Since the contracts were terminated Monday, Feb. 5, physicians at Prime have reported prolonged, agonizing wait times for patients, the company’s president and chief medical officer said in a Friday letter to Dr. Mark Ghaly, California secretary of health and human services. In some cases, patients have walked out of emergency rooms in disgust and been refused transfers to other nearby CalOptima hospitals, wrote Dr. Sunny Bhatia.

“On behalf of patients, we ask that Department of Health Care Services hold CalOptima accountable to its responsibility to ensure access, continuity, and care to patients and include the safety net hospitals patients have relied on for decades,” states the letter. “These terminations are already negatively impacting patient safety, quality care, and outcomes for the vulnerable patients dependent on CalOptima, very literally putting their lives at risk.”

Ontario-based Prime operates 44 hospitals nationwide, including Garden Grove Hospital and Medical Center, Huntington Beach Hospital, La Palma Intercommunity Hospital and West Anaheim Medical Center.

In a statement Friday, Feb. 9, DHCS said Medi-Cal managed-care plans like CalOptima have the right to voluntarily terminate their contractual relationships with network providers with a 60-day prior notice.

Following termination of the Prime contract, the DHCS said, “emergency services and post-stabilization care continue to be covered” by the company.

CalOptima, which has 954,000 members and is the largest health insurer in Orange County, provides coverage to its members through three programs, Medi-Cal, OneCare, and the Program of All-Inclusive Care for the Elderly. Its contract with the four hospitals had been in effect for more than 15 years.

The termination of Prime’s contract has sent shock waves through physicians and patients at the four hospitals, some of whom protested outside CalOptima’s headquarters last week.

“Hundreds of patients, representing the tens of thousands cared for at these hospitals, pleaded with CalOptima to allow them to continue their care at these hospitals,” Bhatia said in the letter to Ghaly. “These were the hospitals they trusted, the care that provided them dignity, the quality that saved their lives, and the access and continuity they need and deserve. Despite their pleas, CalOptima unilaterally decided for them that they do not need these hospitals.”

CalOptima claims misrepresentation

CalOptima Chief Executive Officer Michael Hunn has cited under-utilization of the hospitals as a chief reason for the termination of Prime’s contract.

From Dec. 1, 2022, to Nov. 30, 2023, 15,604 members accounted for 26,290 visits to the four Prime hospitals, with 98.6% being emergency room visits, according to data collected by CalOptima. Many members went to the ER more than once. There were 2,800 CalOptima inpatient admissions and 364 visits for elective care at Prime hospitals during the year.

Additionally, CalOptima delegates the care of approximately 750,000 members to large, managed-care medical groups, but there is no evidence of Prime contracting with any of those providers, Hunn said.

Seven other CalOptima hospitals within five miles of Prime facilities can absorb patients, he told the Southern California News Group, adding that the termination of the contract should have little impact on patients.

“We stand against activities that detract from this focus, especially the misrepresentations related to CalOptima Health’s contract change with Prime hospitals,” CalOptima said in a statement Friday. “Those misrepresentations are not consistent with what is actually occurring with CalOptima Health members who have received care at Prime hospitals since our contract ended on February 5.”

CalOptima said it is providing Prime hospitals a clinical response within 30 minutes for those patients who may need post-stabilization hospital services.

“We are collaborating closely with our state regulators, who are aware of our unwavering commitment to quality care for members, delivered by our strong network that includes 39 acute and rehab hospitals across Orange County,” the company said.

Prime reports delays, angry patients

However, in the letter to Ghaly, Bhatia said Prime’s worst fears about delays and care for patients are being realized.

“Despite CalOptima CEO Michael Hunn’s assurances that he does not need these hospitals for network adequacy and can effectively transfer and care for patients requiring inpatient care, patients are suffering and denied the quality care and continuity they deserve,” Bhatia said.

According to the letter, in just three days following termination of the contract, documented evidence shows insufficient bed capacity at other CalOptima hospitals and the inability of Prime physicians to transfer stable patients. In some cases, Bhatia said, patients have reportedly left Prime hospital emergency departments, against the advice of doctors, with untreated medical conditions due to lengthy transfer wait times.

At least 37 Prime CalOptima patients have required transfers since Monday, with an average wait time in the ER of 30 hours, with some experiencing much longer delays, according to the company.

In one instance, a 57-year-old woman who went to a Prime ER with nausea, vomiting, and diarrhea waited 60 hours but could not be transferred to another CalOptima hospital because of a lack of inpatient beds and had to be admitted to the Prime facility’s intensive care unit, the letter says

Fourteen patients had clinical conditions that deteriorated while awaiting transfer, requiring urgent inpatient or ICU admission at Prime hospitals, the letter stated.

“This could have been avoided if these patients were allowed to be admitted promptly while stable and receive the quality, inpatient care that had always been provided,” the letter states. “Patient clinical outcomes have been unnecessarily and negatively impacted, causing irreparable harm as a result.”

A physician reported that a 45-year-old woman who had an acute flare of Crohn’s disease went to a Prime hospital and was denied a transfer to Orange County Global Medical Center.

