospital is not about a hard budget decision It's mismanagement and it's negligence.
If you didn't already know that closing this hospital perpetuates racial and economic injustice, now you do. Thank you Bridget for your comment. And if you move forward knowing this... Sorry
thank you Dr. Valadez
for
your comment. If you didn't already know that closing this hospital perpetuates racial and economic injustice, now you do. And if you move forward knowing this, you are showing us exactly who you are and what you're about.
Our next speaker is going to be Bridget Day followed by Sandra Pereo and Sierra Deanda.
Good afternoon, Supervisors. My name is Bridget Day and I'm the Political Coordinator at the Central Coast Labor Council. I am here today representing the 75,000 plus union families on the central coast. Healthcare access is a labor issue not only because essential workers like nurses make healthcare available to our communities but because these workers deeply care about the patients and communities that they serve These workers see how these proposals will exacerbate racial and economic disparities amongst those who don't have access to resources like transportation or housing that they'd require under these options.
Working families all over Ventura County deserve equitable access to health care and option two will not suffice to serve communities and save lives in the Santa Clara River Valley. When establishing a process to learn the facts and develop options, center the voices and experiences of your workers people who both work in and receive care in county healthcare facilities It's the workers who can best understand the lives of their clients, patients and neighbors. People who don't have the time or cannot afford to be here at 11 a.m. on a Tuesday to advocate for themselves and their communities.
When workers are speaking we plead you listen to them. Thank you so much.
Thank you for your comment. Our next speaker is going to be Sandra Perello followed by Sierra Deanda and David Estrella. Sandra?
Good afternoon and it's easy to just talk about this as an issue of the haves and have nots. This is also what we're seeing in the national level people here have been unduly discriminated against in their health care in many different ways. So many people have talked about their own situations and I just, it's another voice to say do the right thing. You've had years to come up with a program to solve this and now we're down to the wire and we're being given options that are not equitable. And it's true that none of you who live in other districts would allow this to happen.
Thank you for your comment. Okay our next speaker is going to be Sierra Deanda followed by David Estrella and Leslie Cornejo, and then we're going to transition over to our Zoom speakers if you were in the boardroom um and you wanted to make public comment on this item please check in with the deputy clerk at the entrance of the board room thank you Sierra.
All right so you've seen us pack the room and you've heard every single person up here In support of the Santa Clara Valley having emergency 24 hour access to health care. It's something that's absolutely vital to our lives. You've heard from hospital staff, healthcare workers that there will be blood if we do not have a hospital accessible and we also understand that this is something that disproportionately happens in communities of color It's something that is systemic racism.
And so I really urge you to understand that this is something that our community needs and that health care is not something that should be viewed through the lens of profit. It's not something that should be understood by the numbers. If we want to look at it that way, California alone has one of the largest economies in the world. We have the money to keep our hospitals open. Something I have seen as someone who has grown up in Santa Paula I have lived all of my 30 years there, and who has delivered my first child at Santa Paula Hospital.
It's an extreme shame that the labor and delivery unit was closed a few months ago. I'm having my second child now. I am nine months pregnant here at this very inaccessible time, I will add. And a few months ago, I was told that I could no longer receive my maternity care at Santa Paula Hospital. I was forced to go to another city, another hospital where the staff didn't know me, where I'm seeing different doctors every single time and that's not the fault of the hospital and healthcare staff. It's the fault of diminishing resources, of taking away vital care that our communities need and deserve and that shouldn't be up for debate.
So I would urge you to maintain that our communities need
a hospital. Thank You Ciara. Okay our next speaker is going to be David Estrella followed by Leslie Cornejo and then we have Eric who's in the boardroom but also like public comment thank you David please proceed
Yeah, good morning. So I'm here in support of the patients and the people of the 126 Santa Clara River Valley and the demand, the overwhelming demand to maintain a emergency health care option in the in their own home, essentially. It is quite ridiculous that we continue to prioritize the profits that we can try to make on our healthcare when in reality from each and every speaker that you've heard today The profits are not on our minds. We do not care what it costs to save the lives of our people. We do not care that it is going to be, it doesn't make the profits. That should be overwhelmingly clear to y'all that the people prioritize the health, the wellness and the dignity of one another because we understand that we are working We are working people, poor people that really just want a life.
A life you know? That's really it and again there is a pattern here. There is a pattern with the closure of the labor department right? There is a pattern of the closure of this hospital And I would urge everybody to recognize that pattern. I would not be surprised if in a few years on this trajectory they propose that we privatize this hospital with whatever choice they make so again
Thank you, David for your comment. Okay our next speaker is going to be Leslie Cornejo followed by Eric Mirabella and then Miranda Miller if you're in the boardroom so please proceed Leslie thank you
Thank you, Mister Chair and supervisors. I was not going to speak. I have a lot going on in my own family but this mattered so much to me that I had to be here to speak before you. I'm a member of the Blue Ribbon Committee and so we've worked with the county. I have seen intent and caring towards coming to a solution but there has not I have felt enough urgency.
I have felt that sometimes that this was slow walked We spent probably a year working through the fire department to find an entrance and an exit to where proposed hospital might be. I found it very frustrating today that this decision is being made in a bubble that we're not talking about assets in the community, we haven't even done a proper I'm here today to talk about the proposed new location which has been offered and so it seems like.
It's the conversation is being so controlled that you're being forced to make a decision that's predetermined in a bubble. And if we're working on a vision for our future and the future of the valley, which is the only area in the county that is growing, we all need to work together to look at every option. I know it's hard. It was already hard before H.R. one. But there's money out there. It may have to be a private or public private solution so we can work together And it's very important that we not give up on the health care for our valley or for the whole county. For that matter, I understand you have to care for all of us. It's not just it's not just our Valley but our Valley matters and we're in very dire straits with a delayed decision.
That just got worse with HR one, but we shouldn't hang our hats on that as our only as a reason to quit. We can't quit. We gotta keep working on this. I feel that a hospital or micro hospital or hybrid of that working with other solutions public private. Partnerships may be the way to go. There may be more money in the private sector. I know you're limited and I understand budgets, and I know this is really hard and it's gotten harder. Thank you for your comment. So I just urge you to work
with us. Thank you. Thank you so much. Okay. Two speakers who are in person we called Miranda Miller and Eric Marabella and then we will transition over to Zoom to hear from Sarah So Eric, if you were in the boardroom and would like to make public comment on this item please proceed to the podium followed by Miranda Miller. And to our zoom participants please accept the prompt to be promoted and then unmute your mic when it's your turn to speak for now we'll go in here from Eric thank you Eric
Oh, hey, Board and everybody. Sorry I missed my call apparently the words good citizen aren't allowed to be used here. So yeah, I live in Santa Paula. I lived there 10 years now down by the freeway man in the lowlands ain't nothing special about me but whoa, I lived in Thousand Oaks for 17 years before that Wow are things different in a Santa Clara Valley versus the Thousand Oaks Camarillo Simi Valley Department Sure seems to be a lot of good hospitals out there. Why don't they put up those slides and we see what the response times are, the percentage of the socioeconomic status of the patients, what ailments they're there for and see how that relates to the Santa Clara Valley. All you guys are doing, okay from your own slides there. You've already got a failing hospital.
You've already got a failed hospital. 50% of the people are going elsewhere for care. Santa Clara Valley is 30 miles long that's a big place. We don't bring in the big tax base. We ain't white people so we don't get what Simi Valley gets. We don't get what Thousand Oaks gets. These are just people who work, man. If you've got to take money away from Ventura County Hospital and other sites around the county to make things equitable, that's what you need to do. All these people are equal, man. Ain't no people above any other people. Everybody is the same. Everybody deserves health care. Why don't you offer them health care at the same rate? You're just trying to show what part of the county you want, what part you don't. You guys are all tools in the capitalist system.
What a bunch of ghouls to talk about healthcare and profit. That's what you're judging your service to these people at. It's non-profit, you can make on the health care? Why don't you drop them sheriffs and come out patrol Santa Paula who's got its own municipal police force? Why don't you close that county building you're renting there on the 600 block of Main Street in Santa Paula? Other people could drive over here to do their job. Let's make things a little bit more equitable huh?
