CVIndependent

Wed09232020

Last updateMon, 24 Aug 2020 12pm

A while back, a reader complained that I never discussed the plight of people who are unable to wear face masks—so I asked readers who deal with that plight to write in, and explain how they handle (or don’t handle) that dilemma.

Even though this Daily Digest is emailed to 4,000 people, and available to the entire world at CVIndependent.com, I received a grand total of … zero replies from people who say they won’t wear a mask.

I did, however, receive replies from some people who said they have difficulties wearing masks—but do so anyway.

“I have COPD, and it is VERY uncomfortable to wear a mask,” said one reader, who asked not to be identified. “It is hard to breathe through a paper or cloth mask.”

This reader mentioned mask and oxygen options that would help—but are out of the reader’s price range—before concluding: “Anyways, I do wear a mask when out in public and try to keep my breathing slow and steady which helps.”

I also received this from a reader: “Don’t like Newsom. Don’t like gay marriage. Don’t like anarchy. Don’t like looters. Don’t like Biden. Trump is stupid about masks, but he is better than Biden on the issues in my opinion. However, if I am within six feet of a person or going into any store, bar, etc. I will wear a mask.”

OK then!

I’ll conclude this non-debate with this advice from the Los Angeles County Department of Public Health, as stated in some of the agency’s news releases: “People with medical conditions that prevent safe use of a face covering are asked to wear a face shield.”

Translation: One way another, cover your gosh darned face. There’s no excuse not to.

Today’s links:

Here’s the latest District 4 report from Riverside County. (District 4 includes all of the Coachella Valley, plus the vastness between here and the state line to the east.) The numbers, simply put, are not good. Please note that the cases are presented here based on the testing date, NOT the report date, so the more-recent weeks’ numbers will always seem smaller than they actually are, given the length of time it takes to get test results back.

• However, I do want to point out one encouraging sign: For the third straight week, the weekly positivity rate has decreased. As of the week ending July 5, it’s 12.2 percent—still too high, as the state wants that number below 8 percent, and preferably much lower. However, that’s down from 14 percent as of the week ending June 28; 14.6 percent as of the week ending June 21; and 16 percent as of the week ending June 14. I am still waiting on an explanation from the county on how, exactly, this number is calculated—but lower numbers are always good, and I am crossing my fingers tightly that is evidence that the measures we’re taking locally are finally starting to slow down the COVID-19 spread.

• From the Independent: Kevin Fitzgerald recently spoke to Desert Healthcare District CEO Dr. Conrado Barzaga about his declaration that systemic racism is a public health crisisand we’re seeing that play out in the eastern Coachella Valley during the pandemic, as COVID-19 cases there are sky high compared to the rest of the valley.

• Sigh. Squabbles between Moderna Inc. and government scientists are responsible for the delay in one of the most-promising vaccine candidates, according to Reuters.

The Palm Springs Unified School district plans on starting the school year on Aug. 5 with all-online instruction, before moving to a hybrid model within a month or so, if the pandemic allows it. 

• Related and utterly unbelievable: The president is threatening to withhold funding from schools that don’t reopen for in-person classes in the fall, and his administration is forcing the CDC to issue weaker guidelines for school openings. Why?!

• The results are in regarding Sweden’s grand experiment to keep society mostly open and let the virus run its course: The death rate there is sky-high, and the country’s economy is no better off than the economies of its neighbors that did shut down.

Related: Is the cure worse than the disease? Experts writing for The Conversation crunched the numbers—and came to the conclusion that, no, shutdowns were better for society overall than letting the virus run amok.

Also from The Conversation: The feds’ plan to send home foreign college students if they can’t attend in-person classes would be very bad for the economy.

• Oh, great! Our partners at High Country News are looking at the possibility that North American bats could get SARS-CoV-2. Key quote, from the subheadline: “This is bad news for bats and humans.

• CNBC put a weird spin on this story: “Apple Maps driving activity is slowing again in warning sign for the economy.Yeah, but if more people are staying home, isn’t that a good sign for battling the coronavirus?

