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27 October 2016

A fresh take on the Rancho Mirage referenda of April 2016

I recently posted a notice about the Whitewater Bike Trail on the Rancho Mirage News page, and I received a comment from the moderator there, Charlie Barrett. I've known Charlie through his online posts for a while, and I don't expect him to take any progressive opinions in the near future.

His comment read, "Rancho Mirage voters have turned down [Coachella Valley Association of Government] CVAG's plans to bring the CV Link through Rancho Mirage. City Council was considering even rescinding the offer the city made to CVAG whereby the CV Link would come through Rancho Mirage via Ramon Road, which CVAG flatly rejected months ago. So ..it clearly appears that CVAG is not willing to even discuss anything else but what it dictates and wants, while RM city officials offered to discuss the Ramon Road proposal."

I recognized his comment distills the exchanges between Rancho Mirage and the CVAG executive committee, likely in the interest of writing a cogent but short reply. The distillation only slightly misrepresents how the 18-month-long back-and-forth went in finding any route that could be agreeable to the City Council, CVAG, and the ultimate users of CV Link.

With Charlie's comment in mind, I went back to the referenda that the City Council had brought to the citizens in April 2016. Four issues were on the ballot:
  • Measure 1, binding: Shall the City of Rancho Mirage require that any future amendment or repeal of Ordinance No. 1099, which currently prohibits Neighborhood Electric Vehicles (not including golf carts) on or adjacent to certain designated streets including Highway 111, Bob Hope Drive; Country Club Drive; Da Vall Drive; Dinah Shore Drive; Frank Sinatra Drive; Gerald Ford Drive; Magnesia Falls Drive; Monterey Avenue; Plumley Road, and others, be subject to prior voter approval?
  • Measure 2, advisory: Do you approve of the Coachella Valley Association of Governments (CVAG) spending One Hundred Million Dollars ($100,000,000) or more to construct the CV Link, plus, according to the March 2015 Master Plan, an additional $1.6 million annually to operate and maintain the CV Link pathway, which CVAG proposes to extend through Rancho Mirage business and residential districts?
  • Measure 3, advisory: If CV Link were to be constructed, would you approve the City Council committing Rancho Mirage to pay for CV Link's annual operations and maintenance expenses, which on April 6, 2015, CVAG projected Rancho Mirage's share to be between $110,300 and $251,800 per annum as of the 9th year of operations, and continuing to increase annually at the rate of inflation? 
  • Measure 4, advisory: Because in 2002 County voters approved Measure A, which is a ½ cent increase in our sales tax to be used to repair dilapidated and crumbling roads and highways in the Coachella Valley, should CVAG be allowed to divert up to $20 million dollars ($20,000,000) from this Measure A fund, to pay for the construction of the Neighborhood Electric Vehicles portion of the CV Link?

In actions separate from the referenda, Rancho Mirage city council did in fact rescind all routes offered through the city. The council specifically stated that Highway 111, Gerald Ford, Bob Hope, Frank Sinatra, Butler-Abrams Trail, and—later, as a punitive step against CVAG—Ramon Road could not be used for CV Link routing. —Strangely, the city commission never excepted a CV Link route along Dinah Shore Drive!— Some day the residents may get fed up with the walkers, runners, cyclists, and electric vehicles using their existing streets instead of a dedicated corridor through the town.

However and contrary to popular opinion, the Rancho Mirage ballot measures were poorly written, and they could be interpreted to encourage building CV Link, albeit with confusing restrictions. (Blame then-mayor Dana Hobart and city attorney Steve Quintanilla for this.) As the April ballot issues were written, the city had the following restrictions on CV Link:

  • Measure 1 (approved by 75%): No electric vehicles are allowed on Ramon, Dinah Shore, Gerald Ford, Frank Sinatra, Country Club, Highway 111, Plumley, Da Vall, Bob Hope, Magnesia Falls, or Monterey. However, electric vehicles are allowed on any other streets—and on any other routing of CV Link through the city.
    Further, any changes to this list must be agreed to in a city election.
  • Measure 2 (79% of the vote): This "advisory referendum" likely has no force on actions by the Coachella Valley Association of  Governments, in which Rancho Mirage has one voting member of 11. However, by this advisory, CVAG is allowed to spend less than $100 million for construction of CV Link and less than $1.6 million annually for maintenance.
    As CV Link is to be built as a joint effort of Riverside County and the ten cities of CVAG, interpretation of this advisory Measure 2 is, indeed, cloudy. Perhaps the closest approximation would be that construction and maintenance in Rancho Mirage would be limited to $10 million ($100/10 million) and $160 thousand ($1.6/10 million), respectively.
  • Measure 3 (78% of the vote): This "advisory referendum" likely has no force, although it may guide the city council in enacting local ordinances. However, this advisory allows Rancho Mirage to maintain CV Link with annual amount either less than $110,300 or more than $251,800 each year. Combined with Measure 2, the maintenance funds apparently would be limited to less than $110K.
  • Measure 4 (81% of the vote): This "advisory referendum" prohibits using $20 million from Measure A funds for building the part of CV Link that serves NEVs (electric vehicles). Because of the restrictive language, it appears that other funding sources would be allowed, and apparently using Measure A funds for the non-NEV routing would also be allowed.
So much for the legal acumen of the former mayor, the city attorney, and the current city council.

