Family of nursing home resident who died: ‘She had 3 really good years there and 1 really bad week’

Karen Johnson, 77, spent about three years in the Highland Springs Care Center in Beaumont.

“She was at an unlocked memory care facility in Hemet, but she got to the point with her Alzheimer’s and dementia … where she needed to be in a locked facility,” said her daughter, Dena Garcia.


Eye of the Storm

Southern California Nursing Homes during the Coronavirus Pandemic

Latest installments in a continuing series

  • Part One:  What do Southern California nursing homes hard hit by COVID-related deaths have in common? We spoke with experts, nursing home administrators and advocates to find out.
  • Part Two: A tale of two Pasadena nursing homes. One, Gem Transitional Care Center, hard hit by COVID deaths and another, Camellia Gardens, about four miles away, that wasn’t.
  • Today, Part Three: Highland Springs Care Center in Beaumont has one of the highest percentage of COVID-19 deaths per average daily number of residents of any skilled nursing home in Orange, Riverside or San Bernardino counties.

The series was produced by correspondent Brenda Gazzar and SCNG staff writer Beau Yarbrough, participating in the USC Annenberg Center for Health Journalism’s California Fellowship.


Garcia, who lives in Moreno Valley, would visit her mother regularly.

“I had a really good relationship with people who worked there. I knew them, they knew me, I could show up at any time,” she said.

And her mother seemed to like Highland Springs:

“She was a very outdoorsy person, so I think she liked getting outdoors and still feel like she was getting outside,” Garcia said, although she noted that Johnson still wasn’t allowed to leave the grounds.

In March, as the coronavirus pandemic swept into Riverside County, Highland Springs stopped all visitation. Management told residents’ families they had a rigorous routine for keeping staff, residents and the facility clean and virus-free. All employees were screened for temperatures when they arrived each day, for example. According to her family, Johnson even appears in a March 23 video about hand washing on the Highland Springs Facebook page.

“She had three really good years there and one really bad week,” said Johnson’s grandson, Kyle Garcia, who lives near Fort Worth.

On April 11, Dena Garcia was told that her mother was running a fever. Three days later, Johnson was sent to the emergency room at Banning’s San Gorgonio Memorial Hospital, where she was nonresponsive. Previously, she was capable of holding conversations and, her dementia and Alzheimer’s aside, was in generally good shape, according to her family.

Highland Springs spokeswoman Liz Tyler blames asymptomatic spread for the virus getting into Highland Springs.

“It’s not like the memory care facility created this virus or served it with breakfast,” she said. “It came in from the outside.”

Despite housing those most vulnerable to COVID-19, nursing homes don’t have the same tools as hospitals do to fight it, she said.

“Nursing homes, they don’t have negative space rooms like you have in hospitals. They have shared ventilation,” Tyler said. “It is an extraordinary effort to contain it.”

Highland Springs stopped admitting new residents on April 13, after the facility was first informed a resident had tested positive for COVID-19.

On April 17, Highland Springs was told Johnson had tested positive for COVID-19. Staff ended up testing all of their patients that same day, Tyler said. Sixty-one out of 86 residents tested positive, most of whom were asymptomatic.

“Their suspicion is it came with an asymptomatic staff member and it may have been a staff member who had a job in more than one facility,” Tyler said.

The facility gave employees an ultimatum, requiring them to only work at one facility, and residents who had tested positive were put in isolation.

Johnson died April 19 — the only person to die of COVID-19 in Riverside County that day, according to county health officials. She was the 75th person to die in the county of the disease.

A nurse at the hospital held up the phone so Dena Garcia could say goodbye to her mother.

“I just told her that I loved her and that we didn’t want her to suffer,” she said. “If it’s your time, it’s your time and you can go. Even without the coronavirus, Alzheimer’s is just a terrible, terrible disease.”

It has been a tough year for Dena Garcia: The last time she saw her mother alive was the day before Garcia’s father was buried. Two of Johnson’s six other siblings also have been diagnosed with COVID-19.

As of Sept. 11, 20 Highland Springs residents have died of COVID-19, roughly 24% of their 84 average daily residents, according to an analysis of data from Medicare’s Nursing Home Compare database and the California Department of Public Health’s Skilled Nursing Homes COVID-19 database.

According to Tyler, Highland Springs hasn’t had any new residents test positive for COVID-19 since the beginning of June.

“They got hit with an invisible bomb, they jumped on it, they did the isolation necessary,” she said. “Even with their dementia population, they kept it from spreading.”

The Garcias feel Highland Springs wasn’t as forthcoming as it should have been about the spread of the coronavirus in the facility, something Tyler denies. But the family is sympathetic to the challenge that Highland Springs faces trying to keep dementia and Alzheimer’s patients from contracting COVID-19.

“You can’t teach them to not eat off each others’ plates. You can’t teach them to keep their hands to themselves. You can’t teach them to not pick up a half-smoked cigarette and smoke it for themselves,” Dena Garcia said. “It’s just going to happen.”

