Sigrid Bathen

Writer • Editor • Teacher

Category: Uncategorized (page 1 of 3)

Sacramento State News

Professional Activities, April-June 2019

Sigrid Bathen, Communication Studies, was the guest speaker for the California Writers Club (Sacramento area chapter) on March 1, speaking on the topic, “Magazine Writing: Then and Now, Print to Digital,” describing her experiences “then and now” as a longtime journalist who has been a writer and editor for many local and state newspapers, magazines and other media, both print and online, including the Sacramento Bee, the Los Angeles TimesCalifornia JournalCapitol WeeklySacramento MagazineCalifornia Lawyer, the American Lawyer Newspapers GroupComstock’sMagazine,California MedicineMagazine, the Sacramento Business Journal, the California Health Care Foundation, and many others . She also recently completed a major oral-history project – a 90-minute video interview with legendary former lobbyist Clay Jackson, who for many years was one of the most prominent, highest paid lobbyists in California, and later served more than five years in federal prison following a massive “ Capitol Sting” investigation of political corruption in which many legislators, staffers, and one lobbyist were convicted on federal corruption charges. The oral-history series is funded by the Institute of Museum and Library Services through the California State Library, and is posted on the Capitol Weekly website http://capitolweekly.net/oral-history-project-clay-jackson/  Jackson had declined all interviews since his release from prison in 1999, and he was last interviewed by Bathen in prison in 1995, for a lengthy article published in the California Journal, a magazine about state politics and government where she was senior editor. That article received a first-place award for “enterprise reporting” from the Society of Professional Journalists, Central California chapter, and is linked in the oral history. http://sigridbathen.com/wp-content/uploads/2016/01/Clay-Jackson-1.pdf And Bathen recently wrote an in-depth article for the California Health Care Foundation, which publishes a variety of online health-care media, about the accomplishments of the late Herrmann Spetzler, who for decades directed (and vastly expanded) the “Open Door” health-care clinics in rural Humboldt and Del Norte Counties, which have become a national model for effective rural health care https://www.chcf.org/blog/herrmann-spetzler-visionary-rural-clinics/  The article was recently cited by the foundation as one of its “top ten” 2018 blogs.  Bathen has been an adjunct professor of Journalism and Communications at Sacramento State since 1988, and was also communications director for three state agencies.

The New Laws of Hiring

In a tight market, law students need professional and personal skills

Published July 1, 2012 in Comstock’s Magazine.

John O’Malley is the recruiting partner at Sacramento’s largest law firm, Downey Brand, which was founded nearly a century ago and employs more than 120 lawyers in five regional offices, 103 of them in Sacramento. As at many law firms, there was belt tightening during the recession, but Downey Brand withstood the financial challenge better than many, including several that sharply downsized or dissolved altogether.

“Overall, the firm has done surprisingly well, given the economy,” says O’Malley, crediting Downey Brand’s diverse practice. “We have continued to hold numbers and grow to some extent.”

Historically, the firm has hired eight to 10 summer associates annually, the entry-level positions for students between their second and third years of law school. But those positions have been a major casualty of the downturn. Last year, the firm hired seven, this year six.

O’Malley, 44, a family law attorney who also serves on the UC Davis School of Law alumni board, says he looks for certain qualities in a new hire: “Being a strong writer is critical. Having some work history is certainly desired. Law firms are businesses, and we’re really looking for people who we can put in front of a client, who presents maturely, who ultimately can be a partner.”

Summer associates typically only spend one session with their firm, though exceptional students are sometimes asked to return. Such was the case for Harveen Gill, 22, who is now entering her third year of law school at UC Davis. Gill says that when she arrived at Downey, she strived to be an amiable worker who could endure professional criticism without becoming defensive. In the application process, Gill focused her personal statement on her family roots and why she wished to start a career in the region.

“I come from a large family of farmers,” she says. “I talked about growing up in the agriculture community and going to law school with the desire to do law in agriculture or agriculture business…That is the reason I would like to stay in the Sacramento region.”

But associates can’t get by on passion alone. Increasingly, many local lawyers say hiring is based on the practical legal experience students have gained during law school — law clinics, moot court, law reviews — an emphasis reflected in a recent decision by the State Bar of California to examine whether to impose a practical skills requirement for bar admission.

“Law firms are looking for students who have been in a clinic, represented clients in a courtroom under the supervision of an attorney, have been in trial competitions,” O’Malley says. “Those (factors) carry more weight than before.” And, as the population becomes more diverse, ethnic diversity is increasingly important. As law firms have adjusted to recessionary times, they also have had to adjust to new technology and to the cost concerns of clients, especially in the corporate world.

“Things have become so mechanized, and there is so much information on the Internet,” says Iris Yang, a partner in the Sacramento office of Best Best & Krieger, a national firm with more than 200 attorneys in eight California offices and Washington, D.C. “You can do things more efficiently, (but) that also creates a greater expectation on the part of clients. Everybody is always checking their emails and expecting prompt responses. Clients are getting more cost-conscious, and they’re asking for different types of billing arrangements.”

A former Sacramento Bee reporter who graduated from the UC Davis law school in 1982, Yang, 61, started her legal career as a summer associate and became a partner at the venerable Sacramento law firm of McDonough Holland & Allen, which had been one of Sacramento’s largest law firms before shuttering in 2010. “There were plenty of jobs when I graduated,” she says. “Now, that is not the case.”

“They ought to think carefully about why they want to go to law school. For some people, it’s just more school — they don’t really know why. … get some experience for a couple of years. See what the real world is like.”

IRIS YANG, PARTNER, BEST BEST & KRIEGER

Her son David Gibson, a 2010 graduate of Tulane University Law School in New Orleans, “was incredibly lucky and found a job (with a San Francisco firm) in a couple of months. But he was very stressed out for two to three months, working for free, serving internships.”


Her advice for today’s graduates? “They ought to think carefully about why they want to go to law school. For some people, it’s just more school — they don’t really know why.” She advises them to “get some experience for a couple of years. See what the real world is like.”

Job placement and help with school loans have become major challenges for law schools as the nature of law practice changes and the job market remains tight. At UC Davis, an active career center staff works to prepare students for interviews and jobs. “A lot of what I do is helping students prepare for their interviews,” says Craig Compton, assistant dean for career services at the UC Davis School of Law.

As firms have reduced hiring, Compton says larger firms — hard hit by the recession and sometimes forced to rescind job offers — have become “very conservative” in their hiring. “They don’t want to go back to where they have to rescind offers.” The result for law schools, he says, “is more outreach to small and mid-size firms to increase the number of employers who will hire students and give them experience.”

Compton says he encourages alumni and other contacts to hire graduates on a trial period while they await bar results. “Try them out on an hourly basis,” he says, “not as an expectation of permanent hire, but a paid tryout. Bill them out at a modest rate. Re-evaluate when they receive bar results.

“In a good percentage, the law firm really likes them,” he says. “If for whatever reason it doesn’t work out — not a good fit, work product — that law student has real experience on their resume that they can sell to another employer.”

Slowly and with abundant caution, Compton and other law school administrators and law firms see the Capital Region’s job market improving, including signs of tepid hiring in some sectors of government.

“The market for the class of 2013 is better than the previous two years,” says Compton, and more employers are recruiting on campus. Among large law firms, he says, “The numbers are starting to grow again.”

Law School Blues

Heavy debt plus no jobs plague grads and deter applicants

Published July 1, 2012 in Comstock’s Magazine.

Like so many recent law school graduates, Seth Benkle searched vainly for a job after graduating from the University of the Pacific McGeorge School of Law in Sacramento in 2010, increasingly stressed about his $160,000 in student loans, interest accruing.

“I pay what I can,” Benkle says. “In the meantime, it’s just growing and growing.”

Benkle, 29, was raised in Roseville, graduated from Oakmont High School and carefully prepared for a legal career, building his resume after earning a bachelor’s degree in history from the University of California, Irvine.

“I never planned to be a litigator,” he says. “I always planned to have a career in public policy.”

For two years before law school, he worked as a clerk in the San Francisco office of Orrick, Herrington & Sutcliffe. During law school, he held several government internships and jobs, including a paid summer associate’s position in the state Legislative Counsel’s office. Along the way, he received awards and scholarships, was on the dean’s list at both UC Irvine and McGeorge, wrote about legislative issues for the McGeorge Law Review and served as president of the school’s Governmental Affairs Student Association.

He finally found work last year in San Francisco as a temporary contract attorney for agencies that review the often mind-numbing volumes of paper and online documents involved in legal cases.
“It pays pretty well, but it’s basically legal temp work,” Benkle says. “I may work for six months and be off for three weeks. I just started a job that will last eight days.”

He also volunteers in the San Francisco Bar Association’s legal assistance program for low-income residents. And he feels fortunate to have health insurance through San Francisco’s public health insurance program.

His experience is typical of thousands of recent graduates across the country who were in law school during the recession and upon passing the bar exam learned that a law degree no longer guarantees a well-paid, secure job — much less the ability to pay off massive school loans. While there are some programs to trim school loan debt for lawyers who work in public service or for nonprofits, both sectors have been hard hit by the economic downturn in the Sacramento region. And, student loans cannot be discharged in bankruptcy.

“I couldn’t find work in Sacramento at all, even law clerking,” Benkle says. “I like to think I question the things that I do, not follow blindly. I thought I’d be able to pay these (student loans) off and be a lawyer. But that’s not the reality.”

Benkle takes most of the blame for not recognizing growing signs of trouble before and during the recession, but he also questions why law schools continued to enroll students and promise huge sums of financial aid.

A key measure of the rocky legal job market has been the sharp decline in the number of students taking the Law School Admission Test (LSAT). There was a 16.2 percent drop in the number of LSATs administered by the Law School Admission Council (LSAC) in the 2011-2012 academic year, which followed a 9.6 percent decline in the 2010-2011 academic year. Those declines came after a 13.3 percent increase in 2009-2010 and a 9.6 percent hike in 2008-2009, as students returned to school, seeking more “secure” careers at the height of the recession.

Now, many law schools across the country are cutting enrollment. LSAC figures from early May 2012 (when an estimated 95 percent of applications nationwide had been reported) show a 14.6 percent decline in applications to American Bar Association-accredited law schools nationwide, continuing a downward trend from fall 2011 when applications were down 10.7 percent.

Administrators at the prestigious UC Hastings College of the Law in San Francisco announced in May that 20 percent fewer students would be admitted in the fall, and several staff positions were eliminated.

“The critics of legal education are right,” said Hastings Chancellor Frank Wu in a dramatic announcement that made national headlines. “There are too many law schools, and there are too many law students and we need to do something about that.”

A ‘tectonic shift’ in the market for lawyers
For young law school graduates who believed a law degree meant a secure, well-paying job, the reality has been particularly disconcerting. Many graduates are expressing public anger in articles and blogs — and even lawsuits — excoriating what they see as an entrenched system in which high student debt was encouraged, or at least not discouraged, by a law school culture fueled by easy credit and empty assurances. And, while top-rated law schools report high levels of full-time student employment after graduation, many others suggest realities characterized by longer job searches and part-time or temporary employment.

“It’s a tough market for law schools generally,” says Kevin R. Johnson, dean of the UC Davis School of Law, where annual tuition has increased to more than $46,000 and is climbing as a result of general economic malaise and state budget cuts. “The job market is rough, and prospective students are unclear (about) what will happen. I don’t think we’re going to return to the law firm heyday when hiring $160,000 associates was their way of doing business.”

Johnson says UC Davis does not plan to cut its law school admissions and has long offered numerous grants and scholarships to help defray student loans. And, like many law schools, it has stepped up internship and job-placement services to current students through an active career-
services center. It also increased outreach efforts — particularly in underserved communities with poor representation among law students, mainly African Americans and Latinos — to educate undergraduates about the realities of law school.

“I thought I’d be able to pay these (student loans) off and be a lawyer. But that’s not the reality.”

SETH BENKLE, GRADUATE, UNIVERSITY OF THE PACIFIC MCGEORGE SCHOOL OF LAW

At McGeorge, administrators are sharply scaling back admissions in response to the sluggish, rapidly changing job market for lawyers. Last fall’s first-year, daytime class of 181 students was 100 students smaller than the first-year, day class of fall 2010 and the smallest since 1969. McGeorge’s law tuition is more than $41,000 annually (excluding books, housing and other fees), and the school offers evening classes as well as its highly regarded programs in international law and clinical experience.


McGeorge Dean Elizabeth Rindskopf Parker, who is retiring this summer after 10 years in the position, made minority recruitment a priority and says law schools must respond to “a tectonic shift in the market” for legal services.