How much time I got left yeah nine seconds. I appreciate your reference to free speech it's nice to not be able to get tased or pepper sprayed for using my free speech
4:36 – 4:4314 turns
Thank you for your comment, Eric. OK, so we're going to transition over to Zoom. I did not see Miranda Miller present herself and then Chair Garrell after public comment will need to give our interpreters a little break.
Yes. OK. That'd be great. Thank you.
So our zoom participants. So Sarah, I see that you have been promoted. We'll follow you with Zuleth Lucero, Laura Galindo and Michael McDonald Sarah, thank you for accepting the prompt to be promoted. If you unmute your mic, you will have two minutes to give your comment.
Good afternoon. Thank you for allowing me to speak today as so many who have spoken before me closing a 24 seven acute emergency service at Santa Paula Hospital will gravely affect the Heritage Valley, Santa Paula, Fillmore, Piru and surrounding communities. Santa Paula Hospital is not simply a building, it is a lifeline. For generations this hospital has provided emergency and acute care to the people of our valley. Historically this hospital has been described as the healthcare lifeline for approximately 50,000 residents of Santa Paula, Fillmore and Piru. And with new homes and residents being added to all three of these communities It's unethical for Ventura County to remove emergency medical support and services for the communities as they are continuing to grow.
It's already a really tragic loss for the community that the OB unit was closed, When it comes to an emergency, distance matters. A heart attack does not wait for traffic to clear. A stroke does not wait for an ambulance to travel further. A serious accident does not give a family time to plan which hospital to drive through, drive to. Minutes can mean the difference between life and death. I understand the challenges facing this hospital Um, and I understand that this board is facing a difficult decision. Um, but I urge you to take into consideration that this is.
A hospital that should not disappear from our community. Please advocate that whatever future health care plan is adapted will preserve accessible 24 7 emergency and acute care services at the Santa Paula Hospital. We are asking for a commitment that our community not be left without the healthcare infrastructure it needs. Santa Paula Hospital belongs to the community it serves.
Thank you, sir. Thank you for your comment.
You've used your two minutes.
Thank you. Okay, our next speaker is going to be Zulef Lucero followed by Laura Galindo and Michael McDonald. If you're on Zoom and you want to speak on this item please go ahead and utilize the raise hand button and we'll get you added to the queue for now Lucero thank you for accepting the prompt to be promoted if you unmute your mic you have two minutes to give your comment
Hi, everyone good afternoon. My name is who let many of you know me as a community advocate but today I'm here as Joseph's mother my son has severe allergies to peanuts tree nuts and shellfish he has experienced an Alexis at life threatening allergic reaction that can happen very quickly and without warning. The last time this happened, Joseph was treated at the Santa Paula Hospital emergency room. It is seven minutes from my home. Seven minutes matter when you're shy with having a life-threatening reaction. Joseph's reactions can happen unexpectedly even when while Even while he's sleeping as a mother that thought of losing at 24 hour emergency room isn't it in our communities frightening, but this is also a community and a health care access issue.
This hospital is an essential part of our local healthcare system residents should not have to travel farther during an emergency. Because care is no longer available in their community. We cannot accept closure as the only solution. I urge the board to work with the healthcare providers, community members and local partners to find another path forward. Every Ventura County resident deserves equitable access to quality healthcare. Thank you.
Thank you for your comment. Our next speaker is Laura Galindo who we don't see on Zoom so we're gonna go ahead and hear from Michael McDonald. Thank You Michael please unmute your mic and give your comment
Thank you for the opportunity chair and members of the board. My name is Michael McDonald, and at its core this is about people and whether we are willing to fight as hard for the health care in Santa Paul on the Santa Clara Valley has anywhere else in this county generations of hard working families in the Santa Clara Valley have grown our food they've raised our families built our communities and contributed to the prosperity of Ventura County. They deserve more than to be told that quality health care is simply too expensive to provide close to home. No zip code should determine your health outcome and when a community has historically received less, the answer cannot be to give it less again. This is where we should be investing more. The community has overwhelmingly asked for option one and I support option one I understand the financial realities but government isn't a business and not every essential public service is supposed to make money.
We invest in libraries, parks, public health, emergency preparedness and other services because they provide a public good. Sometimes the return on public investment isn't measured in dollars it's measured in lives healthier communities prevention and access If option one requires us to work harder to make it sustainable, then let's do that work. Pursue state resources build partnerships invest in this community and whatever happens today commit to a long term Santa Clara River Valley health care plan not another study but a commitment to where we're going over the next 20 and 30 years. This valley is growing our population is aging. We cannot plan for more people while planning for less healthcare And don't define tomorrow's needs solely by yesterday's utilization.
Utilization tells us who access care, not necessarily who needed it if option 2 is chosen and 24 7 emergency care should be non negotiable and the 126 is not a substitute for a hospital. If reducing services means more transfers. Then family should not bear those ambulance costs. If we save money here and only shift costs elsewhere, we haven't solved the problem. We've simply moved the cost and move care further away. Make option to the floor not the ceiling. No zip code should determine your health outcome. The Santa Clara Valley deserves healthcare not just sick
care. Thank you Michael for your
comment.
Thank You Michael you've used two minutes thank you. Okay one more time for Miranda Miller With that, Chair Girl, that concludes the public comment for this item. Thank you.
Okay thank you everyone for your public comments we're going to take a 10 minute break to give the interpreters a chance to rest and we're gonna come back at 8 after 1 so we're gonna be in recess for ten minutes thank you
5:04 – 5:1528 turns
Board of Supervisors
Okay, we're continuing with the public hearing which is open. We've concluded with public comments and invite Mr. Friedman back up to the podium and there are questions from the board of Mr. Friedman or staff related to this. Supervisor Long?
Thank you very much. I wanted to ask some questions specifically based on public speakers that we're talking today. The first one, the community did not mention it but I know that our Blue Ribbon Committee has been very passionate about ensuring that our mammogram is in the facility. Option 1 and 2, I just want to confirm option 2 would that have? Yes The member of the
supervisor
OK thank you. Another was it was talked about access to high quality health care and I know that has been a huge focus of ours, I know the 10 years that I've been here to ensure that we have just excellent quality health care and question I had is the diagnostic services would be in on option 2 Okay. And then also, transportation costs was brought up and so if someone was to come to the option two, the extended urgent care facility and they needed to be transported how is that process?
I think there's two dimensions to look at that supervisor members of the board. One is if the person's in an emergent situation, so at the expanded care center emerging the facility could call 911. to pick up that patient and move that patient to a 911 receiving facility. That's one. The other, there might be an urgent but less emergent situation that requires further evaluation at a hospital. And I understand the VCMS system would arrange inter-facility transport for that patient.
Okay, thank you. And another constituent spoke about going to the Santa Paula Hospital in their emergency center to get looked at stabilized and then they went to CMH. Why would they go to CMH and not a VCMC hospital? I'm trying to understand how our community is using our healthcare system
Yeah, so emergency rooms can receive everybody. But whether a hospital can serve everybody gets to that skill mix and the type of services that are inside the hospital as well as depending on the urgency of the case there could be patient preference here that determines where inpatient stay occurs. So for instance There is not a cardiac service at Santa Paula Hospital. If somebody comes into the emergency room needing stenting or evaluation and angiography or something like that, they would need to be moved to a facility that has that capability. Another instance there might be as an example, a Kaiser patient that comes into the Santa Paula Hospital and they have a less urgent need but still requires inpatient. They may be transferred into a Kaiser facility
OK, because we've had so we've had many, many stakeholder engagements with this community. Yes. Many mothers at our facilities and talking about how they need health care services for their family. And so as Medi-Cal plays into this and if someone falls out of Medi-Cal and it's a fee for service What are the fees at an emergency room versus a extended care facility, the option two. Is there differences on that for having to pay for those services?
There are cost differences and there are payment differences in those two options. In the emergency room, if the person has coverage under law and the person makes what's known as the prudent lay person choice to access service, the payer has to cover the cost of that emergency room visit. In Medi-Cal, there are no co-pays that can be applied in emergency care as well as other settings of care.
In the option two and option three, that would depend on payer contracts that the system would have to develop that determine what the reimbursement And copayment requirements would be on the non Medi-Cal patients there.