22 October 2016

On the proposed CVLink for the Palm Springs region

Imagine having a road all to yourself for jogging with the rosy-fingered sunset behind you, ravens making a black flutter above you.

Imagine leaving the golf course on your electric cart, escaping along the wide Whitewater Wash, clubs rattling softly to accompany your solo ride home.

Imagine yourself among friends on their bikes in that heaven between the sky and the pavement, the gears buzzing like cicadas as you share a couple of spare energy bars with the other cyclists.

Imagine the pull from your dog when he sees a Gray Heron float to a rest in the wash below, and your chance to point out that part of nature to your two kids on their trikes beside you.

A Real Bike Trail Comes to the West Coachella Valley




Gravel levee above the Whitewater River, future site of the Whitewater
Bike Trail
All these are not daydreams. They will be soon a part of the leisure activities easily at hand to all in Palm Springs and Cathedral City. In early September 2016, the cities of Palm Springs and Cathedral City agreed on the construction and maintenance of the Cathedral City Whitewater Bike Trail.

The trail "will extend along the west levee of the Whitewater River between Ramon Road and Vista Chino." Cathedral City will construct the concrete bike and pedestrian path for a total distance of about 2.5 miles. (The west levee of the Whitewater River follows below the easterly walls of the Escena development, and it is located within Riverside County Flood Control District rights-of-way.) At Ramon Road, the path will continue west along the north side of Ramon Road for approximately 0.22 miles to end at Crossley Road. The path along Ramon will be added within the existing right of way.

Artist rendering of the Whitewater Bike Trail, near Ramon Rd
Although long-developed plans for CV Link incorporate the levee from Vista Chino south to Ramon Road, the engineering of the Cathedral City Whitewater Bike Trail is distinct from the valley-long corridor. The Cathedral City planning document states, "The Whitewater Bike Trail is a project being undertaken solely by Cathedral City separate from CVAG's CV Link project. Cathedral City is the lead agency on this project, and has completed an environmental document and final design. Cathedral City prepared a conceptual presentation on the proposed elements of the Whitewater Bike Trail."

Planned route, with access points at A and B
Because part of the trail is located in the City of Palm Springs, a contractual agreement between the cities outlines how costs are shared:
  • Cathedral City is 100% responsible for all construction cost.
  • Cathedral City is 100% responsible for all maintenance costs within the City of Palm Springs for a period of 5 years, or until CVAG assumes responsibility for the maintenance of the trail as part of CV Link.
  • Palm Springs grants Cathedral City permission to construct the trail located within the City of Palm Springs.
  • Palm Springs is 100% responsible for all maintenance of the trail located in the City of Palm Springs 5 years after Cathedral City completes the project, until CVAG assumes maintenance of the trail as part of CV Link.




In the November 8, 2016 referendum on their local ballot, voters in the City of Indian Wells have an opportunity to decide whether CV Link can go forward only if there is another, future ballot initiative that results in a majority approval. If this referendum is passed, CV Link will be impeded in Indian Wells by this new obstacle, since, characteristically, building projects are undertaken after city council approval, without city-wide voting.

15 October 2016

Desert Health Care candidate answers

The Desert Sun has provided questions and answers for candidates for the three positions on the Desert Health Care District commission. However, the format of the material does not conveniently allow comparison of the candidates' answers. So those published answers are presented here in tabular format.

First, let's explore what the function of Desert Health Care District is.  Their website provides succinct descriptions of the agency.

Our Mission

Promote good health for the District’s residents by providing community grants and by protecting and enhancing the assets of the District.

Our Vision

To be a leader in promoting a healthier community and higher quality of life for all District residents. To help meet health care needs in the District by continually enhancing our expertise, assessing the provision of health care services, reaching out to leading agencies to support their efforts, and advocating effective health care policy to key decision makers.

Our Values

We believe every resident in our District deserves:
  • Access to health education, disease prevention and comprehensive diagnostic and treatment services
  • The opportunity to participate in District matters through access and input to the board
We support positive health system change via:
  • Incorporating best-practice methodologies where possible
  • Encouraging accurate outcome measurement by benchmarking, monitoring and evaluation
  • Supporting innovative new practices and programs
  • Fostering collaboration and partnerships

Board of Directors

The five publicly elected officials bring a wealth of business experience and expertise, health care background, and community involvement to the board.

President - William J. Grimm, D.O.

