Wednesday July 30, 2014

I keep telling myself, don’t buy anymore books until you’ve finished the stack on your bedside table and then I read another one of Carols’ Books review and the next click is on Amazon books…. I keep thinking someday, I’ll have lots of time to read and will ketchup… sure kid sure…. this week is one of those books I have to read, I don’t know how Carol finds them, but they are usually not on my radar till I read her report. Anybody else have that problem?

Progress is still continuing with the Downieville WSMC Clinic and optimism reigns  for a long term solution. However, The Fringe DeVita wrote an article that kind of made my brain twitch and so I wrote a response. The DC-PAC has really been attempting to work cooperatively with GV-WSMC to keep the 5 day Primary care, and 24/7 urgent and emergency care a continued service for western Sierra County. So remember my response is an editorial, what I think based on looking at many facts. Not all the facts because for some reason the administration has been secretive and unwilling to share some financial information, “For fear of being sued”, well, openness and honesty is one way to thwart lawsuits if you have nothing to hide, why hide it? Simple question. There should be a simple answer. We’re not asking for anything that violates HIPPA … soooo…. just show us the money facts please.

We have Gabby, the Cats, The Others, The Mountain Messenger and our guest columnists Tom Hastings, John LaForge and Erin Niemela and Laura Finley. Enjoy, keep those cards, letters and comments coming and have fun at the annual Downieville Classic Mountain Bike Race and Festival this weekend. http://www.downievilleclassic.com

Janice Maddox took this weeks’ lovely, cool, peaceful photo while on a walk in Calpine.

WSMC Care Explained 7/30/14

A letter from Frank Lang to the DC-PAC clearly explains the different types of care necessary at the WSMC Downieville Clinic.

Thanks for your report. First, I suggest that we are clear about what type of care WSMC provides at all sites. That is Primary Care. A primary care practice serves as the patient’s first point of entry into the health care system and as the continuing focal point for all needed health care services. Primary care practices provide patients with ready access to their own personal physician or medical provider or to an established back-up medical provider when the primary physician or medical provider is not available.
Primary care practices provide health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.).
Primary care practices are organized to meet the needs of patients with undifferentiated problems, with the vast majority of patient concerns and needs being cared for in the primary care practice itself. Primary care practices are generally located in the community of the patients, thereby facilitating access to health care while maintaining a wide variety of specialty and institutional consultative and referral relationships for specific care needs. The structure of the primary care practice may include a team of physicians and non-physician health professionals.
Second, Downieville provides Urgent care in addition to Primary Care. Urgent care is a category of walk-in clinic focused on the delivery of ambulatory care in a dedicated medical facility outside of a traditional emergency room. Urgent care centers primarily treat injuries or illnesses requiring immediate care, but not serious enough to require an ER visit. Urgent care centers are distinguished from similar ambulatory healthcare centers such as emergency departments and convenient care clinics by their scope of conditions treated and available facilities on-site. While urgent care centers are usually not open 24-hours a day, 70% of centers in the United States open by 8:00 am or earlier and 95% close after 7:00 pm.
Third, Downieville provides Emergency care which refers to emergency medical services required for the immediate diagnosis and treatment of medical conditions which, if not immediately diagnosed and treated, could lead to serious physical or mental disability or death.
Fourth, Downieville provides Jail Care which is defined as mostly Urgent and Emergency Care to inmates of the Jail Facility on a scheduled and as needed basis determined by protocols approved by the WSMC Chief Medical Officer and the Sierra County Health Officer.
The Downieville Clinic provides a hybrid of these services which make it unique by virtue of its geographic isolation and the lack of other healthcare facilities to provide any or all of these services. The Clinic services are mutually supported by an EMS and Fire Service that supports an integrated response to these types of care. The Clinic then also requires a medical provider with a skill set to meet these needs or there needs to be an increased capacity of the EMS System to support these needs.
Lastly, I want to assure you and others that I am willing to be a part of a process to maintain those services in western Sierra County in any way that is helpful and constructive. We all want the same thing, that is a sustainable health care system that meets the care requirements for ourselves and our community. We need to be unified in that commitment. It is to our mutual advantage to work together. We all need to look “outside the box” to accomplish that. I will be back on August 1st.
Thanks,
Frank Lang

Photos of the Week 7/30/14

 

Cindy McCreary and daughter Randi McCreary cheering for the Dodgers I think, while not at Sierra Hardware.