• The Washington Post has revealed that at the government-run Southeastern Veterans’ Center, in the Philadelphia area, patients received a “COVID cocktail” including hydroxychloroquine—which has some pretty terrible side effects. According to the Post: “Though precise estimates vary, the state Department of Military and Veterans Affairs said about 30 residents received the drug. Several nursing home staff members placed the number higher. The Chester County coroner, who reviewed the medical records for some of those who died, said at least 11 residents who had received the hydroxychloroquine treatment had not been tested for COVID-19.” Yikes!

NBC News looks at what it’ll mean for the United States to pull out of the World Health Organization. Key quote: “Apart from the effect on fighting the COVID-19 pandemic, the U.S. exit from the WHO also puts at risk a polio vaccination program that has long been a priority for the U.S. across several administrations. Trump’s decision comes just as doctors believe polio is on the verge of being eradicated from the planet.”

• Equinox—which operates 23 gyms in Southern California—is asking some of its teachers to do a lot more for a lot less, with a lot more risk mixed in, according to BuzzFeed. Key quote: “Despite the risk, Equinox is asking its group fitness instructors to come back to the gym and teach classes at a discounted rate, keeping the teachers at their 75 percent pay, rather than restoring their pre-COVID-19 rates. Instructors have also been asked to help clean the group fitness studios after classes, without additional pay, as part of an effort to more frequently deep-clean the studios.”

• Finally, Randy Rainbow is back with another Trump parody video: “Poor Deplorable Troll.”

That’s today’s news. Please consider supporting honest independent local journalism by becoming a Supporter of the Independent. Be safe. Be kind. Wear a mask. The Daily Digest will return on Friday.

Published in Daily Digest

On July 31, Dr. Conrado Barzaga will celebrate his one-year anniversary as the CEO of the Desert Healthcare District—and what a completely unforeseeable year it’s been.

His organization and the valley’s overall health-care infrastructure are being severely challenged by the SARS-CoV-2 pandemic—as well as a related and much-longer-term issue that came to the forefront of the nation’s consciousness on May 25, when George Floyd was killed while restrained and lying on a street in Minneapolis police custody.

The baring of the long-simmering racial injustices in our society ignited the passion of Barzaga—so much so that on June 3, he issued a statement linking systemic racism to the subpar public-health outcomes of minority populations, both in the Coachella Valley and across the country.

Here is an excerpt: “As communities across the country take to the street and risk their lives to demand justice, the Desert Healthcare District and Foundation stands in solidarity with protesters and against racism, oppression and inequality in all of its forms, because we believe that inequities have consequences, both visible and invisible. … Some may say that our focus is health care. It is in this context that we recognize that the killing of Black Americans in this country is, and for too long, has been a public health crisis.

“It is a crisis rooted in the toxic traditions of systemic racism and white supremacy. George Floyd, Breonna Taylor, Ahmaud Arbery and many more have died at the hands of the police and vigilantes—they should all be alive today. For this, we condemn racism, bigotry and white supremacy. No one should have to fear for their lives because of the color of their skin, ethnic origin or identity. No parent should have to worry for their child’s safety and well-being when they venture outside of their home. No community should disproportionately bear the burden of social, economic and health challenges, and yet studies show that the overall health of people of color ranks lower than the overall health of whites.”

The Independent spoke with Barzaga recently and asked what motivated him to issue such an emphatic statement.

“I believe strongly that racism has public-health consequences, and that is the reason why we took that position,” Barzaga said. “For one thing, we see that Black Americans have higher mortality rates compared to other races due to a variety of issues. One is the murder rate. If you look at deaths from a public-health standpoint, there is such a thing as ‘untimely death.’ Black Americans die in an untimely (fashion) resulting from police brutality. That is a fact. But there are other public-health issues that affect that community, and those are the result of systemic racism. Black children are born at a lower weight, and they’re born prematurely (more frequently) as a result of racism. That inflicts a tremendous amount of stress and distress on Black women.”

Barzaga said institutions of policing, learning and health care all need to undergo an important change in perspective.

