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

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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.

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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