In an early-morning special meeting, the Tulare Local Healthcare District Board of Directors voted unanimously to hold a vote-by-mail election for a $55m bond, similar to the method being used for Visalia’s Measure H.
The vote and meeting, held in a conference room at the TLHCD-owned Evolutions gym, was held on May 2 and took up all of the seating made available, with many individuals standing at the back of the room.
The Tulare Fire Department had cleared the room for up to 125 people; crowding in the hospital board’s usual meeting space became an issue after a packed meeting the April 27 had hospital officials scrambling to create an overflow room and audio system.
According initial statements from hospital officials, the meeting was held because Monday was the final deadline for the board to vote on the bond and move toward starting a mail-in election. Tulare County elections officials stated to the Valley Voice that May 2 was actually the first day to file such paperwork; the last day to file paperwork for an August 30 special election is actually June 3.
The board ended its special meeting at 9:05am, and by 9:25am the paperwork had been signed and submitted to Tulare County officials.
The effort stood in large contrast to Visalia’s Measure H process.
“We started a year and a half ago discussing in during the board meetings when would be the best time to put the bond measure on the ballot. It was part of a long and cohesive plan,” Carl Anderson, Kaweah Delta Board of Directors member told the Voice. “We felt the best plan was a mail-in ballot so that we would not interfere with the City of Visalia’s tax measure.”
Officials for the TLHCD stated that the bond is necessary not only to finish the ill-fated Tower One expansion project, and for the hospital to meet earthquake compliance laws, but for the operational continuity and survival of the Tulare Regional Medical Center and the Tulare Local Healthcare District.
Changes Made Between Agenda, Meeting
The version of the ballot measure uploaded to the HealthCare Conglomerate Associates (HCCA) website on Friday night, April 30, and publicized throughout the weekend, and the signed, final version uploaded by HCCA and submitted to Tulare County officials had key differences in the full text of the ballot measure.
The version posted by the District on Friday night stated:
“To pay for the District’s infrastructure projects that includes completion of the Tower One building with addition of earthquake compliant expanded Emergency Department space, labor and delivery suites, and alignment of the District building needs, including refinancing outstanding debt related to construction, shall the Tulare Local Healthcare District issue $55,000,000 in bonds, with 100% of the bond proceeds being used for construction-related costs and with no bond proceeds being used for hospital administrative costs or to refinance any debt supporting hospital operational costs?”
“All funds stay local for the benefit of Tulare Local Health Care District Facilities. All bond proceeds shall be used to improve healthcare facilities within the Tulare Local Health Care District for the benefit of healthcare in the local community. No funds may be taken away by the state government, federal government, or other hospital districts or healthcare institutions.
The version posted on HCCA’s website with signatures, and ostensibly submitted to Tulare County, for inclusion on the ballot states:
“To pay for the District’s capital improvement projects that includes completion of Tower One, including earthquake compliant expanded Emergency Department space, labor and delivery suites, and refinancing outstanding debt related to construction, shall the Tulare Local Healthcare District issue $55,000,000 in bonds, with 100% of the bond proceeds being used for construction-related costs and with no bond proceeds being used for hospital administrative costs or to refinance any debt supporting hospital operational costs?”
“All funds stay local for the benefit of Tulare Local Health Care District Facilities. All bond proceeds shall be used by the Tulare Local Health Care District for the benefit of healthcare in the local community. No funds may be taken away by the state government, federal government or other healthcare districts or healthcare institutions.”
The full text of the proposed and submitted resolutions and ballot measures are available at the end of this article.
Tax Costs and Purpose
The presentation by the TLHCD Board of Trustees states that the bond would cost $2.28 per month per $100,000 of assessed property value and that, at its peak, the bond would cost $4.33 per month per $100,000 of assessed property value.
The average, the presentation and documents filed by the District state, would be in the order of $2.49 per month per $100,000 of assessed value, or $3.74 per month per average house in Tulare.
The purpose of the bond, the HCCA/TLHCD presentation states in large letters, is to complete the tower project. The original construction project culminated in the district paying $7.9 million to Harris Construction of Fresno to settle disagreements between the two entities.
Detractors Cite Initial Bond Missteps
Some say that mismanagement paved the way for the new bond.
“CEO Bob Montion felt the hospital should put up some money and that not all should come from the taxpayers, thus the $20 million commitment from the hospital. We also knew if we came up just short, we could shell the upper floor until money became available,” Rick Elkins, then-Public Information Officer for the then-Tulare District Hospital, commented on one article on the Valley Voice website. “More than $17 million in changes — including the helicopter pad which is a waste of money since it will only be used to send patients out — is what is to blame for the shortfall along with other mistakes, and it is the board which approved all those changes to get us where we are today.”
Deanne Martin-Soares, a former Tulare Local Health Care District Board member, wrote “I agree there has been “multiple poor decisions” but why are we are being asked to give more money to the board that has made some extremely poor decisions. Including stonewalling record requests from citizens that were trying to get answers on the bond, filing lawsuits and threats from District/HCCA attorneys to others for speaking out, including myself. These costs are a financial burden to the District and do nothing but waste money that could be used towards the Tower. Why are you threatening immediate hospital closure if this bond is not passed and yet it is being represented that the hospital is extremely profitable? That makes no business sense.”
John Hobbs, of Tulare, addressed his concerns to the board.
“It seems positively ludicrous to me that someone .. would come to the voters and ask for a $55 million bond before they’ve accounted for the first $85 million,” Hobbs said. “There has been no full and complete accounting of how the [initial] bonds were spent.”
