The senior foot care program is a popular, little heralded program of Gravenstein Health Action. Who will fund it once the Palm Drive Health Care District dissolves?
This is part two in a three-part series about the work of Gravenstein Health Action. Part three will run next week.
The long-awaited demise of the Palm Drive Health Care District is just months away, but as its board begins to put the district’s affairs in order, even some of its critics have begun to worry about what will happen to the grab bag of public heath programs the district has been funding through the Gravenstein Health Action Chapter.
Take the senior foot care program, for example. For the last three years, Nyna Somerville, a registered nurse, has performed this humble, yet important service for local seniors.
“Essentially I’m there to cut nails, get rid of corns and ingrown toenails (as much as I can in my capacity as a nurse), file calluses away and what not. I also do a simple nursing assessment for feet — that’s what’s nice about having a nurse doing this care — and when I see something that looks problematic, I refer them” to a doctor or podiatrist.
You can tell a lot from feet, Somerville said, mentioning the unnoticed foot wounds of diabetes that can lead to amputations and the swelling that sometimes indicates a worsening cardiovascular problem.
Somerville started out doing foot care for Sebastopol seniors once a week starting in 2016, but her services proved so popular that she now does it four times a week — three times a week at the Sebastopol Area Senior Center and once a week at Burbank Heights.
Her appointment schedules fill up quickly, she said, and there’s always a waiting list.
“They just love the service, and they are really wanting to see it continue,” she said. “They’re like, ‘I don’t know what I would have done.’ A lot of people don’t see podiatrists, and they can’t afford these fancy salons.”
Somerville said she sees a huge need for this service in Sebastopol — she’s booked out months ahead.
“A lot of these folks can’t reach their feet, can’t see their feet, and a lot can’t feel their feet,” she said. “I just see the need for this growing with the aging population.”
Seniors don’t need to have their feet done every week.
“Just once every other month will do,” said Somerville, who will be leaving the program in April when she moves out of state. She hopes the program will continue after she leaves.
There’s no question that the foot care service is appreciated by local seniors.
“The nail service at the senior center is a lifeline for me,” said Lorraine Stribling. “I find it almost impossible to take care of my toenails anymore, and this service is really important. Bending and cutting is hard when you are 90. The nurse that did this service was always so competent and careful.”
Jack LeFevre, another visitor to the Sebastopol Senior Center, feels the same.
“The nail care service has made a great improvement in my wife’s and my ability to walk and go places again. Prior to getting this care, we tried to cut each other’s nails, and that about broke up our 62 years of married life. We found that it takes a trained person, usually a RN to do the job correctly, and the only place we can get this service is at the senior center in Sebastopol. Please find a way to continue this service for so many of us count on it.”
Who will pay to continue this program and others?
The problem is this popular service is currently funded through the Gravenstein Health Action Chapter, which gets its money from the Palm Drive Health Care District, which ultimately gets its money from propery owners via parcel taxes from Measure W, the 2004 ballot initiative that was passed to raise money to support the hospital.
Now that the Palm Drive Health Care District has sold the hospital and is scheduled to dissolve this June, there’s a lively debate forming about whether, before it dissolves, it can grant Gravenstein Health Action some money to continue supporting public health initiatives, like senior foot care, in west county.
Based on some of the responses to last week’s article on Gravenstein Health Action in Sonoma West, some long-time opponents of the district are ready to see Health Action and the programs it funds go down with the ship.
“Collateral damage from bad district decisions” is the way Sebastopol’s Barbara Barney described the possible demise of Gravenstein Action on Facebook.
Longtime district opponent and former Palm Drive Health Care District board member Jim Horn said he objects to the district’s effort to fund Gravenstein Health Action on its way out the door as a matter principle.
“I object to it because it’s an illegal use of parcel tax money,” he said. “That’s not what the district was created for. It was created to fund a hospital with an emergency room.”
There is a legal opinion on the legality of non-hospital expenditures, but at the last Palm Drive Health Care District board meeting, the district’s attorney William Arnone said that the law firm that wrote the opinion, Hanson Bridgett, has advised the district not to release that opinion (or even a shortened version of it) to the public.
“I doubt that the legal opinion would support those expenditures,” Horn said, “but we have no way to know that because the board continues to keep it secret.”
Alan Murakami, one of the founders of the petition drive to dissolve the hospital district, doesn’t doubt the value of the public health programs funded by Gravenstein Health Action, but he thinks they should be funded another way.
“I don’t doubt that these grants are helpful to the community, but the feedback I’m getting is that this is not an appropriate use of Measure W parcel tax funds,” he said “If it’s a worthwhile service, maybe it needs to be a multi-agency expenditure.”
Sebastopol resident Marsha Sue Lustig doesn’t see it that way. According to Lustig, who was one of the co-founders of the Gravenstein Health Action Chapter, it’s common for health districts and hospitals to take an interest in and fund public health programs.
“Health districts are, by their nature, public health entities,” she said. “Hospitals have a responsibility to give back to their community and support public health efforts that prevent hospitalizations. That’s why you see large arms of Sutter, St. Joseph’s and Kaiser gifting nonprofits that build housing or do other public health work.”
Sandra Bodley, another co-founder of Gravenstein Health Action said she understands people’s frustrations with the debts wracked up by the Palm Drive Health Care District, but she feels nonetheless that they have a too narrow view of what a health care district is supposed to do.
“That’s a very narrow and outdated perspective on health care,” she said. “As if a hospital is the end all. Healthcare is more than an institution. The district recognized this and tried to do outreach off and on throughout its history.”
“People can choose to have this narrow and out of date definition if they like, but I’m a nurse educator and I can tell you that interpretation does not serve the community well.”
Lustig is hoping the district can figure out a way to fund Gravenstein Health Action before it dissolves.
“I would love to see the health district help secure the future of Health Action before it dissolves, with funding that will tide us over the next couple of years as we figure out a new structure and develop new partnerships to deliver these important services,” she said.