Urgent Care Crossroads
What Proposition BB Could Mean to Ramona

Dr. Marcelo Rivera leads a community discussion on Proposition BB in Ramona.Seated left to right: Chuck DeMund, Michael Covert, President and CEO of Palomar Pomerado Healthcare, and Arvie Degenfelder. PHOTO BY CAROL KINNEY

By Jim Evans

It’s one thing to get sick or injured and have to go to the doctor. It’s something else if you have to be hospitalized for urgent care and the facilities are substandard or, worse, the hospital is filled to capacity, and there are no beds available to accommodate you.

Unrealistic? Not really. Healthcare is already in a crisis mode in this country with regard to cost and quality of care — in fact, more than 40 million Americans are currently uninsured, and there are more frequent reports of inadequate or negligent care than ever. However, BOTH of these elements may be overshadowed by the need for modern urgent care facilities to meet the needs of the growing — and aging — population in North County.

PPH board member Dr. Marcelo Rivera supports passage of Prop. BB which may mean the creation of an emergency care facility in Ramona.

Proposition BB, a general obligation bond in support of hospital, emergency care, and trauma center improvement for the Palomar Pomerado Health System, will appear on the upcoming November 2 election and could have a direct — and very positive — impact on Ramona residents — especially if an urgent care and primary care center is established in Ramona. The current proposal indicates the possible construction of urgent care and primary care centers in Ramona, Rancho Peñasquitos, Rancho Bernardo, Valley Center, and San Marcos. According to Dr. Marcelo Rivera, PPH board member and Chairman of the Finance Committee, “Ramona is the primary site under consideration in our planning. We have already surveyed Ramona for possible locations, and architectural designs have been completed subject to passage of Proposition BB.”

“Ramona currently has no after hours or urgent care services,” says Rivera, “and our trauma area — including Ramona — is expected to increase by 1.2 million people over the next several years. Our district is already the largest public hospital district in California, and is expected to expand. We look at Ramona as a center point for the back country which is well situated to handle urgent care services for some of the remote areas.”

The full text of Proposition BB supports Rivera’s projections indicating that the district’s overall population is expected to grown by 30% over the next 30 years and the number of residents over the age of 65 by 34% — a group which traditionaly uses more healthcare services.

The proposal indicates that “all bond proceeds must be used for the proposed capital projects. No monies may be used for administative salaries, materials, equipment, or supplies.” More-over, “the measure establishes a nine-member, unpaid, independent citizens’ oversight committee” with members appointed by the PPH board of directors.

In addition to the liklihood of a new urgent care and primary care center in Ramona, the bond proceeds would also pay for a new hospital — Palomar West Medical Center — which would double the number of available beds and expand trauma and emergency services. The current Palomar Medical Center would be renovated to support mental health services, outpatient care and administration. Pomerado Hospital would be expanded to double the number of beds from 107 to 211 and include the addition of a women’s floor, outpatient imaging center, outpatient women’s center, and outpatient surgery center (www.smartvoter.org and www.ca.lwv.org).

The measure calls for Palomar Pomerado Health to issue $496 million in general obligation bonds which, in addition to $210 million in revenue bonds and $47 million from cash reserves and philanthropy — a total projected cost of $753 million — would provide for all land acquisition and building, renovating and improving existing or new medical facilities within the district.

“This project would carry us forward for another 30 years,” says Rivera, “and the average cost to Ramona property owners would less than $50 a year ($17.75 per $100,000 of assessed valuation). The Ramona Chamber of Commerce, Poway Chamber of Commerce, and the Escondido Chamber of Commerce have all endorsed Proposition BB, and the League of Women Voters has given it their strong support.”

Adds Rivera, who has medical offices in both Ramona and Poway, “Ramona residents have made their needs known to us for a long time, and we feel that this is an enormously important project to help meet those needs. However, the measure must receive support from 2/3 of the North County voters to succeed, so every vote is important.”

Palomar Pomerado Health is already required under California law (SB 1953) to replace or vacate approximately 43% of its current inpatient hospital buildings by 2008, and Palomar Medical Center is currently the ONLY trauma center in North County.

HOTO BY JENNIFER JENKIN