“This is a market that since the early ’70s has done nothing but increase, paralleling to some extent what we saw in housing,” she says. “Nationally, many law schools have simply taken advantage of what seemed to be irrevocable growth, with a sizable growth in the number of law schools and hence the available seats.”

“We’ve long been too large for the market we serve,” she says of McGeorge. “We should be smaller. We don’t want to bring students in who can’t find jobs.”

Always an anomaly of sorts among the region’s law schools, Lincoln Law School in east Sacramento has long served a specific niche of working adults who, for various reasons, want to earn a law degree. Enrollment has remained consistent in recent years, from 220 to 260 students (230 currently), and tuition runs about $10,000 annually. Established in 1969 and accredited by the California State Bar but not the American Bar Association, Lincoln offers classes taught by working attorneys. Graduates include many local judges as well as Sacramento County District Attorney Jan Scully and Sheriff Scott Jones. The school maintains a job bank, stays in touch with its alumni and many students “pay as they go,” often graduating with no school loan debt, says longtime Registrar Angelia Harlow. “I don’t know of many who can’t find jobs,” she adds.

Current law students cautiously optimistic
Though many recent law school graduates struggle to find legal jobs, current students express cautious optimism about the future as law firms slowly begin to expand what had been a drastically curtailed pool of summer and post-graduation hiring.

Heather Cantua, 23, who completed her second year at UC Davis law school in May and is in the top third of her class, expects to emerge with “only” $50,000 in student loan debt when she graduates next year — the result of a UC Davis program in which a portion of law student tuition is returned to students in the form of need-based grants. She also works as a paid research assistant for one of her law professors and has been active in the school’s King Hall Women’s Law Association.

A UC Davis undergraduate from Livermore who went directly to law school after earning her Bachelor’s in sociology, Cantua had no student loans as an undergraduate. Her working-class parents, who are not college graduates and have experienced layoffs and other economic setbacks during the recession, paid the tuition for their only child.

“My mom works in a community college, and education has always been important,” Cantua says. “They had planned for it, put a lot of emphasis on it.”

This summer, she will work as a paid summer associate at Reed Smith in San Francisco at a time when many law firms have scaled back — or even rescinded — paid summer associate offers, which historically have been the path to permanent employment for law school students and graduates.

Other law students have taken unpaid internships to gain legal experience. Colin Roberts, 25, who expects to graduate from McGeorge in the top third of his class in December, searched unsuccessfully for a paid summer position in Sacramento.

“It was ultra-competitive,” he says. “Firms that traditionally hire several students over the summer may be hiring one or none.”

Roberts says he feels fortunate to have landed an unpaid summer internship as a law clerk at the California Department of Water Resources. President of the Governmental Affairs Student Association at McGeorge, he has long planned a public-policy career, double majoring in political studies and peace and conflict studies at Pitzer College, one of the Claremont Colleges in Southern California, and serving in a peer mediation program at his Manhattan Beach high school.

“That got me interested in alternative dispute resolution,” he says. “And I decided mediation was something I wanted to pursue as a career.” In college, he took a course in water policy and chose McGeorge for its environmental law, conflict resolution and public-policy programs.

Despite high student loan debt estimated at about $150,000, Roberts says he has no regrets about his decision.

“Anything I think I would be happy doing would require a graduate degree. And the (juris doctorate) is one of the most flexible,” he says. “But I will say that a lot of law students don’t know what they’re getting into. Taking out $150,000 in loans with interest, I admit I’m scared that I will have that much debt hanging over me.”

Roberts is hopeful, however, that the public-policy and government job market for lawyers — once a secure career choice in the capital — will improve and that national concern over crippling student loan debt will result in more programs to forgive and/or reduce that debt.

His hopes were recently buoyed when his girlfriend, who graduated at the top of her McGeorge class, started a job with a government consulting firm in Sacramento after a year of searching.

For Kelly Bradfield, 27, her first year of law school at UC Davis ended a few days early, when she rescheduled a final exam to deliver her first child. She graduated from UC Berkeley with an English degree in 2007 and landed a job at the UC Center in downtown Sacramento the same year, working as a policy analyst and legislative liaison for the center, which provides an intensive internship and seminar program for public-policy and journalism students from UC schools throughout the state. The highly regarded program was nearly eliminated during massive budget cuts in 2009. The program survived, but several positions, including Bradfield’s, were cut.

Undeterred, she found a job as volunteer and development coordinator for the nonprofit Children’s Receiving Home of Sacramento, which provides emergency housing and services to abused and neglected children. Always focused on a public-policy career, she is firm in her career choices. “I know I want to work in Sacramento in public policy,” she says. “I’m familiar with the terrain.”

She serves on the board of the King Hall Women’s Law Association and was impressed by the support for new mothers in the law school. “They let me rearrange my finals, and there is a babysitting cooperative on campus, which is free, staffed by volunteers who watch the kids when students are in class,” she says.

Her husband, Bryant Burmich, is a manager with the California State Teachers Retirement System in Sacramento. “We are really blessed with his gainful employment during this unstable employment time, and I was able to take the summer off,” she says.

As for the high cost of law school, she says, “I think I’ll be really lucky if I end up with $100,000 (in debt). … I can’t believe I just said that.”

The MBA is Not Dead

Demand has ebbed and flowed but remains on high tide



Published August 1, 2012 in Comstock’s Magazine.

When Laurie Grimsman graduated in June from the Graduate School of Management at UC Davis, she was 51 and a self-proclaimed “age outlier.”

“It took me a while to get my bachelor’s degree (in accounting from Brigham Young University in 1988) because I got married and had three children,” she says. “I definitely have some gaps in my résumé.” She worked for five years as an accountant with several area firms and 10 years with Sutter Health, but had been out of the workforce for seven years when she sought her master’s degree in business administration.

“When my last child left, I knew I wanted to go back to work,” she says. “But I wanted to get my skills back up to speed — and build my confidence.”

Echoing the views of other Capital Region MBA grads, she says the business administration program did all that and more. “It gave me a much more global perspective,” she says. “I got multiple (job) offers, and I don’t think my age mattered at all.” She now works at Intel.

Her story highlights the diverse career and life stories of MBA grads — as well as the enduring value of a graduate degree periodically lampooned in national news media as duplicative or even obsolete. But local MBA students, business school administrators, professional groups and employers, and a growing volume of recent news accounts in major media such as Forbes and the Wall Street Journal, paint a much more nuanced and somewhat rosier picture.

“When the economy tanked in 2008, we initially saw a 50 percent jump in applications,” says Dr. Sanjay Varshney, dean of Sacramento State’s College of Business Administration. The curriculum there includes a 15-month, “self-supported” executive MBA costing about $36,300, not including books, fees or room and board. Annual tuition for the standard, state-supported MBA is $10,000 and generally takes two and a half years to complete.

“As the economy became more protracted, we saw a 50 percent decline (in applications),” he says. “Slowly, we have seen the applications coming back to normal levels.”

Varshney describes the analytical skills developed in MBA programs as “very marketable and recession-resistant.” At the same time, graduate business programs and employers are increasingly selective, with stiffer admission requirements and tougher competition for jobs. As a four-year degree becomes a “threshold” requirement for many positions, he says, “The MBA program is becoming more critical, and the need for getting an MBA is getting even higher.”

Many MBA candidates are working adults who plan to stay with their current employers, and some employers will help foot the bill, although others have been forced to scale back on tuition reimbursement programs in the economic downturn.

At the University of the Pacific Eberhardt School of Business in Stockton, where tuition for the 16-month MBA program costs nearly $60,000, Dean Lewis Gale says enrollment was sharply affected when financially strapped businesses “began to pull back on reimbursement for younger employees” to attend graduate school. “But we’re starting to see much better data on the horizon,” he says with more than 200 applications for fall 2012, a huge jump from 58 last fall.

Employers and business groups say competition for MBA-level jobs is stiff. “I still believe there is high value to having a master’s in business administration,” says Larry Dicke, chief financial officer and executive vice-president of the California Chamber of Commerce. “It demonstrates to me that this person has upper-management potential. There are more hiring opportunities because of that background … and you do get paid more.”

He advises people contemplating an MBA who may feel stymied professionally: “When the ceiling is closed … go get the MBA and do a part-time program.”

Roger Niello, former state legislator and county supervisor and now president and CEO of the Sacramento Metro Chamber, agrees.

“General economic conditions are such that everybody is cutting back,” Niello says. “Fewer jobs are available, and companies are significantly more challenged. … But I don’t think that in any way compromises the value of the degree.”

Among employers who continue to recruit and hire MBA students and grads from area business schools, state retirement system CalPERS must follow stringent civil-service guidelines. Salaries may be somewhat lower than in the private sector, but such positions include excellent benefits and a high degree of job security.

Did You Know?    Nearly two-thirds of community college students who transfer to the University of California complete a bachelor’s degree within three years — a rate comparable to “native” UC students, those who are eligible and enter as freshmen.

As with other government and nonprofit positions, a portion of federal student loan debt also can be forgiven under certain conditions after 10 years of repayment.

As an independent pension fund, the agency is somewhat insulated from political pressures, although it has taken major media hits in recent years over various pension fund scandals and widespread concern about public pensions.

“Hiring hasn’t stopped, but it hasn’t been aggressive or robust,” says PERS spokesman Brad Pacheco.

Colin Crane, 31, who was initially hired more than five years ago as a paid, part-time MBA graduate intern from UC Davis (the typical path to landing a permanent, full-time job as an investment officer), specializes in private equities and has risen rapidly up through the ranks.

“It’s important to have the skills to work with private-equity managers and fit with the team,” Crane says. Applicants who pass the civil service test and are invited for interviews must also master a timed test of their ability to interpret complex financial tasks and errors using Microsoft Excel spreadsheets. “It’s a very specific skill” and key to job productivity, Crane says.

MBA programs in the Sacramento area all have career counseling programs and alumni groups, and students serve internships with employers who are actively cultivated and recruited.

“We actually got through the recession fairly well, and a lot of that has to do with our relationship with employers,” says Christine Dito, senior director of career services for the UC Davis Graduate School of Management. “When companies nationwide started cutting back, it didn’t impact us as much as other schools (because) we’re involved with employers from the outset.”

UC Davis offers business or MBA graduate programs on campus as well as at satellite centers in Sacramento and San Ramon. Tuition ranges from at least $70,000 for the two-year, on-campus program to more than $96,000 for San Ramon center students, who receive catered meals and books as part of the cost.

Many grads say the ties they forge in their graduate programs are carried into the workplace.

“Having the business degree means that I’m more efficient and entrepreneurial in how I approach my job,” says Mary Beth Barber, media consultant and communications director for the California Arts Council.

Armed with a creative writing degree from the University of Michigan, she completed her MBA last year at Drexel University, which opened its Sacramento program aimed at working adults in 2009. Current tuition for the entire two-year Drexel MBA is $58,000.

Like many grads, Barber, 43, remains close to her Drexel classmates and praises the networking benefits of the degree.

“There were a lot of group projects, and the teamwork was incredibly important,” she says. “I thought maybe my diverse career path would be a liability, but they were looking for creative minds, and it made the discussions very interesting because you had this mix of people.”

Sandra Kirschenmann, director of Drexel’s Sacramento Center for Graduate Studies, says the program encourages the teamwork critical to business success.

“Our focus is on the practical nature of work,” she says. “I really feel this is the formula for higher education going forward.”

Herrmann Spetzler Remembered as “Visionary” Who Developed California Rural Clinics

The CHCF Blog

Herrmann Spetzler

Herrmann Spetzler built a small clinic in a remote corner of California into the region’s primary care anchor. Photo courtesy of Open Door Community Health Centers

May 01, 2018

by Sigrid Bathen

In 1977, idealistic young people were moving to California’s strikingly beautiful but impoverished Humboldt County to escape urban congestion and do good works. One of them was Herrmann Spetzler, who came to the tiny city of Arcata to run a small counterculture health clinic called Open Door. Spetzler, a tall, bearded man with a German accent, wanted a safe, uncomplicated place that would suit a young family just starting out. He got that — and then he stayed for 40 years to pursue his vision of a health care system accessible to everyone regardless of income. Because of Spetzler’s leadership, thousands of people of all income levels in California’s rural northwest region receive medical care in an expanded network of modern facilities.

On March 12, Spetzler died suddenly at age 70, shocking the sprawling community that coalesced around his charismatic personality and irresistible vision. Colleagues and friends say Spetzler’s reach extended far beyond California’s North Coast, although he often described himself in meetings and speeches as “Herrmann Spetzler, RURAL,” to underscore his commitment to providing health care in remote locales.

