THE DAILY ASTORIAN • THURSDAY, JULY 30, 2015
NORTH COAST
3A
Walmart site design gets one-year extension
City Commission OKs request
while Army Corps litigation pends
By ERICK BENGEL
The Daily Astorian
WARRENTON — Walmart’s
site design is safe for at least an-
other year.
The City Commission, at
its Tuesday meeting, unani-
mously approved a one-year
extension of Walmart’s site
design review plan approval
for its proposed location at
Ensign Lane and U.S. High-
way 101, in the North Coast
Retail Center.
The extension will last
until mid-August of next
year. Walmart supporters
hope that, by that time, the
retail giant will have over-
come a recent obstacle.
Last April, Clatsop Resi-
dents Against Walmart filed
a lawsuit in U.S. District
Court against the U.S. Army
Corps of Engineers, which
issued Walmart a permit to
fill a small wetland on the
affected property.
In the lawsuit, CRAW
alleges that the Army Corps
issued the permit without
properly assessing the en-
vironmental impact of fill-
ing the wetland and without
exploring available alterna-
tives.
“The proposed Walmart
store would already be con-
structed if it were not for
the hate speech proponents
of CRAW,” said Jim Ray,
a Walmart supporter from
Hammond. He added, “If
CRAW hates Walmart, they
have the right to do business
elsewhere but not to violate
the free exercise of trade
and capitalism which is to
the advantage of all of us.”
Lori Durheim, a Walmart
opponent from Astoria,
advised the commission
to take a larger view of
Walmart’s potential impact
on the community. A new
outlet, she said, would in-
crease the already high level
of traffic congestion on U.S.
Highway 101 between War-
renton and Astoria.
Walmart’s site design re-
view application was orig-
inally approved in August
2013. The approval period
had been previously extend-
ed from August 2014 un-
til next month because the
wetland fill permit had not
yet been issued, preventing
Walmart from beginning
construction. The CRAW
lawsuit has pushed back the
construction date even fur-
ther.
“The permits are ready
to go; they’re just waiting
for the appeal process to
be resolved,” Community
Development Director Skip
Urling said.
Walmart expects to break
ground in spring 2016, as-
suming all the legal loose
ends are wrapped up by
then, according to the ex-
tension request written by
Bryan Dickerson, an attor-
ney with PacLand, the firm
representing the corpora-
tion.
In other business, the
City Commission:
• Unanimously approved
an ordinance prohibiting
vehicle parking from 8 a.m.
to 6 p.m. on postal delivery
days in front of mailboxes,
or places where mail is de-
livered, except when neces-
sary to avoid conflict with
other traffic, comply with
the law or directions from
law enforcement, or mo-
mentarily to pick up or drop
off passengers.
The amendment to the
municipal code grants a 15-
foot buffer on both sides
of curbside mailboxes, al-
lowing mail carriers a 30-
foot comfort zone to access
them.
Devised by Police Chief
Matt Workman, the or-
dinance seeks to address
the parking complaints of
residents who often have
to contend with parking
overflow in their neighbor-
hoods, especially during
such popular draws as the
Buoy 10 annual sports fish-
ing season.
• Appointed by a unani-
mous vote Lorna Anderson,
a Warrenton resident, to
Position No. 4 on the War-
renton Community Center
Board.
Woman accused of Doctors are bringing house calls back
rape, sexual assault
By SAEROM YOO
Statesman Journal
“If the victim is under
16, then it can be a felo-
ny,” Marquis said. “The
A 20-year-old wom- assumption is they can-
an pleaded not guilty not consent. The idea is
Wednesday in Clatsop you protect children.”