Orange County Global Medical said Friday it could not comment because of patient privacy regulations and does not speak on behalf of decisions made by physicians who are independent contractors.

Dr. Kevin Truong, an emergency medicine physician at Garden Grove Hospital, said in a phone interview that earlier this week a man came to the ER complaining of shortness of breath and chronic obstructive pulmonary disease. However, after waiting for 31 hours to be transferred to another CalOptima facility, the man angrily stormed out of the ER, describing the lengthy delay as the worst service he had ever experienced.

The man’s frustration is understandable, Truong said, adding the ER is a “loud, noisy environment and is not good for inpatient care.”

But that feel-good moment came to an abrupt end when 26-year-old Chris Wessels’ tone turned, and he uttered: “I feel like I’m going to faint.”

Then he slumped over onto his surfboard. His heart had stopped.

Friends Jeffrey Weber and Shayla Bauer frantically paddled him to the sand, pleading with others to call 911.

Weber put his hands onto Wessels’ chest and pressed down. A scene from the popular television show “The Office” played in his head – in the episode, during a CPR class, actor Steve Carell pressed down on a dummy to the song “Stayin’ Alive” as a way to remember how to time the compressions.

“Ah, ah, ah, ah, stayin’ alive, stayin’ alive,” the beat racing through Weber’s mind with each chest compression.

California dreamin’ 

Samantha Dellenoci and Wessels met while in college in Maryland. That was October 2019 and less than a year later, the pair moved to Orange County to start their lives together.

“We both had the California dream,” Dellenoci said. “Once we got here, we just made it our home.”

And part of that dream was learning to surf, hitting the waves two or three times a week between Newport Beach, Dana Point and San Onofre.

“We were just loving starting our day together in the ocean, that for us felt so spiritual,” she said. “It was just so grounding for us.”

The couple created a community here, meeting on Friday mornings at Blackies beach in Newport Beach with fellow surf enthusiasts, including Weber and Bauer, and making friends at Canopy Church in Costa Mesa.

The couple stayed active together, both running a half marathon in San Diego in December, exactly one month before Wessels’ heart stopped.

“He was in great shape and his heart withstood a half marathon,” Dellenoci said. “And then he’s out on his surfboard and his heart stops. It’s mind boggling.”

Stayin’ alive

On a recent day driving to Hoag Hospital to visit his friend, Weber recounted that fateful Jan. 16 morning in Huntington Beach; they were surfing off the dog beach, a remote area tucked behind cliffs where lifeguard towers are spread far apart.

They were about 20 minutes into their surf session when Wessels passed out and had no pulse.

“We didn’t know if it was serious or what was happening initially,” Weber said. “We paddled toward him and realized quickly there was something wrong.”

Even with small waves, getting Wessels to shore wasn’t easy, Weber said. They managed to wedge him between their boards and paddled him to shore, screaming out to two young surfers “We need help, now!”

“The transition from getting someone on the board to the beach was the hard part. He was limp and heavy so it took us longer to get him out and out of the waves,” Weber recounted. “It was a really freaky moment.”

Weber had taken a CPR course in high school, and somehow instinct took over. Then, as he pressed down, the melody from “The Office” episode kicked in.

“Ah, ah ah ah, stayin’ alive, stayin’ alive…” 

“Even though it was super serious, I had that ringing in my head,” he said.

“I can do this,” he remembers thinking.

Bauer was on the phone with lifeguards, the operator on the other line counting out the beats.

“We were spiraling, mentally, trying to realize what happened, there were so many thoughts in our brains,” Weber said. “A lady walking her dog and a man came up and they were just quick to be there and stop what they were doing to help.”

They took turns pumping onto Wessels’ chest until first responders showed up.

Weber never caught the passersby’s names, he simply gave them hugs before they parted ways on the sand as Wessels was rushed away in an ambulance.

“They helped save his life as much as we did in those moments before the first responders came,” he said. “That was the crazy thing, for strangers to come and help. We are super grateful for them.”

Blessings

For Dellenoci, the kindness of others is what has been giving her comfort during the hard days since. Wessels was kept in a medically-induced coma for days, and then was on a ventilator, then slowly was able to give a peace sign.

His brain is foggy and slow, but he kisses Dellenoci on the cheek. He’s smiling and laughing. But even simple memories or tasks like walking and talking remain challenging.

“We have to be patient, but we are really hopeful with time and proper care and experts doing what they can that he will continue to make steps. We’re praying for a full recovery,” Dellenoci said. “It’s a crazy and horrible situation, but there’s been a lot of blessings along the way.”

Doctors still don’t have an explanation of why Wessels heart suddenly stopped. But it is clear that he will need much therapy and rehabilitation in the months, maybe years, to come, Dellenoci said.

He has been accepted into the Fudge Family Acute Rehab Center at Hoag Hospital, where he will get at least three hours of therapy, five days a week.

Friends set up a GoFundMe, already raising nearly $35,000 from the community to help toward what will no doubt be a pile of medical bills.

Wessels’ family recently met with every first responder who helped keep him alive that day, from paramedics to firefighters and lifeguards, thanking them for their part. They all said the same thing: Had Weber not started CPR right away, his friend would not be alive.

