Imperial Valley Coalition for Sustainable Healthcare Facilities

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PMHD Has the Right Idea

For months now the Imperial Valley Coalition for Sustainable Healthcare Facilities (CSHF) has warned of the consequences of a rushed, ill-advised implementation of AB918. We have provided detailed information on the flaws in the new law and the consequences of its implementation. 

This week, Pioneers Memorial Healthcare District filed a lawsuit against the newly formed Imperial Valley Healthcare District (IVHD) and the Imperial Valley LAFCO to stop the implementation of the law. They cite numerous issues and violations of rights as the basis for the lawsuit.

We believe they got it right. 

As previously noted, AB918 fails in many ways—beginning with the stated basis for the bill in the first place. It was purportedly needed to prop up the finances of Pioneers Hospital and protect against the failing financial management of the El Centro Regional Medical Center. Two things are wrong with this as a foundation: 1) AB918 conflates the financial status of Pioneers (which is stable) with that of ECRMC which is facing “imminent financial collapse” and 2) AB918 does not even require that ECRMC become a part of the new district, thus nullifying the specific urgency that it cites. How can it be the “fix” for ECRMC, when including ECMRC is optional?

Then we have the issue of voters’ rights. PMHD was created by voters and funding for it was approved by voters. Voters have rights here—something AB918 strips away, setting a devastating precedent. As the filing by PMHD lays out quite succinctly, voters are empowered through a local process with the right to approve—or deny—the creation, expansion and dissolution of a healthcare district. This was hand-waved away here under the argument of dire and urgent situation facing one hospital – ECRMC—which again is not even required to be a part of the new district. This leaves the voters within the PMHD—and the rest of the county—completely left out of a process enshrined in state law and routinely practiced. In fact, as the filing notes, AB918 specifically states that there have been “two unsuccessful attempts to establish a countywide health care district through the local process” (AB918, Section 1(k)). That those previous attempts failed does not waive voters rights under the “local process” nor indicate necessity for a heavy-handed state legislative intervention as is the case with AB918.  It is the voters who should make the decision, not the state legislature—NO member of which actually lives in Imperial County, including AB918’s author, Assemblymember Eduardo Garcia. 

So, what role do voters have under AB918? Only to approve a funding mechanism for this new district. But what if voters reject taxing themselves to fund an inherently flawed district with undetermined leadership, unsecured licenses and unknown assets and liabilities and which may or may not include ECRMC? Well, as the filing points out, if voters reject a funding mechanism (and at this point they most assuredly would), “there would be no revenue available for IVHD” to operate. 

We have spent a lot of time and energy analyzing AB918’s potential impact as well as the unintended consequences of its implementation. What we have determined, and argued for, is that either AB918 needs wholesale changes—including the required voter approval of IVHD’s actual creation as well as its funding—OR it needs to be thrown out entirely as it cannot meet its stated goals as written, nor does it follow applicable state law. 

We look forward to seeing where this lawsuit goes and at the very least, hope voters are able to retain our rights afforded to us by our state Constitution. 

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