“He had an amazing ability to build coalitions among the huge diversity and types of clinics,” said former state Senator Wes Chesbro of Arcata, Spetzler’s friend and supporter. “He built a broad political base.” The longtime CEO of Shasta Community Health Center, Dean Germano, who attended many conferences with Spetzler, said he “was often the smartest guy in the room.”

Modeled on a free clinic in San Francisco’s Haight-Ashbury neighborhood, Open Door began in 1971. “It became a clinic serving the broader low-income community in Humboldt County, then became the default clinic system for all citizens as mainstream primary care [physician] practices began to disappear,” Chesbro said. Today, experts say it is a national model for primary care.

Dramatic Expansion

Herrmann and Cheyenne Spetzler
Herrmann and Cheyenne Spetzler. Photo courtesy of the Spetzler family.

Spetzler and his wife, Open Door Chief Operating Officer Cheyenne Spetzler, are widely credited with expanding one tiny Open Door clinic into a string of 12 clinics and three mobile vans. Altogether, they provide a broad range of health services to an economically diverse and growing patient base in Humboldt and Del Norte Counties.

“Herrmann was the visionary, while Cheyenne provided the pragmatic assistance needed to implement those visions,” Chesbro said, “and they built a structure that would continue to grow.”

Chesbro was one of many elected officials who spoke to an overflow crowd of more than 500 at a memorial service for Spetzler in Arcata on April 2. The turnout was testament to the political reach of Spetzler’s collaborations and connections with other clinic directors, associations, and local, state, and federal lawmakers.

“He was a larger-than-life character,” said Bobbie Wunsch, a health care management consultant and longtime friend. “He was the kind of person that when you walked into a room, he lit up, he wanted to greet you personally, and he always asked about you. . . . He was a real conceptual thinker, always thinking about the next challenge.”

Spetzler was deeply committed to the health care safety net for low-income residents and co-founded or led multiple local, state, and national associations focused on rural health and primary care services. California State University in 2014 presented him with an honorary doctorate “in recognition of his enduring and extraordinary impact on North Coast rural health care.” He added that to a bachelor’s degree in geography from California State University, Los Angeles, and a master’s in education from Humboldt State University.

Dr. Bill Hunter had been practicing medicine on the North Coast for 20 years when Spetzler recruited him to become Open Door’s medical director in 1998. The two were kindred souls committed to providing quality health care to those who had none.

Primary Care for All

“Herrmann was such a strong leader, a great boss, great instincts about people and how they worked together, a really strong intuitive sense, and a tireless advocate for the particular needs of rural primary care,” Hunter said. As technology advanced, he said, Spetzler was “a really strong proponent of telemedicine, which is very important in rural areas.”

Archetectural rendering of clinic
The Fortuna Community Health Center now under construction. Rendering and design by Julian Berg of Arcata.

Spetzler pioneered a telehealth center, partnering with UC Davis Medical Center and specialists in big cities to link remote areas with specialty services that weren’t available in the region. Open Door deployed mobile vans for dental and medical care to remote sites in Humboldt and Del Norte Counties.

“Although it’s breathtakingly beautiful, there is also devastating poverty,” Hunter said.  According to 2015 US Census data, 21% of Humboldt and Del Norte residents live in poverty. “We started out taking care of so many marginalized people, and now we have become a big part of the primary care network in Northern California.”

Whenever the subject of retirement came up, Spetzler would avoid commitments, Germano said. Spetzler said he planned to retire after “one more project,” or that he had to “close the loop on this . . .”

After Spetzler’s death, Cheyenne Spetzler was named interim director of Open Door. “I’ve put my life into this organization,” she said. “I want to be sure we have a soft landing.” She is focused on completing current projects, including a 32,000-square-foot “state-of-the-art” clinic under construction in Fortuna, about 30 miles south of Arcata, and the accreditation of a residency program in rural health care for family practice physicians. Open Door already has residency programs for nurse practitioners and dentists.

“Herrmann’s vision is in good hands,” said US Representative Jared Huffman, D-San Rafael.

A Family of Immigrants From Germany

Herrmann was born in Nuremberg, Germany, in 1948, emigrating to the US when he was seven years old with his mother and four siblings to join their father, an engineer and watchmaker credited with inventing the self-winding wristwatch. His father had come to the US a year earlier. “It was a big deal,” Cheyenne said. “How do you take six kids away from their grandparents? And they don’t speak the language.”

But the family thrived in America, with all the Spetzler siblings earning advanced degrees (including two PhDs and two MDs). His four brothers and a sister live all over the US, and the extended family is close, with large reunions every two years. “Each sibling sets aside 1.5% of their gross annual income to pay for all the children, grandchildren, and their families to come to the reunions,” said Cheyenne. “That was Herrmann’s idea.”

The Spetzlers settled in Illinois. After he graduated from high school, Herrmann Spetzler moved to Southern California for college. Cheyenne was the divorced single mom of a toddler son working as a waitress at an Italian restaurant in Pasadena when she met her future husband. Herrmann, a Cal State LA student, was working in the seismology lab at the California Institute of Technology. “One of my jobs [at the restaurant] was to check the IDs of students,” she says. “I ‘carded’ him, and he was insulted. He made such a big fuss about it.”

After they married in 1973, they lived in Orange County in an apartment with Cheyenne’s 4-year-old son Gary from her previous marriage (who was adopted by Herrmann), and she was pregnant with their daughter Maria, now a physician assistant at Open Door.

Herrmann was hired by Orange County as assistant director of county mental health services and briefly served as interim director before he became executive director of the Sierra Council on Alcoholism and Alcohol Abuse in South Lake Tahoe.

The Green Hills of Arcata

The couple chose to move to Arcata partly because “it looked like southern Germany,” Herrmann’s birthplace, Cheyenne said. “When we first came [to Arcata], the hills were green, with patches of woods. . . . It was nostalgic, rural, and had a university.” Their third child, Gabriel, was born in Arcata.

Spetzler Family in 1977
Herrmann and Cheyenne Spetzler with their children Gary and Maria in Arcata in 1977. Photo courtesy of Cheyenne Spetzler

Spetzler was severely dyslexic, and his wife helped him with his college papers. “I think it is why he was so good at verbally communicating,” she said. “As technology improved, he could listen to everything. He listened to hundreds of audio books a year. He listened to the news in German so he could communicate with family in Germany.”

Spetzler extolled the natural beauty of the region to recruit highly qualified professionals to work at Open Door while also offering clinical support and training. He helped create and sustain the Clinic Leadership Institute, which provides training and mentoring for emerging health care professionals.

“He believed very deeply in fostering leaders in community health,” said Carlina Hansen, who for 17 years was executive director of the San Francisco Women’s Community Clinic. Hansen recently joined the California Health Care Foundation as a senior program officer working to improve access to care for the state’s low-income residents. “I first met him because I was an early participant in the Clinic Leadership Institute,” Hansen said. “He was a standout presence — a man of strong opinions, game-changing ideas, and a big, big heart. He’s done so much to develop leaders in community clinics.”

Herrmann created a unique and enduring template for rural health clinics, Hansen said. “The community clinic movement has always been extremely important in California, and rural clinics have their own unique challenges,” she said. “There can be a scarcity of providers and great distances to cover. Open Door is a real lifeline, often the only source of care, and very well-respected for the high-quality, comprehensive care that they deliver.”

Spetzler’s unexpected death leaves a huge void in the leadership of California clinics, especially in rural areas. But the structure he left in place will endure, said many clinic administrators, clinicians, and government officials. “My perception is that they are fully prepared to [carry] on,” said Chesbro.

“Herrmann directly or indirectly impacted the lives of tens of thousands of people,” he said. “One could only hope to have so much impact in one lifetime.”Related Tags: CHCF Goal: Improving Access to Coverage and CareCommunity Health CentersCommunity-Based CareFederally Qualified Health CentersProvidersTelehealthThe CHCF BlogSigrid Bathen

Sigrid Bathen is a Sacramento-based journalist whose award-winning health care coverage has appeared in many publications. She was a Sacramento Bee reporter for 13 years; a senior editor at the California Journal, a magazine about state government and politics; and communications director for three state agencies. She has been an adjunct professor of journalism and communications at California State University, Sacramento, since 1988. She can be reached at sigridbathen@gmail.com.

Mario Gutierrez: Improving Access for All, “Giving Voice to the Voiceless”

The CHCF Blog

Mario Gutierrez: Improving Access for All, “Giving Voice to the Voiceless”

September 07, 2017

by Sigrid Bathen

Debra Johnson vividly recalls the day she met her future husband, Mario Gutierrez. She was a young physician interviewing for a position in an Indian health clinic in Mendocino County, and he was working for the California Rural Indian Health Board. It was 1982.

“I was invited to go to a community meeting, and there were several different tribes represented. The clinic was in trouble,” she said. “Mario was the only person I knew, and he signaled me to sit next to him. The meeting was getting more rancorous, more heated. People were calling people out. I sincerely thought it was going to come to blows in the parking lot. He turned to me and said, ‘I think I’ve had enough.’ And he went to the podium and said the tribes were going to have to come together and see this as a common good, and that the government was trying to keep them apart so they would remain as an underclass. After 30 minutes, he had them setting up a new board of directors and making a mission statement. I was just astounded. He could talk to a room full of people and make everyone feel important — and steer the ship in the direction it was meant to go. I thought, ‘This is a man I really need to get to know.'”

Mario Gutierrez

Gutierrez, a trailblazer who devoted his career to improving the health of people marginalized by disparities in California’s health care system, died on August 16 in Sacramento after complications from surgery. He was 68. Renowned in California as a pioneer in bringing health care to the rural poor, he gained national recognition for supporting telehealth programs to reach that goal.

For the past six years, Gutierrez was executive director of the Center for Connected Health Policy (CCHP), a program of the Public Health Institute, and a leader in the developing field of telemedicine. He was instrumental in the passage of California’s Telehealth Advancement Act of 2011. The following year, Gutierrez helped CCHP win a contract from the US Health Resources and Services Administration to serve as the federally designated National Telehealth Policy Resource Center. He also worked on a groundbreaking two-year pilot project for CCHP that linked 43 safety-net clinics across California with medical specialists at the five University of California medical schools. Before joining CCHP in 2010, Gutierrez served as director of strategic programs and director of rural health strategies at The California Endowment, a longtime supporter of telehealth.

 

Gutierrez saw telemedicine as “a way to enfranchise rural Americans and those with chronic conditions for whom access to care was difficult and costly. . . . He saw telemedicine as the great equalizer.”

Throughout his career, Gutierrez was heralded for bringing disparate communities together for a common purpose. “He was always really interested in helping those people who didn’t have a voice,” Johnson said. “Native Americans. AIDS patients when they were ostracized. Agricultural workers. He worked with communities of poverty that were rich in culture and banded together to improve public health through education and public development.”

Gutierrez saw telemedicine as a “way to enfranchise rural Americans and those with chronic conditions for whom access to care was difficult and costly,” she said. “He really thought that was the wave of the future for the poor. He saw telemedicine as the great equalizer.”

He was the first Latino to receive the prestigious Terrance Keenan National Leadership Award in Health Philanthropy in 2007, and he served on multiple health care boards and advisory panels.

Clinics Endure and Thrive

Longtime friend Jim Crouch, who succeeded Gutierrez as executive director of the California Rural Indian Health Board in 1987, said Gutierrez’s efforts were always based in “community organizing, facilitating, very much a community-focused public health approach to wellness — making things happen by making state law and policy.” He said Gutierrez’s lasting contribution was the “permanence of the structure” of the Indian Health Board, including clinics “from Bishop to Crescent City,” first created in the 1970s. “He created the structure, providing technical assistance, policy development, and advocacy,” Crouch said, enabling the clinics to endure and thrive.

Richard Figueroa, director of prevention for The California Endowment, said Gutierrez “lived the work.” He had a “real knack for connecting people who ordinarily wouldn’t connect — communities, funding sources — to collaboratively work on issues facing agricultural and rural communities,” Figueroa said. “He would always make the connections. It’s such a loss.”

When Gutierrez worked at the Sierra Health Foundation with Chet Hewitt, now its CEO, Gutierrez “was the ultimate bridge-builder, bringing together people with different perspectives and backgrounds without compromising populations that are too often marginalized,” Hewitt said. “He had a very rich history and extraordinary accomplishments in rural health, and was one of the first to focus on health in the Central and San Joaquin Valleys.”