From the beach to the hospital, Wessels went without his own heartbeat for 45 minutes.

With so much unknown, Dellenoci had to cancel their big wedding planned for Feb. 24 overlooking the ocean at Casa Romantica, but hopes her fiance will be well enough to say “I do” during a small ceremony on that same day they picked to wed.

“My hope is to just marry the guy,” she said. “He is the love of my life.”

Whatever happens in coming days and months and years, she wants the people who have helped them on their journey to know they have made a difference.

“We have so much love holding us up,” she said. “You just start to realize how many people it took to get him to where he’s at now. This was such a crazy, horrible thing that happened, but the community is caring for him. It’s amazing to be a part of. I felt so safe and that God’s got this and there’s no need for me to worry and try and control the situation. The gift of that has shown up every single day.”

What’s also apparent is how CPR helped in those critical moments. Friends and family are already talking about organizing a CPR class for anyone who wants to attend.

Dellenoci is especially thankful to their friends for being next to Wessels and giving him the heartbeat he needed to survive.

“I think it was really difficult for them to witness,” she said. “But we have been covering them in prayer for peace and healing and blessing, because they saved his life.”

Weber is glad, he said, he remembered the basics from his high school class – and that he caught that Office episode years ago that was somehow still deep in his mind.

He also wants to urge people to learn CPR, in case there is ever a friend or stranger in need.

“I feel like it’s a no-brainer, to at least have that awareness,” he said. “It’s such a basic thing, but it’s a lifesaver.”

Want to learn CPR? Go to redcross.org to schedule a class.

The California King Tides Project is asking for people to document the coast for a citizen-science project that aims to give decision-makers a look at how to address sea-level rise in future years.

Many beaches will be swallowed by salt water in the early-morning hours Friday, Feb. 9, with tides reaching 6.6 feet high at about 8 a.m.

The phrase king tides is used to describe very high tides, caused when there is alignment of the gravitational pull between the sun, moon and Earth. They are predictable and happen a few times of year, allowing documentation of vulnerable areas impacted by high sea levels, officials with The California King Tides Project say.

When king tides occur during floods or storms, water levels can rise even higher and have the potential to cause great damage to the coastline and coastal property. Waves on Friday, however, are expected to be small and flooding issues will likely be minimal, though high waters due to the recent rain could push water levels up over harbor seawalls and into streets.

KC Fockler, educational coordinator for Surfrider Foundation North Orange County chapter, said he planned to photograph Dog Beach in Huntington Beach, an area he has been keeping an eye on in recent weeks as sand has eroded with recent big swell events.

He’s noticed rocks that have been buried for decades exposed as high tides and storms have swept sand away, he said. The space for dogs to frolic is shrinking; at higher tides just a sliver is left for the pooches to play on.

“We need to be able to show a history, for scientific reasons, that way we can look back at these incidents and be able to take measurement of what’s happening,” he said. “Why is the beach eroding? How can we protect it in the future? Are stronger storms driving stronger waves and moving the sand away?”

The Roundhouse Aquarium at the Manhattan Beach Pier will host a “King Tide Watch” from 8:30 to 9:30 a.m. Friday during which nature enthusiasts and scientists will document the king tides from the base of the pier.

Climate Action Santa Monica will host a 7:30 a.m. gathering at the Santa Monica Pier to explain how the king tides happen and to document the phenomenon.

To contribute photos to the citizen science project from a beach near you, go to coastal.ca.gov/kingtides

Huntington Beach resident Eric Meyer was riding his bike near Seapoint Avenue in Huntington Beach when he spotted what looked like foam from the waves, he said, but as he got closer it was a 30-foot, decomposing gray whale.

Gray whales are on their annual migration, which spans from Alaska to Mexico and passes Southern California along the way – it’s the longest migration of any mammal on Earth.

“It’s kind of sad. I just went out on a whale trip and saw a gray whale,” he said. ‘It’s pretty sad to see a big creature dead.”

It is likely the whale found in Huntington Beach was washed ashore by the recent storms, said Justin Viezbicke, the National Oceanic and Atmospheric Administration’s California marine mammal stranding response coordinator.

“With all the recent fronts we’ve had blow through, this is typically what happens,” he said. “Those things that are floating around, they do get pushed ashore.”

Wounds on the animal could have been from sharks after the whale died, but “with a carcass floating around the ocean, that’s not surprising to see at all.”

Researchers with the Pacific Marine Mammal Center were taking samples for a necropsy Thursday, while lifeguards were assessing whether to tow the whale out to sea, bury it or have it taken to a landfill, Viezbicke said.

There’s been either two or three dead whales in recent weeks off Southern California, according to Viezbicke. It’s unknown if this one that washed up is the same as one recently found and towed out to sea in San Diego.

“My initial feeling is it is a new one, but we have to double and triple check to make sure we’re not mistaking the counting,” he said. “We want to make sure we have accurate counts and numbers. Sometimes, it’s hard to match the whales after weeks floating at sea and bad degradation.”

Another small calf washed ashore dead recently in Humboldt County.

