For Clients & Friends of The Gualco Group, Inc.
IN THIS ISSUE – Broken Hearts in the Capitol
- Legislature Struggles to Consider 700 Bills by Aug. 31
- State Budget “Balanced on Hope”…Options: Tax More, Borrow More
- California Economy Recovered A Bit In July, But…
- Key COVID Database Broken: “We’re Back to Feeling Blind”
- $12 Million to Treat 9 Patients – State Missteps in Pandemic Response
FOR THE WEEK ENDING AUG. 7, 2020
Capital News & Notes (CN&N) harvests California legislative and regulatory insights from dozens of media and official sources for the past week, tailored to your business and advocacy interests. Please feel free to forward.
READ ALL ABOUT IT!!
A maxim in the California Legislature: “Don’t fall in love with your bills.”
This year, there are a lot of broken hearts in the Capitol.
Hundreds of bills meant to alleviate the homeless crisis, decrease medical bills and bolster labor laws ran into the buzz saw of a legislative year twice abbreviated by the coronavirus outbreak.
Now, with just three weeks to go on the legislative calendar, Democrats in each house are showing hard feelings over which remaining proposals deserve a vote and which will have to wait until next year.
Sen. Hannah-Beth Jackson, a Santa Barbara Democrat and chair of the Senate Judiciary Committee, lamented in a July 23 letter to Assembly members that she was left with the “unpleasant task” of making the “extremely difficult and frustrating” choice to shave dozens of bills from the 80 assigned to her committee.
“I recognize there will be many who are disappointed, but I want to assure you that this painful process has not been undertaken lightly, nor has any Assemblymember been singled-out one way or the other,” Jackson wrote. “This has been a conundrum that has made my work in my final year as chair of this committee extremely difficult and frankly, unsatisfying. This was not the way I had hoped to conclude my service in the California Legislature.”
A bill has to clear both houses before it can go to Gov. Gavin Newsom and become law.
Lawmakers had little time to get their bills to the finish line after recessing because of the coronavirus outbreak for much of the spring and again in July when two Assembly members tested positive for COVID-19.
The Senate, with its 40 members, sent around 160 bills to the Assembly this summer.
The 80 Assembly members passed on 540 measures to the Senate.
Before returning to Sacramento from a summer break July 27, Senate President Pro Tem Toni Atkins, D-San Diego, and Assembly Speaker Anthony Rendon, D-Lakewood, asked members to prune their bills. They also limited policy hearings to one meeting per committee.
Both houses nixed about 75% of their proposals since January introductions, according to Sacramento lobbyist Chris Micheli, who tracks legislative action.
Senate committee chairs, however, said the coronavirus breaks had chiseled too much time from the calendar to allow all the remaining Assembly measures a hearing. Instead, senators asked their counterparts to cull their legislation again to focus only on the coronavirus, wildfire issues and, amid national protests against police violence, law enforcement policies.
Even then, the senators said they had too many bills.
Sen. Steve Glazer, D-Orinda, said he had to decide how to fit as many of the 43 bills referred to his Senate Committee on Business, Professions and Economic Development, into nine hours of committee time as possible.
“I’ve never not heard a bill. It’s a very uncomfortable position for me to be in,” Glazer said. “It is a factor of how much time is available to hear as many as I can. That’s my goal. To hear as many bills as possible with the time that’s been allotted.
Assembly members have rejected that argument. Instead, they say Senate chairs failed to communicate why certain bills — some of which aren’t related to COVID-19 or other urgent priorities — made the cut and others were tossed out.
Assemblyman Adam Gray, D-Merced, said during a July 27 hearing that because the Senate had not scheduled two of his bills, he would not weigh in on a Senate proposal his committee was considering.
“There’s been real mixed messages from the state Senate on how we’re prioritizing legislation during a public health crisis that’s unprecedented,” Gray said. “As of today … I won’t be supporting any SBs at this time until we can get some rational agreement with our colleagues on how to move forward during this public health crisis.”
“The Senate is failing us, and is failing the state of California,” Assemblyman Marc Levine, D-Marin County, echoed during the same meeting. “We’re doing our job and the Senate is not up to this moment.”
On July 28, as tension between the two houses caught public attention, Rendon canceled committee hearings.
“Negotiations between the houses are a normal part of the legislative process,” Rendon said in a statement, continuing that the delay was only a “temporary pause that will allow the Assembly and the Senate to come to work out some outstanding issues.”\
Gone is a bill to streamline construction for homeless shelters and affordable housing by exempting certain projects from environmental review.