Dr. Tom Nesbitt, associate vice-chancellor for Strategic Technologies and Alliances at UC Davis Health, shared Gutierrez’s interest in health disparities and telemedicine’s potential to ease them. “It was really never about the technology for Mario,” he said. “It was about the ability of technology to address health disparities — trying to remove barriers, reduce injustice and disparities, bring people together to create policy. He made everyone feel valuable — people in government, rural health, Native Americans, farmworker organizations. Everybody knew and trusted him as someone who was working for their benefit rather than his own.”

Moving Expertise Where It’s Needed

Nesbitt worked with Gutierrez in securing Sierra Health Foundation funding for telemedicine programs in the early 1990s. “It was slow going, difficult to get traction,” he recalls. “Now, as people talk about problems with access and geographic health care disparities, telemedicine is seen as a tool to move expertise where it’s needed.”

Gutierrez was a key participant in regular meetings of the 14 national and regional telehealth resource centers in the National Consortium of Telehealth Resource Centers. Deborah Peters, co-program director of the Pacific Basin Telehealth Resource Center, based at the University of Hawaii-Manoa, said Gutierrez was adept at “smoothing out the edges, without acrimony” to form an umbrella organization for the centers, which are in various stages of telehealth development. “Our situation is very different from California, or the Northwest,” she said, “with different infrastructure, varying levels of adoption [of telemedicine]. He had a vision for us. I can’t imagine what it will be like without him at our next meeting in October.”

The son of Cuban immigrants, Gutierrez grew up in Miami. He earned his bachelor’s degree at the University of Miami and a master’s in public health at UC Berkeley. His Cuban roots were strong, and he made frequent trips to Cuba with his wife, a plastic surgeon, as she performed reconstructive surgeries for international medical missions in developing countries. They developed programs to teach Cuban physicians new techniques. During his training, he took classmates to Cuba, gravitating to the health needs of residents, becoming close friends with the director of a pediatric hospital. Johnson said he was “perfectly bilingual” and enjoyed sharing his culture with family, friends, and colleagues.

“I was a great fan of his paella,” said Hewitt. “He was truly a Renaissance man, loved art, loved service, and had a deep devotion to the poor and disadvantaged. He lived a full life, cut too short, but his passion, his work left benefits for so many communities.”

In addition to his wife, Debra Johnson, Gutierrez is survived by their two children, Gabi and Pablo, and his brother, John Gutierrez. http://www.chcf.org/articles/2017/09/remembering-mario-gutierrez

Related: The CHCF Blog, Medi-Cal & Public Coverage, Telemedicine & Technology

About Sigrid

Sigrid Bathen is a Sacramento-based journalist whose award-winning health care coverage has appeared in many publications. She was a Sacramento Bee reporter for 13 years; a senior editor at the California Journal, a magazine about state government and politics; and communications director for three state agencies. She has been an adjunct professor of journalism and communications at California State University, Sacramento, since 1988. For more information, see www.sigridbathen.com.

LAO in retrospect: A conversation with Elizabeth Hill

Legislative snalyst Elizabeth Hill discusses her office's review of Gov. Arnold Schwarzenegger's revised 2007-08 state budget during a news conference in Sacramento, Calif., Tuesday, May 15, 2007. Hill said the governor's budget plan, released Monday, overstates California's reserve by 75 percent. (AP Photo/Rich Pedroncelli)

Legislative Analyst Elizabeth Hill discusses her office’s review of Gov. Arnold Schwarzenegger’s revised 2007-08 state budget during a news conference in Sacramento, Calif., Tuesday, May 15, 2007. Hill said the governor’s budget plan, released Monday, overstates California’s reserve by 75 percent. (AP Photo/Rich Pedroncelli)

Published April 25, 2016 on Capitol Weekly.

Elizabeth Hill became the first woman to head the California Legislative Analyst’s Office in 1986 when she was eight months’ pregnant with her second child. For 22 years, she held one of the most important positions in state government — advising the 120-member Legislature during fractious times and sometimes clashing over policy recommendations in an increasingly partisan environment beset by the passage of term limits, deep budget cuts, and recession.

Through it all, she quietly maintained a reputation as a no-nonsense, nonpartisan, data-driven, objective analyst of legislation, the state budget, and a growing number of ballot initiatives. She testified in countless hearings, was peppered with questions from legislators, state agency heads — even governors — and was always open with the news media, always on the record.

Nonpartisanship has been a hallmark of the office since it was created in 1941.

Sometimes the disagreements would devolve into invective, but Hill never wavered from her even, fact-based analysis, acknowledging that her job sometimes made her unpopular. “It comes with the territory,” she once told a reporter. At one point, she managed this mammoth, sometimes thankless responsibility with a staff of only 43.

Yet restrictions on budget and staff did not limit her ability to shape public policy, and in 2015, because of her influence on the state’s political and public developments, she was asked by the Center for California Studies at California State University, Sacramento, to be the subject of a detailed oral history (PDF)for the California State Archives.

Liz-Hill-290-WHill joined the LAO as a program analyst in 1976, following a steady climb from humble roots in the Central Valley city of Modesto, where she was born and raised. She earned degrees from Stanford and the University of California, Berkeley; served as a Fulbright Scholar in Sweden; and had stints with several state and local agencies. Four years after she was appointed to the top job, voters passed Proposition 140, the term-limits initiative that also cut legislative budgets and slashed the analyst’s office by 60%.

“It had a seismic effect on the office,” said Dan Carson, a former San Diego Union-Tribune Capitol bureau reporter who left journalism and joined the analyst’s office in 1995 — and stayed for 17 years. “But we found ways to develop new roles that were in keeping with the resources we had. And Liz pushed us forward on computer technology.”

“Everyone in that office is dedicated to the ethic of nonpartisanship,” former Republican Assembly member Roger Niello of Fair Oaks said when Hill retired, “because Liz has developed it that way.”

Despite the cuts, Carson and others said, Hill was personally and deeply involved in day-to-day decisions, while emphasizing a collaborative approach. “Any significant fiscal issue — she personally read and edited it, as the last line of defense for us,” he said. “She was very cognizant. She didn’t phone it in.”

Her employer was the Legislature — all 120 members — and she was widely viewed on both sides of the aisle as even-handed, thoroughly prepared, and a straight shooter. “She’s a solid shot with absolute, impeccable integrity. Couldn’t be any better,” John Vasconcellos, a powerful Santa Clara Democrat in the state senate, told a reporter when Hill announced her retirement in 2008. (Vasconcellos died in 2014.)

“Everyone in that office is dedicated to the ethic of nonpartisanship,” former Republican Assembly member Roger Niello of Fair Oaks said when Hill retired, “because Liz has developed it that way.”

Echoing other legislators, Denise Ducheny, a Democratic senator from San Diego at the time, said Hill’s departure “will leave a huge hole.” During legislative ceremonies after she announced her retirement, the San Francisco Chronicle reported how “evidence of her legacy rippled through the standing ovations from both sides of the aisle.”

With characteristic humility, Hill says nonpartisanship has been a hallmark of the office since it was created in 1941. From its inception, the analyst maintains credibility through nonpartisanship, she said, “providing untainted advice that is objective,” giving lawmakers the tools to make decisions about programs and policy.

When Hill left government, she said she initially spent time “decompressing,” traveling with her husband, Larry, who retired as director of cooperative education at California State University, Sacramento. She also wanted to spend more time with their two children, Erik, 34, and Kristina, 29, and two grandchildren. Today, at 66, Hill continues to focus on public policy issues in retirement, mainly health care and higher education.

In a wide-ranging April 4 interview for the California Health Care Foundation at her home in Sacramento, Hill spoke with veteran Sacramento journalist Sigrid Bathen about her path to becoming one of the most trusted and sought-after public policy experts in the state, and about how solid policy analysis can influence future decisions. Her recall for complex details, dates, and names is precise, razor-sharp — a quality often lauded by legislators, governors, other public officials, and her own staff. And while her long career in public policy spanned a range of issues, health care — especially access for low-income Californians — remains a major focus.


Ed’s Note: This interview originally appeared here on the website of the California Health Care Foundation, which gave Capitol Weekly permission to republish it. Sigrid Bathen, a former newspaper reporter, teaches journalism at Sacramento State and is a regular contributor to Capitol Weekly. The interview has been condensed and lightly edited.

Q: Your family has deep roots in the Central Valley, and you were born and raised in Modesto. Tell us about your early years.

A: My father was born there, and my mother moved there when she was three. Both my parents went to high school in Modesto, and I attended public schools. My father was a salesman with Leslie Salt Co., and my mom was an elementary school teacher. Stone was my maiden name. Our roots are still strong in the community. My mom is 90 now and still lives in Modesto. My father died about 20 years ago. My sister, Ann Falk, who worked in local government, lives in Turlock.

Q: You were active in debate in high school, and 4H, and were strong academically, attending Stanford University on a state scholarship. You also worked in university food services during the school year and summers in a tomato processing plant near Modesto. How did those vastly different cultural and academic experiences affect you?

A: I always knew that if I was going to attend college, I would need to get a scholarship. Luckily, a guidance counselor at my high school — we still had guidance counselors in those days — was a huge help to me, just to figure out how to navigate the waters when applying for college. I was a strong academic student, and had also been on the debate team. So I had a chance to actually visit a number of campuses throughout California for debate tournaments. One of them was Stanford, and I became very interested in that as a possibility. And UC Santa Cruz was just starting about the time I was graduating from high school, and I was quite intrigued by the cluster-college model. So those were the two places I applied, and fortunately, I got in to both.

Q: And then an opportunity to study in Sweden intervened, and that became a significant experience in your life.

A: Yes. After I was accepted at Stanford, I was also accepted into the American Field Service Program (AFS), which is based in New York City and matches the interests of accepted students with families around the world. And they felt that a family up in Umeå, Sweden, which is just shy of the Arctic Circle, was the best fit for me. . . . Stanford was really terrific about it. They said that while they couldn’t guarantee me a slot for the next year, they thought that it was a wonderful idea to participate [in AFS in Sweden] and to go — and, in effect, reapply. So that’s what I decided to do.

Q: Did you know any Swedish?

A: No. I had studied Latin and Spanish. Growing up in Modesto, we had gone up to the snow once, but I had never seen snow fall out of the sky. I really didn’t understand whole sentences for quite some time. But after three months, you know, I became more conversant. It was kind of comparable to a junior college-level education, which is a difference between the system in Europe and the American high school system.

Q: And you‘ve remained in touch with your Swedish family over the years?

A: It will be 50 years ago in 2018 that I went to live with them. And my children know my host sister’s children, and the next generation, our grandkids, are starting to know each other now that the world is a little smaller, with Skype and Facetime and the Internet.

Q: You remarked in the oral history that the families of some of your roommates at Stanford spent more on groceries in a week than your family did in a month. How did your different backgrounds and experiences affect your time there? How did you adjust?

A: I think the wonderful thing about growing up in California is that you’re influenced by all these different things. I had a really good public education. Then I had the opportunity to go to Sweden and learned a great deal about cultural differences, and had a different view of the United States from the outside looking in, which was really valuable. And I learned you could still have an incredible commonality with people even if your backgrounds were perhaps totally different. And I think it’s kind of driven by the Golden Rule, to be honest. Do unto others as I’d like them to do unto me, and that seemed to work out pretty well in terms of being professional and fair. At Stanford, I think that served me well. I was a bit unusual, being a scholarship student. I was very fortunate, and once the university admitted you, they sent you a strong message that they wanted you to succeed and would be helpful in seeing you through. . . . And again, I could learn from my colleagues there; I was fortunate that a new major had started when I was a freshman, called the Program in Human Biology, to try to look at folks by integrating biology and the behavioral sciences, which was actually an experimental program supported by the Ford Foundation — a nice tie to philanthropy. I just thought it was fascinating.

Q: You did food-service work at Stanford, where you held a job as a “hasher.”

A: That was what they called us in my day. I worked around 20 hours a week, and I later became the head of the hashing crew at our little part of Lagunita, which was the dorm complex where I lived. And then the human biology program had student advisors, and I was paid for that. And I worked in the summers, first at Contadina putting “eight great tomatoes in that itty-bitty can.” I also picked peaches and berries.

Q: You have said that experience gave you an appreciation for the challenges facing other workers at the Contadina plant.

A: Absolutely. The canning industry is seasonal by definition, depending on — in our case — peaches and tomatoes. And sometimes there are rains in the Central Valley in the summer. And when it rains, sometimes there are layoffs for a few days when the fruit isn’t harvested. I remember, very vividly, when we were laid off for a couple days, and I was walking behind some ladies as we left that evening, and they said, “Gee, I just don’t know how I’m going to make it without the couple days of income for that work.” And that struck me. I was earning money to be able to go to college. They were there just to make ends meet.