County Circuit Court to
The teenage boy re-
allegations of raping and ported the alleged abuse
sexually abus-
in June 2014,
ing a teenage
and the case
boy.
was
brought
Alejandra
before a grand
Espinoza,
of
jury in Febru-
Hammond, is
ary, when Es-
charged
with
pinoza was in-
four
counts
dicted.
of
third-de-
She had an
gree rape and
arraignment
four counts of
scheduled
in
Alejandra
third-degree
March, but she
Espinoza
sex abuse.
said she never
She is ac-
received the no-
cused of touching and tice and missed the court
unlawfully engaging in date. A warrant was is-
sexual intercourse with sued, and she was arrest-
a 14-year-old boy, ac- ed and booked Tuesday.
cording to the indict-
“I just got back from
ment.
out of state,” Espinoza
The alleged incidents said in court Wednes-
occurred between Febru- day. “I was on vacation
ary and May 2014, when for about a year. That is
Espinoza was 19.
why I didn’t receive any
Third-degree
rape mail.”
is a class C felony and
She appeared in court
third-degree sex abuse is via video link from Clat-
a class A misdemeanor.
sop County Jail, where
Since the victim was she is being held on
under 16 and the age $25,000 bail.
gap between the two was
Defense lawyer Kris
more than three years, Kaino has been appoint-
the charges rose to the ed to represent Espinoza.
level of felony rape, ac-
She is due back in
cording to Clatsop Coun- court for an early reso-
ty District Attorney Josh lution conference in Oc-
Marquis.
tober
By KYLE SPURR
The Daily Astorian
Burning cigarette sets
Astoria house ablaze
The Daily Astorian
An Astoria home caught
fire Tuesday morning from
a burning cigarette left on a
couch in the living room.
Astoria Fire Department
responded just before 7 a.m.
to the scene on the 1500
block of Franklin Avenue.
Upon arrival, crews found
two bay windows already
broken as fire and smoke
came out from the living
room area.
The lone occupant, who
was home at the time, was
not injured. One of the fire-
fighters suffered a pulled
calf muscle and was taken
to the hospital.
The fire damaged about
half of the home’s first floor.
Smoke damage extended
from the living room to a
stairway. The total damage
is estimated to cost about
$50,000 to repair, according
to the fire department.
Astoria Fire Department
cleared the scene at about
8:30 a.m. The fire depart-
ment was assisted by Lew-
is and Clark Volunteer Fire
Department and Olney Wal-
luski Fire and Rescue.
SALEM — Mary Ventura-
cci is 98 years old and lives by
herself in her northeast Salem
home.
It’s an ideal situation for
most older adults, who pre-
fer to continue living in the
comfort of their home and
maintain independence. But it
takes some work.
Much of it falls on her
daughter, Wanda Urban,
who helps Venturacci with
her health care, medications,
grocery shopping and more.
Another good portion falls on
Venturacci’s Kaiser Perma-
nente nurse practitioner, Mar-
ty Surface, who provides her
with primary care services at
her home.
When Surface made his
¿rst visit with Venturacci, he
immediately recommended
changes — to the home. The
bathroom needed bars to help
her get down and up. The
bed’s wheels needed stoppers
to make sure it doesn’t move
around too much when Ven-
turacci lands on it. Surface
then taught Venturacci how to
use her walker.
These are all things a typ-
ical primary care doctor in a
clinic setting would not have
been able to do, yet they could
have a profound impact on
Venturacci’s health outcomes.
Fall prevention
One out of three adults
aged 65 and older fall each
year, which can lead to hos-
pitalizations, loss of inde-
pendence, worsening health
and death, according to the
Centers for Disease Control
and Prevention. More than 95
percent of hip fractures are
caused by falls.
Fall prevention is key to
keeping frail, older people
healthy.
House calls, which may
conjure an image from a
different generation, when
doctors traveled with black
satchels, are gaining recogni-
tion for their effectiveness in
lowering costs and improving
outcomes for the most fragile,
complex -- and, in turn, most
costly — health care consum-
ers.
Kaiser Permanente began
its Primary Care at Home pro-
gram in 2007 and started ex-
panding its reach to Salem a
year and a half ago. Its patient
base has grown from 500 to
1,500 people, but more could
be helped.