According to Tyler, the big challenge isn’t keeping the virus controlled inside nursing homes; it’s keeping it from coming in from the world outside, where, six months on, the public still can’t agree on how to prevent the virus’ spread.

“This bug is easy to kill. You just have to know it’s there. Once you know it’s there, you separate, do all the cleaning and all the things like that and you get rid of it, like this facility did,” Tyler said. “But any facility in this country, no matter how good their protocols are, they’re just one day from an asymptomatic person coming in.”

This article was produced as a project for the USC Center for Health Journalism’s California Fellowship.

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A tale of two Southern California nursing homes in the era of coronavirus

Administrator Hrag Bekerian felt confident, he said, that they were taking the right precautions at Gem Transitional Care Center before the coronavirus struck.

The four-star-rated nursing home on South Fair Oaks Avenue in Pasadena had closed its doors to visitors a week before the state’s guidance. Managers held frequent training sessions, screened all entrants and ramped up hand-washing checks.

“We believe we were well-prepared,” said Bekerian, 31.


Eye of the Storm

Southern California Nursing Homes during the Coronavirus Pandemic

Latest installments in a continuing series

  • Sunday, Part One What do Southern California nursing homes hard hit by COVID-related deaths have in common? We spoke with experts, nursing home administrators and advocates to find out.
  • Tuesday, Part Two: A tale of two Pasadena nursing homes. One, Gem Transitional Care Center, hard hit by COVID deaths and another, Camellia Gardens, about four miles away, that wasn’t.
  • Wednesday, Part Three: Highland Springs Care Center in Beaumont has one of the highest percentage of COVID-19 deaths per average daily number of residents of any skilled nursing home in Orange, Riverside or San Bernardino counties.

The series was produced by correspondent Brenda Gazzar and SCNG staff writer Beau Yarbrough, participating in the USC Annenberg Center for Health Journalism‘s California Fellowship.


 

Yet since mid-April, nearly 55 residents at Gem Transitional tested positive for COVID, more than a dozen of whom died. With typically around 65 daily residents, the nursing home has one of the highest COVID-related resident death rates in Los Angeles County for its population, according to a review by the Southern California News Group.


A caregiver gets a temperature check while Nelida Arlante, administrator of Camellia Gardens, poses at the Pasadena care center on Friday, August 7, 2020. Arlante says a dozen staff members and three residents tested positive for COVID-19, with one patient death. Arlante believes the strict rules, educational sessions and oversight she implemented at her facility helped curb the spread of the virus. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

About four miles up the road is Camellia Gardens Care Center. As a one-star facility, it has the lowest possible overall rating on Medicare’s Nursing Home Compare. The slightly larger home had three residents contract COVID and only one death, said Nelida Arlante, the home’s administrator.

Arlante believes their vigilance helped curb the virus there. As a former physician in the Philippines, Arlante said, she may have had an edge.

2,900 deaths in region

More than 2,900 nursing home residents have died of COVID-19-related causes in Los Angeles, Orange, Riverside and San Bernardino counties, comprising about one-third of this region’s total coronavirus deaths, according to data from the California Department of Public Health.

Nursing homes across the region have touted early studies showing that location and size largely determine how they’ve fared with the virus. But it’s becoming increasingly clear that several other factors can help seal a home’s fate.

Mass testing with quick results and adequate personal protective equipment are clearly important, experts say. Nursing staff levels, infection-control practices, resident demographics, leadership and even a home’s for-profit status also can contribute to the death toll.

“It’s all those factors,” said Charlene Harrington, professor emerita at UC San Francisco and a registered nurse.


Hrag Bekerian, administrator of Gem Transitional Care Center, poses at the Pasadena center on Friday, August 7, 2020. The nursing home had a high number of patients and staff including Bekerian who contracted COVID-19. Today they have no coronavirus patients. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

Behind the high death toll

Bekerian believes the high death toll at his for-profit facility is due at least partly to the type of residents it serves.

“We take high acuity patients,” said Bekerian, whose Gem Transitional facility often accepts patients from neighboring Huntington Hospital. “We had residents in the building that had higher and severe chronic conditions.”

People of color, who are disproportionately affected by the virus, also made up nearly 60% of their residents, according to data Bekerian provided.

California nursing homes with overall quality ratings of four and five stars were less likely to have COVID-19 cases and deaths when adjusting for a home’s size and patients’ race, according to a study in the Journal of the American Medical Directors Association. Nursing facilities with smaller white populations and for-profit ones were more likely to have higher cases and deaths.

Learning hard lessons

Like with many homes, there were also hard lessons they learned in real time.

First, Bekerian said, guidance from local, state and federal agencies kept changing.

He also realized it would have been best to quarantine staff working at multiple facilities at home for 14 days right away. Instead, Gem Transitional had at first waited for COVID-19 cases to surface at an employee’s second facility before doing so.

The nursing home, which has a four-star rating for staffing, eventually told employees they had to pick one facility after the Pasadena Public Health Department directed nursing homes to avoid using employees with multiple jobs “by any means possible” on April 12.

