Originally posted at the California Health Report.
By Matt Perry.
When the posh Mizell Senior Center in tony Palm Springs trumpeted the success of a new fall prevention program in the surrounding Coachella Valley last week, it was a lily white victory.
On the surface, the program was a rousing success. Older adult attendance in the seven-site program was higher than expected. Participants reported more walking confidence and greater willingness to get out and socialize, helping to minimize a health scourge worse than smoking: social isolation.
But these improvements did not include area Latinos, who make up more than half of the 400,000 residents in the Coachella Valley.
Of the 266 older adults participating in the four-week program, fewer than 1 percent were Latino.
The complex answer begins with the valley’s service boundaries drawn in 1948 — three years after the end of World War II — for program sponsor the Desert Healthcare District. Supported by property taxes from district residents, it funds programs that support a wide range of services, including the senior center and cancer prevention as well as the Arrowhead Neuroscience Foundation and horseback riding therapy.
“The money stops at Cook Street,” sighs Suzanne Spencer, program manager for the falls prevention program at Mizell, identifying the eastern edge of the coverage area. “Everybody east of that location wants the program. We are working feverishly with other organizations to get further funding to go into east Coachella and up to the Salton Sea. To no avail so far.”
The nearly 70 year-old boundaries have also deepened a divisive east-west separation in Coachella Valley. The district largely covers the western valley, including wealthy communities like Palm Springs, Rancho Mirage and Palm Desert. East Coachella Valley lies outside its service boundaries, and is home to the vast majority of valley Latinos who often live in crushing poverty while working in the agricultural and service sectors – often for their white counterparts.
In 2010, there was only one primary care physician per every 8,400 residents in the East Coachella Valley.
“Structural racism explains a lot about what happens in the Coachella Valley,” says Christine Newkirk, a research associate at the Center for Healthy Communities at UC Riverside.
She cites a legacy of deep racism that has created poverty and isolated conditions in east Valley communities like Thermal and Mecca.
“There are no good grocery stores, there’s nothing to do for recreation, so they’re just stuck out there,” says Newkirk.
While the Affordable Care Act has given more eastern Valley residents health care, the international aid organization Flying Doctors still holds an annual clinic in the area. And Latinos complain that the Desert AIDS Project – another district grantee – serves its wealthy Palm Springs clients with top-shelf service while relegating east Valley HIV-infected Latinos to second-class status.
The disparities are so great—and the poverty so extreme—that the California Endowment* has targeted the Eastern Coachella Valley as one of just 14 state regions for critical healthcare improvements, joining underserved areas like East Oakland and Southern Los Angeles in its 10-year plans.
“We’re learning that 10 years is just a start,” says Silvia Paz, who directs the Building Healthy Communities hub for the Eastern Coachella Valley.
Yet change may be afoot.
Last Wednesday Gov. Jerry Brown signed legislation that would extend the Desert Healthcare District into Eastern Coachella Valley — if a funding source can be secured. The bill is Assemblymember Eduardo Garcia’s (D – 56th district) top legislative priority.
“Organizations that provide health care services to Third World countries, they come to the eastern Coachella Valley,” says Garcia.
Last December, Garcia began earnestly sponsoring talks with area service providers, community organizations, ethnic groups, and the five, all-white board members of the Desert Healthcare District.
The sticking point for the district? Paying for the expanded services.
“That seems to be where the conversation would end every time,” says Garcia.
So Garcia decided on an end run. Instead of trying to further collaborate with entrenched powers like the Desert Healthcare District and Riverside County’s Local Agency Formation Commission — which officially opposed the expansion – he authored the legislation that would put the expanded district on the 2018 ballot — but only for voters in the new coverage area.
Desert Healthcare District officials weren’t happy. In fact, board member Michael Solomon — a physician trained in both western and Traditional Chinese Medicine — historically has been expansion’s most vocal opponent.
“We were sued by one of our own directors [Solomon] for providing services outside the district, even if we did have a matching grant from another foundation,” says board director Carole Rogers.
Garcia was tired of the stall tactics.
“He forced the hand, and I love it,” says Rogers. “We’ve never needed legislation to get this done, to expand the district. The hand needed to be forced.”
But the board withheld its support for Garcia’s bill, AB 2414, until after it had passed both the Assembly and Senate, waiting until the bill was heading towards Gov. Brown’s desk for signature before finally announcing its support in July.
And in part two of an attempted power play, a month later, the Desert Healthcare District asked for the expansion vote to be put before the entire Coachella Valley at a special meeting. It also asked to be listed as the new district’s applicant (instead of the County of Riverside) and take over its financial authority.
Garcia said no.
Looming behind this tactical chess match is perhaps the most powerful player in this equation: Tenet Healthcare. The country’s third-leading for-profit hospital management company, Tenet has rapidly gobbled up hospitals with promises of reducing overhead, streamlining services, and maximizing profits. It began managing Desert Regional Medical Center in 1997 and is influential in decisions both at the hospital and within the district.
To help finance the new district, Garcia offers two such possibilities: redirecting existing property taxes, or demanding that a new contract with Tenet Healthcare include operating funds for the expanded district.
A month ago, Garcia also asked the California Endowment to help identify all potential funding sources. The Endowment will release a final report in February, 2017.
The situation is highly-charged, pitting wealthy west Valley retirees against impoverished east Valley Latinos.
Who will win? Or perhaps the better question is: Who will lose?