A proposal to let California workers get paid even if their boss abruptly canceled their shifts met the same fate.
Another measure to ban lead ammunition at shooting ranges was also axed.
Some Assembly members, however, said senators cut priority bills that aimed to ease disparities the pandemic highlighted in California and that the Legislature couldn’t afford to ignore this year.
Assemblyman Adrin Nazarian, D-North Hollywood, said his proposal to cap insulin copays would provide crucial relief for low-income individuals with diabetes, a condition that puts people at high risk of COVID-19.
Nazarian blamed state Sen. Richard Pan, D-Sacramento, for not scheduling the bill in the Senate Committee on Health.
“He has to be held accountable for that,” Nazarian said. “He had the audacity to tell me that this bill is not directly a COVID-19-related bill. I thought he was absolutely wrong about that.”
Levine similarly lambasted Pan for rejecting Assembly Bill 1324, which would have required the state’s public health department to develop health and safety guidelines for nursing homes and other congregate care settings.
Pan said he had to review 45 bills and determine from that list which of those prioritized COVID-19 and had few outstanding policy questions.
“By the time it lands in the second house, we need to settle all the policy stuff,” Pan said. “What we don’t want to do is move legislation that hasn’t had that vetting that we would expect bills to have.”
The Assembly and Senate face an Aug. 14 and 15 deadline, respectively, to pass bills from policy committees to the floor for final votes.
Atkins, who also served as Assembly speaker from 2014 to 2016, said this year has required anything but “business as usual.” As Californians “delay important things in their own lives,” she said, “we all have to face the realities of these unprecedented times.”
“The Speaker and I and our staffs talk constantly, especially at the end of session,” she said. “That will continue. Having led both houses I know the approaches along the way can differ, but in the end we reach the same goal.”
The state budget that Gov. Gavin Newsom signed earlier this summer had been hastily adjusted to cope with projections that state revenues would plummet by tens of billions of dollars due to the COVID-19 pandemic and the sudden recession it sparked.
Nevertheless, it was a budget based on hope — that the federal government would provide as much as $14 billion in emergency aid so some spending could be restored, and that the recession would be relatively brief.
In the final month of the 2020 legislative session, however, neither of those hopeful scenarios appears likely to occur and state finances could be submerged in red ink for years.
That likelihood grates on the Capitol’s dominant Democrats, who have long yearned to spend heavily on social welfare, medical and education services for the 15-plus million Californians living in poverty, or near-poverty — and who are even worse off now.
Democratic politicians, therefore, have been busily drafting elaborate schemes to generate more money, generally falling into two categories — borrow more or tax more.
The borrow-more faction, which includes the legislative leadership, has floated a $100 billion plan to “securitize” various revenue streams — using them as collateral for loans. It also would borrow money from personal and corporate income taxpayers by inducing them to pre-pay future taxes with discounts.
The downside of the scheme is, of course, that money borrowed and spent now must be repaid later, thereby reducing resources when the loans come due — unless, of course, taxes are also raised later to close the shortfall.
The tax-more faction is a coalition of left-of-center organizations, particularly public employee unions, and their legislative allies. Their plan, contained in Assembly Bill 1253, would impose surtaxes of 1% to 3.5% on taxpayers with taxable incomes over $1 million a year and raise perhaps $6 billion a year.
California already has, by far, the nation’s highest personal income tax rates and the approximately 80,000 individual or joint taxpayers who would be hit by the proposed surtaxes already pay about 40% of income tax revenues.
Assemblyman Miguel Santiago, a Los Angeles Democrat who is the lead author of AB 1253, told a Senate committee hearing this week that “we are talking about people who are doing very well in the state of California while others are hurting.” He said he wants them “to pay their fare share.”
Several factors underlie the tax-the-rich debate, which isn’t a new one.
One is that relying on so few taxpayers is fiscally dangerous, as past experience has shown. The incomes of the rich are especially volatile because a high percentage are capital gains, thus making state tax revenues especially volatile. Adding surtaxes would make revenues even more unpredictable, creating even deeper deficits during economic downturns.
Another is that the rich can minimize their taxable incomes by leaving capital gains untapped. They also can — as some already have — avoid California’s taxes by moving their residences to low- or no-tax states such as neighboring Nevada.
Moreover, the recent federal tax overhaul that limited the deductibility of state and local taxes increased their net impact and gave wealthy taxpayers another incentive to minimize state-taxable incomes.