  • Elected in November 2012

Kay Hazen - Vice-President

  • Appointed January 2001
  • Elected in November 2002
  • Appointed In Lieu of Election December 2010
  • Elected in November 2014

Mark Matthews - Treasurer

  • Appointed in Lieu of Election November 2000
  • Appointed In Lieu of Election December 2004
  • Elected in November 2008
  • Elected in November 2012

Michael Solomon, MD - Director

  • Elected in November 2008
  • Elected in November 2012

Carole Rogers, RN, MPH - Director

  • Elected in November 2014

Desert Health Care District Candidates Answer Questions

David Duffner Jerome C. Estes Lind Marie Levinson Donald Lorack Mark Matthews Jennifer Susan Wortham Les Zendle
What priorities do you have for the use of health care district grant money?
The best return on investment for grant money would be support for healthcare related educational programs. That would include nursing, nursing assistant, nurse practitioners, physician’s assistant, physical therapist and aides, x-ray technologist, lab techs, and any other related health care professional that I have forgotten to mention. There is a significant problem with the shortage of available workforce in the Coachella Valley. Many young people leave here to get training for a job in healthcare and then find a job where they get training. The district should act to reverse that trend, and support programs that encourage young people who aspire to healthcare vocations to get the training they need for the jobs we need to fill. Enhance mental health care awareness, particularly in our public schools and universities through education and anti-stigma campaigns. Support and develop early intervention and preventive health care services with special emphasis on mental health care which currently is at a crisis level in the Coachella Valley. Support specialized training regarding mental health issues in first responders and law enforcement. Identify and assist local not-for-profit organizations providing health care for our high-risk residents. I am on the grants committee and can speak to this question based on my experience. Currently there is one mental health clinic in our district in Desert Hot Springs for the geriatric population only. There are few programs, group homes or other long term treatment for this undeserved population, and nothing for the mentally ill who have a medical comorbidity. There are funds available to address this lack of resources and that is my priority. I would expand street medicine to include a mobile medical clinic to reach the undeserved unable to get medical care. Spending grant money for these programs will positively impact Desert Regional Medical Center’s Emergency Room and provide needed health care for all our residents. The current district organization has as a major mission statement “providing community grants”. My orientation as a former Desert Healthcare Administrator and career long Healthcare/Hospital Executive is that of the district mission being driven by its charge to provide an acute care hospital environment to a specific district community within its model. Recognizing the Desert Healthcare District has a modified model due to the change of control through the current lease, grants now appear to be the priority in an expanded community based agenda. I need to better understand where all the elements of the overall district strategy are in supporting the acute care model before setting any priorities for grants. The current list of grant activity appears to be impressive and I would like to know more about its sustainability against the daunting challenges facing the district. This column left blank because of blog format text. Each change in healthcare policy at the state and federal level will cause re-evaluation of where your finite grant funds go. The future decisions by the district and our neighbors east of the existing boundaries to address healthcare access and inequality will be paramount to both allocation and deployment of grant funding. This is why the outcome of the coming Desert Healthcare District election is so important. We have two directors who have chosen not to run for re-election. I am the only candidate on the ballot who has over 30 years of healthcare governance experience at Desert Hospital and 20 years at Desert Healthcare District. I played a role in negotiating the existing arrangement with Tenet Health which saved Desert Hospital from desperate financial straits while creating enormous value for the constituents of Desert Healthcare District. Our plan worked better than we imagined. I would invest a portion of the grant money in new technology and upgrade the hospital’s medical equipment. I would also invest in improving the outdated areas of the hospital. I would continue to fund health education programs; programs focused on the region’s youth; programs serving patients with HIV/AID’s, and those serving at-risk populations including victims of child, elder, and spousal abuse. I would continue to fund training for future health care providers and programs designed to bring quality health care providers to the area. The 2013 Coachella Valley Community Needs Assessment study reported that the Valley has a 13% higher rate of cancer deaths than the California average. I would like to see the district develop a program to provide cancer prevention and early detection services for our community. Finally, I would like to see funds spent on improving access to mental health care and substance abuse services. Improving access to primary care and especially mental health care (for people with and without insurance – including the under-insured). The District should help fund training programs for providers in these fields. Also, the District can use grants to help non-profits expand their counseling services (e.g., Jewish Family Service, LGBT Community Center of the Desert, etc.) Developing community-based programs in health education - both teaching people how to navigate our often non-integrated healthcare system (e.g., urgent care, emergency care, home health care, social services, etc.) and educating the community in wellness, disease prevention and self-treatment. Addressing issues of healthcare disparities and educating all providers in culturally competent care. The Coachella Valley’s Latino, Native American, African-American and the LGBTQ communities present unique challenges to those delivering high quality healthcare. As a community-wide organization, the District is in a unique position to address issues these challenges.
What role should the Desert Healthcare Foundation play in funding programs? What changes would you like to see in the foundation’s role or in its board of directors?