Q: Your major at Stanford was human biology, but you decided to focus on public policy, especially during your internship at the state Department of Transportation (now CalTrans).

A: The major at Stanford wasn’t a classic biology major, although a number of my colleagues in the major did go on to medical school and public health. Because it was a melding of biology and the behavioral sciences, there was a contingent of us who went into related areas like public policy, sociology, and psychology. It was fantastic. At first, I thought I would like to work in nutrition. And then I took my first chemistry-related course, and I realized, nope. . . . I can do nutrition, but not from the scientific point of view of a nutritionist.

Q: The program required an internship?

A: Yes, during the academic term. I became acquainted with Claire Dedrick, who later became secretary of resources under Jerry Brown during his first or second term. And I got very excited about public policy. I then had a chance to work with Assemblymember Clare Berryhill from the Modesto area who actually went to high school with my parents. I found I really enjoyed government. And the people of California had given me an opportunity to go to college with taxpayer dollars through the California Scholarship, supplemented by financial aid from the university. I was really interested in giving back through public service.

Q: After graduating from Stanford, you were accepted at the Goldman School of Public Policy at UC Berkeley, where you earned a master’s degree, working during the summer at Caltrans. After grad school, you went directly to the analyst’s office?

A: First I spent a year in Sweden as a Fulbright Scholar studying their transportation systems. Interestingly enough, when the analyst’s office had an opening upon my return, I was hoping it would be in transportation, but there was nothing available. So I ended up in criminal justice as my policy area.

Q: This was a very different policy area from transportation. Could you discuss the interrelationships among the various areas of public policy analysis — how health care, for example, is impacted by education, social services, criminal justice issues, even transportation?

A: One advantage that we had at the analyst’s office, as a small office, is that I encouraged the staff that if they thought an issue they were looking into had implications for another policy area in the office, they were supposed to walk down the hall and talk to a colleague about what the interaction was and where they could potentially partner on a potential solution. We clearly have huge health care needs in state prisons that also have some implications for the Medi-Cal budget, substance abuse, mental health. The interrelationship of those policy issues was something I really tried to emphasize during my time as legislative analyst. That’s not to say it’s easy to break down those barriers. I’m well aware that it isn’t. But that cross-fertilization I think enabled us to make some important recommendations. In 1993, for example, we made a proposal called Making Government Make Sense, and that encompassed not only health but social services, criminal justice — a whole variety of policy issues. And we were concerned about uniformity in service, particularly in health issues, so that you wouldn’t have as much variation from county to county. And so again, that kind of cross-fertilization certainly came to bear in our proposals.

Q: You clearly have a strong preference for data-driven objective analysis, while maintaining the historically nonpartisan nature of the LAO. How did the presence or absence of data and objective analysis influence policy outcomes when you headed the office?

A: A good example is our work on welfare reform. In 1997, the state had to respond to the elimination of the Aid to Families with Dependent Children’s (AFDC) program at the federal level. And we had been, of course, following social-services and welfare-related issues, cash-grant and work-related programs for many, many years. A lot of evaluations had been done of these programs. So when it came time in 1997 to assist the legislature in crafting the state’s response to the new federal requirements, one of the things we did was to point to the evaluation literature. What worked? But we also had a sense that some of the data wasn’t crystal-clear and wasn’t a full-powered evaluation, and was, frankly, more anecdotal evidence as to what might work. And so what we did in coming together with a proposal for the legislature on welfare reform was exactly to that question. . . . We thought, “Here are some really important messages coming out of this anecdotal evidence that the legislature should consider.” So sometimes, not enough work has been done to come to a conclusive decision. But you give it your best judgment, and you be explicit as to what has been “proven,” and what is instead anecdotal. And so we did that with a good deal of success in our welfare reform proposal.

Q: Do you think data-driven, objective analysis is well utilized in state government generally?

A: Objective analysis is one of many things that policymakers have to take into consideration. I think sometimes its impact may not be clear in the immediate term but becomes clearer in the long term. As local Assembly member Phil Isenberg would say, “Information is power,” and to get your facts straight and know where the weaknesses are in the information — and also the strengths. That can have a very powerful effect on decisionmakers.

Q: It must have been difficult when public officials would balk at your analyses, or sometimes yell at you or make profane comments.

A: I think when you work in the policy environment, you have to understand that analysis is one of many factors, that politics is kind of a contact sport, that my chosen line of profession was making powerful people uncomfortable, oftentimes with objective analysis. And so there were clearly going to be times that officials were not pleased. But if they knew you could be a straight shooter, be objective, evenhanded, and appreciate that they were elected to make decisions, and as staff we were employed to be advisers, not decisionmakers, it worked out. And I think sometimes folks don’t understand that difference, between advice and decision.

Q: You have told the story about the time when Assembly member Maxine Waters said she planned to vote for a budget item you were analyzing, and she told you, “I want you guys to be as hard as nails on that proposal. I want it to be improved.” Did most members have that view of your work?

A: Members who had been around quite some time understood what a neutral third-party could do for them in the policy arena. I think in the early years of a term-limited legislature, some new members had a harder time understanding how they could use the resources of the office . . . to benefit their decisionmaking.

Q: You always had an unusually good relationship with the news media during your tenure — certainly not the norm in government. How did you handle media requests, interviews?

A: We were always of the view that we had so much in common with reporters — trying to explain how state government worked, what was happening. We wanted to be as transparent and open as possible about that, and had the view that all of our staff should talk on the record and not offer their own opinions. But we also thought that the individuals who were responsible for the analysis were usually the best people for the media to talk to because they had the most expertise. I mean, you could talk to me about education, but it would be far better to talk to our education expert. We had debated, “Gee, in this media world, should we have a public information officer?” But ultimately, we decided that the way we were doing it — trying to connect media folks with our experts and talking on the record — was really important.

Q: You’ve said that health care has always been an important interest of yours. How does health policy differ from other types of policy?

A: That’s a really good question. In the analyst’s office, we were dealing with a whole variety of issues, from mental health to substance abuse to developmental services, public health, and Medi-Cal. And Medi-Cal is far and away the largest health program in California. While I didn’t do a deep dive into health [policy] in the analyst’s office, I was responsible for the overall analyses of the health budget. I think health is unique in that, while there are other policy areas that have some similarities, in health particularly it’s a partnership between the state and federal government, particularly when it comes to Medi-Cal. . . . When I retired [in 2009], roughly 6.5 million Californians were served by Medi-Cal; now that number is over 13 million. So it’s changed significantly, and largely because of the passage of the Affordable Care Act.

Q: In 2011, you decided to join the California Health Care Foundation board. What did you find appealing about that role?

A: It was right around the time that the Affordable Care Act was going in, and everybody has some health stories in their families. In my case, in the 1990s my mom had had fourth-stage fallopian tube cancer, a very rare cancer. And she, amazingly, pulled through. She was treated here in Sacramento at UC Davis — she’s 90 now. . . . And having dealt with health over the years, in all of its various permutations, I thought, “Gee, it would be really nice to do more of a deep dive.” Health affects everybody, and with the Affordable Care Act, hopefully I could be helpful to CHCF with my own state experience. I didn’t know that much about philanthropy, but CHCF was, I thought, really unique in that it was willing to work with government and find opportunities where it could be helpful to the government process, again with information, analysis, and data. And that was very intriguing to me . . . with many similarities to what we did in the analyst’s office. . . . I’ve found it incredibly interesting — great staff, great board of directors. And I think that the mission of CHCF is so important — to be sure that there is access to high-quality care for all Californians, with a particular focus on low-income individuals who often don’t have access, or the system isn’t working well for them.

Q: Have you found that your background in behavioral health, going back to your studies at Stanford in human biology, has been a factor in your work with the foundation?

A: We are really moving the foundation more into the behavioral health environment, which is a newer endeavor for us. But I think trying to see the whole person — both the physical and behavioral health ailments and the substance abuse issues that are also a part of behavioral health — that is very important, as is our continued emphasis on access to care, quality care.

Q: And end-of-life issues?

A: The foundation has done important work in that area. I’m a baby boomer, and knowing how many of us are coming, to be sure that high-quality care follows the patient’s wishes is really important. We also have a number of collaborations with other entities that are underway. We’re a fairly small foundation, and being able to collaborate with other partners to make a difference in people’s lives is really important.

Q: You utilized that collaborative philanthropic model to work with the UC Davis Comprehensive Cancer Center after your mother was successfully treated there.

A: I’ve had the opportunity as a CHCF board member to work with the Comprehensive Cancer Center at UC Davis to initiate a women’s cancer-care program. And I’m really pleased with how that’s been able to develop with a little seed money that I was able to direct their way as a director at CHCF. That happens to be where my mom got care, and I wanted to see if there were some things that we could do for other folks going forward. So it’s been an exciting time.

Q: As analyst, you emphasized the importance of field research to learn firsthand about the issues you were examining. In the oral history, you spoke of an early experience, a meeting in Los Angeles with a social worker and a client with a child in her lap trying to apply for Aid to Families with Dependent Children (AFDC). And you were struck by the complexity of the paperwork, and the challenges faced by that caseworker and her client. What did you learn from that experience?

A: That intake experience gave me a profound appreciation for what eligibility workers were facing as they were trying to manage a caseload of several hundred people, to be sure they were meeting all the requirements of federal and state law, and the client who was juggling a one-year-old on her lap as she was trying to answer all the eligibility questions and be honest and factual, and she wasn’t trying to cheat the system. . . . Ultimately, what the state budget and public service are about is understanding people’s needs and how to provide services in the most cost-efficient and beneficial way. And so it really brought it home to our little world in the analyst’s office and in explaining to members of the legislature how programs actually work, what it takes to deliver services in a cost-effective way.

Q: You went through draconian budget cuts in the LAO during your tenure. How did you maintain the quality of the work following passage of Proposition 140 in 1990, when term limits were imposed in the legislature, and your budget was slashed by 60%?

A: It was a challenging time. I think each legislative analyst has been shaped by some unique event during their tenure. Mine was certainly the Proposition 140 experience. The standards for excellence certainly predated me, and they were among the things that attracted me to the office. So when we lost 60% of our staff, we basically had to figure out how could we maintain our excellence, how could we keep the analytical focus, and how can we keep producing things that were required by statute — largely our ballot work — as well as what the legislature expected us to do on the state budget.

Q: How did you manage priorities?

A: We went from 105 to 43 employees at one point, over a two-year period — at the same time the state was in an incredible recession. I approached the legislative leadership and said, “We can’t do the same amount with 60% fewer people,” and I recommended to them that we no longer do all the bill analyses. I just didn’t see a physical way the office could do that. We still operated on a special-request basis, but we would no longer produce 3,000 bill analyses a year.

Q: What about the budget analyses?

A: In previous years, we analyzed every single item of the budget. After Prop. 140, we made a decision each year about where we were going to concentrate our efforts, but that basically, we were going to concentrate our staff resources where most of the money was, and the overall revenue and expenditures of the state. In effect, we tripled all of the analytical staff’s budget assignments as a way to make up for the loss of staff. . . . I think it is a really good case in point of the dedication of my colleagues at the Legislative Analyst’s Office who remained when a very dark cloud was hanging over our heads — and still produced solid, professional work. I think it’s a real testament to public servants.

Q: You were the first woman to be named legislative analyst, in 1986, when you were eight months‘ pregnant with your second child, your daughter. How did you manage issues of work-life balance and the needs of families versus demanding careers?

A: You know, I think for all of us, the work-life balance is a constant struggle. I was very fortunate in that my husband was very supportive of me working at the analyst’s office and throwing my hat into becoming the analyst even though I was eight months’ pregnant at the time that I was appointed. He worked at CSU Sacramento most of that time, and other than May, our schedules were different enough that we could complement each other. But May was particularly trying, both for the academic and the budgetary calendar. Initially, we didn’t have any family residing in Sacramento, and so we had to rely on neighbors and friends to help with picking up children. When our children got sick, one of us would take off in the morning, and one would take off in the afternoon. Clearly, during my tenure in the office, overtime was a big component, year-in and year-out and also during tough budgetary times. The budget often wasn’t done in time for summer vacation, so that always affected things as well. So it was tough on my kids at times. But it was also my dream job, my kids were flexible, and with my husband’s support we made it work.

Former California Legislative Analyst Liz Hill, Renowned Straight Shooter, Turns Her Focus to Health Policy

LizHill

Published April 20, 2016 on the California Health Care Foundation website.

After 22 years navigating state political waters, a respected policy expert looks back on a career that depended on objective facts and data, and explains why she chose to serve on the board of the California Health Care Foundation.

