The city also collected more than $1.7 million in transient occupancy tax  in 2012, according to the bureau, the destination marketing organization that was

Highlights of Solano County’s tourism data were released as part of National Travel and Tourism Week, which took place May 4–12.

“This national observance provides us an opportunity to truly appreciate what Fairfield and the Suisun Valley has to offer leisure travelers, small conferences and meetings, and tour groups,” said Anand Patel, bureau president and chief executive officer. “Attractions that set us apart from other destinations include Suisun Valley wineries and the Western Railway Museum, Jelly Belly and Anheuser-Busch brewery tours, plus wildlife viewing and nature hikes at Grizzly Island Wildlife Area and Solano Land Trust open spaces. It’s also a time to recognize what tourism means for us in terms of jobs and much needed revenues for local businesses.”

The tourism bureau created by a business improvement district to market and promote tourism to the area, including overnight stays. The independent nonprofit 501(c)6 organization is funded by 18 lodging properties in Fairfield.

 The announcement of participating plans and monthly premiums on the individual side offers the first real glimpse of what type of plans at what price points will be available to some 5.3 million consumers across California, about half of whom will qualify for a federal subsidy.

Concerns about out-of-reach rates had persisted for months leading up to the announcement, with brokers and carriers wondering if enough plans would enter the exchange in order to keep prices competitive.

Early reaction, though, seemed cautiously optimistic, with a strong cross-section of health plans and seemingly competitive rates — though the latter can depend on a number of factors and may not be the best for some consumers.

For Marin, Sonoma, Napa and Solano counties, region 2 out of 19 in the health exchange, the following health plans will participate, hoping to serve some 44,000 exchange-eligible residents: Western Health Advantage, Blue Shield of California, Anthem Blue Cross, Kaiser Permanente and Health Net of California. The only HMO that operates in the North Bay absent from the exchange is United HealthCare, which joined major HMOs Cigna and Aetna in not participating in California’s exchange.

Lake and Mendocino counties are part of region 1, where Anthem Blue Cross, Blue Shield of California and Kaiser Permanente will offer a range of plans. Some 97,000 residents in that region will be eligible for subsidies.

“I think that’s a big win for the exchange,” Victor McKnight, a principal at EPIC Insurance Brokers in Petaluma, said of the lineup of health plans. “That is a pretty strong offering. The have just about everybody. They definitely have choices.”

Statewide, the remaining plans participating include a mix of public and private health plans, among them: Alameda Alliance for Health, Chinese Community Health Plan of San Francisco, Contra Costa Health Services, L.A. Care Health Plan, Molina Healthcare, Sharp HealthCare, Valley Health Plan and Ventura County Health Care Plan.

“We are proud to partner with Covered California for this historic moment in health care reform,” Western Health Advantage President and CEO Garry Maisel said in a statement.

Covered California will make a similar announcement about available plans in its Small Business Health Options Program, or SHOP, geared toward employers with 100 or fewer workers, in early June.  Western Health has stated it intends to offer plans through that programs.

According to Covered California, the participating health plans and their provider networks make up for 80 percent of physicians and 80 percent of acute-care hospitals in the state.

While the number of plans in the exchange is an important metric, the monthly rates can range widely depending on a person’s or family’s income, or what region they are in.  Those earning between 138 percent and 400 percent below the federal poverty line will be eligible for federal subsidies, which could make the premiums drop significantly for some but not for others. Additionally, plans offered through the exchange are tiered by “metal levels,” with bronze on the lower end and platinum on the top end. Price and coverage depend on which level is selected, as well as age and region.

Peter Lee, executive director of Covered California, said it’s impossible to directly compare its rates to existing premiums in the commercial market because, come 2014, new standards in benefit design will be mandated by the Affordable Care Act. Instead, Covered California compared today’s individual rates to small group rates.

The rates, which are being reviewed by  state regulators, across Covered California’s individual market proposals range from 2 percent above to 29 percent below the 2013 average premium for small employer plans in the state’s most populous regions, according to the exchange, which it considers impressive since all plans offer 10 essential benefits and guarantee issue, meaning no one came be dropped or charged more for a preexisting condition.  

However, Mr. McKnight said that upon closer examination, the rates, while not excessive as some had feared, come with a few caveats.  For instance, the difference between the lowest-tiered plan with a high deductible and the highest-tiered plan with a low deductible is far less than what it has been. That could spell the beginning of the end for high-deductible plans, which are favored by some employers and healthier individuals but can leave less healthy and low-income individuals underinsured.