7/30/14 Cindy McCreary and daughter Randi McCreary have a life outside of Sierra Hardware in Downieville; here I believe they are cheering for the Dodgers I think, in San Francisco. (Cindy may have turned older on Tuesday)

These young people were at the Downieville Museum enjoying the local lore.

7/30/14 These young people were at the Downieville Museum enjoying the local lore. We think they are from the Clearlake area, but not sure, they may also be part of the Jackson family reunion at Jackson Hole in Indian Valley but also not sure about that, we can blame the OBP. David Marshall

Yesterday's fire east of Sierraville Photo by DeVita

7/30/14 Yesterday’s fire east of Sierraville Photo by DeVita

Diannes’ Ponderings 7/30/14

CLIMATE CHANGE AFFECTS US ALLUnknown-2

U.S. Weather Bureau officials announced last week that in many parts of the country June was the hottest month since records started being kept in 1880.

Melting polar ice caps are causing mayhem — hurricanes, tornadoes, blizzards, wildfires and drought, and even flooding rains. Our climate is in turmoil and it is our fault and it affects all of us.

We need only to look at photos or TV images of heavy traffic on the nation’s freeways to realize the air is changing, and not for the better.
How our activity leads to climate change

When we extract and burn fossil fuels such as coal or petroleum, we cause the release of carbon dioxide (CO2) and other heat-trapping “greenhouse gases” into the atmosphere.

Though natural amounts of CO2 have varied from 180 to 300 parts per million (ppm), today’s CO2 levels are around 400 ppm. That’s 30% more than the highest natural levels over the past 800,000 years.

We also can tell that the additional CO2 in the atmosphere comes mainly from coal and oil because the chemical composition of the CO2 contains a unique fingerprint.

Losing forests makes it worse

When we clear forests, we also release large amounts of CO2. On top of that, plants and trees use CO2 to grow. Worldwide deforestation means we don’t have as many trees to absorb the extra CO2.
This means more CO2 stays in the atmosphere, trapping more heat.

So what do we do about it?

We can take simple steps to decrease climate contamination. Walk, if you can, rather than taking the car, or use public transportation if it’s available.

Limit use of air conditioning or electricity as much as possible.

Reduce use of water in drought-stricken areas. Your lawn will be fine if you don’t use the sprinklers for the summer.

And in drought-stricken areas, DO NOT use matches or build a campfire. If you smoke (subject of another day), don’t discard smoldering butts into dry grass. If you do throw away your butts, make sure they are complete extinguished.

Everyone of us needs to become more aware that the climate changes will only worsen and endanger all of us if we don’t take action. Wildfires, floods and other natural disasters are a direct result of our disregard for our planet. Stop and think about it.

 

Myth Busting 7/30/14

Insidious Myth Prevents Peace in Gaza

by Erin Niemela

Erin Niemela

Erin Niemela

Media frame violent conflict to reinforce certain biases and myths, emphasizing some facts and omitting others to produce compelling narratives. Good guys and bad guys are crafted and re-crafted in media discourse, and this is especially the case with the protracted Israel-Palestine conflict. Unfortunately, many of these myths enter the public discourse, on both sides, to the detriment of peace.

What’s even worse, well-intentioned authors hoping to dispel these harmful myths also degrade peace efforts by perpetuating harmful assumptions. Chiefly, that violence could be justifiable, depending on who the real victim is. This myth is dangerous, perpetuates violent conflict and seriously hinders peacemaking efforts on both sides.

Nathan Brown, professor of political science and international affairs at George Washington University, addressed five myths about “militant Islamist organization” Hamas in a July 18th Washington Post article. Brown argued that although Hamas may have some capacity to provoke fear in Israel leadership, it is “absolutely true that Hamas does not pose an existential threat to Israel.” The existential threat of Hamas: myth-busted.

Kim Sengupta and Khan Younis, Belfast Telegraph reporters, exposed the myth of Hamas’ human shields in Gaza in a July 21, 2014 article. They wrote, “Some Gazans have admitted that they were afraid of criticizing Hamas, but none have said they had been forced by the organization to stay in places of danger and become unwilling human-shields.” The use of human shields by Hamas: myth-busted.