Getting the number of whales that have died correct is important because there’s still an “Unusual Mortality Event” declared following years of high numbers of dead gray whales washing ashore, prompting concern about the species.

The gray whale population is only about half of what it was seven years ago – it dropped from an estimated 27,000 in 2016 to 14,500 in 2023.

While gray whales are not washing up in the hundreds as they were several years go, the number of gray whales counted passing Southern California so far this year has been concerning.

It’s been the lowest southbound count in 40 years for the Gray Whale Census & Behavior Project off Point Vicente in Palos Verdes, said co-founder Alisa Schulman-Janiger.

As of Jan. 31, volunteers had counted 176 southbound gray whales, including 22 newborn calves, and 19 northbound gray whales, including one calf.

At the same time last season, the count was 197 southbound gray whales, with 29 newborn calves, and eight northbound gray whales.

In previous seasons, by this time the count had recorded 210 to more than 1,200 southbound grays.

There are potential reasons for a low count, other than the species struggling, Schulman-Janiger said, noting southbound grays could be traveling further offshore and out of sight of the volunteers who track their numbers.

The 2019-23 Unusual Mortality Event is under review, she said, and may be declared over soon depending on southbound counts this season, calf assessments, body conditions, and the number of stranded grays.

The policy says no city library should allow children “ready access” to books that contain content of a sexual nature. Books with sexual references are to be placed in shelves designated for adults.

Jennifer Carey, a spokesperson for the city, confirmed that staff have begun reviewing books for relocation.

Books pulled from shelves are being taken to a back area and evaluated if they should be re-cataloged within the library system and then placed back on their new shelf, Carey said. She said picture books could be re-cataloged within a day, but longer books may need up to two days before they are back on shelves.

“The intent for them isn’t to take a whole section of books off the shelf,” she said. “they are keeping everything on the shelf with the exception of those that they consider to fall within the guidelines outlined within this resolution.”

Carey said library staff have been working with Community and Library Services Director Ashley Wysocki and staff from the City’s Managers Office to interpret what is outlined in the City Council’s resolution setting the policy “so that they can make an informed decision as to what would qualify.”

Library staff on Wednesday were seen loading books onto carts for evaluation. Those books included “Will Puberty Last My Whole Life,” “Everyone Poops,” and “It’s Perfectly Normal: Changing Bodies, Growing Up, Sex, and Sexual Health.”

It is unknown if any of those books were ultimately moved to shelves in the adult section.

There’s no timeline for how long re-cataloging all the books could take and only the central library has begun the process, Carey said. Books that librarians may deem as not straightforward would be later reviewed by an appointed community board that will have oversight of children’s books in city libraries. Both Carey and Huntington Beach Mayor Gracey Van Der Mark, who originated the push last summer, said there’s no specific time for when that board might start.

The city in February is celebrating “We Love Our Libraries – Huntington Beach’s commitment to books, reading and learning” as part of its new monthly history-focused calendar.

“It’s extremely hypocritical when you have ‘We Love Our Libraries’ month and you are trying to honor that and you are removing books, important books, that’s part of our collection that’s been developed over many years,” said Carol Daus, a resident who has been opposed to the city’s efforts.

“Not only is it a loss for the community when you start to remove books, but then there’s also the issue of First Amendment rights,” she said. “A public library should offer a diverse range of books and materials that are of interest to a community.”

Daus, who was at the library while books were being pulled, said the staff looked to be focused on paging through books about body development. Daus said there remains concern that LGBTQ books could be restricted.

Van Der Mark said her goal is to have the children’s section be an area where parents “can be confident that their children are going to pick up a book that is appropriate.”

While the review of books hasn’t started at the city’s other four branches, the libraries will be in communication so that if any books are moved at one library, duplicate copies are moved at the other branches, Van Der Mark said.

Pacific Airshow has typically been a three-day affair from Friday to Sunday. Now, organizers are looking to start the air show as early as Wednesday and include a plethora of new activities as they plan for the next decade of the annual event.

The air show anticipates adding to the event air racing, a nightly music festival over three days, wave pool surfing and BMX bowl competitions. The new information comes from a public study looking at what should be considered in a future environmental impact report.

Previous air shows had practice flyovers begin as early as Monday the week of the event, according to the study. If the event were to expand to five days, practice flyovers would continue with a Monday start date.

The study, completed by consultants, said many of the aircraft seldom fly over land, instead holding out over water.

The air show’s music festival, which would start right after the flying demonstrations finish, could return in future years and expand to a three-day series that goes until as late as 11 p.m. The music festival’s speakers would be pointed toward the ocean, but “may result in a temporary net increase in noise,” according to the study.

During the evenings, there could be nighttime flyovers with parachute jumps and pyrotechnics.

The music festival previously has been in a fenced-off area on the sand and featured artists like Sammy Hagar & The Circle.

Other activities looked at being added include skateboarding competitions, a helicopter landing on a temporary helipad on the beach and art installations.

The final environmental impact report would include an analysis of noise and pollution caused by aircraft during the show.