Elizabeth Hill became the first woman to head the California Legislative Analyst’s Office in 1986 when she was eight months’ pregnant with her second child. For 22 years, she held one of the most important positions in state government — advising the 120-member legislature during fractious times and sometimes clashing over policy recommendations in an increasingly partisan environment beset by the passage of term limits, deep budget cuts, and recession.

Through it all, she quietly maintained a reputation as a no-nonsense, nonpartisan, data-driven, objective analyst of legislation, the state budget, and a growing number of ballot initiatives. She testified in countless hearings, was peppered with questions from legislators, state agency heads — even governors — and was always open with the news media, always on the record.

Sometimes the disagreements would devolve into invective, but Hill never wavered from her even, fact-based analysis, acknowledging that her job sometimes made her unpopular. “It comes with the territory,” she once told a reporter. At one point, she managed this mammoth, sometimes thankless responsibility with a staff of only 43.

Yet restrictions on budget and staff did not limit her ability to shape public policy, and in 2015, because of her influence on the state’s political and public developments, she was asked by the Center for California Studies at California State University, Sacramento, to be the subject of a detailed oral history (PDF) for the California State Archives.

Hill joined the LAO as a program analyst in 1976, following a steady climb from humble roots in the Central Valley city of Modesto, where she was born and raised. She earned degrees from Stanford and the University of California, Berkeley; served as a Fulbright Scholar in Sweden; and had stints with several state and local agencies. Four years after she was appointed to the top job, voters passed Proposition 140, the term-limits initiative that also cut legislative budgets and slashed the analyst’s office by 60%.

“It had a seismic effect on the office,” said Dan Carson, a former San Diego Union-Tribune Capitol bureau reporter who left journalism and joined the analyst’s office in 1995 — and stayed for 17 years. “But we found ways to develop new roles that were in keeping with the resources we had. And Liz pushed us forward on computer technology.”

Despite the cuts, Carson and others said, Hill was personally and deeply involved in day-to-day decisions, while emphasizing a collaborative approach. “Any significant fiscal issue — she personally read and edited it, as the last line of defense for us,” he said. “She was very cognizant. She didn’t phone it in.”

Her employer was the Legislature — all 120 members — and she was widely viewed on both sides of the aisle as even-handed, thoroughly prepared, and a straight shooter. “She’s a solid shot with absolute, impeccable integrity. Couldn’t be any better,” John Vasconcellos, a powerful Santa Clara Democrat in the state senate, told a reporter when Hill announced her retirement in 2008. (Vasconcellos died in 2014.)

“Everyone in that office is dedicated to the ethic of nonpartisanship,” former Republican Assembly member Roger Niello of Fair Oaks said when Hill retired, “because Liz has developed it that way.”

Echoing other legislators, Denise Ducheny, a Democratic senator from San Diego at the time, said Hill’s departure “will leave a huge hole.” During legislative ceremonies after she announced her retirement, the San Francisco Chronicle reported how “evidence of her legacy rippled through the standing ovations from both sides of the aisle.”

With characteristic humility, Hill says nonpartisanship has been a hallmark of the office since it was created in 1941. From its inception, the analyst maintains credibility through nonpartisanship, she said, “providing untainted advice that is objective,” giving lawmakers the tools to make decisions about programs and policy.

When Hill left government, she said she initially spent time “decompressing,” traveling with her husband, Larry, who retired as director of cooperative education at California State University, Sacramento. She also wanted to spend more time with their two children, Erik, 34, and Kristina, 29, and two grandchildren. Today, at 66, Hill continues to focus on public policy issues in retirement, mainly health care and higher education.

In a wide-ranging April 4 interview at her home in Sacramento, Hill spoke with veteran Sacramento journalist Sigrid Bathen about her path to becoming one of the most trusted and sought-after public policy experts in the state, and about how solid policy analysis can influence future decisions. Her recall for complex details, dates, and names is precise, razor-sharp — a quality often lauded by legislators, governors, other public officials, and her own staff. And while her long career in public policy spanned a range of issues, health care — especially access for low-income Californians — remains a major focus.

This interview has been condensed and lightly edited.

Q: Your family has deep roots in the Central Valley, and you were born and raised in Modesto. Tell us about your early years.

A: My father was born there, and my mother moved there when she was three. Both my parents went to high school in Modesto, and I attended public schools. My father was a salesman with Leslie Salt Co., and my mom was an elementary school teacher. Stone was my maiden name. Our roots are still strong in the community. My mom is 90 now and still lives in Modesto. My father died about 20 years ago. My sister, Ann Falk, who worked in local government, lives in Turlock.

Q: You were active in debate in high school, and 4H, and were strong academically, attending Stanford University on a state scholarship. You also worked in university food services during the school year and summers in a tomato processing plant near Modesto. How did those vastly different cultural and academic experiences affect you?

A: I always knew that if I was going to attend college, I would need to get a scholarship. Luckily, a guidance counselor at my high school — we still had guidance counselors in those days — was a huge help to me, just to figure out how to navigate the waters when applying for college. I was a strong academic student, and had also been on the debate team. So I had a chance to actually visit a number of campuses throughout California for debate tournaments. One of them was Stanford, and I became very interested in that as a possibility. And UC Santa Cruz was just starting about the time I was graduating from high school, and I was quite intrigued by the cluster-college model. So those were the two places I applied, and fortunately, I got in to both.

Q: And then an opportunity to study in Sweden intervened, and that became a significant experience in your life.

A: Yes. After I was accepted at Stanford, I was also accepted into the American Field Service Program (AFS), which is based in New York City and matches the interests of accepted students with families around the world. And they felt that a family up in Umeå, Sweden, which is just shy of the Arctic Circle, was the best fit for me. . . . Stanford was really terrific about it. They said that while they couldn’t guarantee me a slot for the next year, they thought that it was a wonderful idea to participate [in AFS in Sweden] and to go — and, in effect, reapply. So that’s what I decided to do.

Q: Did you know any Swedish?

A: No. I had studied Latin and Spanish. Growing up in Modesto, we had gone up to the snow once, but I had never seen snow fall out of the sky. I really didn’t understand whole sentences for quite some time. But after three months, you know, I became more conversant. It was kind of comparable to a junior college-level education, which is a difference between the system in Europe and the American high school system.

Q: And you’ve remained in touch with your Swedish family over the years?

A: It will be 50 years ago in 2018 that I went to live with them. And my children know my host sister’s children, and the next generation, our grandkids, are starting to know each other now that the world is a little smaller, with Skype and Facetime and the Internet.

Q: You remarked in the oral history that the families of some of your roommates at Stanford spent more on groceries in a week than your family did in a month. How did your different backgrounds and experiences affect your time there? How did you adjust?

A: I think the wonderful thing about growing up in California is that you’re influenced by all these different things. I had a really good public education. Then I had the opportunity to go to Sweden and learned a great deal about cultural differences, and had a different view of the United States from the outside looking in, which was really valuable. And I learned you could still have an incredible commonality with people even if your backgrounds were perhaps totally different. And I think it’s kind of driven by the Golden Rule, to be honest. Do unto others as I’d like them to do unto me, and that seemed to work out pretty well in terms of being professional and fair. At Stanford, I think that served me well. I was a bit unusual, being a scholarship student. I was very fortunate, and once the university admitted you, they sent you a strong message that they wanted you to succeed and would be helpful in seeing you through. . . . And again, I could learn from my colleagues there; I was fortunate that a new major had started when I was a freshman, called the Program in Human Biology, to try to look at folks by integrating biology and the behavioral sciences, which was actually an experimental program supported by the Ford Foundation — a nice tie to philanthropy. I just thought it was fascinating.

Q: You did food-service work at Stanford, where you held a job as a “hasher.”

A: That was what they called us in my day. I worked around 20 hours a week, and I later became the head of the hashing crew at our little part of Lagunita, which was the dorm complex where I lived. And then the human biology program had student advisors, and I was paid for that. And I worked in the summers, first at Contadina putting “eight great tomatoes in that itty-bitty can.” I also picked peaches and berries.

Q: You have said that experience gave you an appreciation for the challenges facing other workers at the Contadina plant.

A: Absolutely. The canning industry is seasonal by definition, depending on — in our case — peaches and tomatoes. And sometimes there are rains in the Central Valley in the summer. And when it rains, sometimes there are layoffs for a few days when the fruit isn’t harvested. I remember, very vividly, when we were laid off for a couple days, and I was walking behind some ladies as we left that evening, and they said, “Gee, I just don’t know how I’m going to make it without the couple days of income for that work.” And that struck me. I was earning money to be able to go to college. They were there just to make ends meet.

Q: Your major at Stanford was human biology, but you decided to focus on public policy, especially during your internship at the state Department of Transportation (now CalTrans).

A: The major at Stanford wasn’t a classic biology major, although a number of my colleagues in the major did go on to medical school and public health. Because it was a melding of biology and the behavioral sciences, there was a contingent of us who went into related areas like public policy, sociology, and psychology. It was fantastic. At first, I thought I would like to work in nutrition. And then I took my first chemistry-related course, and I realized, nope. . . . I can do nutrition, but not from the scientific point of view of a nutritionist.

Q: The program required an internship?

A: Yes, during the academic term. I became acquainted with Claire Dedrick, who later became secretary of resources under Jerry Brown during his first or second term. And I got very excited about public policy. I then had a chance to work with Assemblymember Clare Berryhill from the Modesto area who actually went to high school with my parents. I found I really enjoyed government. And the people of California had given me an opportunity to go to college with taxpayer dollars through the California Scholarship, supplemented by financial aid from the university. I was really interested in giving back through public service.

Q: After graduating from Stanford, you were accepted at the Goldman School of Public Policy at UC Berkeley, where you earned a master’s degree, working during the summer at Caltrans. After grad school, you went directly to the analyst’s office?

A: First I spent a year in Sweden as a Fulbright Scholar studying their transportation systems. Interestingly enough, when the analyst’s office had an opening upon my return, I was hoping it would be in transportation, but there was nothing available. So I ended up in criminal justice as my policy area.

Q: This was a very different policy area from transportation. Could you discuss the interrelationships among the various areas of public policy analysis — how health care, for example, is impacted by education, social services, criminal justice issues, even transportation?

A: One advantage that we had at the analyst’s office, as a small office, is that I encouraged the staff that if they thought an issue they were looking into had implications for another policy area in the office, they were supposed to walk down the hall and talk to a colleague about what the interaction was and where they could potentially partner on a potential solution. We clearly have huge health care needs in state prisons that also have some implications for the Medi-Cal budget, substance abuse, mental health. The interrelationship of those policy issues was something I really tried to emphasize during my time as legislative analyst. That’s not to say it’s easy to break down those barriers. I’m well aware that it isn’t. But that cross-fertilization I think enabled us to make some important recommendations. In 1993, for example, we made a proposal called Making Government Make Sense, and that encompassed not only health but social services, criminal justice — a whole variety of policy issues. And we were concerned about uniformity in service, particularly in health issues, so that you wouldn’t have as much variation from county to county. And so again, that kind of cross-fertilization certainly came to bear in our proposals.

Q: You clearly have a strong preference for data-driven objective analysis, while maintaining the historically nonpartisan nature of the LAO. How did the presence or absence of data and objective analysis influence policy outcomes when you headed the office?

A: A good example is our work on welfare reform. In 1997, the state had to respond to the elimination of the Aid to Families with Dependent Children’s (AFDC) program at the federal level. And we had been, of course, following social-services and welfare-related issues, cash-grant and work-related programs for many, many years. A lot of evaluations had been done of these programs. So when it came time in 1997 to assist the legislature in crafting the state’s response to the new federal requirements, one of the things we did was to point to the evaluation literature. What worked? But we also had a sense that some of the data wasn’t crystal-clear and wasn’t a full-powered evaluation, and was, frankly, more anecdotal evidence as to what might work. And so what we did in coming together with a proposal for the legislature on welfare reform was exactly to that question. . . . We thought, “Here are some really important messages coming out of this anecdotal evidence that the legislature should consider.” So sometimes, not enough work has been done to come to a conclusive decision. But you give it your best judgment, and you be explicit as to what has been “proven,” and what is instead anecdotal. And so we did that with a good deal of success in our welfare reform proposal.

Q: Do you think data-driven, objective analysis is well utilized in state government generally?

A: Objective analysis is one of many things that policymakers have to take into consideration. I think sometimes its impact may not be clear in the immediate term but becomes clearer in the long term. As local Assembly member Phil Isenberg would say, “Information is power,” and to get your facts straight and know where the weaknesses are in the information — and also the strengths. That can have a very powerful effect on decisionmakers.