Additionally, those with current individual policies will likely see their premiums go up, Mr. McKnight said, unless that person is eligible for the federal subsidy.  

“There’s going to be winners and losers — in essence we’re putting our system in a blender and coming out with something completely different,” he said.  

The Redwood Community Health Coalition, a network of 16 health centers across Marin, Sonoma, Napa, Mendocino and Lake counties, estimates that there are more than 110,000 local uninsured residents in those counties who won’t qualify for a Medi-Cal expansion under the law, but will qualify for financial assistance to purchase health plans through the exchange.

Many of those in between the Medi-Cal expansion and federal subsidies could face steeper premiums, but the flip side of that is that the health plan will likely offer better coverage because of the mandated essential benefits, Mr. McKnight said.

Individual consumers must either purchase insurance by Jan. 1, 2014, or pay a penalty under the Affordable Care Act. Enrollment for next January begins this October.

The Staff Nurses’ Association, an independent union based in Santa Rosa, issued a statement saying the strike, planned for Thursday, May 23 at 5 a.m. and ending May 25 at 5a.m., is in response to “onerous, sub-market proposals” from Memorial. The union has been in negotiations with the 278-bed hospital since last August.

Officials at the hospital said it would remain open during the strike with outside staffing brought in to cover for the striking nurses.

The health system said it’s not immune to difficult economic realities facing hospitals, particularly challenges related to the implementation of the Affordable Care Act that include reduced reimbursement rates, heightened competition and additional regulations. As such, the hospital said it needed to balance wages and employee benefits with cost-saving measures.

“We are committed to providing our RNs and all our staff just wages and benefits,” Debra Miller,  vice president of human resources for St. Joseph Health in Sonoma County, said in a statement. “Yet we, like other U.S. employers, also must find ways to de-escalate significant increases in payroll and benefits expenses. With health reform’s impact on our reimbursement and local employers looking increasingly to lower their health insurance costs, we must find ways to save while continuing to fairly compensate our highly skilled RNs. We continue to hope that hard work at the bargaining table will yield mutually agreeable compromises that everyone can support.”

St. Joseph Health also said it will temporarily close its urgent care center in Windsor and will treat all local patients Thursday and Friday out of its Santa Rosa and Rohnert Park Urgent Cares. The Santa Rosa Urgent Care will be open from 7 a.m. to 7 p.m. daily; Rohnert Park will be open from 9 a.m. to 7 p.m. daily.

All three Urgent Cares will be open, as usual, starting Saturday morning, May 25, and striking nurses may be called back to staff those centers as needed.

The union listed several remaining issues centered on staffing levels, benefits, overtime, compensation and wages.

The union said the hospital is proposing that health insurance can be changed without negotiation and that nurses contributions to insurance would be doubled and possibly tripled. The hospital also proposed a two-tiered  paid time-off accrual, according to the union. Additionally, the union said Memorial is proposing that overtime not be paid to nurses who work more than 8, 10 and 12 continuous hours if those hours exceed their assigned workday.

Compensation is also an issue for the union, which said the hospital has proposed a night-shift differential of 5 percent, a reduction of on-call pay from 50 to 30 percent without a shift differential, and no shift differential for jury duty or leaves of absence. 

According to the union, the hospital proposed a 4.5 percent increase in pay over three years, while the union is seeking a 6.5 percent increase over a three-year contract.

Ms. Miller, of St. Joseph Health, said: “While we respect our employees’ rights to strike, these recurring strikes with little or no progress at the bargaining table are disappointing. We believe every means of reaching mutual agreement through negotiations should be exhausted, so that our nurses, hospital and community can see these issues resolved.”

She added that the union’s decision to strike again would not affect the hospital’s ability to serve patients.

The Staff Nurses’ Association’s contract with Santa Rosa Memorial Hospital expired September 30, 2012. The next bargaining session between the union and hospital representative is scheduled for June 6, 2013.

The union engaged in strikes in October, November and again in early January 2013. Nurse at Memorial will be striking concurrently with nurses a three Sutter Health-operated hospitals and two Hospital Corporation of America hospitals in the South Bay.

The board also discussed the early draft of a pact with the city of Napa over the half-billion-dollar project, providing the clearest picture yet of plans to address issues like the area’s eventual annexation, the city’s providing of surface water and the sharing of what the developer has said is a tax windfall of up to $4 million annually.