The Committee for Accuracy in Middle East Reporting in America published a report July 21st on the “top nine Gaza media myths” in current circulation. Among them, in a chicken-and-the-egg analysis, that Hamas’ rockets are not simply responses to Israel’s embargos: “Missiles are not the answer for the embargo, they are the cause for the embargo.” Hamas rockets as retaliation for Israeli blockages: myth-busted.

The problem with these and many other myth-busting analyses, from both sides, is that they impose some under-the-radar assumptions on readers that may seriously hinder conflict resolution and peace processes. If Hamas does not pose an existential threat to Israel, as Brown argued, then Israel’s actions in Gaza are not justified. In other words, if Hamas did pose an existential threat, Israel’s actions would be justified. The Sengupta and Younis argument is similar: If Hamas isn’t actually using human shields in Gaza, then Israel’s actions aren’t justified. Therefore, if Hamas did use human shields, Israel’s actions would be justified. Per the Committee, if Hamas is firing rockets as a response to Israel embargos on Palestine, then Hamas may be justified. Get the picture?

There’s really only one myth that needs busting around here and it’s this: “Violence is justifiable.” Violence is never justifiable.

That’s the only myth that needs dispelling right now. The philosophical tradition of “Just War,” which serves to perpetuate this myth, is an additional fallacy that needs further dispelling. However, what we have to immediately address, if we want to prevent another 666 human deaths and sleepless, fearful nights for children, is the practical limitations of the “violence is justifiable” myth on conflict resolution processes.

If the authors of myth-busting analyses, as well as the original myth-perpetuating journalists, had a foundation in conflict resolution – practical or theoretical – they’d know that arguing over violence justification – who’s good, who’s bad and who “deserves it” – is devastating to peace. It’s the direct violence from both sides, no matter the proportion, that perpetuates the conflict and degrades peace efforts in Gaza, Syria, Ukraine and beyond. Unless the direct violence ends, civil society may not be able to address the actual issues or create a sustainable resolution. Violence only creates additional grievances on all sides and perpetuates a conflict spiral.

Furthermore, what many analysts call “myths” are actually perspectives. These perspectives – such as who the victims and aggressors are and when violence may be justified or legal – are held by people all over the world and, most importantly, by people on the ground coping with the violence on a day-to-day basis.

Myth-busters need to know what conflict scholars already know: Everyone believes their in-group is the real victim, and everyone is correct. Trying to convince someone that their reality is false, that they should adopt the reality of their perceived enemy, is conflict resolution-suicide. In peace processes, accepting multiple realities by listening to one another through sustained, mediated dialogue is a more productive force for resolution than any violence, ever.

We must demand that both Israel and Hamas immediately cease all violence (even if one side isn’t very effective in this regard). At the same time, we must reject this assumption that violence can be justifiable. Peacemakers in Gaza need our support in breaking the cycle of violence – listening. Listening leads to dialogue, dialogue leads to transformation, transformation leads to sustainable peace, and it’s really, really hard to hear over the sounds of rocket fire.

Erin Niemela (@erinniemela), PeaceVoice Editor and PeaceVoiceTV Channel Manager, is a Master’s Candidate in the Conflict Resolution program at Portland State University, specializing in media framing of violent and nonviolent conflict.

3/5 of a Person 7/30/14

Three-fifths of an Attorney General Declares POWs “Non-Persons”

By John LaForge052313_NAT_Commentary

Hand it to President Obama for appointing Eric Holder the first African American Attorney General in US history. Then try to fathom that after generations of civil and human rights work by African Americans — whom the US Constitution once called “3/5 of a person” — it is Holder who declared some brown skinned prisoners of war to be “non-persons.” The men are held outside the law by the US at Guantánamo Bay.

Attorneys for the POWs have asked for an order that would allow group prayers during the holy month of Ramadan, but Holder’s Justice Dept. has formally replied that the men aren’t entitled to relief under the Religious Freedom Restoration Act (RFRA) because the Supreme Court has not found that Guantánamo’s prisoners “are ‘persons’ to whom RFRA applies.”

Holder calls the men “unprivileged enemy belligerents detained overseas during a period of ongoing hostilities.” Calling them prisoners of war would require respecting their human rights.