Q: It must have been difficult when public officials would balk at your analyses, or sometimes yell at you or make profane comments.

A: I think when you work in the policy environment, you have to understand that analysis is one of many factors, that politics is kind of a contact sport, that my chosen line of profession was making powerful people uncomfortable, oftentimes with objective analysis. And so there were clearly going to be times that officials were not pleased. But if they knew you could be a straight shooter, be objective, evenhanded, and appreciate that they were elected to make decisions, and as staff we were employed to be advisers, not decisionmakers, it worked out. And I think sometimes folks don’t understand that difference, between advice and decision.

Q: You have told the story about the time when Assembly member Maxine Waters said she planned to vote for a budget item you were analyzing, and she told you, “I want you guys to be as hard as nails on that proposal. I want it to be improved.” Did most members have that view of your work?

A: Members who had been around quite some time understood what a neutral third-party could do for them in the policy arena. I think in the early years of a term-limited legislature, some new members had a harder time understanding how they could use the resources of the office . . . to benefit their decisionmaking.

Q: You always had an unusually good relationship with the news media during your tenure — certainly not the norm in government. How did you handle media requests, interviews?

A: We were always of the view that we had so much in common with reporters — trying to explain how state government worked, what was happening. We wanted to be as transparent and open as possible about that, and had the view that all of our staff should talk on the record and not offer their own opinions. But we also thought that the individuals who were responsible for the analysis were usually the best people for the media to talk to because they had the most expertise. I mean, you could talk to me about education, but it would be far better to talk to our education expert. We had debated, “Gee, in this media world, should we have a public information officer?” But ultimately, we decided that the way we were doing it — trying to connect media folks with our experts and talking on the record — was really important.

Q: You’ve said that health care has always been an important interest of yours. How does health policy differ from other types of policy?

A: That’s a really good question. In the analyst’s office, we were dealing with a whole variety of issues, from mental health to substance abuse to developmental services, public health, and Medi-Cal. And Medi-Cal is far and away the largest health program in California. While I didn’t do a deep dive into health [policy] in the analyst’s office, I was responsible for the overall analyses of the health budget. I think health is unique in that, while there are other policy areas that have some similarities, in health particularly it’s a partnership between the state and federal government, particularly when it comes to Medi-Cal. . . . When I retired [in 2009], roughly 6.5 million Californians were served by Medi-Cal; now that number is over 13 million. So it’s changed significantly, and largely because of the passage of the Affordable Care Act.

Q: In 2011, you decided to join the California Health Care Foundation board. What did you find appealing about that role?

A: It was right around the time that the Affordable Care Act was going in, and everybody has some health stories in their families. In my case, in the 1990s my mom had had fourth-stage fallopian tube cancer, a very rare cancer. And she, amazingly, pulled through. She was treated here in Sacramento at UC Davis — she’s 90 now. . . . And having dealt with health over the years, in all of its various permutations, I thought, “Gee, it would be really nice to do more of a deep dive.” Health affects everybody, and with the Affordable Care Act, hopefully I could be helpful to CHCF with my own state experience. I didn’t know that much about philanthropy, but CHCF was, I thought, really unique in that it was willing to work with government and find opportunities where it could be helpful to the government process, again with information, analysis, and data. And that was very intriguing to me . . . with many similarities to what we did in the analyst’s office. . . . I’ve found it incredibly interesting — great staff, great board of directors. And I think that the mission of CHCF is so important — to be sure that there is access to high-quality care for all Californians, with a particular focus on low-income individuals who often don’t have access, or the system isn’t working well for them.

Q: Have you found that your background in behavioral health, going back to your studies at Stanford in human biology, has been a factor in your work with the foundation?

A: We are really moving the foundation more into the behavioral health environment, which is a newer endeavor for us. But I think trying to see the whole person — both the physical and behavioral health ailments and the substance abuse issues that are also a part of behavioral health — that is very important, as is our continued emphasis on access to care, quality care.

Q: And end-of-life issues?

A: The foundation has done important work in that area. I’m a baby boomer, and knowing how many of us are coming, to be sure that high-quality care follows the patient’s wishes is really important. We also have a number of collaborations with other entities that are underway. We’re a fairly small foundation, and being able to collaborate with other partners to make a difference in people’s lives is really important.

Q: You utilized that collaborative philanthropic model to work with the UC Davis Comprehensive Cancer Center after your mother was successfully treated there.

A: I’ve had the opportunity as a CHCF board member to work with the Comprehensive Cancer Center at UC Davis to initiate a women’s cancer-care program. And I’m really pleased with how that’s been able to develop with a little seed money that I was able to direct their way as a director at CHCF. That happens to be where my mom got care, and I wanted to see if there were some things that we could do for other folks going forward. So it’s been an exciting time.

Q: As analyst, you emphasized the importance of field research to learn firsthand about the issues you were examining. In the oral history, you spoke of an early experience, a meeting in Los Angeles with a social worker and a client with a child in her lap trying to apply for Aid to Families with Dependent Children (AFDC). And you were struck by the complexity of the paperwork, and the challenges faced by that caseworker and her client. What did you learn from that experience?

A: That intake experience gave me a profound appreciation for what eligibility workers were facing as they were trying to manage a caseload of several hundred people, to be sure they were meeting all the requirements of federal and state law, and the client who was juggling a one-year-old on her lap as she was trying to answer all the eligibility questions and be honest and factual, and she wasn’t trying to cheat the system. . . . Ultimately, what the state budget and public service are about is understanding people’s needs and how to provide services in the most cost-efficient and beneficial way. And so it really brought it home to our little world in the analyst’s office and in explaining to members of the legislature how programs actually work, what it takes to deliver services in a cost-effective way.

Q: You went through draconian budget cuts in the LAO during your tenure. How did you maintain the quality of the work following passage of Proposition 140 in 1990, when term limits were imposed in the legislature, and your budget was slashed by 60%?

A: It was a challenging time. I think each legislative analyst has been shaped by some unique event during their tenure. Mine was certainly the Proposition 140 experience. The standards for excellence certainly predated me, and they were among the things that attracted me to the office. So when we lost 60% of our staff, we basically had to figure out how could we maintain our excellence, how could we keep the analytical focus, and how can we keep producing things that were required by statute — largely our ballot work — as well as what the legislature expected us to do on the state budget.

Q: How did you manage priorities?

A: We went from 105 to 43 employees at one point, over a two-year period — at the same time the state was in an incredible recession. I approached the legislative leadership and said, “We can’t do the same amount with 60% fewer people,” and I recommended to them that we no longer do all the bill analyses. I just didn’t see a physical way the office could do that. We still operated on a special-request basis, but we would no longer produce 3,000 bill analyses a year.

Q: What about the budget analyses?

A: In previous years, we analyzed every single item of the budget. After Prop. 140, we made a decision each year about where we were going to concentrate our efforts, but that basically, we were going to concentrate our staff resources where most of the money was, and the overall revenue and expenditures of the state. In effect, we tripled all of the analytical staff’s budget assignments as a way to make up for the loss of staff. . . . I think it is a really good case in point of the dedication of my colleagues at the Legislative Analyst’s Office who remained when a very dark cloud was hanging over our heads — and still produced solid, professional work. I think it’s a real testament to public servants.

Q: You were the first woman to be named legislative analyst, in 1986, when you were eight months’ pregnant with your second child, your daughter. How did you manage issues of work-life balance and the needs of families versus demanding careers?

A: You know, I think for all of us, the work-life balance is a constant struggle. I was very fortunate in that my husband was very supportive of me working at the analyst’s office and throwing my hat into becoming the analyst even though I was eight months’ pregnant at the time that I was appointed. He worked at CSU Sacramento most of that time, and other than May, our schedules were different enough that we could complement each other. But May was particularly trying, both for the academic and the budgetary calendar. Initially, we didn’t have any family residing in Sacramento, and so we had to rely on neighbors and friends to help with picking up children. When our children got sick, one of us would take off in the morning, and one would take off in the afternoon. Clearly, during my tenure in the office, overtime was a big component, year-in and year-out and also during tough budgetary times. The budget often wasn’t done in time for summer vacation, so that always affected things as well. So it was tough on my kids at times. But it was also my dream job, my kids were flexible, and with my husband’s support we made it work.

Sigrid Bathen, adjunct professor of journalism and communications, California State University Sacramento

California Health Care Foundation


Herrmann Spetzler Remembered as “Visionary” Who Developed California Rural Clinics

Published May 1, 2018

In 1977, idealistic young people were moving to California’s strikingly beautiful but impoverished Humboldt County to escape urban congestion and do good works. One of them was Herrmann Spetzler, who came to the tiny city of Arcata to run a small counterculture health clinic called Open Door. Spetzler, a tall, bearded man with a German accent, wanted a safe, uncomplicated place that would suit a young family just starting out. He got that — and then he stayed for 40 years to pursue his vision of a health care system accessible to everyone regardless of income. Because of Spetzler’s leadership, thousands of people of all income levels in California’s rural northwest region receive medical care in an expanded network of modern facilities.

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Mario Gutierrez: Improving Access for All, “Giving Voice to the Voiceless”

Published September 7, 2017

 

Debra Johnson vividly recalls the day she met her future husband, Mario Gutierrez. She was a young physician interviewing for a position in an Indian health clinic in Mendocino County, and he was working for the California Rural Indian Health Board. It was 1982.

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LizHillFormer California Legislative Analyst Liz Hill, Renowned Straight Shooter, Turns Her Focus to Health Policy

Published April 20th, 2016

Elizabeth Hill became the first woman to head the California Legislative Analyst’s Office in 1986 when she was eight months’ pregnant with her second child. For 22 years, she held one of the most important positions in state government — advising the 120-member legislature during fractious times and sometimes clashing over policy recommendations in an increasingly partisan environment beset by the passage of term limits, deep budget cuts, and recession.

READ MORE

Democrats divided: The race for state schools superintendent

By Sigrid Bathen posted September 23, 2014


 

For an obscure elective office that is often ignored, unknown or regarded as superfluous in California’s convoluted education bureaucracy, the November election for state Superintendent of Public Instruction is shaping up as one of the most contentious — and costly — races among statewide candidates.

The superintendency typically is viewed as a down-ticket backwater – a nonpartisan office with limited power that some say should be abolished.

Superintendent Tom Torlakson, 65, a mild-mannered former state legislator, Contra Costa County supervisor and high school science teacher, against charter-school administrator Marshall Tuck, 41, a Harvard Business School graduate who worked for several years in Silicon Valley and on Wall Street.

But this year, it has become a lightning rod for widespread dissatisfaction with schools in California, which have consistently been ranked among the lowest-performing and poorly funded in the nation.

At the center of the campaign battle is a Superior Court judge’s blistering decision favoring the plaintiffs in Vergara v. California, a closely watched lawsuit challenging the state’s cumbersome, expensive, teacher-tenure and dismissal system. And while ostensibly nonpartisan, the race between two Democratic candidates in a heavily Democratic state has revealed long-standing divisions among Democrats over education reform.

“This is a battle that has been raging [within] the Democratic Party for about 20 years, but it has become quite fierce,” Dr. Raphael Sonenshein, director of the Pat Brown Institute at California State University, Los Angeles, recently told the education news service, Cabinet Report. “In California, with Democrats so dominant, you look for issues that are going to divide the majority party, and I think this one is pretty close to the top.”

The election pits an embattled but well-funded incumbent Superintendent Tom Torlakson, 65, a mild-mannered former state legislator, Contra Costa County supervisor and high school science teacher, against charter-school administrator Marshall Tuck, 41, a Harvard Business School graduate who worked for several years in Silicon Valley and on Wall Street before founding the highly regarded Green Dot Charter Schools. Later, he was CEO of former Mayor Antonio Villaraigosa’s Partnership for L.A. Schools.

Another round of independent expenditures – which by law cannot be coordinated with the candidates’ campaigns – is expected in the general election season.

While outspent in the primary by Torlakson supporters – primarily massive spending by the California Teachers Association and other unions — Tuck has major support from several wealthy pro-charter donors, including philanthropist Eli Broad and businessman William Bloomfield. Tuck’s campaign benefited from some $1.4 million in independent expenditures, including several large contributions from the California Senior Advocates League PAC, a group funded primarily by Broad and Bloomfield.

Tuck was been endorsed over Torlakson – in the primary — by all major California newspapers, which is unusual so early in the election season.

The CTA and other unions spent $2.6 million in the primary for broadcast and print ads for Torlakson, and another $2 million for “issue ads,” which featured Torlakson but don’t expressly advocate for the candidate.