Two years ago, the 2021 air show was canceled following an oil spill off the coast of Orange County. That led to a lawsuit between the city and the air show operator that ultimately ended in a settlement that ignited strong resentment from some in the city. That complete settlement has not been released by the city and a resident is in an ongoing legal battle to obtain it.

Pacific Airshow officials said their 2023 event saw more than 700,000 people watch the show in Huntington Beach and 33% more ticket sales than the prior year.

The Huntington Beach City Council will hold a public hearing on the final environmental impact report before voting to certify it. The city will hold a scoping meeting for the public to weigh in on what the environmental impact report should address on Wednesday, Feb. 21 at City Hall. For more details see here.

The area of Seapoint Street to Warner Avenue was first closed at 7:15 p.m. on Sunday, according to Christine Knadler, Caltrans public information officer for District 12, which is Orange County.

“We haven’t been able to reopen it for safety reasons,” Knadler said.

It was the only major roadway closed as of Tuesday late afternoon, with some smaller closures elsewhere mostly from drainage issues, she said. “We’re working on those pretty quickly.”

The flooding along Pacific Coast Highway – a heavily used roadway – stems from the wetlands area, with seawater flooding up onto the road.

“We’ll reopen it as soon as it’s safe to do so,” Knadler said.

Pacific Coast Highway is a stretch that sees 20,000 to 25,000 motorists daily and the flooding is an issue every time it rains, a significant impact for people who use the major thoroughfare, said Huntington Beach city public information officer Jennifer Carey.

“The rainfall doesn’t have anywhere to go, there’s not a high enough seawall to block the Bolsa Chica Wetlands from overflowing,” she said. “The reality is, anytime there is any sort of rain, we just anticipate for that to be closed.”

There were no other major issues throughout the city, she said, other than a street closure on southbound traffic that started Monday afternoon due to flooding on Magnolia Street just south of Edison High School. The street was expected to reopen sometime Tuesday afternoon.

Newport Beach also didn’t have any major issues, other than pump crews addressing some minor pooling spots as they arose, said Newport Beach spokesperson John Pope.

A concrete wall along the Prima Deshecha Flood Control Channel just north of Calle Grande Vista buckled due to slipping debris in San Clemente, according to Councilmember Chris Duncan.

To repair the wall and restore proper flow in the channel, staff was set to meet with consultants and a local contractor Wednesday morning, he said.

Meanwhile, voluntary evacuation warnings were in place through the day for Silverado, Williams, Modjeska and Trabuco canyons, according to Shannon Widor, OC Public Works spokesperson.

Road and hillside conditions in the unincorporated canyon areas held up well as the rain storms eased up early evening, he said.

Local residents prepared for the rain by using sandbags and wattles to handle storm water, while OCPW crews cleared mud and rocks from roadsides and culverts so storm water doesn’t back-up.

“While there was a voluntary evacuation and flood watch in place, we didn’t see any significant issues,” he said, noting there were several areas of ponding water, rocks and thin layers of mud across canyon roadways.

“Our crews had heavy equipment already staged in the canyons, so we were able to keep roads open for residents, service providers and emergency responders,” he said, noting crews would still be on-call through the evening in case any issues were reported.

“We fared very well throughout this storm,” he said. .

OC Public Works was continuing to monitor any ground movement in the canyons and residents should keep sandbags in place until notified otherwise, OC Public Works warned in a public advisory.

In Dana Point, the city’s public works crews plan to close Coast Highway between Palisades and Camino Capistrano to all traffic on Thursday, Feb. 8, to clear locations where space behind the concrete barrier filled up with debris, a barrier to avoid having any end up on the roadway shoulder.

“Intermittent closures may occur before then and work could continue into Friday,” said Matt Sinacori, the city’s director of Public Works and City Engineer. “We encourage everyone to use caution when driving as weather conditions are constantly changing. We also thank everyone for their support and understanding.  It is Dana Point’s goal to keep everyone safe on the road.”

In Lake Forest, several fields and a few low-lying parks had been closed since Monday due to the heavy rainfall. Some parks in the city are specifically designed to function as retention basins during such weather events, which results in pooling across some of these fields, said spokesperson Jonathan Volzke.

“Today’s rain is certainly more intense than anything we’ve seen in a while, but our storm drains seem to be doing their jobs,” said Volzke. “None of our streets are closed. We do have public works folks out patrolling and so far, so good.”

The Lake Forest Golf Course had to close its driving range because it serves as a retention basin for the city, resulting in significant water accumulation. But, according to general manager Dave Brown, this is normal and there were even some people still playing in the rain on the regular course.

Much of Anaheim was included in Tuesday’s flash flood warning. City spokesperson Mike Lyster said the city was doing relatively well. Water could be seen building up on right lanes along roadways, but no streets were closed due to flooding.

Workers in Anaheim were out cleaning storm drains throughout the city, clearing muddy water runoff on Santa Ana Canyon Road and removing a 70-foot eucalyptus tree that fell over Anaheim Hills Road on Tuesday morning.

That tree blocked two lanes of traffic along Anaheim Hills Road near South Via Montanera. City contractors were out cutting up the tree to clear the roadway, Lyster said.

