Kadima cuts costs via Community Tuition Partnership

Kadima Hebrew Academy/Kadima Heschel West Middle School is confronting the economic crisis by reducing tuition school-wide for 2009-2010 by an average of 20 percent.

Kadima hopes the move — the first of its kind in the Los Angeles area — will encourage struggling families to keep their kids enrolled at the private day school and make Jewish education seem more financially feasible to those who formerly could not afford it.

“We wanted to find a way to make our day school education more affordable for more parents,” said Dr. Barbara Gereboff, head of school. “A couple of our families have come in and said times are tough and they don’t know how they’re going to make it work. We decided it was time to make an innovative, bold move outside of the normal paradigm to make that possible.”

The West Hills school joined community supporters and parents who could afford to donate extra funds in a partnership to subsidize the tuition cut. The Community Tuition Partnership, which will take effect in the 2009-2010 academic year, will lower costs for the entire K-8 student body: kindergarten students currently paying $16,273 for 2008-2009 next year would pay $13,070; elementary school fees would fall from $18,314 to $14,300; and middle school rates would drop from $20,910 to $16,905. New enrollees pay an extra one-time entry fee, but total tuition and fees are slightly lower if families pay for the year in full upfront.

“Most schools in the last few years have continued to increase tuition, in Los Angeles and across the country,” board of trustees president Shawn Evenhaim said. “What we’ve done is we’ve pushed a large part of our community away because it just wasn’t accessible anymore. We wanted to look at what we could do to correct that.”

This year, many families receiving financial aid asked for increased aid, and several families that had never applied for financial aid before did so for the first time, Evenhaim said.

But simply increasing financial aid wasn’t addressing the extra stress put on middle class families, Gereboff said. Even as the economic downturn began to plunge formerly stable households into financial turmoil, many parents resisted making the psychological adjustment necessary to ask for help.

“Many middle-class parents didn’t see themselves as people who should apply for financial aid, so they wouldn’t even walk in the door to begin with,” she said.

Evenhaim also said he spoke to parents who couldn’t afford a day school education on their own, but refused to apply for aid because they didn’t see themselves as “financial aid families.”

Kadima board members started exploring ways to subsidize tuition four months ago in response to what they saw as a “perfect storm” pushing students out of Jewish education across the city and beyond. The school modeled its rate cut on a similar step taken by Gross Schechter Day School in Cleveland, Ohio, five years ago. At that school, parents, community donors and Jewish organizations pooled their funds to cut yearly tuition almost in half — students now pay $6,500, a steep drop from the $13,000-$14,000 they would be paying without the subsidy.

“If we could shock the system by lowering tuition, we felt we could provide relief to our current families and also attract new families,” said Rabbi Jim Rogozen, headmaster. “We figured we could either take a chance, given the economy, and wait to see what the next year brought — or we could do something different.”

Since slashing tuition in the 2004-2005 academic year, Gross Schechter has seen its enrollment rise by 24 percent. The school has also retained more students at all grade levels who might have otherwise opted to switch into public schools, Rogozen said.

Parents and administrators at Kadima are hoping their own partnership produces similar results. PTO president Natalie Spiewak said the move would tip the scale for families who found the school’s former price tag intimidating.

“I think people who otherwise wouldn’t look at Kadima because it was too expensive might say, ‘This is more affordable now; maybe I can consider it,'” she said. “I think this is going to open the door for a lot more people to be able to choose a private day school education.”

News of the program is also a much-needed boon to families that are now struggling to keep more than one child enrolled at the school, said Spiewak, whose two children are students.

But even with the tuition cut, Kadima’s rates are still middle-of-the-road as far as L.A. day schools go. The Rabbi Jacob Pressman Academy of Temple Beth Am this year charged $13,345 to $14,650 for its elementary and middle school students, Valley Beth Shalom Day School charged $16,150, and Sinai Akiba Academy’s fees ranged from $17,083 to $19,275.

“Some schools cost significantly less, some are on par, and others cost more,” said Miriam Prum Hess, vice president of The Jewish Federation and director of day school operations for the Bureau of Jewish Education. “The struggle for schools is to make their education as affordable as possible, yet operate in a responsible way. It will be interesting to see how this works, but it’s hard to tell.”

While Kadima is still “not cheap,” Evenhaim said it wasn’t hard to get donors on board to fund the tuition cut. For the school’s parent donors, it was as simple as asking them to pay what they paid in tuition this year — under the new, lowered-rate system, the extra dollars would suddenly be tantamount to tzedakah.