Finally, $6 billion, as large as that number sounds, is small potatoes in a budget deficit that’s many times larger. But AB 1253’s enactment — which is very unlikely this year — could also undermine another tax increase that many of its backers also support. That’s Proposition 15 which, if passed by voters, would increase property taxes on commercial buildings such as warehouses and hotels by about $12 billion a year.
Our California Economy & Taxes blog provides the latest data on California’s economy and taxes, plus commentary on important trends and research. Below, we summarize the key takeaways from our recent posts.
With tax day delayed this year, July was an important month for state income tax and corporation tax collections. Preliminary data suggests that tax collections came in about 5 percent ahead of budget projections. Similarly, income tax withholding has been surprisingly stable. Despite record high unemployment, income tax withholding since mid-March is only about 2 percent below the similar period in 2019. While recent collections data for the state’s other major tax—the sales tax—is harder to interpret, our analysis of credit and debit card spending suggests that California taxable sales crashed in March and April and have been steadily recovering since then. This is consistent with spending trends seen at the national level. We will continue to closely monitor developments in state tax collections over the coming weeks.
For the state’s economy overall, our recent snapshot of several key economic indicators suggests that, after a dramatic decline in March and April, the economy started to recover slowly in May and June. Nonetheless, economic data continues to tell a mixed story about the economy. Following a positive June jobs report, more recent data from a new Census household survey suggests California’s employment has declined in recent weeks. In addition, although traditional unemployment claims appear to have stabilized recently, the number of self-employed workers receiving unemployment benefits continues to grow. Home building and sales activity seem to be recovering after a dramatic slump in March and April, but remain well below pre-pandemic levels.
California Gov. Gavin Newsom’s press conferences were must-see TV at the beginning of the coronavirus pandemic. Now, crisis fatigue among residents and a summer surge have prevented Newsom from getting into a messaging rhythm.
The state remains in a holding pattern. Indoor restaurant dining, bars and gyms have been closed for weeks. Most schools are planning to start with full distance learning.
A governor’s words have rarely meant more than now, when California’s nearly 40 million residents are looking for guidance and a glimmer of hope. But with the coronavirus firmly ensconced in the state and no signs of a broad economic reopening, Newsom faces a new challenge: how to communicate for the long haul.
“It doesn’t appear he’s making much news any longer,” said Rob Stutzman, a strategist and former adviser to Republican Gov. Arnold Schwarzenegger. “When things are going poorly, as they have been over the last four weeks, then the style starts to get a little tiresome and becomes a point of vulnerability and criticism.”
In late April, Newsom’s approval rating was 70 percent, among the highest in the country and the highest measured since he took office last year. It fell to 58 percent in late May and was holding steady in June, according to a poll conducted by Harvard, Rutgers, Northeastern and Northwestern universities.
Early in the crisis, Newsom garnered plaudits for his early decision to impose a stay-at-home order in mid-March. He was often compared with New York Gov. Andrew Cuomo, whose state was facing a far more severe crisis but who also held court daily with reporters on television.
As Newsom issued a four-phase reopening plan and then allowed counties to reopen despite not meeting the state’s initial requirements for infection rate and testing capacity, cases surged, putting California in the same breath as problem states Florida, Arizona and Texas.
The pandemic has developed a rhythm of its own that has challenged politicians, said Fred Cook, director of the University of Southern California’s Center for Public Relations.
“This virus, the way it has evolved, has created a different sort of news cycle,” he said. “I think in the beginning it felt like people wanted information more frequently and then after awhile it became less frequent and now it seems to be getting more frequent again. The intensity of the virus almost dictates the intensity of the need for information.”
In some cases, Newsom’s messaging efforts have fallen flat.
On a recent Friday, he offered vague assurances to the hard-hit Central Valley, which after nearly an hour prompted an Associated Press reporter to ask whether there was an actual new development. The governor returned the following Monday with a sharper message about spending $52 million in the region and sending strike teams there.
The follow-up press conference was the only one Newsom held last week. This Monday, Newsom announced “good news” that California’s case count had declined by 21 percent. But that message was undermined in subsequent days when county health officers said that data reporting problems had caused an undercount.
Peter Ragone, who served as Newsom’s mayoral communications director in San Francisco and formerly advised both Cuomo and New York Mayor Bill de Blasio, said the treacherous political landscape facing Newsom — and other blue state leaders — is “not anything that we have seen in modern political times.’”