Okay, because my understanding is that urgent care as someone who uses them it's cheaper to go to an urgent care than it is to an emergency room and I just want to validate that if that's true or not.
Typically for insured populations that's true there and on a cost basis meaning the cost of generating that service typically urgent care is lower cost to generate than an emergency room. You don't have all the fixed costs of an emergency room there, but then there's the cost to the patient. The cost to the patient really is dictated by the insurance coverage there and in general for commercially insured individuals, the cost sharing will be lower for urgent care than emergency care.
Okay, and we talked about or it was mentioned in our public comments about clinics being utilized for prevention. And those clinics that we have in the county they're not open extended hours or anything like that. So this would match the need for the extended hour either option one or option
two? That's the game plan
correct. There was something else that was talked about. And is there any other affordable transportation that can be done from, say an urgent care to the VCMC? Is it is it I heard a cost of the 3rd 3000 or so for ambulance and I just was wanting to make sure
we would I mean, I think for a patient seen an option 2 or option 3 that needed higher level of care. The system, VCMS would organize for a non-911. Somebody who needed higher level care the system would organize a transport for that whether it's by ambulance or other type of service. The financial liability to the patient again it goes back to the coverages of the patients uninsured the county has a sliding fee scale that would be applicable in that instance.
Okay, I appreciate that. And I understand that see on your slide 11 it shows that the community Memorial Hospital there they have an urgent care so us having our own urgent care would be more services than what they have I was trying to understand what the difference would be. Well,
urgent care unlike emergency rooms, urgent care is not as tightly defined about what's in an emergency so there is kind of light urgent care which has really extended hours of a doctor's office or a clinic That is what is contemplated in option three. And option two is a much more robust urgent care because you have imaging, laboratory diagnostics and pharmacy services so it's a much more robust service platform than kind of the street level urgent care.
Okay, so I appreciate understanding what the difference what's currently in there and what we would be what you're proposing. Okay. I appreciate that. I think for now that was the questions that I heard from the community or at least some of them Thank you.
Any other questions from the board?
Yeah, Supervisor LaVere. Thank you Chair and thank you Mr. Friedman in a conversation we had I think it was last month you were talking about the utilization rates in terms of hours of the day and did you say that a large percentage of the utilization we were seeing at the ER was after work like that 6 p.m to 11 p. m time range
Correct supervisor. Yes,
so that's that's kind of why when you were looking at option to your that's kind of why you're projecting the extended hours to about 11 o'clock because that's what we're seeing utilization correct and then I had questions about excuse me. The projected patient encounters. You have the slide with all three options in the projected five-year encounters and there was option one was 118,000. Option two was 260,000 and option three was 35,000 I guess two questions there is an encounter a visit or can you yes okay and then how did you model that? I was just curious because option two your more than double the visits that would be provided with option one
Yeah, to 2 issues an option to. 2 issues are going on there one is we're reorganizing the existing ambulatory clinics and then adding on top of it the urgent care expanded access care center there so the base A clinic operation is 30,000 encountered 30,000 visits and the expanded access center would be about 24,000 visits on top of that. Some of those visits, we had to consolidate some of the numbers here for presentation here. But some of those visits are also diagnostic types of encounters etc.
Okay. Supervisor Long covered the rest of
my
questions. I did have a couple others. So I know that we utilize the hospital in COVID with 49 beds but what is the status of our beds currently being used?
I'm going to have to turn to Dr. Finkhauser.
5:15 – 5:2923 turns
Only because I think it's important that we hear about all the different options and what the services are used at the Santa Clara River
Valley. Thank you for the question, Supervisor. And thank you Chair Grell and Supervisors and Dr. Johnson. For the record, I'm John Finkhauser. I'm the Healthcare Agency Director And the question with regard to the current use of beds, we averaged last month 7.9 census. Last night at midnight we had six patients in the hospital so we are licensed as a 49 bed hospital We rarely have a census above 12 or 14, but certainly as you mentioned there during the COVID crisis we did surge to where we were seeing over 20 patients in the hospital.
And is that driven by doctors? Usage or is it by payer mix and insurance? Just trying to understand. It's very complexed
Yeah, I think you you did cover it well those are the factors that drive this census so we have you know community Outbreaks and infection incidents of infections like influenza that will drive up those rates at certain times of the year. And certainly, the growth population which has been mentioned in some of our community meetings as an impact but even more so is the market. And I think John mentioned, for example, Kaiser despite many efforts to get Kaiser to allow us to see their patients in Santa Paula Hospital that has not been their path forward so insurance can certainly make an impact on it and then the community physicians and their utilization of the hospital makes a difference and as we've seen the community physicians have affiliated with various hospitals in Ventura and Oxnard.
And that, you know, includes the private sector as well as clinics that are owned by some of the hospitals and then our sister FQHC in the area who are utilizing hospitals out of the area.
Because and I ask that because I know our staff, our nurses are amazing. And when the Blue Ribbon Committee we asked for surveys and we find that they're getting wonderful care at Santa Paula Hospital. And so I'm trying to understand why those beds aren't being used? And I know that we've been working very hard since 2017 when it got in, 2016. So it's such a struggle and I don't understand it. The fact that people are not utilizing the hospital.
I agree with what you said. It is, or I mean to think when a private hospital group and the IPA sells their practice to the parent organization of another hospital, a hospital out of the area that the reason for that purchase has a lot to do with bringing volume into that hospital into that system so we've seen The repercussions of those kinds of changes in the market. If you would allow me to just remind people we're talking about changes that are out on the horizon, three and a half four years today that is functioning hospital with an outstanding emergency room run by emergency room nurses and emergency room doctors who work in our trauma center and Santa Paula Hospital.
Today that hospital is open for care, The community should feel safe and encouraged to go use that emergency room. The waits are shorter, excellent team great services up there and I think you know your point is well taken we need to remind the community in the context of all of this discussion that Santa Paula Hospital is available to them today
Thank you, and I appreciate you trying to get this classified as a rural hospital. I think the advocation of the state and federal side of trying to even get this to be rural so that we could get some assistance on this. I know the state in advocacy only supported four hospitals with some additional funding for budgets and that they did not classify us as even a rural area Based on how many miles away from the hospital it is.
And dollars, I don't like talking about dollars. I like talking about lives and the care that our hospital brings because they do amazing work there. So I really appreciate you highlighting that. Yes
and we have appealed to CMS, the organization that runs Medicare and Medicaid as well as the state. It's just simply too close to Ventura. That they will not allow us to kind of tap into the resources that are set aside for rural hospitals because.
And they won't allow us to extend the retrofitting, even though I know in John you hit it how long ago they've known about this retrofitting before they closed the hospital in the first place in 2003 and and the state is still not moved on on that cost associated with the hospital so correct OK thank you.
Supervisor Lopez and then Supervisor Parvin.
Yes, thank you chair and thank you everyone who is in attendance today I have a few questions and especially the common concern that we heard from speakers today is the significant health access inequities and what the community is feeling in the Santa Clara River Valley so And I think a lot of this, there's questions about what the plans are right is how we get to continuing to serve the community there. So how are we and how is the county looking at increasing that access and the mention about preventative care? How do we get there?
Well, I think what you see here supervisors. This is a this is a very difficult set of choices for the community and for the or the for the board as I mentioned there's different views of what access is. The the this is not a full withdrawal of the county's healthcare portfolio in the Santa Clara Valley. Is it a full recapitalization of everything? No, it's not that but it tries to strike the balance of providing urgent services with expanded capabilities and some sophistication there to meet urgent needs there and most importantly try to drive better access for routine care To get after those very questions around access to preventive services, early diagnostics, early intervention. That's what this is aimed to do.
Thank you. And I think that, you know, as we're asking questions and providing feedback, I think that is where we need to work with the community to ensure that we are being intentional about creating a plan that will meet these intended goals, right? That we're not just talking about opening up a medical facility with no No increased use of it by people to understand the value of preventative care, rather than waiting for that emergency that takes them to the emergency department.
And I think Supervisor Long was asking about the access and the cost of care What I'm thinking about is the uninsured population and how we help them receive the care that they need, especially in preventative care. So with an urgent care center, is the self pay option sliding scale? Does that also apply there as it does in ambulatory for uninsured? Correct.