Cori Crider, an attorney with the legal charity Reprieve who represents some of the men, said in a statement, “I fail to see how the President can stand up and claim Guantánamo is a scandal while his lawyers call detainees non-persons in court. If the President is serious about closing this prison, he could start by recognizing that its inmates are people — most of whom have been cleared by his own Government.”

According to AG Holder, US Appeals Court rulings mean Guantánamo’s POWs — whom he calls “nonresident aliens outside the US sovereign territory” — are “not protected ‘person[s].’” In the infamous Hobby Lobby case Holder argues, the Supreme Court refused to say that the word “‘person’ as used in RFRA includes a nonresident alien outside sovereign United States territory.”

Even if RFRA applied to the POWs, Holder claims, the law “cannot overcome the judicial presumption against extraterritorial application of statutes.” Translation: US Law doesn’t apply at Gitmo, or, the reason the US isolates non-persons at an off-shore military penal colony in the first place is so we can ignore or violate “statutes” with impunity. And if we convince ourselves that “unprivileged enemy belligerents” are not people, we should be able to sleep even if we violate the US torture statute (18 USC, Sec. 1, Ch. 113C), the Convention Against Torture and the US War Crimes Act (18 USC, Sec. 2441) ¾ for years on end.

America’s indefinite imprisonment without charges, hunger strikers and force-feeding

My own jail and prison time, all for political protests, has always come with a clear sentence: six days, 90 days, 180 days; 54 months in all. Anybody who’s been on the inside knows that a release date gives you something fast to hold on to, even if you’re called by a number, fed through a slot, handcuffed for court. But imagine 156 months in a nihilistic “extraterritorial” military prison, with no charges, no trial, no sentence, no visits, phone calls or mail, and no hope.

This is what the USA imposes at Guantánamo, a torturous psychological vice of legal oblivion and manufactured futurelessness. Add to this appalling construction the fact that 72 of 149 remaining inmates were approved for release more than four years ago — but are chained up anyway. Scores of Gitmo’s inmates have looked into this man-made oblivion and decided to die. They are using the only power they have left, the dreadful hunger-strike, both as a protest against their endless detention without trial and their only means of eventually ending it.

The US military has chosen to force-feed hunger strikers, gruesomely plunging plastic tubes up the non-persons’ noses. This abuse violates laws against torture, and the force-feeding schedule is the original basis for the religious rights petition so vigorously opposed by Obama and Holder. The ghastly traumatic stress resulting from enduring force-feeding and the regime of its application make Ramadan’s prayerful group reflection impossible. US District Judge Gladys Kessler has, according to Charlie Savage in the New York Times, publicly condemned the abuse for causing “agony.” For PR purposes the Pentagon and Justice Department call the abuse “enteral feeding.”

Mr. Holder has called “not credible” the prisoners’ complaints about “alleged aspects of enteral feeding” and “allegations that detainees who were being enterally fed were not permitted to pray communally during Ramadan in 2013.” But after the number of hunger strikers reached 106 last year, the military halted its public reporting of the strike.

Significantly, a Navy medical officer at Guantánamo has become the first prison official known to refuse force-feeding duty. The unidentified nurse’s refusal was acknowledged by the Pentagon July 15.

If Holder wins his frightening argument denying the humanity of the men at Guantánamo, even the American Society for the Prevention of Cruelty to Animals could object. The ASPCA says its vision is that “the US is a humane community in which all animals are treated with respect and kindness.”

Community vs Corporate Money 7/30/14

New post on http://unofficialalpine.com

Squaw Valley & KSL Spend Another $109,000 Fighting The Incorporation Of Olympic Valley
by Mark
Screen-Shot-2014-07-26-at-11.48.16-AM-1024x701 Screen-Shot-2014-07-23-at-10.40.45-AMThe numbers are in for the month of June. They are not surprising, but they are a bit sickening. Squaw Valley Ski Holdings, which is owned and controlled by KSL Capital, contributed another $109,000 dollars during the month of June to the Save Olympic Valley group. SOV is comprised of a very small but vocal group of second homeowners that are opposed to the incorporation effort with Olympic Valley. To date, SVSH and KSL have been the sole contributors to SOV, with contributions totaling nearly $240,000 over the last 3 months.