“You simultaneously have a pandemic, a major economic crisis, major social protests’’ and unrest in cities throughout the state related to Black Lives Matter, he said, while at the same time confronting “the most powerful government on the planet — which is hostile.”
Where Cuomo leaned into his candid, abrasive style in the early months of the pandemic to become a social media star, Newsom has been more cerebral, more likely to deploy “candidly” at the start of an evasive answer.
“He does not communicate in a plain-spoken manner,” Stutzman said of Newsom. “He uses words that people don’t commonly use. He’ll cite statistics, which shows a great grasp of what’s going on, and it can instill confidence, but does any governor or president need to be the one reciting the daily statistics?”
Still, Cook praised both governors’ detail-oriented delivery and said their personal styles matched their respective audiences.
“Cuomo has more emotion, he’s a little more of an everyman sort of person, and Newsom is like a tech CEO, a little bit — he’s good looking, he’s well dressed and he comes across a little more laid back than someone like Cuomo,” Cook said. “It’s not unlike the typical New Yorker versus the typical Californian in that respect.”
Given the risk of saying something too definitive that may have to be walked back or contradicting his own administration officials, like Florida Gov. Ron DeSantis, governors may want to err on the side of being boring and repetitive, Cook said.
“Nobody wants to have those clips shown of them saying something different a month ago than they are now,” he said. “You have to have a consistency of message over a period of time to gain their credibility and their trust, and sometimes that consistency of message is boring.”
Newsom doesn’t have his topics written or speeches prepared on the teleprompter for the sessions — a risky move by any public official, insiders say.
His communications director, Nathan Click, said the governor thinks that speaking directly to Californians is important, “because so much of this challenge is being able to communicate to people what exactly is happening — and how they can address it and fix it’’ — such as when he continues to pound the need for wearing masks and social distancing.
Click said the volume and the intensity of the multiple crises on a daily basis has been daunting — and multiplied by about 200 press calls coming into his office each day.
As the only governor in memory with four children under 11 years old — his youngest, Dutch, is 3 — Newsom “wakes up really early,” Click said, and often starts sending out emails to staffers sometimes as early as 6 a.m.
Click said Newsom begins phone briefings every day by 8 a.m. from his office in the state Capitol, starting with the heads of the Office of Emergency Services and the Department of Public Health, chief of staff Ann O’Leary and cabinet secretary Ana Matosantos. An hour later, he has a broader call with heads of other agencies, where he asks a lot of questions.
“He’s a detail person that likes to have a full view of what’s actually happening — and get real time updates,’’ Click said.
From those briefings, Newsom develops a message for his press conferences: “What are we trying to improve, what are we trying to fix, what are we saying that we’re trying to address,’’ Click said, whether it’s certain segments of workers being most affected, or certain areas like nursing homes or the Central Valley.
Phil Trounstine, the former communications director for Gov. Gray Davis, said Newsom’s detailed, data-driven performances have served panicked state residents well, and that most voters appreciate them.
But now that Newsom is into the fifth month of the crisis, Trounstine said the governor may want to trim those back, if only to better focus his message — and conserve his strength. “If I were advising the governor on communications, I would suggest that he take no more than about 15 minutes — that he has a clear concise point that he wants to make any makes it once … backs it up with a graphic, takes a few questions,’’ he said. “And then, get out and back to work.”
Click defended the press conferences as a crucial way for Newsom to communicate with residents, citing a web audience of several thousand and an ultimate audience of “more than a million” thanks to radio and TV stations continuing to run the live briefings. “We still have almost every TV station in California picking it up live,” he said. “It’s pretty astonishing.”
In line with those numbers, communications experts give Newsom relatively high marks for his social media presence and for hammering the dual message of staying home and wearing masks when outside. He’s been consistently enlisting the help of celebrities, like Bill Nye, who did a hand-washing video, and Sarah Silverman, who urged people to follow the lead of the “hot governor”and wear a mask.
Former San Francisco Mayor Willie Brown, who appointed Newsom to his first political post as a San Francisco parking and traffic commissioner in 1996 — and then tapped him a year later to be a San Francisco supervisor — said that his former protégé may be going through some challenging times as a communicator.
But Brown said critics may be holding Newsom — one of the nation’s most high profile governors — to standards that are daunting for most elected officials. In the day-to-day challenges of the work, “sometimes, [they] get distracted, or lazy, or they’re not as creative,’’ said Brown, who served as the longest-running speaker of the California Assembly in an era before term limits.