All right. And then with the current standing of VCMC How do we make sure that we have bed space, that VCMC is ready to serve additional people? And all that as Dr. Fankhauser walks up is the availability of doctors in an urgent care facility.
Thank you, Supervisor. I just wanted to introduce the CEO of the hospital Dr. Danielle Gable and I think she would be best suited to answer that question.
Yeah, and if you could restate it for me so I make sure I get all aspects of it. I'd appreciate it. Yes.
Thank you. So as we look under option two to redirect people to VCMC or other hospitals. I mean we VCMC is under our control right under the county's control. So how do we ensure that we have enough bed space and the capacity to serve the people of the Santa Clara River Valley?
Yeah, good question. I really appreciate that. I think we're you know on the one hand you know this is just a difficult discussion and conversation none of us really want to have. I think realistically I think you know when it looks when it comes to the emergency department that we can start with that for those folks in the urgent care option two enhanced care center setting that might need higher level of care We are blessed geographically to have a very large footprint of an emergency department at Ventura County Medical Center. We feel confident that we could absorb the additional volume, both in the space that already exists and by also changing some of our workflows and maybe adding a few additional efficiencies to create more better flow for patients to get through there.
But I think from the emergency standpoint, we have both the geography and would have the available resources to be able to accommodate that on the hospital inpatient side as Dr. Finkhauser mentioned, we average more or less let's say eight patients inpatients at Santa Paula at a time At VCMC, we have one department for example that opens and closes based on volume. And so as volume goes up, we can open that space and put patients in there appropriately.
Again you know this is So far, many steps into the future and many things would have to occur. But I think the other piece of VCMC is that the geography is such that we also have additional areas that we could look at expanding to for patient care that are not open for that purpose now but certainly could be. Did that answer your question?
Yes. But if I understand from option two, yes, the approach would be to consolidate the current clinics. In Santa Paula? Yes. Okay, yeah. Yeah.
Supervisor the option two has two dimensions to it one is to consolidate the existing clinics into a more efficient more modern building there's two sites well three sites at the hospital has a patient service today and then to add this expanded access care center on top of it To your question about where will the inpatients go, Dr. Gabel was mentioning that she has the ability at VCMC when she meant geography and additional space within the building to accommodate additional bed needs in the current footprint.
But because those patients that we are talking about in the expanded care center would need to be triaged and treated in the emergency department first, that would be their first stop from when they enter VCMC.
OK, thank you. All right. I have a few more questions. I'm not sure if I'll go through them. To the specialty care, I'm not sure if I understood that there is an opportunity to better understand what specialty care options would be best suited for the community there and being able to identify those?
Yes. Yes, Supervisor. Increasingly particularly for adults who have Chronic disease risk factors there access to specialists is very important. And so that's part of the equation in option two
Okay, thank you and to the comments about the transportation availability I think Supervisor Long asked about the access to an ambulance or the inter-facility transport. And so what would it look like if, or can you explain the inter-facility transport and what it would look like to have a more permanent option available there?
5:29 – 5:3710 turns
share this through a few case different examples. One is if the person is an option to and they're emergent there have an incipient cardiac arrest that's a 911 call 9-1-1 would deploy to that facility move the patient to a 912 receiving hospital there. There another instance, another type of cases certainly has a head A contusion, there was a CT scan. They need further evaluation at a hospital they might need neurosurgery there it's not running as fast it's not as time sensitive is still time sensitive in that type of instance the option to the system would arrange for transport from the Option 2 facility to likely in this case to VCMC
And can we assure the community of that availability that there is? I think we can. I
think that's additional work to specify out what, what that is to your concern and to Supervisor Long's concern. I agree with you.
Okay thank you. Regarding the current assets, the current facility. I think the options do not include the value of property and what about other equipment at the
we didn't we held all of that whole entire. Asset the land, the equipment, the building etc. We've held that neutral relative to the financial modeling of what these options are there's different choices for the county here in the community. What is you know? Is that building get reused as a land get reuse is it for health care purposes at not is it sold Thank you. Can you explain when the projected operating margin of a micro hospital, the option one, how is that
Calculation made how is our projection made on the the 73 million dollar. Operating margin
so we've we've taken we've developed detailed financial performers on each one of these options. We've taken the county's labor costs and operational cost structure. We forecasted it forward here, because we know things cost more tomorrow than they do today. We've done the same for revenues. We forecasted what we think patient care revenues will be for that operation. And we've scaled what the services are and how much of those services are to occur in each one of these options. The volumes, how much pediatric care, how much adult care, how much observation in the hospital etc.
And we've also done payer mix, what proportion of the patients do we anticipate to be at Medi-Cal uninsured commercially insured as well? So we have detailed models underneath each one of these numbers
Thank you and in talking about community outreach, I understand that there were Blue Ribbon Committee meetings. There were some community meetings especially in the recent weeks leading up to today's hearing I would just mention that the importance of having a more robust list of stakeholders. Today we heard from the CEO of the Gold Coast Health Plan, we heard from nurses all part of serving our community in the area and the importance that In having more conversations and making sure that as decisions are being made, that we are tapping into those resources to ensure that we are serving the community to the fullest potential.
Especially because there is a labor component here. And I don't know what the engagement was of those in this process. Especially in the last couple of years and so I think of community engagement always as we We were doing a community engagement But I think there's always room for more right just when we think that we're showing it enough. We have to do more because it's There there's a lot of ways to reach people out there and making sure that that as we're moving forward we are We are working together as much as possible that everyone is a part of that solution for the future. Thank
you, Supervisor. If I may share that point of view and I know the agency leadership shares that point of view there this is in some ways I know there's been a long series of discussions about hospital-hospital future But the purpose of these options is to bring a series of lanes into view for you because you have a very significant deadline in front of you imposed by this seismic requirements.
So, you have to get moving on some sort of planning operational planning and to your point Supervisor Lopez engagement is key because it makes any one of these options successful there. That's the intent of framing these lanes of options for you.
Yeah, absolutely. And thank you for answering my questions and I'll just end with a few comments chair don't want to get ahead but I mean this is hard for all of us it is very hard to hear the concerns from the community to think about what happens in the future and especially those emergencies if these decisions wave heavily I mean I can't even Overstate that the responsibility that we have and how we move forward. And a lot of this, as I mentioned is having those plans making sure that we are engaging with as many people as possible, as many of the stakeholders who are a part of the community in the valley And that we are intentional again, I'll restate that being intentional with those plans. That we're not just talking about increasing access and providing access to preventative care and specialty care in screenings but that we are intentional about making sure that we are getting more people to the preventative care in the screenings And that we see this as an opportunity to invest in the community.
And again, that we don't see the emergency room as the only place where people can seek that care and that takes a lot of collaboration. I get working to build that trust from the community, that we care about the people in the Santa Clara River Valley, in Piru and Fillmore and Santa Paula and the challenges that we have before us, that we do get as creative as possible to ensure that access is maintained. So I'll end there. Thank you Chair.
5:37 – 5:5234 turns
I guess there might be a question or two left. I'm not sure of it. One of the thoughts that I had was that Santa Paula Hospital currently performs how many surgeries per month? I thought I saw in the material somewhere, and I don't know if I'm right but like a hundred? Okay. Okay, so 100 surgeries per month. So if the hospital closes those surgical cases could potentially shift to the medical center okay and integrating that volume which was roughly 1200 additional surgeries annually okay I'm just kind of taking this path here can Ventura County Medical Center handle The additional surgical schedule and capacity I think that's one thing that should be looked at.
And then wasn't there a replacement wing that was constructed and with that intent for that use.
So yeah, just to confirm that our number of surgeries varies a little bit from month to month but it approximates 100 every month. When you look at that volume, we could absorb that volume with another couple of ORs at VCMC. We're currently working at a little less than our capacity at VCMC so we could absorb some of that in our current OR space but we also win that what you're describing as the replacement wing or the replacement hospital.
