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Last updateMon, 23 Mar 2020 12pm

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