Although the SOViets have been focusing their campaign on fear, such as the possibility of more taxation and more government, we think KSL is fearful of change. Monday’s meeting of the Placer County Board of Supervisors in Squaw Valley made it clear to casual viewers that the relationship between Squaw Valley Ski Holdings, KSL Capital and Placer County is very tight. There were moments during the meeting where Placer County officials seemed to function more as cheerleaders, rather than the watchdogs that we need them to be.

It’s no mystery that Olympic Valley residents are looking to protect the Valley for future generations. Most of the population of Olympic Valley is not ready to accept a 90,000 square foot Mountain Adventure Center and 108 foot building heights as an “acceptable compromise.” Those that are willing to accept it have one thing in common, they are hoping to gain financially from the potential of an increased number of visitors, especially those that can afford to own a time share in the Valley.

We applaud that Squaw Valley Ski Holdings and KSL have been a positive force in the community in supporting the Humane Society of Truckee-Tahoe, High Fives and the Tahoe Food Hub, as well as other organizations. We’re beginning to think that their contributions to the negative smear campaign, know as Save Olympic Valley, may far outweigh all of their contributions toward the betterment of the community.

As local citizens, we can only begin to imagine the number of lay-offs that could have been avoided during last year’s poor snow season with a quarter of a million dollar investment in people, not profits. When the snow finally arrived last February, how many times were we told that they just didn’t have the staff to operate available terrain at Alpine Meadows and Squaw Valley. We are all affected by SVSH and KSL’s choice to spend money to stop the will of Olympic Valley voters.

Here’s the the link to the latest Save Olympic Valley financial report at the Placer County elections office. As always, your comments are welcome, even if your ideas don’t match ours.

Truckee Rodeo in August 7/30/14

Save the date!!!!
40th annual CCPRA Truckee Pro Rodeo
McIver Arena – Truckee, CA
August 22nd – Team Penning and Sponsor Dinner 5:00PM – $15 plate, open to public
August 23rd – Rodeo 5:00-7:00 PM – $15 and Dance 7:30-9:30 PM – Free
August 24th – Rodeo 1:00-3:00 PM – $15
Presale tickets available on website at discounted price
Website: truckeerodeo.org
Email: info@truckeerodeo.org

TruckeeProRodeo-1

IHSS Homecare Wage Increase 7/30/14

*IHSS Homecare Workers Approve Wage Increase*

Months of Hard Bargaining Boost Wage to $9.50 an Hour

*Nevada, Plumas and Sierra Counties –* Members of the California United
Homecare Workers (CUHW) Local 4034 have voted to boost wages to $9.50 an
hour for more than 600 IHSS homecare providers in Nevada, Sierra and Plumas
counties. The increase is expected to take effect in October, pending
approval by the County Board of Supervisors and the state.

For three months, CUHW’s team heard the Tri-counties’ negotiator tell them
that their county boards of supervisors had no interest in giving them a
raise. They listened, but they didn’t accept it. They answered by
organizing.

“We wouldn’t take ‘no’ for an answer,” said Wendy Hayward, Nevada County
Chapter Chair of Local 4034, “We mobilized our members to go out into our
communities and talk about the importance of their work and the stress of
trying to live on poverty wages. We built a coalition of community support
which eventually changed the minds of the counties.

Team members had one-on-one discussions with their supervisors and
mobilized providers to go to the Board of Supervisors’ meetings and talk
about their struggle to take care of the most vulnerable members in society
while living on a minimum wage. When the Chair of the Nevada Board tried to
cut off CUHW speakers during public comment, more providers came forward to
speak, undaunted and unintimidated.

The compelling presentation by a Plumas provider prompted front page
coverage in the local newspaper. Meanwhile, providers organized a growing
circle of friends, families and allies in the disability rights community.
CUHW leaders also met with the county executive office and social services
to explain IHSS funding and to emphasize how economic development in the
county is aided by leveraging state and federal dollars.

As a result of the growing community support, the agreement for the wage
increase was hammered out between CUHW and the Public Authority on May 23,
2014.

“We hope county leaders and the community will become more aware of the
importance of IHSS and the pivotal role this program and its providers play
in building a healthy, diverse and welcoming community,” Hayward added.

IHSS workers in Nevada County will be back negotiating next year when their
contract expires December 31, 2015.