That is the term that was used to upgrade VCMC to a seismically compliant building. And so that what we used to refer to as a replacement hospital, replacement wing is our current hospital. But that included an OR that allowed us to expand. So two the term they use shelf space operating rooms and we would have to build those Out we're currently, you know going through the process of planning for building that out. Yes
Okay, so that would be something to discuss in the future
costs
associated with that
It will be included in our future budgets. So yeah, I think that the cost to build that out is much smaller than the costs that we're talking about with building new buildings at Santa Paula Hospital and even the operating costs out of Santa Paula Hospital but certainly that space is intended to absorb additional volume.
Okay, thank you. Supervisor Long do you have some more questions?
Yes, I did. And supervisors, I really appreciate the group think I was talking with some of the stakeholders today and how putting our heads together really gets a better answer. And so I think we definitely need our due diligence to ensure that we're encapsulating everything here. The question we had or I had was on option one. My understanding is it's been consistently $100 million to put in a hospital And we've been trying to figure out where we're going to find that money before the cuts of HR one. But it also stated that it's around 6 years or more in the development 8 years maybe and my I'm going to ask you a question about how we took a year for getting the property to even understand where second exit is based on all the stuff which is not ours to do, but the builders job to do.
If we were to choose the option too if it was this is 3 In service. How do we how do we make sure that there is no gap? What what are the thoughts behind that?
We'd have to develop their if there's a gap in a gap meeting the hospital closes before The new hospital opens or option two materializes. We have to figure out a way to notify patients at the old Santa Paula Hospital, ED as was done when the facility closed. We have to figure out extended hours within the existing footprint. We need a robust communications plan and activity with patients, with EMS, with the community that might involve as I just mentioned expanded hours within the existing Okay,
because I see this as the Santa Paula Medical Center. It would be built by the time or completed by the time, the end date of which the state is mandating that we would close the
hospital. Options two and three have that potential.
Okay.
Very hard it would be very very hard to do for option one.
And then how would that be communicated to our board? To ensure the timeliness in all of that.
Well, I do think that as Dr. Johnson opened up the hearing today this is to kind of lay out where the service models are there's an entire site selection process there's a scoping of that that has to go on for land building construction planning etc and it's from my perspective supervisor it's reasonable for the board to request an accountability
Well,
for all of that
I push back not to you as the podium.
Yes,
but I think that's a stress of all of the community of saying that we were going to have another hospital built and the frustration of of that As a supervisor for that district and and for the voices of the constituents here timeliness and making sure that we have the best health care. We can in the Santa Clara Valley has never been changed. And so I'm just wanting to make sure that if if we were to pick option 2 today, that we would be committed To ensuring that
if I'm a supervisor, so whatever option that your board picks today we would be coming back in early 2027 to talk about different locations based on the model that's chosen. We do that in open session. We talk about the delivery of the specific services, we give a timeline with key milestones for accountability and transparency both for the board and for the public. In an enclosed session, we'd be talking about the confidential terms and parameters that we have to be able to discuss privately to go into negotiations for land ownership.
Okay. And then also along with that, if we were to do the option two, I'm jumping ahead a little bit but talk about the process for the current hospital. That would be a separate item in looking at if someone came to us to operate that location or what other ways we can utilize Funding or property for the Santa Clara River Valley. If that property is $10 million, I personally want that to go to Santa Clara River Valley. So if it's $40 million, I want that to go to Santa Clara River Valley. So I wanted to make sure that we don't miss that part.
Understood Supervisor. I think there'd be a series of report back so if we talk to an entity or organization and saying they want to partner We'd be coming back to your board to provide that information to you after we have really, you know went through and if we have terms in a contract That would need your boards approval. We need to engage council So we'd be coming back for that if there's some kind of partnership that we can see a feasible path forward Likewise as the appraisal is done for the property for potential selling we would be coming back to your board reporting what that is so that you all would be aware of that information, so I think at every step of the way we'd be coming back to your board reporting out what we've learned, what we found, what new developments have come up for your awareness and for the public's awareness.
Okay, I appreciate that because we have been having a lot of questions and with this. I know that our board or our oversight committee has been told that we've had other hospital systems interested in things but it has not come to fruition so I just wanted to make sure thank you. You're welcome
Mr. Friedman, thank you. I've got a couple of quick questions and then most of them have been asked but the bright line here between what I'm sensing in the communities line in the sand and your recommendation really is the ER really because I have every belief given my assessment of the expanded access care facility that you're describing that it's pretty robust in terms of diagnostic preventative It's the time when the hospital closed.
out of a bankruptcy in between we as a county started operating it again. I'd like to see that data if that data exists to understand what might be the impacts of not having an ER in the community and the transportation and logistics that took place during that period of time to get people to the closest hospitals. I think that would be helpful as we
can work back with the EMS team
Yeah, thank you to begin understand because clearly it's people are fearful for losing their lives or loved ones lives and for us to understand what that community look like when it actually didn't have any are. I'd like to see that data the second thing. Is that it's been asked twice already so I'm sorry to ask you the 3rd time but to drill down deeper on transportation. There is a lack of an emergency room, the concern is transportation and availability you mentioned twice calling 911 well that may not always be comforting to 2 people to not know how long that might take has there been consideration given at all for potential Augmentation to the 9-1-1 coverage in this particular service area zone for purposes of transporting people from the Heritage Valley to VCMC or the closest.
Has that taken into consideration? Is that potentially a cost offset that the county could look at as parking additional logistics in that community to make sure people can get from Fillmore, Piru, Santa Paula to VCMC or the closest hospital?
I answer this two ways. There's for the 9-1-1 portfolio of the transportation piece of it, my understanding is that you have service level commitments there response times frequencies etc and if you have to add additional capacity additional truck to meet that response time that's what your system does
Right, I know you're not necessarily an EMS expert and you don't know these zones and their coverage areas. And sometimes there's overlap but particular units go from one service area to the other for coverage. But in theory this could be a an application to mitigate some of the concerns related to transportation times.
For the 9-1-1, for the non 9- 1-1 the patients who transport themselves The lack of an ED would make a longer transport for them. They would have to drive further, they'd have to drive to VCMC. Now you could ask the agency we could do it analysis to look at are there non-911 transportation strategies that can be looked at as well?
Good. I think that would be a pretty important discussion to have, especially if we and I think it's important for this board to provide for you in the county North Star to begin to move toward but that momentum in that direction. I think that a lot of other discussions need to take place You know just just like other supervisors have stated there's a lot of discussions that continue to take place transportation.
The the other thing that I'm interested in is you know, there's been overtures to my office and other people's offices from potential private sector partners partners that may be able to mitigate some of this or augment it and would be interested to hear back on on that And then, you know we're really at a crisis in this area of healthcare. Who knows that may change with the new administration Washington D.C., changes in Sacramento and both of those capitals are causing health care challenges right now for us in significant ways that are driving these changes that I'm not sure that the previous boards who went and purchased the Santa Paula Hospital could even have envisioned back then.
So thank you for your work on this and I know that Supervisor Parvin has another state question or. I think
you got my question
so. Supervisor Lopez?
Yes, thank you Chair. I have a question not sure if it might be for you Mr. Friedman or for Dr. Johnson. There was a conversation I had last week and I think someone mentioned earlier about some signs being posted at the hospital. Can you explain what that means and what that transition would look like for staff at the hospital with the closure happening by 2030?
what option we end up moving forward with. I mean, what that looks like. So can you explain? I think there were some signs that were posted about staffing changes.
5:52 – 5:597 turns
So thank you, Supervisor. So there are signs posted. There is something called a bill and hearing. Right. And so this is the bill and hearing today. We're fulfilling that requirement. Any time that there's going to be a decision made that can reduce the scale of services that are being provided by our hospital, you have to post those signs so that the public is aware. And so that's why those signs were posted.
I think on the 4th of the 3rd, they're 14 days before the hearing. So that's what we did currently. The plan is that because we have a runway meaning that this would not happen until 2030 when the seismic requirement comes to be that we would be able to decrease contract services and then move folks to either VCMC or clinics so that we do not anticipate at this time a reduction in workforce.
And so there may be a change of location and where someone works, but right now the plan is that we would be able because we have time through attrition, through reducing contractors and moving people to the main campus or clinics that we would not have to see a reduction in workforce.
Thank you. Thank you chair.