“I believe that we have been (following) a philosophy of diversity, equity and inclusion that’s causing many public entities and the majority of health-care foundations to address funding through an equity-based lens,” Barzaga said. “I believe that we need to take the conversation a little bit further. We need to move from diversity, equity and inclusion to have a conversation about ‘belonging’ in our communities. The people need to feel ownership and that this is their place—not that they’re being integrated into a community or that they ‘count.’ It’s not an issue of counting; it’s an issue of belonging.

“When I moved to the desert, I found that the community is welcoming. I believe that everyone should have that same feeling—not only that you’re welcome, but that you feel you belong in this community, that you’re part of it, and that you’re celebrated. Not because you’re white, or Black, or gay, or straight, or a man or a woman; I think it’s an issue of belonging. And, when we incorporate that lens of belonging, I think we will make our desert a much better place.

“Although, I do have to say that the desert is a wonderful place—but there is space for improvement.”

The DHCD is working on taking immediate action to address longstanding needs in local Black communities, such as the Desert Highlands Gateway neighborhood of Palm Springs. Barzaga and the DHCD Board of Directors have introduced a resolution formalizing a grant of more than $432,000 for minority health-care improvement, some of which will be earmarked to improve overall health-related conditions for those who live there.

“The district has been working for years with the Desert Highland Gateway community, and I think this will be a continuation of that response,” Barzaga said. “But this time, there will be a definitive action to bring health-care as a reality to that community. That’s what the community says they need; that’s what the community wants; that’s what they have expressed through their community health-needs assessment; and that’s what the leaders are saying. They have been raising the issue of a lack of affordable, nutritious food in that area. There’s no supermarket or any market at all that’s providing services to that community. So there are many issues that I believe require a collective response, not only from the DHCD, but from the city of Palm Springs as well. We are trying to mobilize other resources so that this can become a more comprehensive response to the needs of that community.

“The district is taking a leadership role. We have made a beautiful statement about solidarity, but I think we have to show actions, and not only words—and this might even become a template for how we address the health-care needs of other minority communities in the Coachella Valley.”

The DHCD board recently voted to allow all funding provided to the district to be spent in any region of the expanded “One Coachella Valley” district, whose boundaries now run from Palm Springs in the west to communities like Coachella, Indio and Mecca in the east. The district’s eastern boundary for years was Cook Street, but voters approved the expansion in November 2018. However, that expansion did not come with an expansion in revenues.

“The people have decided that the DHCD should cover the entire Coachella Valley, so, that’s what we’re doing,” Barzaga said. “We will continue to raise the issue of funding disparities between east and west. I think, ultimately, it may have to be the Legislature who will have to provide a solution for that valley-wide funding issue.”

Barzaga said the imminent danger presented by the pandemic has highlighted inequities in the Coachella Valley. By a wide margin, there have been more COVID-19 cases in Indio and Coachella than any other valley city.

“It is clear that we cannot neglect the health-care needs of the eastern Coachella Valley residents, and COVID-19 really put this front and center,” Barzaga said. “Very early on, we knew that we were going to have a much larger problem in the eastern valley as related to COVID-19. These are residents who depend on working day-to-day (outside of their homes). They don’t have the same ability, as many of us do, to work from home. They have to go into the fields, and they have to go and serve the people of Coachella Valley (via the service industry) while being in close proximity to one another. This population doesn’t have the same access to health care as residents in the western parts of the valley. That combination of less protection, less access to care and a more impacted (personal) immune system has been a formula for disaster, and we are seeing the results right now. We have made very heavy investments in our community clinics to make sure that we’re deploying resources for the serious needs of that community.

“There is a gap between the health outcomes in the east and west that we intend to close,” Barzaga said. “It will be years before we have a more-robust health-care infrastructure that can meet the needs and demands of everyone in Coachella Valley. That’s why we’re doing the Community Health Needs Assessment, which is a community-driven plan. Through that needs assessment, we want the community to tell us what they want as a health-improvement plan, and that health-improvement plan will be the road map for the next 10, 20 or 30 years for the district’s investments in the health-care structure of the valley, and to be responsive to the needs of the neediest in our communities.”