The CUHW Tri-County leadership included Nevada Chapter Chair Wendy Hayward,
Sierra Chapter Chair Carol Iman, and Plumas County Chair Teri White.
They were assisted by organizer Teresa Caples.

 

*About IHSS*

In-Home Supportive Services (IHSS) is a state program to provide low income adults and children with physical, mental or developmental disabilities the services necessary to allow them to stay safely in their homes. IHSS providers perform many responsibilities, which may include shopping, cleaning, cooking; grooming, incontinence care, transportation to appointments, medication management, and safety supervision. Without such services, frail seniors or disabled persons risk injury or institutionalization. Many homecare workers are family members, some of whom left careers to care for aging parents or disabled relatives.

 

Carrie’s Stop Corner 7/30/14

Carrie’s Corner
By: Carrie A. Blakleybridin05

Ok folks, it’s time for my annual pre-bicycle race heads up article. First things first. The population here in town is about to increase by 10 fold. Unless you are completely blind, or happen to be a hermit living in one of the many mine shafts, there is no way you’re going to not notice this. Please use your best manners at all times. This is also the time when I point out to our visitors that we live here, you do not. Please bear this in mind when you come to visit our town. Although we love having you up here, we will not, under any circumstances, turn into a full blown town wide catering service. The nearest chain store, of any kind, on any level, is at least 1 hour south. For that matter, the nearest Wal-mart is 2 hours either North, or South. This is just how we roll. You’ll get used to it eventually.

Up here, we give you driving directions in hours, not distance. There’s a reason for this, incase you missed that lovely 15 mile per hour hairpin turn on the way up here. The reason for this is that lovely 15 mile per hour hairpin turn that just so happens to be smack in the middle of what we call Depot Hill. ‘The Pass’ is also known as ‘Dead Man’s Curves’ (notice the plural of this word), and is north of us. Furthermore, we have a wonderful set of handy duty law enforcement officers that can drive these roads, and catch up to you, should you decide that someone needs to hold your drink while you take a 2 wheeled attempt at a dead man’s curve. It is aptly named, keep this in mind.
http://www.chp.ca.gov/html/bicycleriding.html
Finally, there are stop signs in town. It is well advised that you obey these signs at all times. We don’t care if you’ve just come off of one of the most hideous and dangerous mountain bike trails on the face of this planet. In fact, we might even congratulate you just for having the back bone to ride that course to begin with. Moreover, although we’ll celebrate your success with you, we will also take no issue in fully reminding you that the stop signs are there for all traffic, not just motorized traffic. Bicyclists, this means you. Please use your good manners and judgement at all times, and have your Starbucks and Wal-Mart shopping done prior to entering our fair county. Have a wonderful time at the races, and have a lovely week. Y’all come back now. Ya hear?

You Are Wrong DeVita 7/30/14

This week the Fringe DeVita explains why western Sierra County has to stop expecting too much on our health care.  After all he says, “many towns bigger than Downieville” don’t have what we have`. He minimizes the service area which is all of western Sierra County including many resorts, campgrounds, summer home tracts, 6 well established towns Alleghany, Pike City, Goodyears Bar, Downieville, Sierra City,  Green Acres and many outlying homes scattered along Highway 49 and side roads. In the summertime the population triples in size.

He is right about the problems that are hurting the clinic, “policies and economics “determined in another more populated county. The Downieville Clinic does not need the massive staff and overhead costs of the Nevada County site. The Clinic in Downieville needs the support of the locals using it as Primary Care, use it or lose it. We need a full time provider and 2 or 3 Nurse Practioners who are willing to rotate for some of the 24/7 urgent and emergency care. If we were an independent entity again we could use the same medical billing company that Downieville Ambulance does for billing, we would need assistant LVN’s or RN’s  to help the Providers, a secretary/receptionist, the phone calls for after hours clinic assistance could go through the Downieville Fire Department who are able to reach the provider immediately. There are overhead costs of course, payroll, taxes, insurance and all of these things need income, income provided by the Affordable Healthcare Act, everyone has insurance, provided by smaller grants for smaller facilities. Nevada County needed the 850,000 “330” grant but there are many grants, endowments and other sources of fundings to seek if it was directed at our small Clinic.