But “Gavin’s a matinee idol,’’ he said. “He’ll come back.”
San Jose Mercury
The accuracy of California’s downward coronavirus case trend was thrown into question as health officials scrambled to fix persistent technical problems in the state reporting system, stymieing local officials and prompting questions surrounding policy decisions regarding reopening plans.
Ongoing glitches with the state’s coronavirus tracking database, CalREDIE, have resulted in tests — and cases — going unreported, health officials said this week. Worse yet, officials weren’t sure of the scope of the problems with the data, which is used to track California’s battle with the pandemic and inform decisions about when — and whether — individual counties can resume reopenings.
Santa Clara County Health Officer Dr. Sara Cody said in a Wednesday briefing that the data lag makes it impossible to discern which direction the county has trended for several weeks.
“We just don’t know,” Cody said. “We don’t know if our cases are rising, plateauing or decreasing. We are very anxious for this issue to get resolved. We expect all of these numbers will go up. To what extent — we don’t know.”
Other Bay Area counties, including Contra Costa and San Mateo, posted notes on their public COVID-19 data dashboards expressing frustration with the inaccuracies. Without accurate data — nor an understanding of the issue’s scope or the state’s timeline for fixing it — local health officials will struggle to adequately investigate and trace cases, San Mateo officials wrote.
Kate Folmar, a spokesperson for California Health and Human Services Agency, did not reply to detailed questions from this news organization about the extent of the problems with CalREDIE — including when state officials became aware of the issue and the extent to which it has affected both the case count and positivity rate — noting only that “these are all issues we are looking into.”
Still, the system-wide problem wasn’t believed to have an impact on the numbers of COVID-19 deaths or hospitalizations, which are reported separately. Those figures have been moving in opposite directions, with a decreasing number of hospital patients over the past three weeks while daily death tolls continue to rise.
Word of the reporting snafu first came Tuesday, when CHHS Secretary Mark Ghaly told reporters that “discrepancies” in the CalREDIE system had been discovered in the past few days.
“We’re working hard and immediately to reach out to the labs that we work with to get accurate information in a manual process so that we can feed that to our county partners,” Ghaly said.
Just a day earlier, however, Gov. Gavin Newsom had touted the lower case numbers in Southern California, pointing out during a press briefing that cases had “stabilized.” Overall across the state, the seven-day case average had declined by about 21% since the prior week, a trend that the governor praised as “good news.”
Newsom was made aware of the reporting problem on Monday evening, according to spokesperson Nathan Click.
Counties around the state meanwhile reported their second-highest number of deaths on any single day Tuesday, while hospitalizations fell to their lowest level in nearly a month, according to data compiled by this news organization.
The 167 newly reported fatalities Wednesday — down slightly from 197 Tuesday — pushed the state’s seven-day average to its second-highest point of the pandemic: about 138 Californians dying from the virus each day over the past week. The average daily death toll has jumped about 11% just since last week, according to this news organization’s analysis.
The faulty numbers led health experts to believe that the state had passed its peak of cases and could expect daily deaths to top off soon, too. But the unreliable testing and case data has thrown that consensus into question.
However, the dovetailing trend of hospitalizations gives some credence to the notion that the state is moving in the right direction.
In the past week, the state has shed some 500 patients from its hospital count, down 8.5% to 6,182 on Tuesday, according to the California Department of Public Health. The last time there were fewer patients currently hospitalized was July 9.
With just 5,730 new cases reported Wednesday, that seven-day average fell to 6,732 cases per day, a 26% decline since last week and the lowest it has been since July 5. The positivity rate of tests reported over the past week has fallen to its lowest point since June 28, the last time it was below the 6% threshold.
But, just like recent case counts, “the seven-day positivity rate is absolutely affected by this,” Ghaly said.
In Santa Clara County, data indicated the underreported tests dated back to July 16 — resulting in nearly a month of incomplete results.
“We’re back to feeling blind. We don’t know how the epidemic is trending,” Cody said. “This lack of data doesn’t allow us to know where this epidemic is heading, how fast it’s growing — or not.”
SACRAMENTO, Calif. (AP) — Doctors arrived at an arena-turned-medical center in Sacramento in mid-April and were told to prepare for 30 to 60 coronavirus patients to arrive within days. They spent the weekend working feverishly to get ready.