“I think it would have shown us good results if we had done it much, much earlier,” Bekerian said, noting the facility was simply following the guidance given by local health officials.

The vast majority of their employees stayed, he said, and all received hazard pay. He declined to say how much.


How to find nursing home ratings, deficiencies


 

Employees work at other facilities

Sometimes, employees work at nursing homes with known COVID outbreaks and then are allowed by employers to work at a second facility, said Molly Davies, who oversees L.A. County’s ombudsman program that investigates concerns of residents in long-term care.

Along with a lack of adequate staffing and training, Davies believes this has been a main reason why some nursing homes have been harder hit.

“Part of that is because facilities don’t want to pay overtime so they’d rather have you work even at another building because it starts the clock again,” Davies said.

Watch employees ‘like a hawk’

Arlante has pondered how the for-profit Camellia Gardens, which has below-average ratings for staffing and health inspections, had managed to escape a harsher death toll.


Nelida Arlante, administrator of Camellia Gardens, poses at the Pasadena care center on Friday, August 7, 2020. Arlante had a dozen staff members and three residents test positive for COVID-19 with one patient death. Arlante believes the strict rules, educational sessions and oversight she implemented at her facility helped curb the spread of the virus. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

“Maybe (it’s because) we are strict with our employees and we watch them like a hawk,” Arlante said. “Hand hygiene seems so simple but if you are lax, you will forget the steps and do the shortcut.”

Calming employees’ fears with regular shift training was important, she said. Being available to answer questions at any time was as well.

Arlante and Camellia Gardens’ director of nursing slept on couches in the conference room for a week after their first COVID case, she said. They later often stayed until 10 or 11 p.m. at night to supervise the employees.

“I treat the facility as family and these employees like children,” she said. “If they are afraid, they can do something drastic unless the mother hen is there.”

Camellia Gardens also provided its employees with meals three times a day to reduce their trips and their exposure outside, Arlante said.

OT and double-time allowed

The home began requiring nursing staff to pick one facility in May, she said, and lost 15 nurses in the process. But Camellia Gardens gave “bonuses” to all employees and allowed for overtime as well as double-time, which enabled them “to get by.”

Bekerian believes the local health order directing facilities to avoid using employees who work at other facilities helped turn things around at his home. Gem Transitional also learned to adapt to a new, stringent reality.

They had separate entrances for those caring for COVID patients, separate areas to put on their PPE and separate break rooms. The nursing home became vigilant about watching its staff put on and take off their masks, gloves and gowns.

It was “being very strict with every policy and procedure we have put in place,” Bekerian said.

New residents accepted

In mid-August, the city gave the nursing home clearance to accept new residents again. New residents are put in an observation unit for 14 days before they can go into the “green zone” with patients who don’t have the virus or have fully recovered from it.

As of Sept. 10, Gem Transitional had 44 patients in a home with 75 beds.

With all the different zones in the building, it has “beds ready in case a breakdown happens,” Bekerian said. But ultimately, he would “love to get back to full capacity.”

“It’s a little challenging but that’s our goal down the road,” he said. “We’re taking it day by day.”

Contributor Elissa Lee contributed to this report. This article was produced as part of a project for the USC Center for Health Journalism’s California Fellowship.

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O.C. Chief Health Officer Dr. Nichole Quick resigns amid mask controversy, threats

Orange County’s chief health officer, Dr. Nichole Quick, resigned Monday night.

She has faced push back from some members of the Orange County Board of Supervisors and criticism from residents for her order last month to require face coverings for the public as the county allowed some businesses to reopen.

Quick was receiving heightened security due to threats stemming from her the mask order. She was not made available for comment Monday night.

Supervisor Doug Chaffee said Quick resigned apparently because “it was too much for her. She has three young children and she’s been severely criticized by people who came out demanding her resignation, demonstrations in front of her home.”

“She’s done her best to give her medical opinion and it’s not popular so she has resigned,” he said.

Quick’s resignation was the second major and abrupt departure in Orange County since the pandemic began. David Souleles decided to retire in April as deputy agency director of public health services.

The plan is to have the recently appointed Health Care Agency Director Dr. Clayton Chau also serve as the chief health officer so the county can issue health orders required by the state to reopen businesses and activities such as bars, day camps, community pools, hotels and youth sports.

Chaffee was not sure what would happen with Quick’s mask order. Chau has defended it, explaining it is required when residents cannot maintain six feet of social distancing.

Chaffee noted that for all the residents who have shown up at Board of Supervisors meetings to complain about the mask order, officials have received a great deal of expressions of support for it. One resident’s online petition supporting the rule got 1,100 signatures in less than a week.

“The email is 10 to one to keep it,” Chaffee said. “They’re afraid to show up (at board meetings) because of the confrontation it will entail.”

Chaffee said he would “stand by whatever the medical opinion is” going forward.

Quick has said she would reconsider the mask order in three weeks, “and we’re at day nine or 10,” Chaffee said.

