Imperial Valley Coalition for Sustainable Healthcare Facilities

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An argument to wait on AB 918

As a maturing adult, that is a kind way of saying getting older, I am concerned about healthcare for myself, my family, and all of Imperial Valley. In December 2022 news of the financial collapse of El Centro Regional Medical Center (ECRMC) was made public creating concerns about healthcare in our community.

Assemblymember Eduardo Garcia authored AB 918 which is an attempt to address the issues fast-tracking the bill due to the impending emergency. I have reviewed the bill in depth and published suggestions to make it a better bill based on a lot of research.

That bill was introduced in February and has had six amended versions, the latest on July 13, and is now in California Senate Appropriations Committee’s Suspense file with a potential timeline for changes no later than September 1, 2023.

Let’s review.

In December and January 2023, ECRMC and Pioneers Memorial Healthcare District (PMHD) were in discussions of a possible merger to include Heffernan Memorial Healthcare District (HMHD). PMHD filed an application with the Imperial County Local Agency Formation Commission (ICLAFCO) to start the process. Those discussions ceased with the introduction of the bill.

As the bill changed, PMHD voiced opposition to the section that dissolved the PMHD and HMHD creating a totally new district that did not include ECRMC. Then the City of El Centro filed litigation against ICLAFCO for a perceived notification violation. A county-sponsored mediation with all parties including Assemblymember Garcia’s office went well and would continue once the Boards of ECRMC, PMHD, HMHD met to determine how they wished to proceed.

Then the City of El Centro filed an injunction against ICLAFCO to stop the requisite feasibility and financial analysis. This is while ECRMC is doing its own feasibility and financial analysis. These events do not demonstrate a state of urgency. As of today the urgency clause of the bill is not relevant. ECRMC indicates that it is now not in danger of a financial collapse. This is remarkable since its 2023-2024 budget was approved with a $9.4 million deficit and does not meet the definition of insolvency.

Assemblymember Garcia continues to work diligently, however, the elephant in the room remains the bond debt of ECRMC, and no new revenue source to support the new district. Patient fees and property taxes alone would have to support the new healthcare district. ECRMC’s bond debt cannot be legally forced upon any city, county, or district. Any bill can only recommend a negotiated settlement.

Can ECRMC and PMHD agree to terms prior to September 1, 2023? Objectively speaking, it seems clear to me that the bill has not been a benefit to the process, but rather created a problematic sequence of actions that create major problems for Imperial County. AB918 should either be abandoned or made a two-year bill. With a change to a two-year bill, the following could be accomplished.

  1. The two primary parties could have some time to allow the mediation process to continue.
  2. The City of El Centro should suspend its legal action against LAFCO.
  3. The two separate feasibility and financial studies could be completed and provided to all three boards.
  4. A ballot measure for the March 2024 ballot for a new funding source. The deadline for a ballot measure is December 8, 2023, to the Imperial County Election Office. The voters of Imperial County can then exercise their right to make a decision on their healthcare system here, rather than having one “forced” upon them.
  5. More time can be spent on local efforts to inform the public about the issues. Given the current state, if the bill is passed, it will result in a very contentious partnership between PMHD and ECRMC, a poor prognosis for the future of the new district.

Assemblymember Garcia, we implore you to make this a two-year bill so we can get this right.

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