In a time of relentless federal budget cutting, Pedro Toledo has a surprising vision: building a new geriatric health and senior day care center to serve West Marin’s growing elderly population, financed in part with government funds.
One potential location for the compound has already proved controversial—the former Station House Café at the center of town. But Mr. Toledo, C.E.O. of the Petaluma Health Center, told the Light this week that his board is considering several potential locations for the center, which would provide extensive services intended to allow low-income seniors to live safely at home for as long as possible.
Meanwhile, Petaluma Health is engaged in a separate but complementary project with the Point Reyes Good Luck Fund to purchase and operate the West Marin Pharmacy. The transfer could be complete by as early as July 1, Mr. Toledo said.
The geriatric care facility would include staff housing, medical offices and a senior day care center with a cafeteria, a game room and walk-in showers with easy access for the disabled.
In addition to the former Station House, Petaluma Health is also considering a county-owned lot near the public restrooms on Mesa Road and a vacant lot at Sixth and B Streets, across from the Walnut Place senior housing complex.
The Station House location prompted a lively discussion at this month’s Point Reyes Station Village Association meeting, where some members argued the project would bring too much traffic and would not fit well with the village’s historic commercial center.
“Many of us have serious concerns about that site,” Andrew Walmisley said. “Broadly speaking, we support services in the community, but the scale of this seems to be just enormous.”
Mr. Toledo said the complex would likely be two stories, with medical offices and other facilities on the first floor and housing on the second. If the facility were built on the Station House site, it would likely incorporate the current building, which has a commercial kitchen, and fill much of the lot, which extends back to Mesa Road.
Several village association members favor the vacant parcel at Sixth and B Streets, known as the “calving lot” due to its former life as part of the Waldo Giacomini dairy. Like the half-acre Station House site, the one-acre calving lot has been on the market for well over a year. The asking price for the Station House is $2.8 million; the calving lot is listed for $1.5 million.
But that parcel may soon become unavailable. The county is also considering purchasing it, perhaps as a location for interim housing for residents displaced from 12 ranches slated to close in the Point Reyes National Seashore. During its April 15 meeting, the Board of Supervisors held a closed session to discuss the potential acquisition of the calving lot but offered no details about plans.
Supervisor Dennis Rodoni recused himself from the session because he and his family own property nearby and his nephew is a real estate agent who could be involved in a potential sale. Mr. Rodoni also recused himself from the board’s vote on the gas station renovation last year, citing similar conflicts of interest.
This week, Mr. Rodoni told the Light that he believes the calving lot, which is zoned for residential and agricultural use, would be a suitable site for interim housing. He said he wasn’t sure that a senior facility could be permitted there.
Mr. Rodoni said a geriatric care facility would fill a significant community need and could generate well-paying jobs, and he said he supports the Station House site “as long as it fits the zoning and other community restrictions.”
The Petaluma Health Center already operates community clinics in Point Reyes Station and Bolinas as part of the Coastal Health Alliance, which it took over several years ago. Together, Mr. Toledo said, those clinics serve 3,800 patients.
“About a third of our patients are over the age of 60, and then we have a large group that will be turning 60 very soon,” he said. “We want to develop a clinic that is built and customized for our geriatric patients and for patients with disabilities.”
Most Coastal Health Alliance clients are either uninsured or on Medicaid or Medicare, and the geriatric clinic would serve a similar base as part of a network known as PACE, or Program of All-Inclusive Care for the Elderly, operated by federally approved community health clinics.
PACE centers offer medical treatment, dental care, optometry, occupational therapy and physical therapy as well as extensive in-home care services and rides to and from medical appointments. Onsite, members share meals in a dining room and socialize with one another throughout the day, attended by trained staff.
The program is designed as a less-expensive alternative to nursing homes.
“It’s a program of all-inclusive care for the elderly,” Mr. Toledo said. “And it really does mean all-inclusive care. PACE becomes your health care coordinator and advocate, which is especially important for those seniors who don’t have family members. It makes sure you’re getting everything you need, when you need it, how you need it, and it coordinates everything up to end-of-life care.”
Petaluma Health operates a PACE center in Rohnert Park, and Mr. Toledo gave three members of the village association a tour of that facility last Friday. They came away impressed with the operation but concerned about locating one in the center of their town.
“This issue is logistics,” said Pamela Bridges, a member of the village association’s design review committee who joined the tour. “Let’s imagine a summer day with 30 people being dropped off at the day care and at doctor’s appointments, and caretakers and workers coming and going, as well as food being delivered at the site.”
At their April 10 meeting, association members expressed a strong preference for locating shops or restaurants in the old Station House building.
Laura Arndt, who also participated in the tour, said it would make much more sense to locate the PACE center at the calving lot, a less busy location that is close to the Petaluma Health Center’s clinic, the county’s Health and Human Services building and Walnut Place. “That’s a perfect place for it, and we’re hoping that can happen,” she said, adding, “All of a sudden, the calving lot seems to be in demand.”
Although Petaluma Health hopes to purchase a site soon, construction could not begin until it completes the planning and permitting process, which could take several years. Ms. Arndt suggested that the county and Petaluma Health strike a deal on the calving lot wherein the county would use the property for interim housing site in the meantime. “What a win-win that would be,” she said.
Wherever the center is located, it needs to include housing for the medical and support staff, Mr. Toledo said. Nearly a dozen of Petaluma Health’s employees live in the seashore and will have to move within a year as a result of the settlement ending most ranching in the park.
The Petaluma Health board will take community opinion into account before moving ahead with any purchase or executing design plans, Mr. Toledo said.
“We wouldn’t build something that the community doesn’t want and or need,” he said. “We would always want our location to be somewhere that makes sense, where zoning is appropriate and it makes sense from a parking and transportation perspective.”
A mix of public and private funds would cover the land purchase and construction, and once the facility was up and running, it would be sustained by reimbursements from Medicaid, Medicare and private insurers.
Despite the binge of federal budget cutting led by DOGE, Mr. Toledo remains confident about obtaining federal funding for the project. Health and Human Services Secretary Robert F. Kennedy Jr. has expressed support for community health centers, and they have strong bipartisan support in Congress.
“There’s federal funding, there’s state funding, and there are tax credits available for health care and for rural health care in particular,” Mr. Toledo said. “The money is out there. We live in the North Bay, one of the wealthiest places in the world.”
Purchasing and upgrading the West Marin Pharmacy would be crucial to the operation of the PACE program, he added. The pharmacy is currently prohibited by the California State Board of Pharmacy from dispensing controlled substances and its owner has been seeking a buyer.
“We’re working very closely with the Good Luck Fund on the pharmacy project to ensure that the whole community has access to the full spectrum of medications,” Mr. Toledo said.
Heather Mickley, the Good Luck Fund’s director of operations, confirmed that Mr. Hulls is coordinating with Petaluma Health on a possible pharmacy purchase.