Residents along a remote stretch of the North Coast straddling the Sonoma-Mendocino county line are being asked to decide what it's worth to them to have local access to urgent medical care services.
A ballot measure to be decided by voters April 8 will determine if a Gualala urgent care clinic open 10 hours a day on weekdays will continue to be available or even have its hours extended into the weekend, as backers hope.
But it's unclear if the proposed cost - $112 more a year for most households - will earn the two-thirds majority needed for Measure J to be approved.
"I'm certain that we'll get well over 50 percent," said supporter Richard Perry. "Whether we'll get 66 percent and two-thirds, I don't know."
Critics argue it's unfair to force the same financial burden on all voters in the geographically linear district even though not all rely as heavily on medical services in Gualala, the district's center. Those who live at the extreme ends are more likely to drive to hospitals in Santa Rosa, Fort Bragg and elsewhere for urgent care, they say.
"Why is an area that isn't going to directly benefit from this tax being asked to pay for it?" asked opponent John Rosson, of Timber Cove.
But proponents say the additional expense for local service is what one called "a bargain" compared to the cost of visiting an emergency room 1.5 hours or 2.5 hours away.
Extending urgent care to 10 hours a day on Saturdays and Sundays would mean bridging the 62-hour timespan between Friday nights and Monday mornings, when there's currently none available.
It would raise the potential for life-saving intervention or even necessary treatment of non-life-threatening injuries and illnesses that would otherwise warrant an emergency room trip, proponents say.
Perry, a Sea Ranch resident, cited a report that he said showed the coastal village is "the farthest community from a hospital in the state of California."
"It really is, in my mind, important that we have service seven days a week because of our tenuousness up there," he said.
Perry serves on the board of directors for the Coast Life Support District, formed to provide emergency ambulance service along a 60-mile stretch of Highway 1, from about Fort Ross State Park to Irish Beach on the Mendocino Coast. The district extends inland nearly 15 miles, taking in Annapolis and parts of Fort Ross, Seaview, Fish Rock and Stewarts Point-Skaggs Springs roads.
The district also provides urgent care through Redwood Coast Medical Services, a federally qualified community health center with offices in Gualala and Point Arena, currently available from 8 a.m. to 6 p.m. weekdays at the Gualala clinic.
More than 4,200 patients seek urgent care each year - about 55 percent from Gualala and nearby Sea Ranch, according to figures for a 10-month period in 2012 and 2013, district officials said.
About 8 percent of the patients in that timeframe were residents of communities on the district's extreme edges, such as Timber Cove, Annapolis, Elk and Irish Beach, District Administrator Scott Foster said.
But even the week-day service is in jeopardy because of a disparity between what it costs and what the center is permitted to charge for urgent care, he and others said.
The urgent care clinic is operating at a $430,000 deficit this fiscal year, not quite half of which is offset by a special tax that has most district residents paying $36 a year toward urgent care.
Measure J would repeal that tax and replace it with a new rate under which most residents would be charged $148 annually to subsidize weekday urgent care and make it available from 8 a.m. to 6 p.m. Saturdays and Sundays.
Extended urgent care ranked high on a federally required survey of patients conducted last winter. Of about 700 respondents, 86 percent labeled it "important" or "very important," district officials said.
The district has 3,764 registered voters, including 2,370 in Mendocino County and 1,394 in Sonoma County, according to elections personnel.
Measure J supporter Steve May concedes that voters may be fatigued "by being nickeled and dimed on various tax measures."
"And I also I think people are sort of rightly cynical about government," he said. "But if you haven't noticed, stuff costs money, and if you want services in your community, you need to pay."
But Rosson, the Measure J opponent, said the district's history and annexation of areas to the extreme south have set it up for opposition from those who feel unfairly saddled by the needs of more remote communities.
Scott Farmer, who lives at the extreme south end of the district and helped craft ballot statements opposing Measure J, said resentment among those inclined to seek treatment in Santa Rosa and Fort Bragg could be enough to sink the ballot measure.
"We feel very left out of the benefits of what they're doing, and (are) asked to pay more and more," Farmer said.
(You can reach Staff Writer Mary Callahan at 521-5249 or mary.callahan@pressdemocrat.com.)
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