It was the fourth time that those items had been on the board’s agenda, after a swell of public comment and continued questions pushed supervisors to return the measures to staff for additional work on three separate occasions since they first went before the board on Jan. 15. The vote, which would adopt the “Napa Pipe Zoning District” designation, water supply findings and general plan changes related to the project, is now planned for a fifth meeting on the topic on June 4.

County staff were directed to include direct mention of the nearby Napa River in the zoning change, as well as a directive to prioritize the employment of area residents in the project’s construction and ongoing operation.

Keith Rogal

If approved, the zoning change and related measures would then set into motion the deeper design process that would guide the look and layout of the residential and commercial development, said Keith Rogal, co-founder of the development firm Rogal + Walsh + Mol, which purchased the site with Farallon Capital Management in 2005 as Napa Redevelopment Partners LLC.

That work could be done before the end of the year, with initial site work and environmental remediation soon after, he said.

“”We’re now at a stage where there’s a focus on the details,” Mr. Rogal said. “It’s indicative of the fact that the development plan and its components, and how they’ve been shaped over time, have come to a good point.”

The development has drawn a steady stream of public comment since it was first proposed in 2007, and has evolved significantly from a proposal that once called for 3,200 housing units on the former industrial site. The current proposal involves an approximately 70 percent reduction to those units — now less than 1,000 housing units including 140 units of affordable housing — a 154,000-square-foot Costco Wholesale store, a 150-unit continuing care retirement center, a 150-room hotel and other community, warehouse and office space.

The current proposal follows recommendations that the county’s Planning Commission proposed last year, one that has engendered an increased level of public support. Yet for the city of Napa, questions remain as to how to pursue a relationship with the county over a significant development that sits just beyond its borders. Formal talks to develop a memorandum of understanding began between city and county staff last November.

“We have gone from working against each other in an adversarial relationship to working with each other to develop the best project we can,” said Keith Caldwell, supervisor for the eastern district that includes the city of American Canyon.

High among those concerns is the source for potable water for the development’s homes and businesses. As currently proposed, Napa Pipe will receive the majority of its water from surface water sources in use by the city of Napa, and rely on groundwater only in cases of emergency. That relationship with the city, however, is still under negotiation, and another source may be pursued that includes a groundwater component if an agreement is not established.

In addition, both the county and the city have agreed to seek an extension of the city’s sphere of influence and the eventual annexation of the site, which would ultimately entail a voter-approved measure, according to the draft memorandum of understanding provided by the city of Napa. If approved, non-residential portions would join immediately, while residential portions would join either when new permits are issued or automatically in 2022.

When that sphere is extended, an existing 45 to 55 percent property tax sharing agreement between the city and the county will then apply to housing within the Napa Pipe area. The county and the city tentatively agree to evenly split revenue from sources like sales tax and transient occupancy tax, with the city receiving 100 percent after annexation. Affordable housing credits will remain for the county, planners have said.

“We have to make decisions about this property while it’s under our jurisdiction. We want to go forward in partnership with the city,” said Hillary Gitelman, director of the county’s planning, building and environmental services department, to the board.

Medtronic spokeswoman Cindy Resman told the Business Journal that approximately half the job cuts will take place overseas and 70 jobs would be affected across California, including Santa Rosa. Most affected employees have already been notified, she said.

“The company’s current worldwide employee populations is approximately 45,000 — this is relatively flat from the start of our (fiscal year 2013),” Ms. Resman said in an email, also pointing out that Medtronic currently has 555 positions posted on its website, including 105 in California.

About 65 percent of all cuts have already taken place. The remainder will take place before the end of the company’s 2014 fiscal year, Ms. Resman said, adding that while job cuts have occurred in some areas, growth has occurred in others.

The announcement of companywide jobs cuts came during a conference call with investors and reporters announcing Medtronic’s fourth-quarter earnings.

Minneapolis-based Medtronic anticipates it will save between $200 million and $225 million annually as a result of the job restructure. Cuts will take place primarily in medical device maker’s Cardiac and Vascular Group and spine segment.

The Cardiac and Vascular group, which includes the cardiac rhythm disease management, coronary, structural heart and endovascular businesses, reported international sales of $1.34 billion in its fourth quarter and fiscal 2013, ended April 26. That’s a 7 percent increase over the year after adjusting for currency changes, or 4 percent as reported, according to Medtronic.

Companywide, Medtronic reported international fourth-quarter revenues of nearly $4.5 billion, up 5 percent for the year when adjusted for currency, which included a $48 million hit from currency fluctuations.