Quick has said she issued the order because she was concerned about an increase in coronavirus cases as residents would be interacting more as stay-at- home orders were relaxed. As of Monday, the health agency reported 7,527 confirmed cases of the virus and 177 deaths.

Last week, Quick drew criticism from Supervisor Don Wagner, who questioned the need for face coverings as he said other parts of the state were backing away from those orders. Quick replied that Los Angeles and San Diego counties were requiring them.

“We are seeing an increase in community transmission,” Quick said at the June 2 board meeting. “I also think our hospitalization rates have been trending up.”

Quick said face coverings “can help prevent the transmission of COVID- 19. There is evidence to support that and I feel strongly we need a face covering order in place as we continue to send people out into more social interactions.”

Reached Tuesday night, Wagner said: “It’s disappointing that she’s leaving us. It’s a very difficult time for all of us.

“My stance hasn’t changed,” he said of the mask order. “Whoever replaces her needs to look at the mask order and decide if it’s appropriate and explain to us and to the public why it is necessary under the current circumstance.”

Wagner had said at the recent board meeting some residents have complained of “public shaming” for not wearing a face covering and have been denied service in “pharmacies and other places. Is that an appropriate response to your mask policy?”

Quick replied, “I absolutely think people should not be shamed if they have a medical reason for not wearing a mask.”

When Wagner asked her how much longer it needed to be in place, Quick said: “Like all things in COVID, we evaluate the data and evidence on a daily basis… As long as we’re seeing increasing numbers in the county… I feel the need for a face-covering mandate.”

Staff Writer Jeong Park contributed to this report.

Read more about O.C. Chief Health Officer Dr. Nichole Quick resigns amid mask controversy, threats This post was shared via Orange County Register’s RSS Feed

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Trump crosses into North Korea, shakes hands with Kim in history-making event in the DMZ

President Donald Trump and North Korea’s Kim Jong Un shook hands across the border at the Korean Demilitarized Zone in an historic photo-op as Trump seeks to make a legacy-defining nuclear deal with the North.

It happened late Saturday, California time.

  • President Donald Trump and South Korean President Moon Jae-in, left of Trump arrive to talk to troops at the Korean Demilitarized Zone at Camp Bonifas in South Korea, Sunday, June 30, 2019. (AP Photo/Susan Walsh)

  • President Donald Trump talks to troops at the Korean Demilitarized Zone at Camp Bonifas in South Korea, Sunday, June 30, 2019. (AP Photo/Susan Walsh)

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  • President Donald Trump and South Korean President Moon Jae-in, left, walk up to view North Korea from the Korean Demilitarized Zone from Observation Post Ouellette at Camp Bonifas in South Korea, Sunday, June 30, 2019. (AP Photo/Susan Walsh)

  • President Donald Trump talks to troops at the Korean Demilitarized Zone at Camp Bonifas in South Korea, Sunday, June 30, 2019. (AP Photo/Susan Walsh)

  • President Donald Trump walks up to view North Korea from the Korean Demilitarized Zone from Observation Post Ouellette at Camp Bonifas in South Korea, Sunday, June 30, 2019. (AP Photo/Susan Walsh)

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It is the third time the two leaders have met, and the first since a failed summit on the North’s nuclear program in Vietnam earlier this year. Trump briefly crossed the border into North Korea after greeting Kim.

There are as yet no indications of a breakthrough in the stalled negotiations to end the North’s nuclear program.

Trump was joined by South Korean President Moon Jae-in, who praised Trump for deciding to meet with Kim. He called it “a bold decision”

Peering into North Korea from Observation Post Ouellette before the meeting with Kim, Trump was briefed on the North’s extensive artillery across the border that threatens the 35 million residents of Seoul, just over two dozen miles away. “All accessible by what they have in the mountains,” Trump said.

Trump claimed to reporters that, after his first meeting with Kim last year, “all of the danger went away.”

Trump and Moon greeted several dozen U.S. and South Korean troops guarding the Demilitarized Zone. Trump shook hands with the troops and received a gift of a golf jacket from the joint command. “You’re doing a fantastic job,” Trump told service members. “We’re with you all the way.”

The president departed Seoul aboard the Marine One presidential helicopter shortly after Moon announced Sunday, alongside Trump, that Kim had accepted Trump’s invitation to meet at the heavily fortified site at the Korean border village of Panmunjom.

Trump told reporters before departing that he looked forward to seeing Kim and to “shake hands quickly and say hello.”

The meeting between Trump and Kim marked yet another historic first in the yearlong rapprochement between the U.S. and North Korea, which technically are still at war. It also marked the return of face-to-face contact between the leaders since negotiations to end the North’s nuclear program broke down during a summit in Vietnam in February.

Moon praised the two leaders for “being so brave” to hold the meeting and said, “I hope President Trump will go down in history as the president who achieves peace on Korean Peninsula.”