All right, thank you any other questions? Okay if there's no questions then I'm gonna close the public hearing and bring it back to the board for comments or actions. Supervisor LaVere.
Thank You Chair and it's been said over and over again but this is not an easy hearing to have It's not an easy discussion when we're talking about healthcare, which I know is so personal to everyone. You know one of the things that stood out to me and it's when we were talking about the overall disparities in health outcomes to residents in the Santa Clara Valley and the fact that those residents are seeing such lower overall outcomes than The residents in other parts of the county and that's real, and that's something the county has to be much better at.
But as I look at this, I think if we really want to put a dent in those disparities it's not done through an emergency room. It's done through greater access, robust access to preventative care, to screenings, to giving people appointments and visits with their primary and their specialty care doctors. That's where you're really going to see impacts in these overall disparities. And so that's really one of the ways I'm looking at this issue.
If we look at the actual utilization, you know what the residents of the Santa Clara River Valley are using our services for. It's largely emergency room visits for lower to medium or moderate acuity problems. And we're seeing that 80% of the residents in the Santa Clara River Valley don't stay in our hospital when they need inpatient services. They go to other facilities throughout the county.
And to me, there's this a real disconnect between a 49 bed fully licensed hospital and what the actual healthcare needs of the community are that we're seeing. And we have that data. This isn't speculation. We're seeing where the needs are, what people are using our services for And it's been mentioned the county has finite resources. Those resources are diminishing to the tune of $400 million over the next six years because of HR 1.
And so with these finite resources, do we invest in hospital beds which are often empty? Or do we invest in the preventative actual services that people need in the Santa Clara River Valley? And so that's how I'm approaching this. And that's why to me, option two makes the most sense. These are the services that are going to improve overall health outcomes and these are the services that the Santa Clara River Valley residents are actually using. It's a state-of-the-art facility and it's the primary care they need, the specialty care they need, the urgent care they need, the diagnostic services they need.
And when we say it's... And this is the modern building I think Dr. or Mr. Friedman mentioned, you know the extended hours it's going to meet the hours that we're seeing where people are using our services. It's the CT, the mammography, those ultrasounds, the x-rays, the lab services, the pharmacy services that were seen actually being utilized and we're going to enhance those.
I think if the goal is actually providing greater health care to the residents of the Valley Option two is gonna provide more than double the visits of option one, more than double. If we're actually talking about access to healthcare, option two is gonna more than double the access provided and I'm trying not to make this an emotional, we're looking at the actual data that we see and so that's why to me...
And I haven't even mentioned the fact that option two is the only one that's I think financially viable long-term but to me every road leads back to option two being the best resource that we can provide the
residents. Any other comments? Supervisor Lopez.
Thank you, Chair. I echo the comments of Supervisor LaVere and I think with that as I mentioned in my questions earlier is making sure that we are intentional in including those plans and how that outreach is going to be done, how that community engagement is going to take place That it's not just opening up a building but really being intentional about that community engagement and working with the multiple stakeholders in the community to ensure that when we talk about access, it is opening that door. It is welcoming people to receive that attention, that access to health care that the community deserves so We're not talking about a 10-year reduction in someone's lifespan.
And so I would just ask that with whatever option we're moving forward, that we also include those requests for some detailed plans to be a part of that process. But I would defer to Supervisor Long given that this is the district that she represents but we all share this responsibility and this decision. Thank you.
And I think Supervisor Long or Lopez is absolutely right about whatever option we do. It has to be, we have to intentionally drive people into these services. You're right.
5:59 – 6:145 turns
Thank you. Is there any other further discussion or a motion?
I wanted to make sure that I was able to give the opportunity to the other board members hearing what they had to say first. Is there any other comments?
No, not for me.
No I think it's been very challenging how long have you said you've been working on this?
I've been serving since 2016 So, I just wanted to say thank you. I took a picture in the very beginning if anyone saw that because I was very proud that my community showed up today at 1030 Time Certain and they have been showing up at our stakeholder engagements and our town halls for ten years now And I wanted to say thank you. Our city council members and our managers have been there, and whether it's Santa Paula or Fillmore even Piru Neighborhood Council we've had members coming in. I just want to say thank you. We have key leaders in our community that have showed up We have had our labor show up, and I want to make sure that you know the dedication of our board. And you've heard it today of making sure we have the best health care we can possibly provide.
So I just wanted to start there. And yes, I have been working since I got on supervisor and someone said Santa Clara Valley is not getting the health care they need. How do we do this? And when Dr. Johnson was a behavioral health director and I, we stood in those meetings and listened And we understood there was a lot of information just of not knowing what services were available for community members. Who was providing those services? How do they get them?
So I appreciate John, Mr. Freeman have a map of where all those clinics are because our community are hardworking and their number one priority is making sure there's food on the table And that they have a job and their kids are getting educated. And the last thing you want to do is worry about your health care, but we worry about our health care because we know that healthy communities is a really key thing.
And so that's our dedication where county is our safety net and so we need to always remember that. So I do want to say thank you to Dr. Finkhauser and the entire healthcare team agency You've carried an incredible difficult assignment, caring for the most vulnerable neighborhoods while also being honest with all of us about what our system can and cannot sustain. But it's always about how we can do better.
And Supervisor LeVere and I are on the oversight committee and we hear that at every meeting And hear about the wonderful resident programs, our nurses, our doctors. And so I wanted to make sure today everyone knows that Santa Paula Hospital is amazing. I need everyone to understand that. It's not the case that it's well it's just not doing good. So it's a whole other federal level that we have to deal with and so striking a balance is very hard And healthcare is definitely not a political issue, because we all come together for health care. So I want us to remember that this is all about our community, our family, our friends. To Jonathan Freeman and the team of Healthcare Management Association Thank you for your rigor and the independence you brought in this analysis.
It had to be a third party because internally we think a little bit different but like we talk about with all the different people, we have to figure out what's best. You told us that the data has shown us that this is exactly what the community deserves. And to Dr. Johnson and our county executive team that are all in the room, thank you for keeping this process moving and insisting on real community engagement rather than decisions made behind closed doors. I know that all of our board has asked for it. I know I've been asking for it even in hard times. Kelly, why are we... Supervisor, why are we needing to do this now? Because we need to think ahead, we need to build the future.
And I want to say thank you again to the residents of Santa Paula, Fillmore and Piru who joined the Blue Ribbon Committee and take that extra effort to the Latino Town Hall, to the other community forums and told us in your own words what losing local health care would mean for our families. We need to hear that. I've heard you and everything I say today is because of what you shared with me And I appreciate the time and conversations that we have.
I think this issue has been on my mind, like I say since 2016 because I represent this valley and I know what this hospital has meant to our community since 1963. And I know that it meant when we lost once in 2003. And Mary Ann was there with Supervisor Long and they rebirthed it, and when the private run hospital went bankruptcy and what it took to bring back this county To bring it back, our county has taken I think the report said 7.5 to 15 million loss every year since then and if you add that up that's 150 million to 300 million that our board is committed to be giving to the community and the residents because we want to reinvest and make our community healthier And so that is why early in my first time we did the board, the Blue Ribbon Committee.
We thought it was very invaluable providing a meaningful opportunity for community leaders and healthcare providers and others to come here today to address the hospital challenges. I mentioned today about doctors because the stakeholder engagements that were having was very few doctors And how healthcare has really come to insurance is really what strikes it so hard to me.
Is why is health care driven by insurance companies versus the care from our doctors and where they want to be? Because the doctors I talk to, they want to be treating at the Santa Paula Hospital. But because of health care and insurance, it's not happening. And I just want to say thank you to the Blue Ribbon Committee. We didn't talk about it as much but the OBGYN unit was another opportunity after a proposed closure and we got that going and we were promised to have 10 births a month and that was not delivered.
And unfortunately, because the outside provider couldn't commit we had to close that ultimately and how it couldn't sustain itself after three or four births a month. It just couldn't. One you want someone who's practicing a lot to have birth your babies. You don't want them to make a mistake and how important that critical move was to ensure that our births are Living like that's detrimental. I don't want to lose a life And so, I really do appreciate that the Blue Ribbon Committee has been thinking about this and we didn't want that happen either last year in October when we had to make these tough decisions We didn't want that either but I'm really happy to hear that That the births of those babies have been well taken care of because that's that's essential And no one predicted a year ago that we were going to have HR 1.