“Almost everybody that we went to were extremely excited about this concept,” he said. “Just by writing a check for tuition, they are giving tzedakah to the community. When they become part of this partnership, they feel good because their money is working to ensure the future of Jewish education. This is the best investment that we can concentrate on today.”

The new tuition system would not affect the quality of classroom instruction for the school’s 260 students, according to Gereboff.

Evenhaim said he hopes the program will inspire a local trend. He wants other private schools to adopt similar plans and make a unified effort to boost the number of L.A. students in Jewish day schools. “If this is successful, we would love to share it with many other schools,” he said. “Our goal is not just to make sure Kadima has a lot of students — our goal is to make sure that as many Jewish kids as possible receive a Jewish education.”

Spiewak said she plans to keep her children in private day school.

“I believe in the education that my children are getting there,” she said.

Food prices squeeze Israel’s needy

TEL AVIV (JTA) – It’s mid-afternoon and Michael Dahan is buying food for his first meal of the day. With rising food prices compounding his already dire economic situation, it has become his habit to skip meals, he admits.

“What can I do?” the unemployed 49-year-old says with a shrug, holding the small carton of milk he has just bought at a grocery store in the rundown Shapira neighborhood of south Tel Aviv. “I hardly have anything to get by on once I’ve paid rent and utilities.”

A block away, on a sidewalk strewn with cigarette butts and plastic bags, Maria Arnov, 28, an immigrant from Latvia and mother of two, says food prices have changed the way she shops. Arnov goes to the store less often and cuts corners wherever she can, like buying cheaper frozen meat and not buying the type of rice her family favors because its price has doubled in the past three months.

Israel, like many parts of the world, has seen food staples such as meat, rice and vegetables rise significantly. Its poor, already struggling to make ends meet, have been hardest hit—along with the nonprofit groups that serve them.

Although it is rare for Israelis to go hungry, food insecurity is a growing problem in their nation as traditional social safety nets fall short and nearly a quarter of Israeli families find themselves subsisting on less nutritious diets than before.

Many of the nonprofit groups that deliver food to the needy say they have been reeling from the one-two punch of rising prices and a sinking dollar.

In Israel, groups that rely in large part on funds raised in the United States have been forced by the dollar’s plunge to cut back on services, sometimes reducing the number of families they serve by as much as 40 percent.

In Beersheva, the social assistance group Beit Moriah has had to reduce the number of food packages it delivers to families every month to 200, down from 500 last year.

At From the Heart, an organization in Rishon LeZion that runs a food distribution project called Lev Chesed, volunteers are overwhelmed by requests they cannot meet.

“We have several hundred people on our waiting lists, but it’s not financially possible to help them,” said Ronen Ziv, the director of the group, which provides food packages to 700 families per week. “We have no government assistance.”

With budgets becoming leaner, government officials for the first time are pushing to develop a policy to combat food insecurity. The first-ever interministerial report on the subject was completed recently, and legislation is pending in the Knesset for a new council on food security to be created to develop coordinated policies to tackle the problem.

The ministerial report, which is pending Cabinet approval, recommends increasing annual state funding for nutrition and food insecurity to $10 million to $15 million from the current $1 million.

“There needs to be an appropriate range of government responses, from funding food assistance programs, to reducing state Value Added Tax on staple foods, to ensuring that having basic foods is seen as a right for all Israelis,” said Batya Kallus, the director of the Forum to Address Food Insecurity and Poverty in Israel.

The forum, which conducts research, engineered the establishment of Leket, Israel’s first national food bank.

Established last year, Leket is based on the model of U.S. community food banks. It attempts to coordinate and streamline the efforts of many nonprofit food agencies. In the past decade the number of such groups has grown to about 400, which collectively distribute some 20,000 tons of food per year.

“What we have been seeing in purchasing food to be donated is that people are paying a huge range of prices, from rock bottom to retail,” Kallus said. “We have tried to make sense of that by creating a central purchasing division where organizations can come to Leket and we offer them a wide basket of foods they can purchase that we offer at the lowest possible prices.”

In a 2003 study on food insecurity in Israel commissioned by Leket from the Myers-JDC-Brookdale Institute, researchers found that some 22 percent of Israelis are unable to provide for their basic nutritional needs on a daily basis.