Unfortunately one source of friction right now is the difficulty in understanding why the Downieville founding source of the WSMC has been the stepchild who has to clean the ashes out of the stove for some gruel to be tossed to them. It has been suggested that Downieville residents are responsible to raise money, write grants, get  funding to support our Clinic. Which makes me and others wonder, are the citizens of Grass Valley and Nevada City being asked to do the same for their site.  We are asking for one provider 5 days a week, and some rotating relief personnel to help cover the 24/7 urgent and emergency care.

Lauren Alderdice, FNP, Flene Folsom PA-C, Lora Lee Grutkowski, FNP,  Heather Lucas-Ross, MD, Elaine Lundy, MD, Galen Martin, MD, Celia Sutton-Pado, MD, Glenn Thiel, DO are all Family Practice/Family Medicine at the Grass Valley WSMC.

Lora Lee Grutkowski FNP will be working in Downieville 4 days and week including the Clinic off hours for urgent and emergency care. Celia Sutton-Pado was recently given a contract to be the Sierra County Public Health Officer which is for 8 hours each week but doesn’t really involve any Downieville clinic work right now.

Meanwhile in Pediatric Care there is Michael Curtis, MD, Kris Jessen-Mathers, RN, PNP, Joseph Lambert, MD, Douglas Wagner, MD and Sarah Woerner, MD  at Grass Valley WSMC.

Then there are J. Alberto Chavez, DDS, Elizabeth Miltner, DDS and Justin Pfaffinger, DDS for dental care in GV-WSMC, Dr. Chavez is up here one day a week and I heard it will soon be two days, we can only hope.

Let’s move on to Behavioral Health, Kelly Cirner, MSW, Tracy Deliman, PHD, Karen Higgins, MD, Jennifer Sale, LCSW all at GV-WSMC.

Case Management/Nutritionist Jerusha Horlick,RN ; Diane Miessler, RN, Danielle Yantis, Dietician, MS at GV-WSMC. and last but not least is Maternity Health: Vanita Lott, RN and Midwife and Wendy Paye, RN .

So there are 25 medical staff on their website.   http://wsmcmed.org/index.php/about-us/medical-staff/

Let’s look at Executive Management, all salaried personnel : CEO Scott McFarland, CMO Glenn Thiel, CFO Tom Morrisey, DD Justin Pfaffinger, COF Francine Novak;   CIO Dan and PDD Cheryl Rubin. To be fair,Thiel and Pfaffinger see patients too, I think.

Of course there is the Management Team: Office Mgr Leo Avelar, Director of Clinical Services, Jennifer Edwards, RN, and Exec Admin Asst. Jessica Fraser and Downieville Clinic Manager C.C.Gelatt.

http://wsmcmed.org/index.php/about-us/board-leadership/

The Board of Directors:Sierra County residents: Larry Allen, Tim Beals, Jon Peek, Don Russell and Brandon Pangman, Nevada County Residents: Florence Lyss, Anita Daniels, Derek Williams, Scott Browne, Katherine Medeiros (also CEO at SNMH), Richard Kuhwarth, Jeannie Medley and Lupe Peterson

So where is the money going and if we merged why don’t we have the same service here. We don’t need the same service, we need the basics, what we have always had. We need Primary, Urgent and Emergency care in western Sierra County 24/7. We are not asking for the moon. In Grass Valley, in addition to the WSMC site there is  a plethora of doctors and dentists, urgent care centers, a hospital and emergency room. In all of western Sierra County we have the WSMC Downieville Clinic…. come on… we are not spoiled. Grass Valley needs to stop whining about how costly we are and start facing who is really sucking up the money… and it ain’t us.

 

 

Fringes’ Grip on Reality 7/30/14

Stay well
Finally, a Fringination on the Downieville Clinicfringe logo
By DeVita

Most towns the size of Downieville have, as their medical care, a voluntary ambulance crew, if they are lucky. Many towns bigger the Downieville have a 45 minute wait for a professional ambulance, the kind that will set you back $7,000.

Downieville is more isolated than many towns. It’s a long way to go for medical care. Fortunately, there is the clinic in Downieville.

It’s not the clinic it used to be, but nothing in Downieville is what it used to be. It’s a harsh truth, one some people don’t accept willingly. That isn’t to say we need to throw a shovel full of dirt over D’ville, it isn’t dead yet. But, it isn’t the town it was a hundred years ago, or even 20. Things are different; people are older.