Fourth-quarter earnings on that revenue were $969 million, or 95 cents per diluted share, for a decrease of 2 percent on revenue and 1 percent on share value over the year.

For the Cardiac and Vascular Group, fourth-quarter revenues were $1.33 billion, a 4 percent increase over the same period last year.

Coronary revenue of $465 million grew 5 percent, with sales of drug-eluting stents increasing by 22 percent when adjusted for currency variations, driven gains of the Resolute Integrity drug-eluting stent.

Structural Heart revenue of $310 million grew 8 percent on a constant currency basis or 7 percent as reported.  Growth was driven by the strength of transcatheter aortic heart valves.

Endovascular revenues of $235 million grew 7 percent over the year, driven by “significant growth” with Medtronic’s Endurant aortic stent graft in Japan, while strong growth from thoracic portfolio was driven by Valiant Captivia in the U.S., Japan and China.

Medtronic said fourth-quarter revenue from implantable cardioverter defibrillators possibly outperformed the rest of the market, growing 2 percent over the year to $755 million after adjusting for currency differences.

“These fourth-quarter results were a strong finish to a solid fiscal year and, more importantly,” represented “another step toward our goal of delivering consistent and dependable growth,” Omar Ishrak, Medtronic chairman and chief executive officer, said in a statement. 

The Restorative Therapies Group, which includes the spine, neuromodulation, diabetes and surgical technologies businesses, had worldwide sales in the quarter of $2.117 billion, an annual increase of 4 percent when adjusted for currency. Spine product revenues on those sales were $811 million, which was flat over the year after adjusting for currency changes.

Medtronic also projected its fiscal 2014 full-year revenues to grow by 3 percent to 4 percent, while diluted earnings per share could grow in the range of $3.80 or $3.85 per share, or about 6 percent to 8 percent. Both projections are currency-adjusted.

Shares of Medtronic were $52.35 at the close of Tuesday trading, up nearly 5 percent. In after-hours trading, the price crept back down to $53.17, for an overall increase of 1.57 percent.

“This is great news for Sonoma County’s thriving hospitality industry,” Ken Fischang, president and chief executive officer of Sonoma County Tourism, said in a statement, adding that hotel occupancy rates have steadily improved.

Year to date, hotal occupancy is up 11.4 percent over 2012, according to Sonoma County Tourism.

Visit California, the state’s official tourism booster, also found that visitor-generated taxes equaled $168 per household in Sonoma County, while tourism-related employment accounted for nearly 17,000 jobs in Sonoma County — or nearly one in every 10 jobs.

Hospitality industry revenue also increased 4.9 percent from 2010 to 2011. From 2001 through 2011, industry revenue from tourism soared 41.5 percent.

“Nearly 10 percent of our local jobs come from the hospitality sector, so this increase in revenues bodes well for more jobs and income here in Sonoma County,” Ben Stone, director of the Sonoma County Economic Development Board, said in a statement.

The increase in visitors also means an increase in local government revenue. Spending by visitors to Sonoma County accounts for 19 percent of local tax revenue, according to Mr. Stone. The county collects nearly 17 percent more tax revenue from visitors than the statewide average.

The county has a 10 percent transient occupancy tax (TOT) that goes toward the general budget, along with a 2 percent assessment for the county business improvement area, or BIA, that specifically goes toward tourism efforts.

“Sonoma County has long been an attractive destination for visitors,” said Tim McGregor, board chairman of Sonoma County Tourism and general manager of Bodega Bay Lodge. “We certainly are anticipating that the county will continue the upward trend in TOT revenues that we have enjoyed over the past few years.”

GT Advanced provided 3.4 million shares of common stock and agreed to pay an unspecified amount in the future, the Nashua, N.H.-based company said in a statement today.

Thermal Technology makes high-temperature thermal and vacuum systems that GT Advanced will use to make products including sapphire cover screens for touch-sensitive electronic devices.

In 2012, Thermal Technology reported that it had about 70 employees.

Alaska Airlines ticket counter at Charles M. Schulz-Sonoma County Airport

Nearly 16,800 passengers flew Horizon that month. With 63,600 trips through April, ridership was up 2.1 percent versus the same period in 2012.

Horizon Air, a subsidiary of Alaska Air Group (NYSE: ALK) offers flights between Santa Rosa and the cities of Portland, Seattle, Los Angeles and San Diego.