Michele Moore, also a Tulare resident, showed up to the meeting with a large sign that read “NO OVERSIGHT, NO BOND.” She spoke to the board.
“You need to account for our monies, just like the gentleman previous to me said,” Moore stated. “Why would we want to give you more money when you haven’t accounted for the first $85 million?”
The Tulare Local Healthcare District was hit in March with a report from the Tulare County Grand Jury, released as the first of a small batch of early-released reports, that dubbed the unfinished Tower One the “Tower of Shame.”
The Grand Jury stated that the Bond Oversight Committee, formed for the first bond measure passed in 2005, was stymied in its mission by the TLHCD.
“[The proposed bond] in my opinion is another waste of tax payer money due to the lack of trust, lack of transparency and the lack of confidence that has been created due to the mismanagement of the prior $85 million bond funds,” Alberto Aguilar, a Tulare resident, told the board. “and the irresponsible actions taken by the current Board of Directors.”
He cited various documents that he says exemplify his comments and show rising cost estimates to complete the tower from 2011, 2013, 2014 and 2015, and stated that the TLHCD Board was ignoring recommendations from the grand jury report. These documents are available below.
Unique Method of Bond Oversight
HCCA Chairman/CEO “Benny” Benzeevi, while giving a presentation on the proposed bond, cited Moore’s sign directly.
“I’d like to actually see that sign,” Benzeevi said, “because there’s a word I like on there.”
“What–oversight?,” Moore asked.
“Yeah, oversight,” Benzeevi replied.
In his slideshow, he spoke of two methods of oversight.
Benzeevi spoke of a third-party “construction monitor,” not from the TLHCD or HCCA, and provided “by the bond sellers who are responsible to the investors that buy the bonds.”
He also touted a unique “bond oversight community” model, in which HCCA and the TLHCD would create a website dedicated to the construction project and contain construction work schedules, money draw schedules.
“It will contain the bond bank account, so people can see on the website what money’s there, what money’s been drawn, for when and for what. And all of this will be on the website before a single dollar is spent, before a single nail has been put in the project with a new [general obligation] bond,” Benzeevi said. “We won’t have a bond oversight committee, we’ll have a bond oversight community.”
“Folks, this is our future,” Benzeevi said, showing a graphic rendering of a future Tulare Regional Medical Center, to applause from the board and audience.
The TLHCD Board’s resolution text, as signed and filed by the Board of Directors, does not legally bind HCCA or the District to any oversight other than a yearly report, filed by hospital officials no later than five months after the end of each fiscal year.
Linda Wilbourn, part of the original Bond Oversight Committee and a TLHCD board member, stated that she endorsed the “bond oversight community” model.
“The 12, 15 of us that served on the committee have been criticized for spending money, not spending money, all kinds of issues have come up,” Wilbourn said. “Throwing it back into the community now, it will be everyone’s responsibility to monitor all monies that are spent, brought in and cashed, so I believe this is a better way of doing it.”
“I wish we would have thought of this before,” she continued.
Supporters, Board, Staff Insist for Upward, Forward Outlook
Kerri Bell, the daughter-in-law of Board President Sherrie Bell, received a job with HCCA and stated that she and her husband intended to stay and raise her family in the city. She said that this hospital, and by extension the tower project, was part of a draw for younger citizens to stay and raise families in the city.
“I just wanted to put a face to the future of Tulare,” she said. “I just wanted to express my concern about my future here without this tower.”
Sherrie Bell stated that she “became emotional” during the meeting because Kerri Bell is her daughter-in-law.
“I have now two children that have come back to this community, and grandchildren that are being raised in this community,” Sherrie Bell said. “and I want to leave them with a community that isn’t stagnant, that has growth potential. And that’s what I see here with HCCA.”
“We all remember what we had before HCCA came on,” Bell said. “I testify to you that things are different, that today we have quality and experience and growth potential.”
TLHCD Board Vice-Chairman Dr. Parmod Kumar stated that the hospital expansion and revitalization effort would result in Tulare’s becoming a magnet for talented doctors, from Bakersfield to Stockton.
“The only ways [the next generation of] doctors will come, they won’t come to a 65-year-old building, they’ll come to a new tower. And they’re lined up. They want to come here. But we have to provide them the atmosphere and the tools, with modern technology,” Kumar continued. “And my question for you is: why not?”
To the Voice, Lindsay Mann, CEO of Kaweah Delta Hospital in Visalia, extended his good wishes.
“We have a generous spirit toward Tulare and the Tulare Hospital and believe in supporting their efforts to build their hospital. We wish them the best,” said Mann. Kaweah Delta is attempting to pass its own bond measure – Measure H in Visalia.
The deadline to file arguments, whether in favor or against, is 10 days after the resolution is filed — arguments will be due to Tulare County elections officials by May 12, 2016.
After this story was published online, officials from TRMC’s contracted public relations firm in Los Angeles contacted the Voice to state that the TLHCD Board had a different understanding of the required timeframe to submit their resolution.
The board, citing a Tulare County handbook online, believed that 120 days was needed to submit their resolution, and that while the handbook said it was possible to be accepted later, the Board did not want to take chances.
Officials from the Tulare County Registrar’s office told the Voice that Election Code allowed the TLHCD Board to file for an August 30 election as late as June 3.
April 29, 2016 — Meeting agenda and proposed resolution for May 2 meetingView fullscreen
May 2, 2016 — Filed and signed resolution approving a Tulare Hospital Bond Election
May 2, 2016 — Documents cited by Alberto Aguilar