A father of eight in Jerusalem whose family has slipped into poverty after emigrating from the United States many years ago says he lives with food insecurity every day.

“When there is food we are happy, when there isn’t we are not,” said the man, who asked not to be identified. “It’s not a matter of decision-making. When there’s just no money, there is no food.”

He says there are days when the family goes without food.

Ido Nachum, a spokesman for Israel’s welfare ministry, says he hopes the interministerial report’s recommendations will be adopted, including increased state investment and oversight of nonprofits, the establishment of the national council on food insecurity, expanding a hot lunch program for schoolchildren and ensuring government subsidies for those who cannot afford to feed their families adequately.

Far from the corridors of national decision-making, Dahan, the unemployed man in south Tel Aviv, shuffles away with his small bag of provisions, hoping for better days.

Talmudic Tax Write-Off


Few people are eager to pick fights with the IRS. Michael Sklar, now well into his second voluntary tax lawsuit, is definitely an exception.

Sklar is an Orthodox father with several children in Jewish day school. His courtroom quest: to establish religious school costs as tax deductions.

It all comes down to the Church of Scientology. The Scientologists struck a deal with the IRS that has allowed them to count the cost of their spiritual “auditing sessions” as tax deductions since 1993. The Tax Code OKs this practice for any religious expense paid in exchange for intangible spiritual benefits (for example, it also works for High Holiday seats, church pew rents, tithes, etc.).

Sklar goes further and claims that Jewish day school is no different from the Scientologists’ spiritual auditing sessions, and should also be tax-deductible.

“The idea is that everybody should have the same benefit,” said Jeffrey Zuckerman, Sklar’s attorney.

“You get 25, 30 people, you put them in a classroom and you have a guy get up and instruct them in the tenets of the Church of Scientology,” Zuckerman said. “That strikes me, in a jurisprudential sense, as indistinguishable from a teacher instructing 25 kids in Torah.”

But even if one does equate the two activities, there are still questions about the dangers of pushing government even deeper into religious life simply to establish equity with the Scientologists.

“The comfort level that the Jewish community has in this society in good measure stems from the separation of church and state,” said Rabbi Gary Greenebaum, executive director of the American Jewish Committee in Los Angeles. “It’s certainly clear to me that the Sklars are looking for a loophole,” said Greenebaum.

Interestingly, in 2002, Sklar voiced similar fears in this publication. “As a Jew, I was terrified by what [was] going on,” he said about the Scientologists’ deal. “The current Tax Code amounts to state-sponsored religion, and Jews never fare well under those circumstances.”

But today he seems to have taken parity with the Scientologists as his main concern instead.

“[Even] if we went back to nobody being able to take [the deduction], that would not accomplish anything because then the government would have gotten away with discrimination for 10 years,” Sklar said last week.

Mayoral Election: 102 Days and Counting

Bob Hertzberg’s campaign is rapidly emerging as the assault troop of the Los Angeles mayoral race.

The most recent example: An online petition demanding that the mayor participate in a KNBC televised debate at the Museum of Tolerance on Dec. 2.

Hertzberg writes on his Web site: “Jimmy Hahn is continuing to avoid debating me and my fellow challengers. I don’t know about you, but I am deeply offended by the fact that he is continuing to hide behind press releases.”

“The fact that the mayor is running for re-election, and has raised a ton of money to run TV commercials, but is refusing to stand up and defend his record, we believe is an insult to the voters,” said Matt Szabo, spokesperson for Hertzberg.

Hertzberg’s petition had been electronically signed by 456 people as of Nov. 18.

“Apparently the mayor decided that defending his record would be more damaging than refusing to show,” Szabo said.

The mayor said he simply has a scheduling conflict.

“We actually asked them if they’d be willing to do the debate on another night, but obviously they were not willing,” said Julie Wong, spokesperson for the Hahn campaign.

The debate was originally scheduled for October, but organizer Scott Regberg said it was postponed to avoid distraction with the presidential campaign — and because the mayor asked for another date then, as well.

The mayor has committed to attending another debate later in the month. Expectedly, the Hertzberg campaign is challenging Hahn on choosing to attend the debate three days before Christmas.

“Mayor Hahn will be at the Dec. 21 debate which will be held at the League of Conservation Voters,” Wong said.

She added that this won’t be the last time for a meeting between the candidates by any means.

“I think we’ll have plenty of opportunities for the mayor and others in the race to talk about their vision for L.A,” she said.