I am not clear about the relationship of the foundation board to the district board. My approach would be to subject this issue to analysis from the classic Business approach of identification of strengths, weaknesses, opportunities, and threats. In a transparent way the district board and the foundation must be in sync and the results should be cost effective. The structure must conform to the overall goals of the organization and ultimately to the benefit of the taxpayers/citizens. In 2012, the Foundation revised its bylaws to allow for support of health care and wellness services across the entire Coachella Valley. The roles of the foundation now include "fiscal sponsor and incubator of new collaborative projects.” I am in support of the current foundation bylaws. These rolls will become increasingly more urgent in the next 20 years as the Coachella Valley is the fastest growing population in Riverside County. Anticipating the health care needs of our growing population will require a visionary approach and commitment. The Foundation has come under criticism recently for spending district money for programs outside our district. The Foundation is also funded as a beneficiary of several trust funds. At this time, I don’t think there should be any funding from the District to be used outside the district boundary. The Foundation was originally founded to raise money when Desert was a nonprofit. Since then it funds health and welfare programs across the valley. The Foundation does not have a separate board. The District Board is responsible for the Foundations programs requests. I do think there should be a separate board. I would like to see much more community involvement by making sure through the paper and all other media sources to let our residents know when and where meetings will be held. I believe the district and the foundation are outstanding community assets that could and should play a very significant role in the future of health and healthcare support going forward to the entire C.V. Both entities are most relevant to today’s healthcare services environment, however, both would be benefitted from and benefit the entire community with a redirection of strategy and repositioning of purpose. This column left blank because of blog format text. In years past, the Foundation has developed important healthcare services to address local needs, including the Smile Factory dental program, breast cancer screening programs and Health Car transportation service. The Foundation created the Health Assessment Resource Center (HARC), developed the Wellness Park and worked with valley wide partners to educate and enroll residents during the introduction of the Affordable Care Act. The Foundation investment in Find Food Bank and the Desert Aids Project has dramatically improved the outcomes for food insecurity and Sexually Transmitted Disease. Going forward, however, I think it is possible that the Foundation may take on a less proactive role until we understand better what AB 2414 means when fully implemented. I have listened to ideas to support local business with insurance options for employers small and large that would have the dual benefit of insuring more people and supporting local employment. The foundation should continue playing a key role in identifying the healthcare needs in the community by supporting organizations such as HARC, and providing grants to community service organizations to fund health education and disease prevention programs. The Foundation could play a critical role in coordinating services, and building greater collaboration among government agencies, local healthcare providers, and community service organizations. A significate portion of the current funding for the foundation’s programs comes from the special tax imposed on the District’s property owners. I would like to see the foundation take a more active role in fundraising to support the needs of the District rather than relying on taxes. I would restructure the foundation’s board to include more physicians, healthcare providers and representatives of several community service organizations. It is somewhat confusing that there are two boards (Foundation and District), both of which have identical board members and make community grants. My understanding is that the Foundation Board essentially disappeared in 2004. It was resurrected in 2012 in order to make grants to programs that serve people across the entire Coachella Valley (including east of Cook Street). Hopefully, this will become a moot point if the voters approve the expansion of the district in 2018. Also, there are some theoretical benefits to having a separate Foundation because it can accept money from entities (other foundations and private bequests) reluctant to give money to a governmental agency like the DHCD. Regardless of which entity makes a community grant, the process needs to be transparent and accountable. Recipients of grants need to show that the money was used for the purpose intended and also be able to demonstrate positive outcomes from the funded program(s).
What are your feelings about the district’s expansion into the eastern Coachella Valley? How would you propose paying for new services there?
From a feeling standpoint I would like to see the district provide the maximum benefit over the broadest possible area. My concern would be that by stretching the district, the resources would also be stretched and therefore perhaps not as effective. I would definitely have an open mind on this question. The critical analysis would be based on the sources and uses of funds and the ultimate benefits to the taxpayer/citizens. The Desert Healthcare District voted to back a CV Expansion Bill AB2414 sponsored by Assemblyman Edwardo Garcia, which I support. The Bill could reach Governor Brown by the end of August 2016. Riverside County’s population is rapidly expanding, with the Coachella Valley’s population rising at a higher rate than the rest of the county. The population explosion will largely take place in the eastern Coachella Valley; for example, Indio is expected to increase from 73,000 in 2008 to 112,000 projected in 2030. The city of Coachella is expected to grow from 38,000 to 70,000 in 2020, per the Southern California Association of Governments. There will be an assessment/evaluation by Local Agency Formation Commission to determine the best way to pay for expansion. Also, the California Endowment is studying the issue with a report to be released soon. It appears property taxes and builder impact fees would pay for expansion of services. I support the district’s expansion. I think funding for this would be the same as for our district, through property taxes. There may be other funds through the state government available as well. The East Valley has a hospital, Oasis Mental Health and other programs in place. These programs could expand to accommodate the demand in the East Valley. Riverside Mental Health and Tenet would be good partners to further improve programs and patient care specific to the population in conjunction with the expansion. The expansion of the district into the East Valley is an outstanding idea and should be accomplished as soon as possible. The opportunity to have an all-inclusive valley collaborative strategy is something that is long overdue. An all-inclusive strategy utilizing the district and foundation entities supported by a valley wide coalition of providers and municipalities could very much create a model of best practices and support