Since Sunday, Anaheim had four minor power outages reported, affecting a few hundred people. All of those power outages have been restored, Lyster said.

At the Anaheim Convention Center, the storm didn’t stop a manufacturing trade show that runs through Thursday from beginning.

Thousands of runners hit the pavement along Pacific Coast Highway, despite the threat of rain, for the Surf City Marathon, soaking in the ocean views as they participated in the full and half marathons and a 5K race.

“The start and finish on Pacific Coast Highway, under the palm trees with the pier and in the distance – there is really no experience like it, anywhere in the world. It remains one of the most popular in Southern California,” said organizer Dan Cruz.

The event, now in its 28th year, is a Boston Marathon qualifying event, so it brings out serious racers who enjoy the competitive aspect of the run.

Some prefer the shorter routes also offered and participate for the fun atmosphere, with the sounds of Beach Boys in the backdrop and a beer garden at the finish line. Others come to support cancer survivors or other causes, or use the race as a platform for a fundraising goal.

“I love the spirit of race day, all the people coming together. It brings people together no matter your age, ethnicity, from across the country – all to achieve a common goal,” Cruz said. “It’s such a special feeling at the finish line.”

It’s one of the more scenic marathon runs in Southern California, with runners passing surfers catching waves near the Huntington Beach Pier, all the way up the coast to Bolsa Chica State Beach with the wetlands as the backdrop, and back down the beach path to end at Huntington State Beach.

The race isn’t just a one-day affair, but was a weekend filled with festivities that led up to Sunday’s races.

The Active Lifestyle Expo kicked off Friday and ran through the weekend, and a day before the bigger races, hundreds of runners showed up for a “Beach Mile” event, a short jaunt on the sand to and from the famed Huntington Beach Pier.

All the lanes on Pacific Coast Highway shut down for the race, the smell of the salt-water ocean filling the air.

“You see the waves out yonder, it just creates a memorable experience,” Cruz said. “It’s really just so beautiful, the scenic course, running along the coastline.”

The supporters who line the course, cheering the runners along, also adds to the motivation to reach the finish line.

“Not all the athletes are professional runners. These are people you work with, people you go to church with. When they come out to give high fives, it’s such a positive atmosphere.  It’s no wonder people come out to do this race, year after year.  You’ll see a lot of young people doing the 5K, moms doing the marathon, dads pushing strollers,” Cruz said. “It’s really just a community spirit, a tradition.”

The unlikely mashup of foot soldiers — a dozen homeless individuals with chronic illnesses, health care executives, and doctors clad in white lab coats — held signs that read “Shame on you for taking away our care” and “Every patient matters” during a spirited 30-minute protest Thursday, Feb. 1, outside CalOptima’s high-rise headquarters in Orange.

The aim was to prevent the Medi-Cal insurance giant from terminating its contract on Monday with Ontario-based Prime Healthcare Services, which owns Garden Grove Hospital and Medical Center, Huntington Beach Hospital, La Palma Intercommunity Hospital and West Anaheim Medical Center.

“Garden Grove Hospital is my home away from home,” said Robin Wilson, 63, a CalOptima member who has diabetes and chronic colitis and lives just three stoplights away from the facility she has been using for 45 years. “I don’t feel comfortable going anywhere else. Garden Grove Hospital provides the best care. I can’t emphasize enough how much they do.”

Another CalOptima member, 53-year-old Wendy Bailes of Newport Beach, frequents the Huntington Beach Hospital’s emergency room and was most recently treated for broken ribs.

If CalOptima rescinds the facility’s contract, it will be a “major blow” to the community because medical providers take time to understand the needs of patients, Bailes said, adding, “They know me there.”

Created 30 years ago

CalOptima Health was created by the Orange County Board of Supervisors in 1993 as a county-organized health system and is the largest of six COHS in California.

It manages programs funded by the state and federal governments, but operates independently under the leadership of a board of directors made up of members, providers, business leaders and local government representatives that include Orange County Supervisors Doug Chaffee and Vicente Sarmiento.

“We are always concerned about a patient’s access to quality and timely care,” Sarmiento said. “We also recognize the importance of addressing concerns in the delivery of care and ensuring the rights of low-income patients are protected, throughout the process.”

With 954,000 members, CalOptima is the largest health insurer in Orange County, providing coverage for more than one in four residents through three programs, Medi-Cal, OneCare, and the Program of All-Inclusive Care for the Elderly.

In a last-ditch legal effort, eight CalOptima members filed a petition this week in Orange County Superior Court against CalOptima Chief Executive Officer Michael Hunn seeking a temporary restraining order to block the termination of Prime’s contract.

The petition request was denied Friday by Judge Scott Steiner.

“It is unfortunate that a single decision for no cause can alter the lives of so many in greatest need,” Prime said in a statement. “With this seemingly arbitrary decision, CalOptima is eliminating a significant percentage of the acute care hospitals in its entire network.

“While every person deserves expanded care and access, eliminating hospitals for no cause seems contrary to the best interests of patients, who are left wondering why their care can be limited and why they don’t deserve access to all hospitals willing and able to care for them, especially all safety-net hospitals.”