Published in Local Issues

Back in October, a mulch fire ignited at the Sun Valley Recycling Center near Thermal, on land owned by the Torres Martinez Desert Cahuilla Indians. The smoke plagued schools and neighborhoods for several weeks, creating health concerns for thousands of residents in the eastern Coachella Valley.

Communities and school boards called for help—and one of the organizations that answered that call was the recently expanded Desert Healthcare District, led by newly elected Board President Leticia De Lara, and Chief Executive Officer Conrado Barzaga.

“There were funds (accessible to the DHCD) that were identified for clean air and to address some of the air-quality issues related to the fires that were burning in the east valley last October,” De Lara said during a recent phone interview. “Our CEO, Conrado, was able to identify these funds and some partners who could bring some immediate health-care resources to the residents, including Borrego Health, Clinicas de Salud del Pueblo, federally qualified health clinics, the Coachella Valley Unified School District and the Torres Martinez Desert Cahuilla Indians tribe. Also, (Barzaga) was able to identify some funds that were set aside to address issues like this in the future, and (allow potential responders) to avoid the chaos that resulted … (by facilitating) their coordination.”

This would not have been possible a couple of years ago: In November 2018, Coachella Valley residents voted to expand the Desert Healthcare District beyond its original, antiquated Cook Street boundary, all the way to the eastern end of the valley. Since then, seven districts were re-drawn and approved by the DHCD board, and directors were put in place for each. As 2019 drew to a close, the DHCD was starting to make its supportive influence felt in these historically underserved east valley communities.

In another recent dangerous health-related incident that drew substantial attention, the management of the Oasis Mobile Home Park in Thermal proved to be incapable of supplying reliable access to clean drinking water for its nearly 2,000 residents; the drinking water drawn from wells on the property, also owned by the Torres Martinez Desert Cahuilla Indians, was found to contain unacceptably high levels of arsenic. Immediate attempts to import clean water proved insufficient.

“At our December meeting, we allocated some funding to be used in partnership with the county of Riverside to address some of the water-quality issues affecting the mobile home park in the Thermal area,” De Lara said. “And we also funded a request from Martha’s Village back in October. So, those are some examples of what’s already been accomplished” in the expansion territory.

The arrival of the DHCD as a new funding option in the east valley is welcomed by established nonprofit health service providers working with east valley residents, including the Coachella Valley Volunteers in Medicine (CVVIM).

“It’s nice to see new things happening,” said Doug Morin, the executive director of CVVIM, in a phone interview. “There’s about $300,000 for east valley funding. So, when you consider all the (health-care-related) charities serving residents in the east valley, (the funding) is limited, but anything is better than nothing.”

Morin said he had just submitted an application for a $50,000 grant to be used to defray the costs of the east valley patient services his nonprofit provides. He hopes his proposal will get approved by the DHCD board in February. However, when compared to the roughly $120,000 annual grant that CVVIM has received from the DHCD to serve its west valley population, the geographic discrepancy in available support becomes apparent.

De Lara said the disparity comes from the fact that funding going toward efforts within the previous DHCD boundaries is not being reduced to fund efforts in the expanded portion.

“We’re continuing to provide the same level of funding for the west valley. … We are continuing to address homelessness and (work) for a regional solution,” she said. “We believe that in the west valley, there are some major gaps in services (for the homeless).”

According to the June 30, 2018, audited financial statements, the total outlay of funds to west valley grant recipients was $5,076,039 for fiscal year 2018, the last full fiscal year prior to the expansion eastward. However, efforts by the DHCD to raise comparable funds to support east valley service grants are foundering. Given this reality, it’s impossible for the grant levels to reach parity across the valley without cutting the grants to providers serving west valley residents. However, as De Lara indicated, that is not a likely scenario for the DHCD board to pursue.  

Morin sees his CVVIM as somewhat unique among Coachella Valley health-care service nonprofits, because it has served residents at both ends of the valley for years. He said the distinction and disparity between funding levels for the original DHCD territory and the new expanded territory is obvious and challenging.