Hotel Union Asks Guests to ‘Check Out’

The union representing hotel workers from nine major companies in Los Angeles asked the public to boycott their employers on Nov. 11.

UNITE HERE (formerly the Union of Needletrades, Industrial and Textile Employees and the Hotel Employees and Restaurant Employees International Union), Local 11 has been engaged in a battle with the Millennium Biltmore, Westin Bonaventure, Hyatt Regency, Wilshire Grand, Regent Beverly Wilshire, Century Plaza Hotel & Spa, St. Regis, Hyatt West Hollywood and Sheraton Universal since last spring.

One of the central disputes between the union and management is the controversial two-year contract. The union wants to renegotiate in 2006, when many other hotel unions nationwide will also be in contract negotiations.

Joining together in 2006 would put them in a much stronger position to bargain for benefits with the multinational hotel chains, rather than negotiating city by city.

The hotels oppose a two-year deal, saying the dispute is local and nationwide union contracts should have nothing to do with it.

In the meantime, with no contract between the L.A. workers and hotels in force, management has suspended the free health care workers had been receiving and began charging a fee.

The long-running dispute is beginning to attract political attention.

City Councilman Antonio Villaraigosa, Assemblywoman Jackie Goldberg (D-Los Angeles) and state Sen. Gil Cedillo (D-Los Angeles) attended the Nov. 11 boycott announcement.

California Assembly Speaker Fabian Nunez (D-Los Angeles) has publicly called for a quick resolution, saying the clash could hurt the city’s economy.

Economy Project Crunches L.A. Numbers

Several weeks ago, a variety of newspapers published numbers from a recent report on the health of the Los Angeles economy. The report, called the LA Economy Project, was put together by the Milken Institute and the Economic Roundtable.

Their numbers showed that L.A. workers are at risk of being undereducated for the types of jobs that will be created here in the near future.

Problem is, the study wasn’t finished.

“It’s something that wasn’t supposed to happen for a while,” said Michael Klowden, executive director of the Milken Institute. “Part of the report is done. We’re finalizing the rest of it, but it was essentially incomplete information.”The partial information that was released indicated a huge gap between income levels for native English speakers compared to non-native English speaking immigrants. It showed that the majority of the working poor in the city are clustered around just a few low-paying industries like restaurants, construction and housekeeping.

Klowden said that the sections of the report on how to actually address this problem in terms of public policy are still unfinished. He added that matching the workforce numbers with business data hasn’t been done yet, either.

“The mayor’s office has really been interested in what our findings are,” said Klowden. Joy Chen, a former deputy mayor under Hahn, played a prominent role in the project. Klowden said that Hahn has publicly announced his plans to incorporate the LA Economy Project’s findings into his strategy for the city, and would like to have it “coordinated from their end.”

It’s unclear how exactly the statistics-laden numbers that were prematurely released reflected on Hahn when they made the rounds in the major newspapers. It’s also unclear whether the final report will be more favorable to Hahn or not.

But one thing is guaranteed: They will definitely be released in time for the mayoral election.


Material Instincts

Every day before Dina Goldstein (not her real name) leaves
the house to take her two young children to day care and herself to work, she
grabs two bagels and two boxes of orange juice. After buckling the kids into
the car, she gives them the bagels and the juice, and they eat breakfast in the
car on the way to school.

“I just don’t have time to get them ready, myself ready and
feed everyone before I leave the house,” said Goldstein, who works as a
religious day school teacher.

Like Goldstein, many women find maintaining a family and a
job overwhelming. With over 75 percent of women in the United States between
the ages of 25 and 54 working outside the home (according the International
Labor Organization), it is very likely that at some point most women will have
to do both things concurrently. While women choose to work for a variety of
reasons, for many in the Jewish community, a woman’s employment is not a matter
of personal fulfillment but of financial necessity.

With high tuition fees, synagogue dues and mortgages in the
Jewish neighborhoods, maintaining a presence in the community is difficult to
do on one income alone — meaning that the husband is no longer the sole
breadwinner in the family.

But many women find that their careers give them not one job
but two — their paid employment and their nonpaid work inside the house, which
seldom diminishes with the onset of employment. Few will say that the feminist
ideal of “having it all” is viable unless certain sacrifices are made. Finding
ways to produce calm out of the chaos requires innovation, skill, organization
and lots and lots of help.

“The ‘superwoman’ is a myth,” said Tova Hinda Siegal, a
Pico-Robertson midwife who is on-call seven days a week while raising her six
children. “It’s tremendously tricky to try to do everything.”