Reasons for termination given

Following Thursday’s brief protest, CalOptima members filed into the organization’s expansive boardroom, where for nearly 15 minutes Hunn explained why Prime Healthcare’s contract is being terminated, with approval from the California Department of Healthcare Services.

“It’s not helpful if there’s misinformation about the facts,” he told CalOptima’s board of directors. “It’s not helpful for our members to be frightened or worried. It’s not helpful for our members not to know what’s going on because they don’t understand, or they don’t speak the language. That’s not fair to vulnerable people.”

Hunn cited patient under-utilization as a chief reason for the termination of Prime’s contract.

From Dec. 1, 2022, to Nov. 30, 2023, 15,604 members accounted for 26,290 visits to the four Prime hospitals, with 98.6% being emergency room visits, according to data collected by CalOptima. Many members went to the ER more than once.

There were 2,800 CalOptima inpatient admissions and 364 visits for elective care at Prime hospitals during the year.

“We believe that our networks can certainly handle 364 cases, given the tens of thousands of cases here in our county,” Hunn said.

Within five miles of the Prime facilities are seven other CalOptima hospitals that can absorb patients, he told the Southern California News Group

Additionally, CalOptima delegates the care of approximately 750,000 members to large, managed-care medical groups, but there is no evidence of Prime contracting with any of those providers, Hunn said.

“We believe that our members are best off being in a managed-care environment with a primary care physician in a medical home, receiving coordinated care from both the doctor, their outpatient services, and any inpatient services they might need,” he told the board. “The state thinks they get better care, physicians believe they get better care, and we firmly support that.”

Prime learned only a month ago its lack of designated medical group contracts contributed to CalOptima’s decision to terminate its contract, according to company officials. The officials said they asked for time to pursue the contracts but were rebuffed by Hunn.

Little impact expected

Overall, the termination of CalOptima’s agreement with Prime should have minimal impact on members, Hunn said.

Members and anyone else in the community can go to any emergency room and receive medical screening and stabilizing treatment under federal regulations, he noted.

If a patient needs admission and no beds are available elsewhere, the hospital where they received emergency care — including the four Prime hospitals — can admit and treat them, he said. In that instance, CalOptima will cover medical costs for members based on the California Department of Health’s fee schedule.

“I just don’t want our members to think because of a contract change they can’t receive their medical care, they can’t go to the emergency room, or they won’t be able to stay in the hospital if they need to,” Hunn said. “They can go to the emergency room. They can be seen. They can be treated, and they can be admitted for care.”

Additionally, the termination of Prime’s contract will not affect members’ behavioral health care, outpatient services or the ability to keep their current physicians for elective care.

“That doctor will have privileges at other hospitals,” Hunn said. “And if they don’t, then we will work with them (CalOptima members) to find a primary care doctor that does have privileges at a hospital that they would like to attend.”

Hunn told board members that CalOptima works hard to ensure all members are treated with dignity and respect. “I will not allow us ever, ever to deviate off the mission of CalOptima Health,” he said. “And we will fight vigorously, and we will be unrelenting in making sure that message is clear.”

Patients, doctors fear worst

However, for some Prime officials at Thursday’s meeting, Hunn’s promises rang hollow.

Amy D. Searls, the company’s chief patient experience officer, chided Hunn, who appeared to look down as CalOptima members and medical providers shared their concerns during the meeting’s public comment period.

“I’m very offended that … Hunn hasn’t turned around and looked at one of them,” she told the board while standing at a podium. “These are people with hearts and lives who are trying to make a positive difference in their world.”

Mark Gamble, chief of advocacy and operations with the Hospital Association of Southern California, said the termination of Prime’s contract is fraught with problems and would tax Orange County’s already overburdened healthcare system. He asked the board to pause the contract cancellation

“Many hospitals in the region throughout Southern California, especially in Orange County, are reporting extremely high patient volumes, beyond normal capacity, and even higher than what we experienced during the height of the (COVID-19) pandemic,” he said.

The Orange County Health Care Agency did not immediately respond to a request regarding the potential impact on the EMS system.

Dr. David Ngo, an emergency medicine physician at Huntington Beach Hospital and LA Palma Intercommunity Hospital, estimated as many as 4,000 Prime patients a year will have to be absorbed by other acute care facilities faced with staffing shortages and low bed availability.

Brendan Barth, a patient advocate for Prime’s four Orange County hospitals, said members feel that CalOptima is attempting to eliminate their ability to choose which hospital they go to for treatment.

“They want to be at the hospital that is close to their home,” Barth said. “They don’t just want to be told to go somewhere else. They want to go where they get the best care, and denying them that would have a devastating impact on their social health, their mental well-being and their physical health.”

That uncertainty ranges from whether it would force the city to run its own municipal elections, and not use the Orange County Registrar of Voters to consolidate elections, to who would decide how, or if, the new requirements are implemented. The measure doesn’t explicitly lay out how the city would enact the new requirements.

“There’s a lot of details that will be flushed out as this goes forward,” said Councilmember Tony Strickland, who helped create the amendments and is campaigning for them.

But the city doesn’t need to reinvent the wheel and can model implementing voter ID on other states that already require it, he said.