It’s also more expensive to “do” medicine now. Insurance, supplies, continuing education, all of these have increased in cost in the last 30 years.

As is public knowledge by now, there are a couple of things making it hard for the Downieville clinic to stay open. The clinic serves people in Downieville, Sierra City, and a few points east and west. It also serves, in theory, several thousand tourists. It’s hard to keep a gas station open with that population, let alone something as costly as a medical clinic. If everyone in town was wealthy and paid cash for every service, it would dramatically increase income, but likely it still wouldn’t be enough to support the kind of service we’ve become used to. Government health benefits typically don’t pay well; they are also not consistent, changing every few years or even more often, making it difficult for medical administrators to plan efficiently. The problems hurting the clinic are systemic, founded in policies and economics which are determined far from here.

We all understand the tangible and emotional benefits to having a fully staffed, fully available clinic. It is what makes Downieville a social center, gives meaning to the title “county seat”. It makes us all more secure. Frank Lang brought a level of medical care to the county that doesn’t exist even in some cities. If there was a siren on the west side of the Yuba Pass there was comfort in knowing the victim was going to enjoy the best medical care possible. Western Sierra Medical Center, and the care it provided was, very frankly, the envy of the east county.

But the east county has something to teach the west side about medical care in the modern age. The west was fortunate to have medical care with a small staff, doing essential procedures which are medically sound and fiscally advantageous. The east side struggled with a hospital that was once easily supported and fiscally sound. Local people were born in the hospital, and many spent their last breath there. The community of the east side fought valiantly to save the hospital, or at least salvage what they could of its services. The eastern community is fortunate to have medical services through Eastern Plumas, but even that relationship is not bullet proof; it’s vulnerable to the same systemic realities as the Western Sierra clinic.

Depending on whether the government decides to spend money on war and surveillance or medical care, the clinic might have further reductions in service. A national health plan was supposed to provide not only essential medical care, but also to support the administration of those services. It might work out that way down the road, but for now, more and more providers are declining government insured patients, because they can’t survive on the payments, or the frequent delays or denials of payments, or the inevitable changes in what is covered and how it will be billed.

Of course, the clinic might suddenly enjoy a shower of dependable income, and it could swell to provide more services, but we all understand that once you lose something, getting it back is very difficult. It’s one of the reasons so many people are so upset about any loss of services.

But, here it is, this is the reality. We can spend effort in guessing where the blame lies, or we can deal well with the reality we have.

First, it doesn’t mean the end of Downieville as we know it, or at least it doesn’t have to. Do you want to live in Downieville or not? Life there isn’t just quaint, it’s also often hard. That’s one of the things that make “wintertime Downieville” different from many other places: you only live there if that’s the life you want, which means you can live without power, and deal with bears, and learn to sleep with one ear on the river. It sucks to lose any services, and particularly the enviable services of the clinic, but no one should think of moving over it. If they do, they’ll open a spot for someone who wants to live in the wintertime Downieville.

Second, we aren’t powerless, we can focus our influence. In a brick and mortar business there is a service break even point; you can save money by reducing services or more likely hours, but only to a point. As a community, those who benefit from the clinic can determine what that point is and agree to that range of times or services. In short, clinic users can decide through their behavior to help the clinic remain sustainable. Everyone goes to the clinic on the same days. Also, everyone uses the resources of the clinic when possible. These are consumer choices we make to help a business stay in business. It’s why there are any of the businesses we enjoy in Downieville, which, even in wintertime has things many other little towns don’t have, like a gunshop.

Finally, we can take better care of ourselves, stock meds when possible, and improve local emergency medical care. That last won’t be easy; Downieville and surrounding already have incredible emergency medical care. Still, even more of us can learn to be first responders. Most of us could be more personally responsible for our health.

Get a grip on the reality, and adjust your expectations and needs accordingly; that’s what resilient people, and lasting communities, do.

Critical readers will note I used the “we” term a lot in this piece. The Vets keep my soul attached to my body, but I have used the clinic several times, though geographically I could have gone to Loyalton or Portola in the same time. I value the clinic, and fully understand the great affection people have for the Langs. I know the comfort the little office between the river and the courthouse can provide.

Good luck! Cut down on carbs! Go for a walk!

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