“Their max funding request (for the recent proposal he submitted to serve east valley patients of his clinic) was $50,000, which is what I requested,” he said. “They don’t have that restriction on the west valley, because, of course, they have more funds for the west valley.”

How can the DHCD address this funding imbalance?

“I think we’re realizing that there’s going to be a need to include other partners,” De Lara said. “Sharing costs on some of these long-term visions, I think, is important. Also, there’s the potential to bring in dollars from the state and federal governments by communicating to them in a much better way, through our assessments and studies, where the gaps are, and how they can help us. We can put together a really strong, compelling case statement for some funding. I think the potential to bring in grants that add to our current resources is a very promising possibility for funding.”

In the past, DHCD representatives have approached Riverside County and the state government about various tax strategies designed to generate the new revenues necessary to fund the annexed east valley needs. However, that outreach has so far proved fruitless.

“The possibility of going to the voters or the county for some assessment is something that we have not discussed, so I wouldn’t feel comfortable saying where we’re at on that, because we’re nowhere,” she said. “But in the last board meeting (of 2019), we actually approved two positions to take the lead on exploring funds and grants to help support the work that we’re going to be doing on behavioral health. So I think that we’ll start with grants to try to generate more revenue.”

Despite the immediate challenges presented by the revenue shortfall, De Lara said she sees a bright future for her organization’s ability to enable much-needed quality health care through its grantee nonprofits.

“We have to think strategically,” De Lara said. “We have to think incrementally, and we have to think partnerships. I think that’s how we’ll be approaching the mass of the needs that we (face) now because of the additional area, as well as the district we had before. We’re one Coachella Valley. We’re one district, and we have to keep asking, ‘Are we advancing toward our mission, and are we doing it in a fair way, a smart way and collaboratively?’”

While Morin said the funding disparity is problematic, he praised the efforts the DHCD is making.

“They’re a great foundation,” Morin said. “They’re very transparent about everything that they do, and I like their plan of this ‘One Coachella Valley.’ Their (east valley) impact will be felt immediately, once we receive those (requested grant) funds. Even though I may wish that (those funds) were more, it’s a start. … Sources of funding in the east valley are somewhat limited, so this is valuable. It’s important for us, and it will allow a number of agencies to provide more services. So they’re out there doing their own fundraising, and hopefully, over the years, the amount of funding available to the east valley will increase, and that’s a good thing.”

Published in Local Issues

The last few years have been quite transformative for the Desert Healthcare District (DHCD).

First, there was the need to change the board of directors election process from an at-large standard to a district-based approach, in order to comply with the California Voting Rights Act. As that process moved ahead, voters in the eastern Coachella Valley last November approved the district’s expansion beyond its antiquated Cook Street boundary, creating the potential for improved health-care access and services in the eastern valley—while necessitating that the district figure out how to fully fund services in the expanded district. That voter edict resulted in the launch of yet another rezoning process, which is currently under way.

Through these administrative and organizational challenges, the DHCD has continued to provide support to local health-care providers and community-service programs, addressing needs such as homelessness, public health and behavioral health.

It was against this backdrop on July 31 that the DHCD welcomed its new CEO, Dr. Conrado Barzaga. He brings some 20 years of experience ranging from health-care management and fund development to public-health and public-policy work. After completing his education as a physician and working in his native Cuba, Dr. Barzaga’s career path took him to Argentina, Bolivia and the United States.

Since coming to the U.S., he has held positions as a senior program officer for First 5 LA (2008-2012) and vice president for Planned Parenthood Los Angeles (2006-2008), among other work in health education and public health. Most recently, he spent more than seven years as president and CEO of the Center for Oral Health, where he was instrumental in expanding programs to under-served communities.

During a recent phone interview, Dr. Barzaga talked about the challenges and responsibilities facing the district.

“I believe that addressing health-care needs requires information, intervention and ideas from different sectors,” he stated. “Of course, we need the ideas of those who are the recipients of health-care services, but we also need to understand and listen to the providers of health-care services. So we will inform our work by working with all the sectors of our society that are engaged in health care in one way or another, from the recipients, to the providers, and to the systems.”