Another round of independent expenditures – which by law cannot be coordinated with the candidates’ campaigns – is expected in the general election season, although both candidates and their handlers are understandably vague about when or how much. A recent spate of independent expenditures on Torlakson’s behalf came from the CTA, the state and national Federation of Teachers and other labor unions – some $450,000 as of Sept. 19, according to Election Track and the Secretary of State’s office.

According to state financial disclosure records, both candidates reported less than $200,000 cash on hand as of June 30 – $194,550 for Torlakson and $179, 913 for Tuck. Total reported expenditures by each candidate from Jan. 1 through June 30 were very close – more than $1.14 million for Torlakson and just over $1 million for Tuck. But as of mid-September, a sharp uptick in candidate contributions favored Tuck, with $381,000 for Torlakson and $448,000 for Tuck.

Consultant: “There was a horrible turnout in the primary and [likely to be] horrible in the general. It’s very hard to get anybody’s attention — unless you have money.”

“There is a ton of money involved,” said Kim Alexander of the nonpartisan California Voter Foundation, a nonprofit which monitors campaign spending and elections. “The unions appear to be stepping up for Torlakson because he has an opponent who has demonstrated he can raise significant amounts of money.”

Getting the Word Out. . .
A veteran campaign consultant knowledgeable about the election said funding for the schools is improving with the economy and strong public support for school funding, but getting the word out is difficult, and running for a little-known state schools office requires campaign cash.

“Unfortunately for a lot of us who care deeply about these issues,” said the consultant, who asked not to be identified, “this is the most difficult time to run for statewide office. There was a horrible turnout in the primary and [likely to be] horrible in the general. It’s very hard to get anybody’s attention — unless you have money. . .

“If you look at the people who fund Tuck’s campaign, they have a very different view of what is a public school, and ‘reform’ is often code for vouchers. People upset with the schools are upset with the cutbacks — no money for counselors, for nothing but the bare minimum. This was the first spring when there haven’t been pink slips. Because of Proposition 30 (Gov. Brown’s sales and income tax initiative, which was passed in 2012 and strongly supported by Torlakson), there is now some capacity to put money back into the schools.”

“I support due-process rights for teachers, but the law is broken and needs to be changed,” he said. “The tenure process is dysfunctional.” — Gary Hart

Tuck, who has never run for public office, says he decided to run after his efforts in the L.A. Partnership, aimed at turning around 17 dismally performing schools in low-income, central-city neighborhoods, were repeatedly stymied by arcane teacher hiring and dismissal rules in an entrenched education bureaucracy.

The strongly worded Vergara decision on June 10 — and reaffirmed in a final ruling on Aug. 28 — came at a fortuitous time for the upstart young candidate, galvanizing public opinion on school inequality and teacher tenure. Los Angeles County Superior Court Judge Rolf M. Treu said K-12 education in California “shocks the conscience” and is flatly unconstitutional for many students, particularly those in poor and minority neighborhoods – a decision which has focused unusually intense attention on the race, as well as copious amounts of campaign cash.

The decision is almost certain to be mired in a lengthy appeals process, and the issue of appealing Vergara is itself controversial.

“These court battles can go on for many years, and nothing may happen, but I hope this does help generate more attention,” says former state Sen. Gary Hart, D-Santa Barbara, a former high school teacher who chaired the Senate Education Committee for 12 years. He was education secretary to Gov. Gray Davis and is the author of many major education bills, including measures to increase school funding and create charter schools.

“I support due-process rights for teachers, but the law is broken and needs to be changed,” he said. “The tenure process is dysfunctional.”

Those with long experience in California education – some of whom do not want to be quoted by name in a contentious race – say that too often “blame the incumbent” becomes the mantra when public dissatisfaction with schools drives elections. In this election, many say, “blame the teachers” becomes an equally convenient form of scapegoating in a Byzantine state education system with plenty of blame to go around.

A recent Field Poll found Tuck leading Torlakson among likely voters by 31 percent to 28 percent – with a whopping 41 percent undecided. The Tuck campaign issued a jubilant press release about the poll in which campaign manager/communications director Cynara Lilly said “voters are ready for a change” and “when given a choice, will choose the candidate with experience turning around public schools – not the Sacramento insider.”

Gov. Brown chose not to appoint a Secretary of Education, instead focusing on the role of the state board as a policy-making body and emphasizing more local control of schools.

But early polls often do not reflect final outcomes. What does appear likely is this: The coming weeks will unleash a blizzard of campaign ads – mainly paid for by massive infusions of independent expenditures.

“This is a battle between the CTA and so-called education ‘reformers’ who hate the unions, and have their own agendas about the way the schools should be run,” said one veteran political analyst who asked not to be named. “They have a certain notoriety because of the public’s clamor about bad schools. . .Does it matter? Does it make a difference? That depends on what you think about the power of the superintendent.”

Hart and many other longtime educators involved in education politics say the superintendency is a largely ceremonial position, with few powers beyond the “bully pulpit.” Hart, who seriously considered running for the job and ultimately decided against it, has long said the office should be abolished.

The current system, critics say, too often works at cross-purposes, with an elected state superintendent, who heads the state Department of Education, as well as a state Board of Education appointed by the governor, plus hundreds of local school districts and boards, county offices of education and boards.

Gov. Brown chose not to appoint a Secretary of Education, instead focusing on the role of the state board as a policy-making body and emphasizing more local control of schools. In a recent interview with Education Week magazine, board President Michael Kirst, a veteran state and national educator and administrator, said California “for years had a fractured and fractious policymaking system,” creating confusion over “who was in charge.” He said the governor has worked closely with the board and Torlakson, “most of whose positions on education are close to his own.”

‘Blame the Teachers’
Both Torlakson and Brown took considerable heat over their recent decision to appeal the popular Vergara decision. The state’s appeal was filed Aug. 29.

“The system is so convoluted and it can take two to three years or more, costing districts $100,000 (and more). There is no reason for these cases to drag on so long,” — Joan Buchanan

Torlakson says the Superior Court decision is constitutionally flawed and unfairly blames teachers for problems in schools. “The people who dedicate their lives to the teaching profession deserve our admiration and support,” he said in a prepared statement after the August ruling. “Instead, this ruling lays the failings of our education system at their feet.”

“No teacher is perfect,” he added. “A very few are not worthy of the job. School districts have always had the power to dismiss those who do not measure up.” He pointed to a bill he and the governor supported, by Assembly Education Committee Chair Joan Buchanan, D-Alamo, which aims to shorten the arduous hearing and appeal process.

Although critics say the measure provides only limited relief, Buchanan, who served 18 years on the San Ramon Valley school board, including four terms as president, says it is a good first step and brings opposing sides in the controversy to the table. “The system is so convoluted,” she said, “and it can take two to three years or more, costing districts $100,000 (and more). There is no reason for these cases to drag on so long,”

Colleagues and even longtime supporters of Torlakson are often torn about the election, particularly prominent Democratic educators who may be union members.

But they also know firsthand the failings of the teacher-tenure and disciplinary process, which has allowed efforts to discipline or fire clearly incompetent, even abusive, teachers to drag on for years, deterring administrators from even attempting to fire a teacher because of the time and expense of the hearing and appeal process.

“When a district goes into receivership (state takeover), it’s usually been a long way to get there, and it’s a long way to get out. We’ve made real progress, but we still have a ways to go.” — Paul Hefnerf

Also at issue in the election is the current two-year probationary period for new teachers, which critics say is actually only 16 months and is not remotely sufficient to determine a teacher’s competence. Nor, they say, does the current system provide adequate support and mentoring to a new teacher who may be having trouble in the classroom.

Dr. Barbara O’Connor, a prominent retired political communications professor at California State University, Sacramento, who founded the Institute for the Study of Politics and Media, said Torlakson “gets blamed for all the woes of education,” including the financial collapse of many school districts in California. And, while Torlakson is blamed for education’s failings, she added “he also has access to [campaign] finances, so it counter-balances.”

Torlakson campaign manager Paul Hefner says the number of districts in financial trouble has dwindled substantially since Torlakson took office in 2011. “At the height of the crisis, one of three kids attended a school [that was] in financial trouble,” Hefner said. “When a district goes into receivership (state takeover), it’s usually been a long way to get there, and it’s a long way to get out. We’ve made real progress, but we still have a ways to go.”

As a former department chair, O’Connor said she often faced personnel and tenure issues, which come with different rules at the university level, and much longer “probationary” periods. “In the universities, you have to wait seven years,” she said. “It’s an onerous process. To have collective bargaining and tenure is tough. I can’t imagine [granting tenure] after only 16 months.”

A union member (the California Faculty Association in the CSU) throughout her long career in higher education, O’Connor says, “I believe in unions.” At the same time, “I’m not always happy with them (the unions). . .I’m ready for some people who want to take some risk.” She has not taken a position in the election. She says she has visited Tuck’s Green Dot Schools and was impressed. “He’s nontraditional,” she said, “and smart.”

“And I’ve always supported Tom Torlakson, since he was in the Assembly,” O‘Connor added. “He’s a great human being, and his daughter Tamara is a friend (Tamara Torlakson is a senior associate at Dewey Square Group, a political consulting firm).”

‘Crippling Bureaucracy’
In an interview with Capitol Weekly, Tuck said the state’s education system “has been broken for a long time, and we do need real change. I’m not a politician, I’ve learned what it takes to do this work.”

But he’s vague on the specifics of how he would change a system entrenched in layers upon layers of legislative, administrative and legal requirements, both state and federal. He said he favors a collaborative approach – a position similar to Torlakson’s.

“The [state] Education Code constrains what can be done, and it’s a crippling bureaucracy,” Tuck said. “There is no individual position that is all-powerful, but this (the superintendency) is a uniquely influential position, for setting the vision, for fundamental change. It is the one position that is non-partisan, focused only on kids, with the ‘bully pulpit’ and specific assigned powers to drive unique change and move the work forward. But it has to be a collective effort.”

As for teacher discipline, he favors major changes in the process, one in which “you touch a kid, and you’re gone.” Working in challenging L.A. schools as part of the partnership with Villaraigosa and L.A. Unified, Tuck said, “We had teachers who literally hit kids and pushed them around, but we were told we couldn’t fire them.”

At the same time, he said, the increasingly controversial “last-hired-first-fired” system of union-backed hiring meant that many excellent teachers were regularly facing pink slips every spring – a particularly serious issue in low-performing schools in poor areas with high teacher turnover. “We had to lay off teachers of very high quality,” Tuck said. At one school, he said, half the teachers got layoff notices, while at other, more desirable schools, “only 5 percent received layoff notices.”

Tuck insists he favors tenure, and disagrees with the pro-voucher, anti-tenure views of some of his well-heeled supporters. “I’ve only worked in union schools,” he added. “I’m an independent, first and foremost.”

Former state Superintendent Delaine Eastin, who founded the California Teacher of the Year Foundation to provide funding for recognition of outstanding teachers and is on Torlakson’s list of supporters, said many top teachers favor significant changes in the probationary and tenure system which is at the heart of the current election. “Some of those teachers are not in favor of the current tenure system,” she said. “Many favor a three-year probationary period, with levels of [job] protection. . .I do think it’s too hard and too expensive to fire a teacher for doing evil things, let alone incompetence.”

California remains one of the lowest among the states in per-pupil spending.

Whatever happens in the superintendent’s election, with its promises of reform and a blizzard of campaign cash, the role of the office comes down to educating kids in an increasingly diverse, economically divided state with some 6 million kids currently attending public schools – an estimated one-fourth of them poor, many attending substandard facilities with overcrowded classrooms, too many failing to complete high school.

And while teacher tenure has become a driving issue in the election, adequate school funding is hardly mentioned. “Both sides agree on the need for more funding,” says Sonenshein. “They disagree about how education should be delivered.”

Post-recessionary infusions to K-12 budgets, with emphasis on poor and low-performing schools, in the governor’s budget are a good start, Eastin and others say, but hardly address the overcrowded classes, aging buildings, staff cutbacks and other gaping holes in the system that began with the 1978 passage of the property-tax limitation initiative, Proposition 13.

California remains one of the lowest among the states in per-pupil spending. “The solution is a long-term plan to get us back to where we fully fund K-12,” says Eastin.

As a young community college teacher in southern California in the 1970s, who became a state legislator and state schools superintendent, Eastin also taught youths at a juvenile detention facility – an experience that helped drive her views of public education in California, which spends far more to incarcerate young people than to educate them.

“It was an excellent experience for determining policy,” she mused. “The state Constitution doesn’t say that the first priority is incarceration. It says the first priority is education.”

Ed’s Note: Sigrid Bathen is a longtime education writer who teaches journalism at California State University, Sacramento.

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