One of the ways that some women try to balance both job and
family is by finding careers that allow them to work from home, which gives
them close access to their family while still enabling them to bring in some
extra money. While there is not necessarily the same kind of career advancement
available to those who do not work in an office, many say that the sacrifice is
worth it.

“It’s a hugely satisfying feeling to know that I can be
there for my kids when they need me, because I know how stressful it is for a
mother in an office when her kids have an odd day off,” said Judy Gruen, a
mother of four, Journal contributor and  Pico-Robertson writer on domesticity.

Other women make sure that their husbands are picking up the
slack, and that paid help in the house is not a luxury, but a necessity. “I
think it’s more important to have part-time help in your house than to buy new
clothes,” Siegal said. “People who are working should not be fighting with each
other over who does the laundry.”

Siegal also said that it’s up to a woman to train her
husband to do his share of the work.

“I think you have to tell your husband, ‘No, it’s not a good
idea to sit while I’m in the kitchen cleaning up,'”she said.

“In our house we made a rule that whoever cooks does not
have to clean up,” she continued. “That is an equitable division of labor. I
also think it’s fine that a mother gets up in the middle of the night to nurse
her babies, but in the morning, the father should get up and take the baby out
for a few hours and let her sleep. The husband should not feel that when he
does something he is doing his wife a favor. Both need to feel that they are
contributing to the family’s welfare.”

Even with a spouse’s help, keeping your household together
requires careful organization for it to run efficiently. Esther Simon, a Santa
Monica mother of seven and a professional home organizer, said that there are a
number of things one can do to help this process.

“You need to create a clutter-free home, where everything
has a place,” she said. “You should also have a family calendar day planner
where you write down what you want to do each day and what things need to be
done during the week, and then you work out what things can only be done by you
and what things can be done by someone else. Only you can give love to your
child; someone else can wash the floor.”

Simon also suggests laying out all your children’s clothes,
preparing breakfast and putting backpacks by the door the night before to
minimize the rush in the morning.

There is one upside to trying to do everything. “Working and
taking care of a family definitely keeps you out of trouble,” Siegal said. “You
just don’t have the time for anything else.”  

New Century Poses Challenge

One hundred years ago, when Cedars-Sinai Medical Center’s predecessor, Kaspare Cohn Hospital, opened its doors with 12 beds as Los Angeles’ first Jewish hospital, such medical staples as penicillin and insulin remained to be discovered. Life expectancy was 51 years, and the average annual income was $467.

Today, Cedars-Sinai Medical Center exists in a world of dizzying medical developments, where scientists manipulate genes, and doctors are testing a diagnostic camera in a capsule so small that patients can swallow it. Life expectancy has increased by more than 25 years, and in 2000, the country spent $1.3 trillion on health-care costs.

In such an increasingly complex health-care environment, Cedars-Sinai’s ability to celebrate a second century will depend on how the medical center, which is also a research and educational institution, navigates a modern set of challenges. The 905-bed facility, like other U.S. hospitals, is facing skyrocketing costs coupled with shrinking insurance reimbursements, staffing shortages and an aging population that will place a severe strain on resources in the future.

"[There are a] myriad of challenges being thrown at the institution … [which put] a tremendous amount of pressure on all [health-care] organizations," said Thomas M. Priselac, president and chief executive officer of Cedars-Sinai Health System. "We believe that if we [fulfill the strategic objectives supporting] our mission and our vision — what it is we stand for and what we want to achieve … we will be able to keep the institution at the leading edge."

Perhaps the most formidable challenge facing Cedars-Sinai is rising health-care costs. New procedures and emerging technologies, while advancing medical care, outpace the payments hospitals receive from insurers and government health plans. Many of these plans pay health-care providers a fixed fee rather than one based on the nature of services rendered. According to the California Healthcare Association, the state has had more than $60 billion in Medicare payment cuts over the last four years. About 45 percent of Cedars-Sinai patients are on Medicare, and another 14 percent are on Medi-Cal.

Compounding the problem of limited payments is the prospect of no payments at all. More than 2 million Los Angeles County residents are uninsured, and Cedars-Sinai will now be caring for an even greater percentage of them.

The Los Angeles County Health Department may deal with a projected $700-800 million deficit over the next three years by converting Harbor-UCLA Medical Center in Torrance and Olive View-UCLA Medical Center in Sylmar into outpatient clinics.