for Provider Delivery System Development, going forward into the challenge of National Healthcare Delivery Reform. This column left blank because of blog format text. A vote of the people in the East Valley will determine the expansion. The legislation does not allow for the voters of the Desert Healthcare District to have a voice on expansion. However, funding cannot be approved until a second vote takes place. Paying for these new services is a critical question. I welcome a broad public discussion to help develop a consensus on how to proceed. That sounds like good government to me. If and when East Valley voters approve the district expansion, I believe a funding and facilities plan should be on the same ballot in the future. The voters should demand a comprehensive plan for health service delivery for the near term of 10 years and the long term of 30 years. My concern is that the current bill (AB 2414), does not outline how the proposed expansion will enhance the overall health of our community. I am also very concerned that the proposed legislation fails to identify a funding mechanism for the expansion of services to the area, and that the residents in the current Desert Healthcare District will not have a voice in the decision. In the past few years, Desert Regional Medical Center generated nearly two hundred million dollars in profit. A good portion of the profit comes from serving patients from the eastern Coachella Valley. Most of the profit produced by the hospital currently leaves the region. I believe we should reinvest this money into our community, which would help the local economy by increasing employment and ensuring the healthcare needs of all of the people in the Coachella Valley are well served. I very much support the expansion of the Desert Healthcare District to the eastern Coachella Valley for two reasons. First, it is the most efficient way to offer residents of the eastern valley similar support in improving the health of that community — something they need and deserve. Second, dividing the Coachella Valley into two halves makes no sense from either a public health or an access to healthcare perspective. Residents cross Cook Street (in both directions) to work, shop, eat and seek medical care. Desert Regional Medical Center is home to the Coachella Valley’s only designated trauma center and the only neonatal intensive care unit. As to how to pay for the expansion, AB 2414 calls upon the Riverside County Local Agency Formation Commission (LAFCo) to do an “analysis of funding sources available to the district”. I would hope that such funding could come from the taxes residents already pay rather than new taxes.
What qualities would you like to see in the district’s next CEO?
The next CEO of the Desert Healthcare District must have excellent skills at organizational transformation and communication. The current district board and staff have been rocked by the turmoil of a lawsuit by a director against the district and the CEO with the predictable result of organizational dysfunction. Recalling my studies for an MBA in healthcare, the district board needs to refocus, and by that I mean the process of establishing vision, mission, goals, objectives, and then determining strategy and tactics to achieve those goals. Few people would disagree that the American healthcare system is in a state of flux. It is the job of the district board to organize and direct the organization and resources to achieve the maximum benefit for the taxpayers and citizens. The new CEO must be ready on day one to work under the direction of the board to get the job done. Track record of competence and caring; results-oriented Personal insight - one who isn’t as concerned with titles or power structures as they are about the welfare of the community One who seeks feedback from staff and others including community leaders. Courage - willingness to look at risk and act on what is the right thing to do, not just for today, for the long term. Tackle bad news head on. Foresight - someone who has a vision for the future; leadership as opposed to management. The next CEO qualities I would like to see are leadership, flexibility, task oriented and accountability to district residents for decisions made on their behalf. Improving community relations with community leaders and residents by more interaction and visibility. I would encourage through the press and all other media sources, residents to attend meetings and offer their concerns and comments on the health care of our district. Rather than the district telling us what we need, listening to residents that use health services fits more with our Mission Statement. The next CEO should be able to relate to a classic asset change of control model whereby the hospital has been partially monetized and its community mission somewhat replaced by the corpus associated with a new foundation, in this case, the district. Therefore, the individual should have some history and background associated with hospital operations and healthcare in general together with some but not overweighed experience in a public health environment. The ideal candidate because of the size and scope of the position should have an extensive background in finance with an aspiration in the pursuit of a CEO role of a marginally active district. To that end, an individual with hands-on experience in a California district environment would be very helpful. In addition, the usual and customary things that you would expect such as high professional character, honesty, loyalty, bravery, team leader should be warmly looked upon as values presented by an applicant. This column left blank because of blog format text. Running the Healthcare District of tomorrow requires someone who understands the role and rules of public agencies. I also expect them to have an understanding of our changing healthcare system as brought about by the Affordable Care Act and evolving market conditions. Healthcare is one of the largest and most important businesses in the Coachella Valley. A coalition and consensus builder will be important attributes for our next CEO. The Healthcare District CEO must be a strategic thinker who understands the connections and relationships among various stakeholders and how the District’s work fits into the big picture. The CEO must have a systems perspective, looking at the health of the community as a whole and must consider the past, present and possible future challenges and opportunities when making plans and decisions. I would seek a candidate with excellent results-oriented problem-solving skills and exceptional communications skills. The candidate must be an effective change agent, who drives for better and more innovative ways to improve the health of the community. The CEO must commit to sustained, effective change while consistently re-evaluating the status quo with a focus on value-added activities in a constantly changing environment. The role of the District CEO is to provide leadership and guidance in order to achieve the agency’s mission, strategy, and annual goals and objectives. It should also be noted that the new CEO will be the primary manager of both the possible expansion of the Desert District and the possible renegotiation/renewal of the hospital lease. My ideal candidate should have exceptional communication skills (listening and transmitting information), coupled with a passion for providing high quality healthcare in a collaborative effort — not only with the 5 elected officials of the District Board but with all the other key players in the district. To achieve this, he or she must understand the objectives of the District, be creative in assembling and synthesizing the varied recommendations, and work collaboratively to implement them in the most efficient and effective way possible.
