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Informed citizens offer views on delays in starting hospital
Topics: hospital, Tehachapi, Hicks, Huckins, tvhd
Posted by editor Tue Nov 30, 1999 00:00:00 PST
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0 responses 0 comments When will they get started on the new Tehachapi Hospital?

That question is concerning more local citizens as three years have passed since voters approved a $15 million bond issue to build the hospital and nothing appears to be happening. The Tehachapi Valley Healthcare District is still waiting to get title to the new hospital's proposed site in the Capital Hills development north of Highway 58. Plans for the new facility appear to be in limbo in Sacramento where a little-known bureaucracy known as OSHPD, which has to okay every detail, seems to go back to square one every Monday morning in reviewing the plans. Now the local citizenry is becoming aware that the project is underfunded by at least $10 million and probably a lot more.

The Tehachapi News has asked informed people who are not associated with the TVHD to offer their assessments of where we are and where we should be going in getting the new hospital project moving faster. This week's assessments come from two people with considerable knowledge of the hospital situation. They are Joanne Huckins and John Hicks. They agree there isn't enough money available at this time to build a viable hospital.

Huckins believes the money gap can be bridged through private contributions, corporate grants and appropriations from other government agencies. Hicks is dubious that enough money can be raised in this manner and suggests that voters may have to approve a supplemental bond issue to get the hospital built in a manner that will adequately serve the area. They agree that hospital officials knew at the time of the election that the $15 million bond issue wouldn't do the job but were responding to what they saw as political reality. Huckins indicates that hospital officials made no effort to mislead voters on that point.

Huckins has a long record of volunteer service to the community. A director and one of the founders of the Tehachapi Hospital Foundation, she was Tehachapi Citizen of the Year in 2002. She is a past president of the Guild of Tehachapi Hospital. She has been a member of the Community Advisory Committee since 2001. For two years she was an advisor to the California Association of Hospitals and Health Systems Volunteer Committee. She was chairman of that group for a year. She presently is affiliated with the Kern Medical Center Volunteers.

Huckins' business career included 20 years as vice president of trust and estates for the First Interstate Bank of California. She then served for five years as director of planned giving for the City of Hope.

Hicks is a 36-year resident of Tehachapi. He recently retired from NASA at Edwards AFB after 33 years as a flight test and research aerospace engineer. He is a graduate of the University of  Texas, Austin and Caltech in Pasadena as well as the Defense Language Institute of Monterey, mastering German and Russian. He and his wife of 37 years, Sandra, have two grown children and a grandson.

Now retired, Hicks has become a painter of recognized talent, working with watercolors. He is also an avid chess player and teaches chess classes with a life skills emphasis at county juvenile detention facilities through Youth for Christ. He has long had an interest in helping solve local problems, particularly those involving education and health care.

TVHD's over-inflated optimism jeopardizes new hospital
by John Hicks
Contributing Writer
As a longtime Tehachapi resident, I was skeptical of the March 2004 Proposition J bond issue to raise funds for building a new hospital. It wasn't that the community clearly needed a new hospital but rather a historically-based skepticism that the TVHD would properly manage the development to complete a new facility on time and on cost. After more than three years that opinion has not really changed because not only have we not begun construction of a new hospital but things seem to be getting further away from one as more obstacles arise.

I started attending the TVHD board meetings shortly after the bond issued passed to learn what was going on and to track the progress, or lack of any. Regularly attending public hospital board meetings, and in discussions with TVHD board members and hospital CEOs, I became convinced the project was flawed from the beginning due to over-inflated optimism compounded by predictable government bureaucratic delays.

In spite of this, I tried to stay positive by forming citizen reviews of the evolving hospital plans, even coming up with money saving contingency plans to keep the capabilities of the new design in case of budget overruns. I even suggested they assign a dedicated project manager to push the development, manage schedules, develop contingency plans and control costs but that idea was declined.
I learned early on from the hospital CEO in charge at that time that the TVHD never expected that the bond measure would be sufficient.

The $15 million figure was arrived at as much as anything from what they thought the community would support and were hoping, with some additional funds from community hospital support groups and federal grants, they might make the resulting $16.6 million total budget stretch at least to cover direct construction costs and some limited equipment. To meet this, the TVHD tried to trim the design by early 2006 to fit available funding without losing capability.

This inadequate budget was coupled with the further optimism that the state review and approval process could be accelerated by piggybacking onto a similar small rural hospital development in state review at the time, that was of a similar size and design. The hope from the architectural firm was that plan similarities would cut the normal approval time from 18 months down to as little as 9 months. The goal was to break ground by the spring of 2007 and come close to meeting the state-mandated January 2008 deadline, with perhaps a short delay waiver. This of course didn't happen as the state review agencies changed staff and apparently lost track of the similitude idea, increasing the review time back to the business-as-usual 18 months as the new review staff started the process from scratch.