Both currently operate emergency rooms, and like Cedars-Sinai, Harbor-UCLA is one of the county’s 13 trauma centers. Eleven community health clinics and four school-based clinics have already been closed as part of county cutbacks. The closures will funnel more uninsured patients to Cedars-Sinai’s emergency room and ambulatory care clinic.

Last fiscal year, Cedars-Sinai spent approximately $70 million on uncompensated and under-compensated care and community health programs, Priselac said. "Clearly [these factors present] a financial challenge to the institution.

"However, because we are a not-for-profit community hospital … we welcome [this challenge], because of our roots and founding, and because of our obligation to the community and our desire to be a community-oriented organization," he said.

Barbara Factor Bentley, board of directors chair, added, "It goes back to our Jewish traditions. When people look up and see the Star of David on the medical center, they know it means quality care for all people."

Providing care requires continually updating and adding to facilities and equipment. Under Cedars-Sinai’s Master Facilities Plan, nearly every building on the medical campus is scheduled to undergo renovations and improvements, either to replace facilities lost in the 1994 earthquake or to house expanded programs and services.

Last year saw the opening of a 45-bed neonatal intensive-care unit — close to 7,000 babies are delivered at the medical center annually — and a new unit within the department of psychiatry and mental health. This month marks the opening of the S. Mark Taper Foundation Imaging Center, and the commencement of construction on the new North Care Tower to house predominantly intensive-care services.

Philanthropy helps make such growth possible. The medical center’s major fund-raising initiative, the Campaign for the 21st Century, has so far raised $322 million of its $500 million goal. Cedars-Sinai also benefits from the efforts of 40 different fund-raising groups. In addition, it receives another $80 million in grants.

However, even with sufficient funding, Cedars-Sinai, as well as other hospitals nationwide, faces the specter of staffing shortages. According to the Joint Commission on Accreditation of Healthcare Organizations, more than 126,000 U.S. nursing positions are currently unfilled, and "that number [is] expected to skyrocket as aging baby boomers begin placing unprecedented demands on America’s health-care system." One of the reasons for the national nursing shortage is that nurses are aging. In 2000, 60 percent of registered nurses were over 40.

Dr. Michael Langberg, Cedars-Sinai’s chief medical officer, said the medical center isn’t feeling the nursing crunch right now. To keep it that way, the medical center has just established the Cedars-Sinai Institute for Professional Nursing Development.

Through a partnership with California State University Los Angeles, the institute will eventually graduate 150 new bachelor’s degree nurses annually to help increase the number entering the profession. The hospital will try to persuade institute graduates to stay at Cedars-Sinai by picking up their internship tab if they remain for a specified period of time.

While the nursing shortage has received the most news coverage, shortages of other professionals exist, too. There is a need for hospital personnel such as radiology technicians, computer systems specialists and laboratory personnel, among others.

"We’re working hard to create a work environment . . . that makes Cedars-Sinai an attractive place to come to work," Priselac said. He added that the medical center works with other institutions to provide professional training programs and lobbies at the state and federal levels to increase funding for educational institutions.

As baby boomers edge toward retirement age, they will increasingly utilize health resources. The number of elderly in California will almost double in the next 25 years, according to the National Economic Council.

To gear up for anticipated increases in the demand for services, Cedars-Sinai is boosting resources in fields heavily utilized by geriatric patients, such as cardiology, neurology, oncology, orthopedics and pulmonary medicine. Priselac said that as options for outpatient treatment increase, patients who do require hospitalization will be sicker and require a more intense level of care.

This month construction is beginning on the North Care Tower, which will add 120 intensive-care beds. Educational programs on health and wellness, and early intervention tools, such as the Cedars-Sinai Heart Watch, have been adopted to attract the health-conscious baby boomer generation. The American Association of Retired Persons ranked Cedars-Sinai as the No. 2 metropolitan hospital in the nation.

Baby boomers are only one segment of the diverse population served by the medical center. To reach vulnerable groups with little access to care, 120 programs target the elderly, ethnic minority populations, pregnant women, children and the poor.

As technology advances, the potential for ethical dilemmas also increases, for example, end-of-life issues. As part of the hospital’s bioethics program, physicians and other professionals regularly meet to discuss challenges they face as health-care providers. A committee is also available to doctors and families when they need help sorting through options in a specific case.