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California news agencies join forces to obtain previously secret records from hundreds of police agencies

One Los Angeles police officer had sex with a drug addict he met on foot patrol. A San Diego County sheriff’s deputy was linked to a Mexican drug cartel. That same deputy sold erectile dysfunction pills illegally to a colleague in a jail parking lot. A Brea police sergeant hawked official shoulder patches he took from the department for $95 apiece.

Such misconduct, once secret under four decades of police confidentiality statutes, now must disclosed under a new transparency law targeting police personnel records. Since late last year, police unions have been fighting fiercely in California’s courthouses to keep the internal misconduct files of their members under wraps, with little success.

But news organizations throughout the state are fighting back, forming an unprecedented collaboration to harvest and share records from every law enforcement agency in California. Putting aside competition, 32 online, radio and print agencies are working together to ensure the public gets all the information possible — and as fast as possible.

Under the new law, the collaboration has made 1,137 public records requests from 675 agencies employing police officers.

“We’re proud to partner with news organizations from throughout California on this very important public-service journalism project,” said Frank Pine, executive editor of the Southern California News Group and Bay Area News Group. “If democracy is to flourish, government agencies must be accountable to the people, and that can’t happen if the people are denied access to public records. This is especially important when it comes to law enforcement agencies, to which we entrust our safety and protection.

“The public has a right to review circumstances or incidents in which complaints or claims of serious misconduct by officers are substantiated or when officers shoot at, seriously injure or kill a member of the public,” Pine said.

Other collaborators are the Los Angeles Times, Southern California Public Radio and Voice of Orange County.

The new law — SB 1421 by state Sen. Nancy Skinner, D-Berkeley — took effect Jan. 1, opening all previously hidden internal files involving shootings and the use of deadly force as well as sustained incidents of sexual misconduct and dishonesty.

Theresa Smith has been fighting for that information for nearly a decade, since her 35-year-old son, Caesar Cruz, was shot dead by five Anaheim police officers on Dec. 11, 2009. Police said they saw him reaching for his waistband, as if he were grabbing a gun. But Cruz was unarmed. Officers were operating on a tip that he was carrying a gun and selling meth.

Smith says she knows there often is more to police shootings than the official version.

“There are a lot of untruths being told. (SB) 1421 is so the public can know things,” Smith said, explaining that for the longest time, officers have been able to release the backgrounds of those arrested for crimes without having to disclose their own.

“First they kill them, and then they kill their character,” said Smith, who has become a civil rights advocate. She and her family settled their wrongful death lawsuit against the city of Anaheim for $175,000, but she still believes she hasn’t been told everything.

Perhaps the once-secret files and videos on police shootings will be more forthcoming than the public accounts that always seem to have the same ending.

“It’s the same story, the same story, ‘(officers) feared for their lives,’ ‘he reached for his waistband,’ ” Smith said. “This is the strife I have to see as a mother.”

She added, “If you don’t have anything to hide, why are you fighting so hard?”

Tom Dominguez, president of the union representing Orange County sheriff’s deputies, said the previously secret information can be misused.

“The potential for abuse under this bill will be extraordinary,” Dominguez said. “Not only would the public be given unfettered access to a peace officer’s private information, but they would also be free to provide that information to the media or disseminate it in any way they see fit.”

Many times, he said, the media or criminal defendants set out to “impugn the good character and reputation of individual peace officers.”

Dominguez added that officer-involved shootings undergo much public scrutiny from other government agencies, so no further transparency is needed. Also, there is no evidence that the previously confidential internal affairs process wasn’t working.

Efforts by Dominguez’s group, the Association of Orange County Deputy Sheriffs, to block the release of Orange County Sheriff’s Department records were rejected in court.

“In spite of this legislation and public attacks on the profession,” he said, “(deputies) will continue to do their jobs to keep our residents safe.”

Smith isn’t so trusting.

“They hide everything — if they lied on reports, if they had any sexual misconduct. And that’s important to the families” of those shot or killed by law enforcement.

 

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Suspicious package at home of U.S. Treasury Secretary Steven Mnuchin turns out to be not a bomb, but … manure

LOS ANGELES — A suspicious package found Saturday at the Bel Air home of U.S. Treasury Secretary Steven Mnuchin was determined by the Los Angeles Police Department bomb squad not to be an explosive, authorities said.

The package found about 5:30 p.m. at 965 Bel Aire Road contained manure, Sgt. R. Briggs of the LAPD West Los Angeles Station said.

The bomb squad X-rayed the package and opened it to reveal the contents, she said. No injuries were reported.

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Santa Ana approves $510.7 million budget, with immigration legal defense fund a sticking point

SANTA ANA – City council members approved Santa Ana’s budget for fiscal year 2017-18 on Wednesday, July 5, but not without revisiting a vote on a sticking point – the allocation of $65,000 toward a legal defense fund for immigration resources.

Staff recommended four budget-related items, and a council member presented a fifth. The votes were bifurcated.

On separate 6-1 votes, with Mayor Pro Tem Michele Martinez opposed both times, the council passed a $510.7 million budget, as well as additions and modifications, including new youth services supervisor and economic development specialist positions and an additional assistant city attorney position for increased marijuana enforcement.