The problem is that the delays and approximately 15 percent per year construction cost increases quickly raised the estimated cost from an initial $300/sq.ft. to now over $450/sq.ft. and rising. In spite of a generous donation of 20 acres of land from the Broome Ranch that greatly helped the budget’s bottom line by as much as $1 million, based on earlier property offerings of comparable size; the inadequate funds from the bond measure were quickly outstripped. The latest estimate of $24 million (or more) combined with ongoing delays may necessitate a new bond measure from the voters, since other funding options are too small and limited.

Unfortunately, local hospital revenues are too low to help the new hospital since the old hospital has barely been able to stay in the black financially these last few years and is just able to "keep its doors open" as a previous CEO told me. It's better than its past history when it often operated in the red, but low revenues is typical for small rural hospitals that have no contracts with health insurance providers and receive few physician patient referrals for routine health care or medical tests. Its primary source of income is the ER and long-term care, which isn't adequate to provide any surplus funds toward the new hospital. This may be changing as the new TVHD board and administration are attempting to contract with health care insurers for more routine health care, saving locals a lot of time and money driving back and forth to nearby cities for the same care. Tehachapi residents could help out here by contacting their health care insurers to demand more access to local health care.

Another problem that may have contributed to the overall delays from Sacramento and possibly a loss of the momentum toward a new hospital has been local politics and elections that have resulted in a change of three hospital CEOs within the last year and new TVHD board members who have all had to take time to come up to speed in reviewing hospital finances and the new hospital project.

The original objective in the new hospital, I was told, was just to replicate the existing basic medical capabilities of the old hospital, but with new modern facilities that might encourage local physicians and patients to use the TVHD facilities more often. The bottom line problem here is that this leaves little or no room to shrink the new hospital's size or construction costs without losing basic medical care capability that could render the new facility virtually useless, compared to the one we have now. As I see it, a new shell of a hospital with any less facilities and health care capability than what we have now is not worth building at all, and in fact, if we're going to do this, I'd like to see a lot more medical care capability in the future for our small isolated mountain community — not less.

This state-mandated 2008 earthquake updating for small rural hospitals may be a godsend, but it still takes a lot more money than what the TVHD has today and, in my opinion, a lot more "pushing" momentum to make it happen than they have been able to mount to date. 

Tehachapi Hospital Foundation Director is not willing to put a price on life
by Joanne Huckins
Tehachapi Hospital Foundation Director
Back in 2000 it became apparent that Tehachapi could not retrofit the current hospital to meet the State's unfunded mandate to meet seismic requirements.

Planning began in earnest with the hiring of a bond-consulting firm to determine what this community was willing to spend for a new hospital. For the better part of a year, thousands of questionnaires, interviews and meetings with our citizens led us to believe that this community would support a maximum tax of $26 per $100,000 value to provide a total of $15,000,000 to build a new facility.

The Tehachapi Hospital Foundation, originally formed in 1983, lay dormant until it was incorporated in 2001. The Foundation's primary objectives are “to promote and advance a new healthcare facility and needs of the Tehachapi Valley Healthcare District, to build a new medical facility to include, but not be limited to, a new hospital, new long-term care facilities and to engage in fund raising activities and solicitations to carry out said objectives…” 

There is simply no way the local population through personal donations could make any significant difference in the amount of money needed. What we do need is for our citizenry to become aware of what needs to be done to achieve the goal and begin acting as stakeholders.

In 2004, this community passed a general obligation bond by nearly 80 percent, the second highest total in California's history! At that time, it was clearly understood that those funds could not cover the cost to provide a state-of-the-art hospital and healthcare system to serve Tehachapi and East Kern for the next fifty years. The Tehachapi Hospital Foundation has been and will continue to raise funds through membership, corporate fund raising, grants and funds generated by our governmental representatives. Starting with our own City of Tehachapi or their CRA, funds should be allocated to the hospital. Once our local leadership accepts responsibility, we can then enlist the aid of the county. The county can then enlist the aid of Sacramento. The Capitol, in turn, can enlist the aid of the Federal Government. We all know that vast sums of money are available in all branches of government. It's just a matter of who gets it. 

Many major corporations are doing business here in the greater Tehachapi area and East Kern. They have a vested interest in protecting their businesses and employees. At some point in the future, a capital campaign will be necessary.

Obviously, the road to success will be long and steep. 

Each and every citizen of the Greater Tehachapi and East Kern area must support and assist in building the best healthcare system possible. Something as important as life or death must be given the utmost priority. This need is critical and transcends race, color, creed, religion, age or gender and directly impacts each and every one of us. We have an opportunity and obligation to grant Tehachapi its greatest gift. I'm not willing to put a price on life. Are you?

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