Assess Tenet’s performance running Desert Regional Medical Center. Should Tenet be given approval to operate the hospital beyond 2027?
This extremely important question cannot be fully addressed in a brief response. According to reporting from the Desert Sun over the last couple of years, and the recent one star rating by Medicare, there should be intense scrutiny regarding the administration of Desert Regional Medical Center. After my 12 years of service here, it is obvious to me that Palm Springs and much of the Coachella Valley considers DRMC as “their community hospital.” As the only regional provider of trauma care, neonatal intensive care, and other vital services the hospital is incredibly important for providing healthcare to residents and also assuring that quality care is available to outsiders who choose to visit or become seasonal residents. I have no doubt whatsoever that DRMC can and should do better and I believe it is the duty of the Desert Healthcare District to provide oversight to ensure that high level quality is provided. Tenet has done a fair job in running Desert Regional Medical Center. The hospital has scored high in joint replacement surgery and gall bladder removal; The Comprehensive Community Cancer Program is excellent. The hospital received a gold+ award from the American Heart Association for treatment of congestive heart failure: and of course, the trauma Level II services are vital to our community. That said, there is room for improvement. Several agencies including the Federal Government have given the hospital a low overall rating. I believe it is too early to make a decision on the lease extension of 2027. We have time to measure and weigh our options. This should be accomplished with community partners involvement and the process should be as transparent as possible. The predictions for population growth over the next 11 years indicate tremendous population growth for the Coachella Valley and it will be essential that we be prepared to take on the needs of our growing communities. Tenets performance: I have given that a lot of thought and have talked to residents that have been there recently. My concerns are the long wait time in the emergency room, the reception area not being welcoming and helpful, elevators not working and the physical appearance and crowding of some floors and rooms. To my knowledge, Tenet has spent limited money compared to the income they receive from this facility doing any kind of upgrades or improvements. Particularly the East Wing, Lobby and Emergency Room. Their patient satisfaction is low compared to other county hospitals. I would like to see a Desert Hospital Urgent Care located by the hospital as an option for patients to alleviate the emergency room’s overcrowding and improving patient relations. A comprehensive Urgent Care to include Mental Health. I am not aware of any concrete proposals from Tenet at this time. It is in the District’s best interest to have in place a long-term agreement to deal with the very challenging strategic and operating matters it now faces with the hospital. The hospital needs to deal with significant strategic matters such as master planning for purposes of facility modernization, emergency room expansion, together with the resolution of any seismic issues. These fairly daunting matters cannot be dealt with in a vacuum nor within the context of a remaining 10-year lease alone. The healthcare environment is changing more today than ever before. The transformation of structure, operations and interests are all very time sensitive. For these reasons, again it is in the District’s best interest to move on and expeditiously deal with this situation. This column left blank because of blog format text. That will be determined by District Voters. The only way Tenet can be given approval to operate the hospital beyond 2027 is for a majority of voters in the Healthcare District to approve in a public vote. As it stands today, or as it will look if the voters approve expansion into the East Valley as AB 2414 proposes, we are going to need a tremendous amount of money for capital investment. The only way to do that is thru a compelling strategy created by healthcare leaders in the valley that is approved by a majority of voters in the Desert Healthcare District. If we eliminate a partnership with an entity such as Tenet we put the entire burden on the taxpayers of the district. We lose not just the capital investment made in hospital equipment and facilities, but also the property tax payments. The hospital reported better than average performance in the ED, and for procedures delivered to people who experienced a stroke. However, the hospital has one star out of five in the Hospital Compare Report. The Healthgrades report indicated that 68% of patients who received care at the hospital would definitely recommend the hospital, slightly below the national average. People who experienced a stroke, heart attack, respiratory failure, or sepsis had higher than expected mortality rates, which indicates an opportunity for improvement in the quality of care delivered at the hospital. There are 11 years left on the current lease. The new Board should take its time, and make an informed decision on the future of the hospital. Any future agreement must ensure that a percentage of profits generated by the hospital are reinvested into the hospital, and on services that will improve the health and wellbeing of our community. Although the District Board does not manage Desert Regional Medical Center (DRMC), it has a responsibility to ensure the hospital provides high quality affordable care to District residents. The current lease with Tenet Healthcare does not expire until 2027, however, the District Board can represent the community to help identify issues and to improve the quality of care and service at the DRMC. The low score from the Centers for Medicare and Medicaid Services is concerning, but it needs to be put in the context of other health scorecards such as those from the Leapfrog Group, Consumer Reports, Healthgrades, US News and World Reports, etc. Each of these scorecards gives us information about the quality of care and service at DRMC. Tenet should use this information, as well as its own assessment activities, to continually improve. Two services I think Tenet should add are inpatient psychiatry beds and more beds in the Emergency Department.