No County can't control that I can say no, I'm just not going to participate give us your money because I'd love to do that and We're gonna be losing roughly 400 million or more in federal funding in this system. And that's not hypothetical That's real It's money that the county is depending on and we have to be We have to be good With our finances, no one's gonna bail us out. We don't have a mom or dad or bank or anyone that's gonna bail us out for our bills. We already have a rainy day fund that we use to balance our bills for the hospital because the state and the federal don't pay us on a timely manner. And so we have to carry that cash flow until they do get paid when that's already over $300 million.
It's not a rainy day fund. It's really to support our health care system and I don't know if people really understand this. We take a lot of pride with this so, I mean, I'm talking a lot but there was a comment earlier about the fact that I don't talk as much and so you get this then. I'll tell you all about healthcare. Tell you all the reasons why we need it in our county and I'll tell you that I want to make sure I pay our doctors and our nurses to be able to give them care So, you know as everyone who walks through the doors of Santa Paula Hospital's emergency room today fewer than one in ten are truly facing a true life or death emergency. Thank goodness!
I'm so happy that they don't have to deal with those issues. But the rest need fast, competent local care and not necessarily a hospital bed because we know that they're not using the hospital beds. They're just using for quick get in, get out because I have other things to do than stay in the hospital. Who wants that? Our average daily inpatient we've heard about, but it's not a reason to abandon the community. It's a reason to build something that actually matches what the community needs and that's why I support option two, the medical office building and expanded access care center which I personally call Santa Paula Medical Center. If you're gonna ask me what I care about, it's making sure that Santa Paul is represented Santa Paula Hospital is there, but still is Santa Paula Medical Center.
And so I have a lot more to talk about. So I don't want my words to be lost. And the fact that the medical center will be the best option, I think based on our HMA, our independent consultants and that'll be the best fit of the residents to care. It'll bring real capability to this valley onsite CT ultrasound x-ray a full lab pharmacy mammogram in an urgent way to get the care that our community needs I want to be equally directed about something else. Contrary to what some of the comments we heard today, this decision is not driven by who lives in Ventura County Valley it's driven by the long-term needs of our county and our obligation ensure that health care is still available here in 10 years to come not just today. And so equity doesn't mean building something because it feels right in the moment, it means building something that actually survives a health care facility that still open that is still staffed as still serving the next generation and that's why I really do think that the math matters And unfortunately, we can't spend $120 million to build a hospital that is projected to lose 170 or 72 million in the first five years.
But having something that's financially stable for the entire community county health care system It's a lot of risk and we need to figure that out. I just want to say that at a recent community meeting some people expressed concerns like they did today, that lives can be lost because of additional transport time. We talked about that. I understand that fear and we should never dismiss it and we will follow up on that which i heard because there's It's hard to quantify what lives are lost with the change in the vote today.
But there is something that we can quantify and I want to hit that. I believe that the lives that we're going to be treating, we can improve extend and potentially save by investing in the modern sustainable health care system in Santa Clara River Valley. I believe a state-of-the-art one stop medical center can bring critical services together under one roof and it's going to provide better access to care for people managing diabetes, hypertension and other chronic conditions while providing advanced imaging and screening that can detect life threatening diseases before they become life threatening and the most important So we can do it in ways that are financially sustainable, not just today but for our future generations because what we have today is not sustainable.
And I believe it isn't about accepting less health care. It's about building a healthier future And so with that, I would motion to receive and file. We had our public hearing and to go with staff's option of option two in looking into the transportation as I heard we would. And then I would also ask to continue to look at the location of the hospital and what we can do there based on what Dr. Johnson has said earlier And I've asked to ensure that that funding, whatever it's made is staying in Santa Clara Valley.
Santa Clara River Valley. Thank you. Apologize for that. I get that sometimes. Not an easy decision.
6:14 – 6:2310 turns
There's a first by Supervisor Long. Is there a second? Thank you. Supervisor LaVere.
All right item 37 motion as stated move by Supervisor Long, seconded by Supervisor Revere and that passes unanimously. Thank you.
Thank you we're gonna
move to agenda item number 38 that's comments by the CEO whenever you're ready Dr. Johnson's not rush take your time
Thank you, Mr. Chair. I just want to highlight two quick things first is congratulations to the General Service Agency on the completion of the solar energy installation project brings about an estimated $21 million in energy savings over 20 years. The ribbon-cutting for this will be next week August 25th at 10 a.m.. In the grass lawn northwest of the Hall of Justice fountain so we welcome any and all that like to come and celebrate this milestone with us to come out Again, that's the 25th at 10 a.m., northwest of the Hall of Justice Fountain.
And then I mentioned it last time when I want to bring it up again. I think you can see it but it's the Government and Disability Summit that's coming up September 1st through 3rd. It'll be at the Crowne Plaza Hotel here in Ventura. The theme this year is access that moves us quality care mobility and safety This is our third annual summit we're so excited there are people from all over the state coming to learn about access and ensuring that we are planning, not only for everyday life but disasters for individuals of all mobility levels. So if you have interest, the registration is still open. It should be closing in a day or two but wanted to bring that to everyone's attention. The website is www.govdisabilitysummit.org Thank You Mr. Chair
Thank you, Supervisor Lopez if you're ready.
Yes thank you Chair I'll start off by sharing last week SCAG held the first Regional Housing Needs Assessment known RHNA subcommittee which I am a part of along with Councilmember Rocky Rhodes from Simi Valley And the committee, the subcommittee is tasked with making recommendations on the arena policy methodology and also will serve as the arena appeals board. So I look forward to engaging in conversations with our city partners and city leaders in how we can best address the diverse housing needs of our community here in the region especially here in Ventura County.
I, on August 6th, I went to visit the Camp Hope. It was really nice to see the youth being served through the camp and appreciate the invitation from Brent Nybecker It was to me a powerful reminder of that every child, no matter their life experiences deserves a space to feel safe loved and find connection. And I got to see that so I want to thank them for the invitation and those who have supported Camp Hope over the years.
On August 7th, Council Member Mikayla Perez joined me along with our Public Works staff Sandy Harrison and Yael who's a student worker to do some graffiti abatement on the J Street Chumash Waterway. And also want to thank the La Una Local 585. We had two volunteers Dan and Christina who's a member of the Women in Construction group who helped us get out there. And there's a lot of activity there, so I want to thank them for their support.
I attended the MICOP Noche de Pueblos Originarios. There were a few county representatives there including Dr. Johnson, Dr. Finkhauser and it was a nice celebration of their 25th anniversary as well. On August 11th, Westminster Free Clinic held a backpack giveaway and I was glad to be in attendance and help distribute the backpacks to students. They had, I want to say over 500 children come through to receive a backpack with a lot of other services being provided including their weekly health screenings And this past weekend, the first strike demolition ceremony took place at Fisherman's Wharf. So they are officially working towards it. So it was really great to see a great attendance from the community. I want to thank Michael Tripp who helped organize that and the owner of Carl's who is investing in the development there Robert Dahl was also an attendancy flew in from Germany to be a part of the ceremony and there was a great participation from throughout the community.
They held a live auction of some items, and the funds are supporting some of our local nonprofits. So I just want to give them a shout out. And lastly, I attended the SEIU Local 721 Family Fund Day. So it was great to see some of our county staff there who are members of SEIU And I'll just share this Friday, I have my next Paletas in the Park event at Eastwood Park with Mayor Pro Tem Gabe Turan. It will take place Friday August 21st from 4 to 6 and lastly, I have requested a name that I request we adjourn in memory of. That concludes my comments thank you Chair.
Thank you Supervisor Parvin
Yes, I attended the Simi Valley National Night Out like many of you in your communities. I'm sure to meet with the community members and thank our first responders present participated in the Moorpark Chamber Government Relations attended the Moorpark State of the College where Dr. Sokin you shared updates on their upcoming academic year and planned events He's still going for the amphitheater, the 4,000 seat amphitheater. Still talking about it.
