Heath Care and Other Issues

By Terry Nagel

Our county has one of the best health care systems in the state. One in seven residents depends on it. We need to continue to offer a safety net of essential services for those in need, while finding efficiencies and redoubling our efforts to find grants and funding from private sources to augment our programs. Here are some things we can do:

• Institute priority budgeting that determines funding based on need and priority that includes metrics and requires accountability.
• Improve billing at the county hospital. Millions of dollars are left "on the table" because we do not bill promptly and chase down delinquent patients and insurers.
• Reduce our top-heavy workforce by merging management functions and consolidating departments.
• Reevaluate funding of some discretionary health care programs. Like other Bay Area counties, the county provides service at 200 percent of the federal poverty level, but we are among the most generous in the state in the array of services we provide. It might be time to eliminate things like acupuncture, chiropractic and podiatry.
• Cross-train employees so they can perform more than one job.
• Identify "hot spotters" + patients who cost the most due to repeated visits + and work to lower their costs. (See New Yorker article on this topic here: http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande.)
• If satellite health care services must be closed, provide transportation to the centralized facility at the San Mateo County General Hospital.
• Close the Burlingame Long-Term Care facility, which is a discretionary program costing $8 million to $10 million a year, and transfer residents to less-costly facilities.
• Work with private hospital districts to extend their community grant programs (which are funded with tax dollars) to those most in need.

Natural disasters in other areas of the world made me realize that residents in Burlingame were unprepared for an earthquake or other emergency. That prompted me to form the Neighborhood Network, [http://www.theneighborhoodnetwork.org] which has started more than 40 individual groups in Burlingame and has become a model for other communities. The Neighborhood Network encourages neighbors to band together for disasters and other emergencies.

In the process, neighbors build a spirit of community, look out for each other and promote crime prevention. Many people have told me how they never got to know their neighbors until a group was formed on their block.

We are now working with the city to integrate the Neighborhood Network into the city's own emergency preparedness plan. We meet regularly with other cities in the county to share best practices for emergency preparedness at the neighborhood level. And the National Disaster Resiliency Center at Moffett Field recently invited us to submit a proposal for emergency preparedness at the neighborhood level as part of a new regional preparedness initiative.

Hold PG&E Accountable

Eight years ago, we took on PG&E and won!

When we were faced with frequent power outages, we were told that nothing could be done.

I believe we can hold companies and government accountable and that once we have identified a problem, we can bring people together to reach a solution. And, that's just what we did. After residents suffered power outages that caused real human hardship, I opened an official complaint file with the California Public Utilities Commission and held two Town Hall Meetings attended by hundreds of citizens.

I got on the phone, hit the streets and sent out emails, building a coalition of residents fed up with the power outages. We worked hard to document the problems with hundreds of letters and emails. The result: PG&E spent $2.4 million upgrading circuits in Burlingame, Hillsborough and Millbrae. The following year, outages on the five most problematic circuits decreased 85 percent.

Since my election to the Burlingame City Council in 2003, we have continued to monitor power outages on my website. Last year we noticed that homes and businesses in the southern part of Burlingame were experiencing more outages, so we met with PG&E representatives, and they agreed to spend another $3 million on power reliability improvements completed last year. These improvements benefited Burlingame, Hillsborough and San Mateo.

Recently, as Mayor of Burlingame, I have requested that PG&E manually inspect all gas pipelines in our city and report back on their condition and safety.

Collaborate with Nonprofits

I approach government service from a different perspective. As a nonprofit manager, I identify community problems and bring people together to reach solutions, using no tax dollars.

For 34 years I have worked and have been an active community volunteer in San Mateo County. For the past 10 years, I've worked in the nonprofit sector, where I've learned to create community change with limited resources. As a Burlingame City Council member for eight years and two years as Mayor, I've worked with others to accomplish some great things in our county. Some of the initiatives that I have founded include Burlingame's Neighborhood Network, [http://www.theneighborhoodnetwork.org] which encourages neighbors to band together for emergency preparedness and crime prevention. I also created the Community Wish List, which links donors of goods and services with more than 80 nonprofits in San Mateo County. I am currently working to create a nonprofit center and social innovation incubator to bring together nonprofits with those who have the resources to create change.

I value the work we do together to make San Mateo County better. This collaborative spirit, compassion and the wealth of creative solutions to be found in our community are what I want to bring to the San Mateo County Board of Supervisors.

Animal Welfare

Our pets are a source of joy and companionship. In celebration of our pets, and the owners who love them, I started the Burlingame Pet Parade in 2004. This free community event brings together animal lovers from all over San Mateo County each September for a parade, competitions for award ribbons and lots of fun.

As mayor and a nonprofit manager, I have worked to bring people together and build camaraderie and a stronger community. I want to take this collaborative approach to the San Mateo County Board of Supervisors and work to strengthen and enhance the character of our neighborhoods.

The welfare of animals is totally dependent on us. As Supervisor, I will approach this issue by considering what is best to protect the welfare of animals.