Sutter Health proposes building a new, smaller hospital at the Wells Fargo Center, north of Santa Rosa, to replace the old medical campus on Chanate Road. But critics, including rival hospitals, worry that the new facility will be too small.

 The planned $176 million, 70 bed hospital would have barely half the 135 beds at the current Sutter Medical Center of Santa Rosa, still known to long-time locals as Community Hospitlal (right). Such downsizing could rupture the delicate  balance among local hospitals regarding who cares for the poor and uninsured patients in the area, says Dr.Gary Greensweig, Director of Medicine for St. Josephs' Healthcare of Sonoma County. He notes that the existing Sutter facilites now provide about 30% of that car, and their Health Care Access Agreeement with the county, the contract that Sutter accepted when they first came to Sonoma County, stipulates that the same level of care be maintained.

Sutter has been weighing the construction of a new hospital on the grounds of the Wells Fargo Center for the Arts for several years now. The current proposal would be situated on the northwest corner of the property, as shown in the site map below. With a specific project under consideration, Sutter spokeswoman Lisa Amador says they are already well into the process of drafting the Environmental Impart Report that the project will eventually require.

 Supervisor Shirlee Zane, the only member of the board to give an indication of her leanings on the proposal, appeared cautiously supportive. She also raised the spectre of Sutter following through on their earlier bid to leave the county altogether if their project is not approved.

Doctors see the effects of poverty in the patients almost every day, but treating the root causes requires taking action outside their clinics and hospitals.

Dr. Paula Braveman (right) is a professor of Family and Community Medicine at UCSF, where she also directs the Center on Social Disparities in Medicine.

 Dr. Mary Maddox-Gonzales, head of the Sonoma County Department of Health Services, urges doctors and other medical practitioners to speak out about the public health implications of policies at every level of government.

The recent  PBS television series Unnatural Causes  answered the basic question it posed in the affirmative. So did the  KRCB-Television report on  same question here in the North Bay. You can see what we found out here. Both the national series and our local report will be rebroadcast again this fall.

The Sonoma-Marin commuter train faces a pivotal decision this week, as its directors choose the type of rail cars they will design the rest of the line to match.

The SMART Board of Directors Meets on Wednesday, July 15 at 12:30 pm in the Sonoma County Board of Supervisors chambers to consider the railcar purchase and other business.

The regulatory standards set by the US Federal Railroad Administration are the biggest single factor shaping SMART's choice for new rolling stock (as railroad cars are often called). SMART General Manager Lillian Hames explains those standards are especially stringent in situations where freight and passenger trains share the same set of tracks.

The global financial woes of the past year are also affecting SMART, Says Hames, particularly their plans to issue bonds against future sales tax revenues. They are hoping to bridge the funding gap with grants, cost savings in planning and construction, and other measures.

One of the variables tied to the choice of rail vehicles that SMART will use is the height of the floor height above the tracks, which is a function of such design considerations as fuel tank placement and structural engineering. The difference could be 24 inches or more, but either way, the passenger loading platforms at each of the 15 stations along the line will have to be built to match the train's floor level, so that wheelchair users can easily access the cars. These new platforms, says Hames, will likely look quite different than the wooden decks seen along historic train stations.