Rather than coming up with the answers, Priselac said, "we put in place the resources and a process to let the individual, the family members and their physician come to the right decision as a group."

Last year, the medical center cared for more than 44,000 in-patients and more than 137,000 out-patients. Assuring quality control and patient safety is challenging for a system where close to 10,000 people — from doctors to orderlies to volunteers — provide care in some form.

Cedars-Sinai "is universally committed to patient safety and patient care quality," Langberg said. Priselac chairs the medical center’s Quality Council, and the hospital maintains numerous committees to address aspects of this issue.

While state law will soon mandate such solutions, the medical center is already in the process of instituting a $20 million computerized patient information system that includes entry of physician orders. By having doctors enter orders electronically, rather than by writing them, the system streamlines the process and allows prescriptions to be immediately and automatically checked for potential problems, such as drug interactions or allergies. Langberg said the system reduces medication errors by about 60 percent.

The patient information system is just one example of how Cedars-Sinai has embraced information technology. The medical center was named one of the 100 "most wired" hospitals and health systems in Hospitals and Health Networks magazine. The new S. Mark Taper Foundation Imaging Center features all-digital instruments, enabling rapid transmission of test results to physicians.

To view a patient’s X-ray or lab results, doctors no longer have to wait for film to be delivered to their offices. They don’t even need to be on site. A special computer program enables physicians to have instant access to patient and other medical data with a few key strokes on their Palm Pilot or computer.

The doctors who founded Cedars-Sinai would be amazed to see how their 12-bed hospital has grown and astounded by today’s world of medicine that utilizes such tools as computers, magnetic resonance imaging and artificial livers. While it’s hard to imagine what the next century might bring, Priselac promised, "What will be here … is Cedars-Sinai’s continued commitment to the community."

Home Is Where the Shul Is

When Sari and Jason Ciment decided it was time to move their two children out of their Pico-Robertson duplex and into a single-family house, they had one major requirement: to stay in the modern Orthodox Jewish neighborhood that boasts three synagogues within walking distance, and was home to their family and friends.

"We never considered moving out of the neighborhood," Jason Ciment said. For him, being able to walk to shul on Shabbat, and having a neighborhood filled with bakeries and other service shops made the neighborhood worth a premium price. But in an area where the cost for a single-family home is often well into the $400,000 range, the Ciments realized that finding their dream house wouldn’t be easy. Their solution? Tear down a dilapidated old structure and built a new house from scratch — a time-intensive but less costly way to stay in their coveted location.

"Buying, we would get half the space for the same money," Ciment said.

As Los Angeles housing prices continue their upward climb, members of Orthodox and Conservative communities, like the Ciments, are having a tougher time finding affordable houses to buy within walking distance of their synagogues — a must for observant Jews who don’t drive on Shabbat. But devout congregations may actually cause homes close to synagogues to have higher price tags because they offer the sought-after benefits of easy access to the community — making it harder for young families to buy in.

Those precious few miles around popular shuls in neighborhoods such as Hancock Park, North Hollywood, Carthay Circle and Carthay Square are not only hip for yuppies looking for a taste of Los Angeles’ urban lifestyle, but also offer religious Jewish families an established community filled with the benefits of kosher stores, schools and social services — helping to keep the flames of a hot housing market burning and leading some to tough choices between religion and real estate.

"A good house in [in Pico-Robertson and the Fairfax areas] can be sold in a week," said Rabbi Perry Netter of Temple Beth Am on La Cienega. "People want to live within walking distance, which of course increases the price of housing."

That’s a point that Larry Harris, a professor of finance at USC and a member of Beth Am, fully understands.

Harris recently moved his six-member family a mile closer to their temple in the Carthay Circle neighborhood, taking them from the "periphery of the Shabbat-walking community" to the heart of it. With four children between the ages of 2 and 9, it’s a relocation that he says has led to "significantly less bellyaching" from the kids on Saturday morning walks. The convenient location of their new house has also led to more invitations to Shabbat dinners and enabled the family to host more popular events themselves, Harris said. Those are all benefits that make the expensive neighborhood worthwhile.

"To participate fully in [an observant] community, you have to be geographically desirable. If you live too far away it doesn’t work," Harris said. But in Orthodox neighborhoods, "there’s limited amount of property available and a lot of people who want it," he adds.