State officials envisioned the cavernous Sleep Train Arena and an adjoining facility as a place where hundreds of patients could be treated, but in the first week just one arrived. The pace never increased, and the 250 assembled medical workers — physicians, nurses, pharmacists and administrative staff — found themselves wondering what to do.
“People began to question within themselves whether they were really needed or not,” said Dr. Charles Moore, a retired internal medicine physician who worked there for about six weeks. “There were no plans for what would happen if you gave a party and no one came.”
Ultimately, just nine patients arrived over 10 weeks. The cost to care for them was a staggering $12 million.
The Sacramento site was one of 15 temporary medical facilities set up around California in anticipation of a surge of cases that never materialized. It shut down on July 1, as did most others.
But as virus cases started rising again around California in June, the state decided to keep some open and take lessons from Sleep Train to run them more efficiently.
Kim Brown Sims, the arena’s chief nursing office, wrote a training manual the state could use across its facilities. She also recommended the state either create its own electronic record system to use at every site or partner with local hospitals to use their systems, rather than requiring facilities to create their own paper systems, something the doctors had been asked to do that first weekend at Sleep Train.
Dr. Amesh Adalja, a senior scholar at Johns Hopkins University Center for Health Security focused on pandemic preparedness, said California wasn’t alone in preparing for a New York City-like flood of cases that would overwhelm hospitals.
“Many places just went very fast because they were scared and they had the ability to do it so they did it, not really thinking about how they were going to make all the pieces fit together and integrate with the existing health care system and deliver efficient care,” he said.
Moving forward, he said when deciding whether to open alternate care sites California officials should use regional infection rates and hospitalizations to set staffing so the sites don’t have too many doctors and not enough patients.
Brian Ferguson, a spokesman for the state Office of Emergency Services, acknowledged the state didn’t use local data when fist setting up field sites.
“I think in hindsight we would certainly make sure that we would do some things similar again, but perhaps be more thoughtful about how fast we ramp up or have more off ramps,” he said.
However, Ferguson said the state benefits from having staff who have been trained to work at such facilities and established procedures for running the sites.
“Having those folks trained, having these sites available will continue to be a value,” he said.
Sleep Train Arena was the site of an April 6 news conference by Gov. Gavin Newsom, who hailed the facility as a prime example of California’s rapid preparedness. It and a nearby building, both owned by the NBA’s Sacramento Kings, would house 400 beds and take people discharged from hospitals or be the first stop for people with mild to moderate virus symptoms, he said.
Newsom didn’t mention the state was paying the Kings to rent and provide services, a cost of $1 million over two months. The state spent another $7 million on mechanical, electrical, plumbing and other improvements, according to the Department of General Services.
The state also spent at least $2.8 million on staff, nearly $500,000 on personal protective equipment and about $1 million on other expenses.
The California Health Corps, a volunteer initiative started by Newsom, provided 199 workers at a cost of about $563,000. The state spent another $428,000 on just five pharmacists and five pharmacy technicians under a contract with Aya Healthcare, a San Diego-based travel nursing company.
Their payment included housing, benefits and per diem allowances, said Rodger Butler, a spokesman for the California Health and Human Services Agency.
Chief executive, nursing and medical officers were hired alongside dozens of other workers through a $1 million contract with Medefis, a vendor management company. A contract with Cardinal Health Pharmacy Solutions provided two more workers.
After an opening week that saw one patient, five came from a nursing home that didn’t want COVID-positive patients. While all of the patients were older, none was extremely sick or in need of round-the-clock care, said Moore, a Health Corps member.
Still, that’s what they got, with one doctor visiting each patient every shift, Moore said.
At one point, doctors brainstormed on whether they could be doing some type of public outreach to let people know the facility existed.
“It still wasn’t clear what our service area was or what we were really doing. Were we decompressing hospitals? Were we decompressing nursing homes? Were we decompressing homeless shelters? There was never any formal mission statement at our level,” he said.
Randal Christensen, a doctor from Nevada who set up mobile health clinics during Hurricane Katrina, served as chief medical officer. He said he expected the mission of the facility would be fluid, given the circumstances.
“I believe that what we did, while not a huge number, was very much needed at that time and place,” he said.
Sims, the chief nursing officer, took a similar view. She was charged with training workers, including nurses fresh out of school and EMTs who didn’t work in hospital settings. Some of the EMTs she trained are now caring for patients at San Quentin State Prison, the site of a major outbreak, she said.
“In health care you plan for the worst-case scenario, and anything that happens better than that you say, ‘Hallelujah,’ ” Sims said.