Martinez said she could not support the budget because $9.3 million in one-time funds were used to balance it. She said in a couple of years, the city could find itself on the brink of bankruptcy, as was the case in 2009.

“We are making short-term decisions, kicking the can down the road,” Martinez said. “We should not be setting policy, approving budgets that we cannot approve, and to be quite honest, we can’t afford this.”

The third budget item – moving $65,000 in 2016-17 general fund savings toward a legal defense fund program for residents facing deportation or in need of other immigration services – failed on a 4-3 vote with Mayor Miguel Pulido and councilmen Jose Solorio and Juan Villegas opposed.

The fourth item, to increase the city and general fund budget by $35,000 to explore options that would assist council members in deciding whether to form a police review or oversight board, passed on a 5-2 vote with Solorio and Villegas dissenting.

A fifth item, proposed by Councilman David Benavides to allocate $350,000 toward a special election for a revenue bond to increase the general fund, failed on a 4-3 vote with Pulido, Solorio and Villegas opposed.

Following the votes, Councilman Vicente Sarmiento, who introduced the legal defense fund nearly six months ago, called for reconsideration of several votes. After a lengthy back-and-forth, council members agreed to vote again on the legal defense fund, before looking at revotes on the budget and additions and modifications.

“Look, I don’t remember ever having this many ad hocs in my entire 10 years on the council. We have an ad hoc for everything we talk about,” Sarmiento said, unwilling to take that route with the legal defense fund. “We either are going to make a decision or we’re not.”

On the second go-round, Pulido changed his position on the defense fund.

“I’m willing to vote and to support, but I want more definition than what we had,” he said of the information provided by staff.

The fund then passed 5-2, with Solorio and Villegas dissenting. Sarmiento then withdrew his motion for revotes on the first two items.

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‘A persistent and growing underclass’ in Orange County, report shows

Parents holding down two or three jobs each.

Families doubled and tripled up in cramped apartments.

Underachieving students.

Poor health and nutrition.

A dwindling working-age population.

It is not all bad news, but Orange County’s new Community Indicators Report, an annual study by government agencies, businesses and philanthropies, points to many woes woven into the fabric of the county’s sunny suburbs.

One thread links them all: a calamitous shortage of affordable housing.

“Clearly, homelessness, overcrowding, and family financial instability are directly linked to high housing costs,” warns the 74-page data-rich report released last week.

“But other factors are indirectly linked. When families spend 50% or more of their income on housing, they have less remaining to pay for health care and healthy foods, affecting overall health.

“With parents working two or more jobs to afford housing, they may lack the time to help children with homework or afford after-school enrichment, affecting educational achievement.”

If the housing crisis continues, the report predicts, the result will be “a persistent and growing underclass,” while higher-income residents bear the burden of supporting a swelling elderly population.

“There are two chief ways to tackle the problem of out-of-reach housing in Orange County,” it adds. “Bring earnings up or bring costs down.”

  • Course-taking in career technical programs related to science, technology, engineering and math jumped 40 percent from 2014 to 2016 in Orange County schools. Here, Aliso Niguel High School students Julia Hopkins, left, and Shanice Berry, worked on biotech experiments at a showcase in December 2016 for OC Pathways, a program that focuses on work-based learning. (Photo by Mark Rightmire, Orange County Register/SCNG)

    Course-taking in career technical programs related to science, technology, engineering and math jumped 40 percent from 2014 to 2016 in Orange County schools. Here, Aliso Niguel High School students Julia Hopkins, left, and Shanice Berry, worked on biotech experiments at a showcase in December 2016 for OC Pathways, a program that focuses on work-based learning. (Photo by Mark Rightmire, Orange County Register/SCNG)

  • As Miguel Hernandez steers, his fellow students Lizbeth Gomez and Rudy Martin Del Campo showed off Century High School’s solar powered vehicle at a December 2016 showcase for OC Pathways, a career-based program for students in 14 Orange County school districts. (Photo by Mark Rightmire, Orange County Register/SCNG)

    As Miguel Hernandez steers, his fellow students Lizbeth Gomez and Rudy Martin Del Campo showed off Century High School’s solar powered vehicle at a December 2016 showcase for OC Pathways, a career-based program for students in 14 Orange County school districts. (Photo by Mark Rightmire, Orange County Register/SCNG)

  • Brandon Bock, left, and Jason Ayala from McFadden Intermediate School in Santa Ana, guided their robotic vehicles at a December 2016 showcase for OC Pathways, a state funded program which encourages students to excel in science, technology, engineering and math-related subjects. (Photo by Mark Rightmire, Orange County Register/SCNG)

    Brandon Bock, left, and Jason Ayala from McFadden Intermediate School in Santa Ana, guided their robotic vehicles at a December 2016 showcase for OC Pathways, a state funded program which encourages students to excel in science, technology, engineering and math-related subjects. (Photo by Mark Rightmire, Orange County Register/SCNG)