10 October 2016

World Gym, rest, Cathedral Cove

Sunday, 9 October 2016

First an easy ride to the gym for yoga and an easy return home. After lunch, I rode for another hour to Cathedral Cove.

New tool: Relive Fly-over of the ride

Ride conditions
Temperature: 86°F at 9:45
Precipitation: none
Winds: calm 
Clothing: Double-layer MTB shorts, undershirt, ankle socks, open-finger gloves
Bike: Lotus Legend fixed 48x16 
Time: 1:19:32 for 17.48 miles
Heart rate: 97 bpm HRave, 149 bpm HRmax
Playback of the ride

08 October 2016

Scylla and Charybdis

Saturday, 8 October 2016

I had biked an errand this morning, the 4-mile ride to the Farmers' Market, but I didn't feel a need to record the errand.

After breakfast, I had an hour or so for a ride before we planned to go see "The Girl on the Train" and "Birth of a Nation." So I took Blue out into the Indian Canyons. Today both Andreas and Murray Canyons were closed for a benefit dinner, so my only route available was toward the Trading Post. By the time I passed between Scylla and Charybdis (the tight passage between the hillside and a single-rock outcropping), I had already done 35 minutes allotted for my ride. So I turned around immediately and pushed to be back within 25 minutes, following the same course. I arrived home a few minutes over, but still pretty close.

Ride conditions
Temperature: 93°F at 13:00
Precipitation: none
Winds: 5 to 10 from the east
Clothing: Skinsuit, ankle socks, open-finger gloves
Bike: Lotus Legend fixed 48x16
Time: 55:06 for 14.74 miles
Heart rate: 136 bpm HRave, 147 bpm HRmax
Bikeway users: 3 cyclists
Playback of the ride

Friends of CV Link announce Fall events

 Joint ride with DAC

Friends of CV Link joint ride with Desert Ability Center on
  • Saturday, October 15.
Two meeting locations are available:
  • 7:00 a.m. at Moguel and Kaya Auto Detailing
    35688 Cathedral Canyon Drive
    Ste 201
    Cathedral City
  • 7:30 a.m. at
    68597 Pasada Road
    Cathedral City
 Road bikes are suitable for the course. The DAC cyclists will ride about 5 miles from Pasada Road. Other cyclists will ride 10 to 30 miles, decided on consensus at the start of the ride from Moguel's.

Meet and hear what's new with CV Link

  • Saturday, October 22
  • 8:00 a.m. to 12:00 noon
  • Desert AIDS Walk  - Health and Wellness Village
  • Ruth Hardy Park, Palm SpringsBounded by Tamarisk Road, North Avenida Caballeros, East Tacheva Drive, and North Via Miraleste


Meet and hear what's new with CV Link

  • Saturday, November 5
  • 7:00 a.m.to 10:00 p.m.
  • Dia de los Muertes
  • Rancho Las Flores Park, Coachella
    841999 Grapefruit Boulevard
    at Ed Mitchell Drive


Fall bikeway cleanup

  • Sunday, November 6
  • 7:00 a.m.
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201

Meet and hear what's new with CV Link

  • Saturday, November 12
  • Sunday, November 13
  • 10:00 a.m.to 4:00 p.m.
  • Italian Festival
  • Whitewater Park, Rancho Mirage 
  • 71560 San Jacinto Drive

Monthly bike rides

  • Sunday, November 13
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201

Meet and hear what's new with CV Link

  • Saturday, December 3
    10:00
    a.m.to 6:00 p.m
  • Sunday, December 4
    10:00
    a.m.to 5:00 p.m.
  • Tamale Festival
  • Oldtown, Indio
  • Miles St, Towne St, Smurr St, and Requa St
    Between Highway 111 and Indio Boulevard

Monthly bike rides

  • Sunday, December 11
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201

Monthly bike rides

  • Sunday, January 8
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201

Meet and hear what's new with CV Link

  • Friday, January 20
    12:00
    noon.to 8:00 p.m
  • Saturday, January 21
    6:00
    a.m.to 5:00 p.m.
  • Tour de Palm Springs
  • Palm Springs
  • North Palm Canyon Avenue
    Between Tahquitz Canyon Way and Alejo Road


Meet and hear what's new with CV Link

  • Tuesday, February 7
    12:00
    noon.to 8:00 p.m
  • Senior Center Health Fair
  • Indio
  • 45-700 Aladdin St

Monthly bike rides

  • Sunday, February 12
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201

Monthly bike rides

  • Sunday, March 12
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201

Monthly bike rides

  • Sunday, April 9
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201

Monthly bike rides

  • Sunday, May 14
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201


Monthly bike rides

  • Second Sunday of each month
  • 8:30 a.m. 
  • Moguel and Kaya Auto Detailing, Cathedral City
  • 35688 Cathedral Canyon Drive
    Ste 201


07 October 2016

CV Link foundation ride

Friday, 7 October 2016

At first I was heading out for a ride on the Goat Trails. But Ch hailed me within a block from home—he was just returning from a doctor appointment. So he agreed -grudgingly- to expect me back in 2 hours. Then on the way, I called him that I decided on a different route and would be back in an hour. Flexibility rules!

So my route was over to the Whitewater River, crossing the Dinah Shore Bridge, going north to Ramon, crossing that street, and going almost up to Vista Chino. Then back, following almost exactly the same path. All on the right-bank levee, the foundation of the future CV Link.