Surface, who serves 102
patients, is currently the only
house call provider in the Sa-
lem area, but Kaiser is look-
ing to hire another provider,
as there are about 100 people
on the waiting list.
The only requirement is
that the patients be home-
bound, or face signi¿cant
challenges making clinic ap-
pointments.
In a cohort of 554 Kaiser
Permanente patients, prelim-
inary data show that house
calls have helped decrease
costs by 40 percent, emergen-
cy room visits by 40 percent
and hospital admissions by
60 percent.
The federal govern-
ment’s home care demon-
stration for Medicare pa-
tients showed similar gains.
First-year results of the
three-year Affordable Care
Act study, Independence at
Home, showed that offering
house calls to Medicare pa-
tients with complex condi-
tions and high needs saved
Medicare $25 million.
Medicare rewarded partic-
ipating providers who met
certain quality measures
with incentive payments,
and Portland-based House-
call Providers collected
$1.2 million for its first
year’s performance.
Federal legislation
The U.S. House of Rep-
resentatives passed legisla-
tion to extend the program
for two additional years
and now awaits President
Barack Obama’s approval.
U.S. Sen. Ron Wyden,
who championed Indepen-
dence at Home from early
on, also helped introduce
the extension.
“Independence at Home
has shown that providing
quality health care to se-
niors in their home works
for beneficiaries, works for
health providers, and works
for Medicare,” Wyden,
D-Ore., said in a statement.
“Given the strong first year
results of the demonstra-
tion, a two-year extension is
a no-brainer. Independence
at Home is an important
step towards reducing our
nation’s inefficient and ex-
pensive patchwork of health
care delivery systems.”
Much of what house calls
allow providers to do is not
medical in nature.
Shari Sanders, chief of
geriatrics and long-term
care for Kaiser Permanente
Northwest, said it allows
clinicians to detect a crisis
before it begins.
“Who cooks for you?
How do you get dressed?
How do you go to the gro-
cery store?” Sanders said,
listing the type of informa-
tion providers gather during
home visits. “And who’s
your social support? What’s
in your fridge? Your eyes
are opened a little bit more.”
Home visits
During a recent visit
with Venturacci, who expe-
riences swelling in her legs,
Surface discussed reducing
the patient’s blood pressure
medication dose by half to
see if that might improve
her symptoms.
If the pills are easy to
cut, then Venturacci would
be able to avoid a separate
copay refilling a new pre-
scription, Surface noted.
Urban brought out the
pills, and Surface demon-
strated how to split them.
When Venturacci mis-
placed her hearing aids,
Surface lent her a personal
amplifier.
Housecall Providers has
been specializing in home
visits for 20 years.
“The need has always
been significant,” executive
director Terri Hobbs said.
“We’ve always had a wait-
ing list. We’ve always been
recruiting for more clini-
cians.”
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ing patients in their homes.
House call providers are
reimbursed the same way
clinic providers are, on a
fee-for-service basis, yet
house calls take more time
and traveling in between
patients. Providers weren’t
able to see the volume of
patients required to keep the
doors open. So the nonprof-
it’s revenue has long been
supplemented by grants and
donations.
But there’s hope that
Medicare’s support for
house calls through Inde-
pendence at Home and its
value-based payment model
is a sign of change, making
the profession a more viable
option.
“I do see a tide turning
and I think there will be
health care systems look-
ing at this as a way to bet-
ter serve these patients,”
medical director Dr. Pamela
Miner said.
Keeping older patients
out of the hospital isn’t just
a cost saving. It could also
be life-saving.
Older patients tend not to
have great outcomes in hos-
pitals, and they often have
to be discharged to a nurs-
ing home. The experience
also worsens memory prob-
lems, Surface said.
Venturacci has no plans
to move.
“It’s a quiet neighbor-
hood,” Venturacci said. “I
enjoy it here.”
Surface turned to Ven-
turacci.
“At least for the imme-
diate future,” he said, “I see
no reason why you’d have
to leave.”
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