  • The landscaping and barbecue area on the second floor at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The landscaping and barbecue area on the second floor at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The 70-unit Clark Commons affordable family apartments was built at the at the corner of Orangethorpe and Stanton Avenues in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The 70-unit Clark Commons affordable family apartments was built at the at the corner of Orangethorpe and Stanton Avenues in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The 70-unit Clark Commons affordable family apartments was built at the at the corner of Orangethorpe and Stanton Avenues in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The 70-unit Clark Commons affordable family apartments was built at the at the corner of Orangethorpe and Stanton Avenues in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The the laundry room is one of the amenities offered at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The the laundry room is one of the amenities offered at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The bike storage area left, and fitness center, right, are two of the many amenities offered at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The bike storage area left, and fitness center, right, are two of the many amenities offered at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The game is one of the amenities offered to residents at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The game is one of the amenities offered to residents at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The second floor outdoor playground at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The second floor outdoor playground at the Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The fitness center is one of the amenities offered to residents Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The fitness center is one of the amenities offered to residents Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The computer lab is one of the amenities offered to residents Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. The room is used for children to do their homework or learn English. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The computer lab is one of the amenities offered to residents Clark Commons affordable family apartments family apartments project in Buena Park on Wednesday, May 10, 2017. The room is used for children to do their homework or learn English. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • The 70-unit Clark Commons affordable family apartments was built at the at the corner of Orangethorpe and Stanton Avenues in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

    The 70-unit Clark Commons affordable family apartments was built at the at the corner of Orangethorpe and Stanton Avenues in Buena Park on Wednesday, May 10, 2017. (Photo by Leonard Ortiz, Orange County Register/SCNG)

  • Clark Commons, a 70-unit low-income housing project in Buena Park, has a playground and a cmputer center. It was built on the site of a blighted retail center. The city provided $7.7 million in loans to Jamboree Housing Corp., a non-profit developer. (Courtesy Juan Tallo)

    Clark Commons, a 70-unit low-income housing project in Buena Park, has a playground and a cmputer center. It was built on the site of a blighted retail center. The city provided $7.7 million in loans to Jamboree Housing Corp., a non-profit developer. (Courtesy Juan Tallo)

  • Bobbi Smith,15, uses the free wifi to do her homework at Clark Commons, a low-income housing project in Buena Park. More than 2,500 families are on the waiting list for the 70-unit complex, which opened in February 2017, with the help of city loans. (Courtesy Juan Tallo)

    Bobbi Smith,15, uses the free wifi to do her homework at Clark Commons, a low-income housing project in Buena Park. More than 2,500 families are on the waiting list for the 70-unit complex, which opened in February 2017, with the help of city loans. (Courtesy Juan Tallo)

  • At Buena Park’s Clark Commons, a 70-unit low income housing project, a resident coordinator helps children with homework. The waiting list for apartments includes 2,500 families. (Courtesy Juan Tallo)

    At Buena Park’s Clark Commons, a 70-unit low income housing project, a resident coordinator helps children with homework. The waiting list for apartments includes 2,500 families. (Courtesy Juan Tallo)

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Some good news

The report notes several positive trends:

— At 3.7 percent, the jobless rate is lower than that of California or the U.S. In 14 of 19 high-tech industries, its employment concentration is higher than the national average.

— At 5.4 percent, the overall high school dropout rate is lower than the state’s 9.8 percent. Course-taking in career technical education related to science, technology, engineering and math (STEM) jumped 40 percent over two years.

— The proportion of residents without health insurance sank to 9 percent in 2015 from 17 percent in 2013, in the wake of the federal Affordable Care Act. The number of poor children with health insurance grew by 40 percent.

— While many communities resist affordable housing projects, a few are being built with city governments’ support, including in Yorba Linda and Buena Park.

We are losing our millennials and Zers,” Lucy Dunn, president and CEO of the Orange County Business Council, a trade group for the county’s largest companies, told a group of 150 executives and government officials at an Orange County Forum gathering last week.

“Cities: you have to say yes to housing…We need city council people not be afraid of the next election.”

Disturbing data

Among the report’s troubling trends:

— To afford a median-priced, one-bedroom rental unit, an hourly wage of $27.62 is needed. Yet 68 percent of Orange County jobs pay below that.

— Orange County’s cost of living is almost double the U.S. average (87% higher). Housing costs are 356% higher than the national average.

— Residents 65 and older are the only group projected to grow proportionate to other age groups in the next 25 years.

— 48 percent of children are not developmentally ready for kindergarten

–Nearly 60,000 households are on waiting lists for government rental assistance.

Michael Ruane, an affordable housing executive who was the county’s project director on its first indicators report 17 years ago, said the data show “there are two Orange Counties.

“What’s striking is the enormous variation. You have poverty in a prosperous region. You have a knowledge economy with high wages, and a tourism economy with lower wages.”

Low pay, high costs

Tourism jobs—some 200,000—make up one of the biggest sectors in the county, along with business and professional positions, and healthcare and social services employment.