Terms of the deal, completed about a week ago, were not disclosed except that Verihealth is now a wholly owned subsidiary of privately held Falck USA, based in Seattle, according to CEO Boo Heffner.

“We’d been in discussions with Verihealth for about the last year and we very specifically targeted them as a great company,” Mr. Heffner told the Business Journal. “We’re very selective in who it is we acquire.”

The acquisition of Verihealth represents the first foray into Northern California for Falck USA, which in just two years has become the third largest ambulance provider in the U.S. after a series of partnerships and acquisitions from Massachusetts to Washington, Mr. Heffner said.  

It’s also yet another sign of the consolidation taking place in the health care sector, spurred largely by the Affordable Care Act and the economic realities that are impacting companies — from physician groups to blood banks to ambulance companies — large and small.

“There’s a lot of interest beyond one company acquiring another,” said Mark Knight, a Santa Rosa-based health care consultant.  ”It does show consolidation in health care, not just in the traditional settings like hospitals and physicians groups, but you’re seeing it in ambulance companies and other providers.”

Verihealth was founded by Gary Tennyson in 2000 at 2190 South McDowell Blvd. as an ambulance and medical transport company, with a training institute for emergency medical technicians.  Combined with Falck Northern California’s new operation, Verihealth has a staff of 268 employees and a fleet of 40 ambulances, according to Mr. Tennyson, who said Falck approached him.

“I wasn’t looking to sell Verihealth,” Mr. Tennyson said. “But when we were approached by Falck and as I got to know the organization, and the quality individuals on the Falck team both in the U.S. and internationally, that truly care about our customers, it was obvious we would be a perfect fit.”

Mr. Tennyson will continue to head Verihealth and will become CEO of Falck’s Northern California region. Staffing levels won’t change and the name Verihealth will remain in Sonoma County, Mr. Heffner said.

“We don’t want to wipe out a reputation that a company has established through the name,” Mr. Heffner said. “We looked at a lot of different companies, and Verihealth is a very well-established company run by a very experienced team.”

He added, “All decisions are made at the local level.”

While Verihealth will retain its name, Falck USA views Petaluma as a key stepping stone in growing its presence in Northern California and the San Francisco Bay Area, Mr. Heffner said.  Petaluma will serve as Falck USA’s Northern California headquarters given its centralized location.

“We view them as a springboard, if you will, into larger markets in Northern California,” Mr. Heffner said. “You couldn’t put a better dot on the map of a central area. It’s within a stones’ throw of some big markets.”

Verihealth is the second ambulance company  in Sonoma County to be acquired within the past year, with REACH Air Medical Services being the first last December. Texas-based Air Medical Group Holdings, Inc. purchased the Santa Rosa-based air medical transport company for roughly $250 million.

Mr. Heffner said that while ambulance companies are distinct from other medical providers, the industry is nonetheless adapting to the post-health care reform world by striking collaborations and partnerships in an effort to become more efficient.

“We have to save money in today’s reimbursement environment,” he said, referring to payment changes in the Affordable Care Act that shift away from the fee-for-service model and more toward bundled payments that take into account health outcomes.  ”It’s real and it’s here. We all have to deal with it. The reimbursement structure has a lot to do with it.”

To that end, ambulance companies play a vital role in the delivery of health care, and Falck, started in Copenhagen more than 100 years ago, is in a good position to share its experiences with hospitals and other providers, Mr. Heffner said.

“Whether hospital or ambulance, we all have to work on patient outcome. We as the transporter are a key cog in that wheel in patient care,” he said. “Making sure people end up in the right facility and have the right type of transportation, you have to be efficient.”

For example, trained paramedics can work closely with hospitals and physicians to utilize technology in determining the most appropriate facility to take a patient or whether they could be treated at home, all with the goal of lessening costly trips to emergency rooms.

“It’s a very important mode of transport — you are a continuum of care. There can’t be a drop-off in care. It has to be equal or better,” Mr. Heffner added.

The ambulance industry in general is well-positioned to help reduce health care spending by carefully thinking about what the necessary level of care is, particularly for non-emergency care.

“We have a multifaceted approach. When it’s more of an ongoing chronic situation, maybe there’s an alternative, such as making sure they are compliant with medications, and focusing on prevention rather than reactionary medicine,” Mr. Heffner said.

Falck USA is currently operating in 14 states and just north of 5,000 employees across the country. Internally, Falck operates in 37 countries and employs more than 16,000.