Voters in March will actually be deciding on three amendments: Measures A, B and C.

Measure A would allow the city to implement voter identification requirements and ballot drop box monitoring and would require a minimum number of polling places throughout the city, yet it doesn’t mandate the changes. Measure B etches deeper into stone the city’s flag policy and would require unanimous City Council approval to fly new flags. Measure C mostly proposes administrative changes, including shortening council vacancy appointments, moving the city to a two-year budget cycle and allowing the mayor to cancel council meetings.

The election is effectively a test of what level of voter support exists for some of the most contested policies the council’s conservative majority of Strickland, Pat Burns, Casey McKeon and Mayor Gracey Van Der Mark is pushing for. Three councilmembers, Rhonda Bolton, Dan Kalmick and Natalie Moser, opposed putting the three charter amendments to voters.

Protect Huntington Beach, a political group largely led by former councilmembers that’s campaigning against the measures, is asking residents to vote down on all three, calling them solutions in search of a problem.

The most scrutinized proposal is one that would let the city, as soon as 2026, ask people to show a government-issued ID when they vote in municipal elections at city polling places; that includes voting for the seven councilmembers and the city attorney, city clerk and city treasurer positions.

Measure A’s supporters say it’s about strengthening faith in city elections and protecting them from potential fraud.

“Huntington Beach voters deserve the right to know that our elections are secure. It is crucial for our democracy that voters have faith in our election results,” Strickland and Van Der Mark wrote in their ballot arguments.

Strickland, in an interview, pointed to how both Hillary Clinton and Donald Trump have contested election results as part of the need for voter ID to give people faith in elections.

The California attorney general and secretary of state in September warned Huntington Beach that implementing voter ID conflicts with state law, which they said requires people voting in person to provide their name and address only.

A resident tried to get a judge to block the measure from appearing on the ballot, with the support of the American Civil Liberties Union, but an Orange County judge in December denied that attempt, saying courts generally don’t do pre-election reviews of ballot contents.

Mark Bixby, who publishes the Surf City Sentinel Facebook page and filed that lawsuit, said it is still ongoing and he intends to prevent voter ID from ever being implemented.

Opponents argue there’s been no evidence of voter fraud and call it a wasteful measure that could be costly to the city if it were to run its own elections.

“Our elections are already secure, overseen by the award-winning, ISO-certified Orange County Registrar of Voters,” Bolton, Moser and Kalmick wrote in opposition. “(Measure A) misleads voters, threatening this security by potentially forcing Huntington Beach to conduct its own elections, a task for which the city is unprepared and lacks infrastructure. This could cost millions, an unnecessary financial burden.”

Kalmick said the measures were poorly drafted and rushed, leaving many unknowns about what happens next should they pass.

“The county has to follow state law, and the people that are in charge of elections for the state of California say you can’t do this,” Kalmick said. “So, the county is likely not going to want to get sued and would likely just kick us loose.”

Sunny Han, the city’s chief financial officer, told the council in September that the current estimated cost to hold an election is $1.3 million to $1.65 million, which includes one-time expenses for buying equipment and recurring costs.

City Clerk Robin Estanislau said previously there is nothing within the city’s charter that mandates the city must consolidate with the county for elections.

Bob Page, who leads the county’s Registrar of Voters Office, declined to comment on the proposed amendments, writing in an email that he must remain impartial regarding any matter on the ballot and can’t make a statement that could influence a voter’s decision.

Strickland hopes Huntington Beach will be able to work with the Registrar of Voters, and “it’s less desired” if the city were to run its own elections, but, “having faith in your election outcomes in a democracy — can’t put a price tag on that.”

Vote by mail would still exist if Measure A passes, Strickland said.

Measure B focuses on the city’s flag policy, requiring unanimous votes by the City Council to fly new flags not already designated. Under Measure B, the city could fly flags representing the United States, the state, county, city, military flags and the Olympic flag.

During a campaign event against the measures, former Mayor Connie Boardman said it was trying to make it as hard as possible to fly the Pride Flag at City Hall.

Burns, who’s led the charge for the amendment, has said the flags the city flies should represent all residents.

“It’s to protect the abuse of display and keep it simple that we are not playing identity politics,” Burns said previously. “Government flags are what we put on our properties.”

Council appointments to fill vacancies on the dais would no longer be for the remainder of the term, under Measure C, but instead would only be until the next general municipal election. Measure C would also move the city to a two-year budget cycle and allow the mayor to cancel council meetings.

Two-year budget cycles give the city more stability, Strickland said.

The most concerning part for opponents of Measure C is giving the mayor the ability to cancel council meetings.

“Well, when you cancel a meeting you have many people, including consultants, but just ordinary people who want to speak to council. And so suddenly, they find the meeting they plan to attend is to be canceled and by one person alone,” former Mayor Shirley Dettloff said. “That just doesn’t seem right to do it in that way.”

The Registrar of Voters will begin mailing ballots to registered voters on Feb. 5. The first vote centers will open on Feb. 24 and more will open as election day on March 5 draws nearer. For more information visit ocvote.gov.