But jobs in theme parks, hotels and restaurants pay far less than other large sectors: $24,300 a year on average, with thousands of workers making the minimum wage of $10.50 an hour or slightly above.

Anaheim, home to Disneyland, Orange County’s largest employer with 28,000 workers, is one of the poorest cities in the county, the report notes, with its highest high school drop-out rate (11.5 percent).

Racial and ethnic disparities are stark.

Latinos, on track to grow from 35 percent to 40 percent of the county’s population over the next two decades, experience far more poverty, less access to health care and worse educational results than non-Latino whites (42 percent of the population) or Asians (19 percent).

“Parents work two and three jobs, even on weekends, to make ends meet,” said Al Mijares, county superintendent of schools.

“I know parents who board early buses in Santa Ana to work at south county eateries. They get home late in the evening. So kids are unsupervised. No one can help with homework.”

Adding to the stress, he said, is “overcrowding. There may not be a bed for every member of the household. There may be no place to study.”

Youngest fall behind

The report makes no policy recommendations, but Mijares, whose department is one of the report’s sponsors, said publicly-funded universal pre-kindergarten would be the single biggest boost to educational success.

Georgia, Florida and Oklahoma have enacted statewide pre-K programs, but California has yet to fund a comprehensive program.

Kimberly Goll, executive director of the local Children and Families Commission, said Orange County is the first in California to measure and track factors affecting kindergarten readiness in all its school districts.

Among the 48 percent who enter kindergarten unprepared, some lack motor skills—too much screen time, not enough crayons and physical play, according to some experts. Others lack emotional and cognitive development.

“It is scary that half of our kids are not ready to start kindergarten,” Goll said. “It is well documented that they are then more likely to drop out of high school. They are more likely to become teen parents. They are more likely never to attend college. They are more likely to be arrested for a violent crime.”

Last year, a third of Orange County eleventh graders failed to meet state literacy standards, while 57 percent failed in math.

Still, efforts are ramping up to prepare students for higher-paid jobs requiring STEM skills. Thanks to a state grant, 14,000 high schoolers participate in OC Pathways, a program offering courses and industry contacts in three areas:  Health Care/Biotechnology, Engineering/Advanced Manufacturing and Information Technology/Digital Media.

Vocational education has changed, Mijares said. “For instance, automobiles have become complex, with sophisticated computers under the dash. You need to be an engineer to understand what’s going on.”

More elderly, fewer workers

If demographics are destiny, then the county’s population trends are daunting.

“Families are migrating to other parts of the state and country that boast cheaper housing and lower costs of living,” according to the report. “For the workforce that remains…the social burden of supporting the growing older adult population will fall on them and them alone.”

The age 65-and-older group will grow from 14 percent today to 26 percent of the population by 2040, the report predicts. The number of working-age residents for each dependent (children and the elderly) will shrink from two to one.

“The fewer people of working age, the fewer there are to sustain schools, pensions and other supports to the youngest and oldest members of a population,” the report notes.

Turning malls into housing

Cities often prefer retail development, which brings in sales tax revenue, to multifamily housing, which sparks political opposition.

Even luxury housing is controversial: in March the Newport Beach City Council rescinded its approval of a 25-story project for million-dollar condominiums after opponents threatened a referendum.

Steve PonTell, CEO and President of National Community Renaissance (National CORE), a non-profit affordable housing developer, called on employers at the forum event to “see themselves as being in the housing business.”

Hospitals, for instance, should “have hundreds of units of apartments in conjunction with their facilities,” he added.

Open land is scarce, but as shopping centers begin to retrench under the e-commerce onslaught, struggling retail areas can be converted to housing, the report suggests. “Underutilized retail corridors may be the only viable option for increasing the supply,” said Ruane, who heads an Urban Land Institute initiative to assess the potential.

In Yorba Linda, National CORE, where Ruane serves as executive vice president, built Oakcrest Terrace, a 69-apartment complex for low-income families on the site of a former car dealership. The city contributed about 20% of the funding.

In February, Jamboree Housing Corp., an Irvine nonprofit, opened Clark Commons, a 70-apartment complex for low-income families on the former site of a city maintenance yard and blighted retail center in Buena Park. The city contributed $7.7 million in loans.

One testament to the housing shortage: Clark Commons has a waiting list of 2,500 families.

Homes for the well-off

Orange County’s home building 2014-2015 was mostly for higher incomes.

To buy a home

Only 43 percent of first-time buyers have the necessary income ($92,000/year) to qualify for buying an entry-level home, down from 52 percent in 2009.

To rent a home

In Orange County, a $28/hour wage is needed to afford a one-bedroom apartment.

Cost of living

Orange County is 87 percent more expensive than the national average.

Homeless students

More than 28,000 students are homeless, doubled-up or tripled up with other families.

Education

Under 30 percent of poor students meet state math standards. Under 40 percent meet literacy standards.

*Live in hotels, motels, shelters or unsheltered
Source: U.S. Census Bureau

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