High housing costs in Jewish neighborhoods can be attributed to far more than just religious affiliations, but Los Angeles’ Conservative and Orthodox hot spots boast price tags well above many less-religious areas. The median price for a Los Angeles county home in May 2001 was $232,710, according to the California Association of Realtors. Realtor.com puts the average house price in the Pico-Robertson area at $474,000. In Hancock Park, the average house price is "$700,000 and up," according to Coldwell Banker real estate agent Cecille Cohen — and that price will only earn a house on a busy street like Highland Avenue.

Cohen adds that while the "discovery" of areas such as Hancock Park by actors and other entertainment industry professionals has helped boost prices overall, the homes around synagogues "definitely" command a premium price from Jewish families.

"The people who don’t care about the Orthodox community, when they leave, they tend not be replaced by other people who don’t care," points out Harris. "So these neighborhoods become more and more Orthodox," and therefore more and more desirable for young devout families.

The impact of religious congregations on neighborhood housing prices isn’t unique to Los Angeles. "Whenever there is [an] Orthodox synagogue, the synagogue tends to attract permanent Jewish residents, and as they come in, the prices tend to go up," explains UC Berkeley anthropology professor Michel Laguerre, who recently completed "The Global Diasporic City," a book on religious communities in urban centers. He adds that any community with strict regulations — from Muslims to some sects of Christianity — can have the same effect.

Despite concerns over those high housing costs, Netter said Beth Am has added 250 families during his nine years at the shul and seen an explosion in the number of students at the synagogue’s school. Rabbi Daniel Korobkin, whose Hancock Park Yeshiva and Kehillat Yavneh are striving to attract young Modern Orthodox families to the area, agrees that synagogue membership isn’t suffering — their school has also seen strong growth, and he adds that typical services attract 75 to 100 people.

"It’s really difficult to say if [housing costs] are limiting growth," Netter said. He points out that young families are finding ways to stay close by pushing the community in new, less expensive directions of the mid-Wilshire area: "The neighborhood east of La Cienega has become full of young families that belong to Beth Am," he said. "Nine years ago [when he moved into the neighborhood], there were only two or three families." Now he estimates that number to be between 10 and 15.

Cohen agrees, pointing out that Hancock Park adjacent — an area east of La Brea and south of Third Street — offers houses in the $400,000 range and is growing in popularity as an alternative to Hancock Park proper.

Still, high housing costs have pushed some congregations to radical steps to ensure shul members aren’t forced out of the neighborhood. At Korobkin’s Yeshiva, a new loan program is in the works that would give modern Orthodox families trying to purchase their first home an interest-free down payment loan of up to $35,000 for 10 years, or until the house is sold.

While the loan asks that the recipients attend Yavneh’s services and send their children to their school, nothing is "written in blood," said Cohen, who helps facilitate the program.

But some families are choosing to move out of Los Angeles altogether, forging into areas of the San Fernando Valley such as Calabasas, Woodland Hills or Northridge. Cohen agrees that prices can be much less outside the city — a single-family home can often be found in the $300,000 range. However, he argues that "you get what you pay for," pointing out that areas such as Hancock Park offer more services, and often have the added benefits of shorter commute times and more cultural pursuits.

But for families like George and Julie Schaffer and their 6-month-old daughter Lily, the benefits of a Valley home far outweigh the merits of the city.

"It’s a great little pocket," said George Schaffer of their Woodland Hills neighborhood. "We’re close to temples, we have Jewish neighbors scattered around — if you want to go to music and plays and concerts we know where those are and we go to them. You wouldn’t get something like this in the city for what we paid."

What they paid was $365,000 for a 2,000-square-foot house with a pool, said Schaffer — a home that would easily have cost upwards of $700,000 in an area such as Beverlywood. Those kind of numbers create a powerful dilemma for cash-conscious buyers.

"We did consider the city," Schaffer admits, but adds that comparison shopping between the two areas quickly convinced them that the Valley offered a better quality of life.

While Orthodox and Conservative communities bear the brunt of high housing costs, other Jewish communities are also feeling the crunch. Rabbi Harold Shulweis of Valley Beth Shalom in Encino points out that high prices can make it hard to attract clergy in Southern California.

"If we get a rabbi who comes in, and we want him to live close to the shul, and the prices are exorbitant, you have to adjust their salary and perks. And therefore you have to find the money to pay for it," he points out.

Although housing prices have leveled off in the past few months, finding the money for a first home promises to remain a challenge in hot neighborhoods. But many locals take the cost of Los Angeles life in stride: "I’d be a fool not to worry," Netter said. "But the market is the market."