We held the Simi Valley End of the Summer Pop Stop event. We had a lot of kids and firefighters show up. Those kids really love seeing the trucks and we had a visit from Sir Isaac Lime, The Green Flavor. My team and I went to the Ventura County Fair and helped with the junior livestock auction, which I'm sure many of you, I think I saw all of you there. Talk about a hot afternoon. I learned that they actually have a swamp cooler in that building but I sure didn't feel it.
We got the high noon shift. Somehow I'm wondering how I got the high noon shift two years in a row? All right. Ribbon cuttings in the fourth district included LaGree Restoration and Second Chance Thrift in Moorpark, Grocery Outlet and The Krusty Krape in Simi Valley. Interesting name for a crepe place. My staff enjoyed attending the Dallas Cowboys training camp. We met with Louise Lampara, the new CEO of the Farm Bureau Chair of the Air Pollution Control Board meeting where we declared October 7th, 2026 as Clean Air Day in Ventura County and approved a grant agreement to provide funding to purchase and install five EV chargers in Santa Paula. So Santa Paula is getting some action here.
I participated in a community meeting along with other stakeholders to discuss protocols of the buffer zone between Moore Park The City of Moorpark and the Unincorporated Homemakers Neighborhood and address questions and concerns. Dr. Johnson actually enjoyed that evening with me. I attended Wings Over Camarillo where I saw many old, very old military aircraft and it sure sounded old too.
Air stunts and car show. The best part for me was the glider. I don't know anyone saw that glider? Oh my gosh, it was amazing. Amazing. Well there are so many great things I won't miss that event ever. Don't forget to come out to the final end of the summer pop stop event in Moore Park for a refreshing Otter Pop. I'm encouraging all my colleagues to join me over at the Moore Park Police Station and lastly I'd like to adjourn this meeting in the memory of the individuals I have provided to the Clerk of the Board.
Thank you Supervisor Long
6:23 – 6:327 turns
Thank you. It was my honor to speak at the Ventura County Economic Development Association members and guests in regards to the economic vitality of Ventura County, and also the future of agriculture. So it was well well. Well attended, that's the word. Sorry I'm still stuck on the last item just really bums me out. Anyways so yes I was at the county fair juniors livestock auction and just really great job to our 4-H and FFA teams. Just amazing to be learning about farming and raising and responsibilities into those families Really proud to support that. Also, my staff attended the change of command for a Navy base Ventura County Construction Group 1 and also the U.S. Coast Guard Air Station in Ventura County. Congratulations to Commander Gregory Walk and Captain Andrew Littoral.
And thank you to the outgoing commander, Amanda Sardone and Captain Angel Santagio for your dedication service to our country really appreciate that also highlight the wings of Camarillo if you weren't there you can watch it online if you're there you could see the explosions on your face and it's hot and great I just wanted to say thank you to the community for supporting this great event Not only for our veterans but how important to our pilots and those that fly. I mean, how many planes have I been on lately? My life is entrusted in all of them so I just appreciate it.
Also, I'm on the 211 California's Board of Directors. We had a retreat last week and you will not believe that there are actually counties that do not have 2-1-1 network They do not have those services and how important it is to have a statewide 2-1-1. So that's what we were talking about, and I just want to say how amazing ours is, how lucky and fortunate we are to have Interface and 2- 1-1 here. Kelly Brown, Eric Sturden, the dedicated staff, they help other counties too.
These systems that we just think are there There are actually people that have been funding that have to be there to help, have our community help. So I just wanted to say thank you to all of them and also just to acknowledge that I've been appointed to the National Association of Counties their human services and education policy Steering Committee, continuing to be the Vice Chair.
And then also on the Large Urban County Caucus and the Resilient Counties members because disasters and large urban counties we all have the same issues no matter what state you are. I think that's a very important one. And then also our California State Association of Counties has now put together a SGMA committee And I've said yes, I should probably say no to more things. But yes to that because how important for Ventura County and water to everything that we do and sitting on the Fox Canyon and Fillmore Piru GSAs, we have urban suburban and rural issues.
The best thing about this committee is that I have supervisors from the north, the south and everywhere in between and we're still saying the same things which is that we need to have better policies for our Sigma to ensure that the water's here for the future. So I think that's great that I can, that we can do this. So just want to let you know that those are some of the things I'm working on. Thank you.
Thanks Supervisor Lavier.
Thank you Chair and it's been mentioned but you know on the week of August 3rd was the National Night Out Week and it's always such a great opportunity for communities to come out into the parks and get to know their local police officers Put faces and names with those badges, and I was able to attend the Tuesday night one with the Oxnard police in the River Park community. And then on Wednesday with the Sheriff's Department in Ojai. Just a great community turnout and really great to see the bonds being formed between other communities and their law enforcement officers.
And it's been mentioned also the Junior Livestock Auction. My daughter is one of the participants this year and there's 400 kids there, anywhere from nine years old to 18 years old who spent six months getting up early feeding cleaning training and just the commitment these kids show. It's so incredible to see these are our future leaders in agriculture And I'm just really proud of every single kid that completed their auction experience this year. And thank you to all my colleagues who helped on actual auction day, making that a success.
And then I would just ask that we adjourn in honor of those on the list. I provided to the clerk there's three veterans I want to mention, James Kirkpatrick who was a United States Navy veteran, Merle Block who was a Marine Corps veteran and then lastly and Chair you might remember him but Judge David Long who was Marine Corps veteran and they went on to have a distinguished career on the Ventura County bench and was always one of the most popular judges in the local legal community He retired from being a judge and had a successful career as a mediator after that, but Judge Long passed away last week. And so we're thinking about his family was a wonderful man. So thank you chair.
Thank
you supervisor long.
I apologize, I do want to submit a list of those on my list for adjournment memory but I do want to say call out soul collision and he's a longtime and deeply loved member of Ventura County community we did do a moment of silence at the auction. He passed away in July 31st nearly 91 years old. I had no clue he was 91. I saw him dancing on the dance floor just recently.
Sol lived a life definitely by family, friendship, service, humor and extraordinary love for his community. He was a longtime supporter and volunteer of the Boys & Girls Club of Camarillo, served on the board of the Crestview Mutual Water Company and was recognized by his generosity and volunteerism organizations throughout the county. But beyond these accomplishments, Sol will be remembered for the way he made people feel. He was a wonderful sense of humor, a genuine curiosity about others and a remarkable ability to turn an ordinary conversation into a lasting memory.
He was devoted to his wife Laura and his children Susan David and Laura And his extended family and friends and so we extend our deepest condolences to the hit that his family in May souls memory continue to bring laughter warmth enjoy to all who was privileged know him. So thank you.
Thank you for sharing that just a couple of things. Dr. Johnson and I had a chance to meet with some really exceptional high school students. They appeared here at our last board meeting to offer some insight on how to make a difference with our wellness centers on public school campuses, and so we invited them to come meet and we brought Salita Dabrowsky Our director of public health nursing. Also, Diane McKay is a member of the Behavioral Health Advisory Board and we listened to their specific inputs in and they have really broad recommendations on how to improve things for high school students with a good great county and city relationships and just amazing young men in this case the ones that met with us were all young men but I think there's both men and young ladies there.
But really outstanding, great ideas and super engaged in student engagement, public engagement, political engagement and just doing amazing things that I wish I had done in high school. I want to congratulate for going to the World Series and winning the 14U Elite Newberry Baseball Club and bringing home the Global World Series Championship. The players attended 11 different schools from throughout this county, and they were recognized with special commendations at their team's party on Sunday by both the mayor of Thousand Oaks and we also at the county level I'll be doing my monthly sidewalk office hours again this time on August 21st in front of Trader Joe's in Newbury Park from 11 to one so feel free to stop by. On September 2nd at 530, I'll And we'll be having public works and Ventura County Fire there, and answer any questions and provide any updates to community members from Camarillo Heights.
On September 6th, there's an annual SOMAS MAC Community Cleanup. There's a meeting in SOMAS Community Church for that. And so we're getting ready for that. I think that cleanups on 9-11 is that correct? Yes, I'd also like to adjourn in the in this meeting in the name of the individuals. I submitted to the Board of Supervisors and with that I think we can adjourn. Thank you everybody.