Barzaga spoke about the value of data aggregation and analysis in identifying and understanding the health-care needs and desires of the valley’s residents.

“I want to engage our community (in order) to listen and to learn,” he said. “Our board is elected by the people, and therefore, it must respond to the people. They will tell us what they perceive to be their priorities. From a data-gathering perspective, it is important that we gather as many indicators as we can. There are different sources (from which) we can get that data, including California’s Department of Health Care Services and the federal government’s Centers for Medicare and Medicaid Services—you name it. But it is the community’s participation which is going to provide the best intelligence and the best approach to addressing the needs of the district.”

Barzaga addressed the expansion of the district into the eastern Coachella Valley—including some of the area’s most under-served communities.

“We need to understand how the health inequities manifest in the health disparities in the district,” he said. “We need to quantify and qualify those disparities. That will help the district understand where it can have a more profound impact, what the best approach will be, and how the limited resources that we manage can have the best outcome and the best return on the public-dollar investments in the district.” Barzaga wants to utilize surveys, town-hall meetings, focus groups and individual interviews to, in his words, “distill and construct a cohesive long-term approach to how we’re going to foster a healthy one Coachella Valley 2030/2040/2050 (strategic plan).”

Lightheartedly, he added, “I’m in it for the long run.”

The Independent asked Dr. Barzaga how he views the collaborative effort involving the DHCD, the Coachella Valley Association of Governments (CVAG) and the office of Riverside County Supervisor V. Manuel Perez to address the homelessness situation in a number of our desert’s cities.

“Homelessness has important public-health implications,” he said. “At the same time, it’s a very complex issue that requires a collaborative approach to have a collective impact. Thus far, the district-commissioned report (on homelessness in our region) has been the framework for how the community can approach the issues of homelessness in the Coachella Valley.”

The district has committed $3 million to go toward addressing homelessness in the Coachella Valley.

“There was a request for proposals released very recently to invite different providers in the community to come up with ideas and plans on how to help solve the challenge of homelessness in the Coachella Valley,” Barzaga said. “I think the district has been active and has been a significant force in catalyzing and providing resources to our community partners to address homelessness.”

Does Dr. Barzaga feel the DHCD’s expansion of service into the east valley is producing desired results yet?

“From my perspective, the board is deeply committed to the expansion,” he said. “We held six community forums in the first half of this year in Mecca, North Shore, Coachella, La Quinta, Palm Desert and Indio. We’re sharing information with the community about the work of the district, and raising awareness about who we are, what we do, and how we can work together to make the district better. We had very good feedback from the community, and it was made clear through that process that, because of the expansion, some of these priorities are going to shift.

“The realities and the needs of the eastern Coachella Valley are different from the needs of the western Coachella Valley. One of the public-health functions of a health-care district is to address health-care disparities. We believe that there are many, and to address them, we need to understand and apply the lens of the social determinants of health, (in order) to make investments that are long-term, transformational and help to create a healthy Coachella Valley.

“Part of our community outreach effort is the platform we created called the Coachella Valley Health Information Place (CVHIP). It’s an online resource that any social-service workers, health-care providers, community health workers and community members can have access to. It connects different resources with the people who need access to those resources, like housing, food, health care, health insurance, day care, etc.

“To give you some examples, fire departments and police departments are using that (online) resource when they encounter people who need access to services—whether it’s behavioral health, housing, food, you name it. They are using this tool daily to provide solutions to the people they encounter in their daily work. Still, we’re promoting it everyday.”

We asked Barzaga if he had a message that he wanted to communicate through this interview—his first since assuming the new position.

“Rezoning is another topic which is now a priority for the district,” Dr. Barzaga said. “So far, we have had two public hearings this year, and we have two more coming up, and like the municipalities that have gone through the rezoning process, our aim is to have a board that reflects the various communities in the Coachella Valley. So we are really encouraging the public to come out and help us.”

Those hearings will be held during the district’s board meetings on Tuesday, Sept. 24, and Tuesday, Oct. 22. To view the initial set of proposed maps, visit www.dhcd.org/zoning.

Published in Local Issues