Ride conditions
Temperature:  9e°F at 15:00
Precipitation: none
Winds: calm 
Clothing: Skinsuit, ankle socks, full-finger gloves
Bike: Trek Fuel/EX mountain bike 
Time: 1:06:29 for 12.60 miles
Heart rate: 131 bpm HRave, 147 bpm HRmax
Playback of the ride

03 October 2016

To the gym and then auto exploration of Mt San Jacinto

Sunday, 02 October 2016

This morning ride was to World Gym at Vista Chino and Sunrise. Mitch had alerted me to a new yoga class held there on Sundays, 9:30 to noon. So that was a good reason for a gentle ride there and back.

The class is a very nice, introductory yoga under a good instructor. His focus today was on very basic, light aerobic movements that had light stretching. On my way home, I zagged over to Ruth Hardy Park to catch any laggard volleyball players, who had already left by my passing by at 12:30.

This afternoon, I drove from P.S. to Banning and then to Idylwild, looking for bikeable roads up the mountain. I had seen roads marked as "Service Road" from Tipton Road to Banning, and I tried these rocky, unpaved routes first. They might be suitable for mountain biking, though the way would be somewhat boring, And then when you've arrived at the road up the mountain, what fun would a mountain bike climb up a paved road be? So after that exploration, I decided against these as any viable route.

I then tried first a couple other roads up from the pass, but both Falls Creek Road (from Snow Creek) and Halls Grade Road (south from Cabazon) were blocked with "No Trespassing" signs posted.

After much doubling back from the unsuitable roads, I took an exit from Banning onto Route 243. The road  rises from 2235 ft at Banning to 3000 feet in less than 2 miles, then 4000 ft by about 5 miles, 5000 ft by 10.5 miles, and finally 6000 ft after 19 miles. Idyllwild is the summit at 6200 ft and 23 miles. The route could be a beautifully challenging bike ride, but I would like to find a couple other cyclists to ride it together.

I returned by Highway 74 from Mountain Center down to Palm Desert, about 36 miles to El Paseo. Along the way, I explored a bit of Pinyon Flats, looking for the uppermost part of Dunn Road. i found Palm Canyon Drive pretty easily, and I took it to a barrier at the point that it likely becomes Dunn Road. Almost all the roads in Pinyon Flats are gravel, but they are in pretty good shape. If ever I get there from Cathedral City, the way back down 74 could be really enjoyable.

Ride conditions
Temperature: 82°F at 09:45
Precipitation: none
Winds: calm 
Clothing: Double MTB shorts, T-shirt, ankle socks, open-finger gloves
Bike: Lotus Legend fixed 48x16 
Time: 00:32:14 for 7.66 miles
Heart rate: 127 bpm HRave, 154 bpm HRmax

Playback of the ride

01 October 2016

Another Cyclist killed on Ramon Road

I note with dismay that another cyclist on Ramon Road has died after being hit by a motorist. The Desert Sun reports, "At 4:48 a.m., officers responded to East Ramon Road west of Paseo Dorotea, where a semi truck traveling eastbound had hit a bicyclist. Upon further investigation, authorities found that the bicyclist, traveling northbound, had attempted to cross the eastbound lanes of Ramon Road when the truck crashed into the cyclist[, who] died at the scene."

Our Coachella Valley cities and transportation planners have to answer us: why is it that only six east-west corridors are available to all traffic, especially endangering pursuers of active transportation (cycling, running, walking, and low-speed electric vehicles)? —Subliminally at least, all vehicle operators recognize those few east-west corridors:
  • West Coachella Valley
    In the west valley are, from south to north, East Palm Canyon-Highway 111, Mesquite-Dinah Shore, Ramon, and Vista Chino below Interstate 10; Varner and Dillon north of the interstate.

    NONE of these corridors have markings that suggest a "safer" riding position for bikes and other active use. ALL of these corridors allow relatively high speeds, and motorists typically surpass the speed limits without Police enforcement.

  • Central Coachella Valley
    In the central valley are more east-west corridors—and heavier, more speed-obsessed traffic: Highway 111, Fred Waring, Country Club, three streets that merge in the east (Frank Sinatra, Gerald Ford, and Dinah Shore), and Ramon below Interstate 10; both Varner and Dillon serve east-west traffic north of the interstate.

    Many of these corridors are marked with bike lanes, some with NEV markings too. ALL of these corridors allow relatively high speeds, and motorists typically surpass the speed limits with little Police enforcement.

  • East Coachella Valley
    In the east valley are the fewest east-west corridors: Airport Boulevard, Avenue 52, Avenue 50, Avenue 48-Dillon, and Highway 111 (if one dares alternate conveyance on a Business Interstate 10)

    I use these corridors little enough to make generalizations, and I welcome comments from my readers about bike lane markings and speed enforcement.

For 15 years (or more), studies of separated corridors for east-west active transport have been made and been ignored. As CV Link nears its first construction in Cathedral City, we still have years to await completion of any significant, contiguous alternate to the motorist-focused corridors. That completion will benefit us all: cyclists, pedestrians, and low-speed electric vehicles will have a safer, dedicated path; motorists will be relieved of the frustration of caring for the low-speed and more vulnerable members of the traffic pattern.

For more reasons behind my support of CV Link, read http://bike-commute.blogspot.c...