In a couple of days, voters in Tulare will be receiving a mail in ballot for Measure I. In case you’ve been living under a rock, Measure I is a $55 million dollar public obligation bond measure for construction at our local hospital. If you’re like me, you’ve been overwhelmed by a half dozen mailers, a half-million yard signs and even a few teenagers knocking on your door asking you to get on board with this.
Admittedly, I’ve avoided the whole hospital debacle for the last several years, as numerous reports and articles reported corruption and mismanagement, greed and self service surrounding the building project and hospital district in general. I got excited when I first heard of Measure I, thinking that maybe this was the turning point we needed in Tulare.
One thing I’ve learned in life is that if something sounds too good to be true, it probably is. So I decided to do my due diligence and research this issue to the best of my ability, make my vote an educated one and feel good about the decision that I would make. I have no interest in this except as an everyday citizen of this great city; no political ties that make me lean in one direction or the other. All of this being said, I want to lay out for you why I’m voting NO on this measure, and why I encourage you to do the same:
1. Lack of Information
When this bond was originally contemplated, it was a $35 million dollar bond. Somewhere along the line, without explanation, it ballooned another $20 million. I totally understand rising construction costs, and there may be change orders, but it doesn’t help that…
To date, there has been no detailed plan released to the public. We haven’t seen any construction estimates, detailed breakdown of costs, or anything offers any assurances that the board has a solid understanding of exactly what it will take to get this done. To me, this feels a lot like the board is telling us to just pass the bond, and then they’ll figure it all out. We’ve all heard that song and dance before. We know how that turns out. No bank would offer a loan with this limited information; we shouldn’t either.
In 2005, a bond resolution for $85 million was created by the board and passed by the people. It was presented to the people as being the only public money needed to present this project. Now they tell us that all along, they knew they would need more. I’ve read the original bond resolution multiple times, looking for any indication of a second bond; I can’t find it. Without a solid construction plan, why should we believe that 10 years down the line, we’re not going to be asked for another $40 million?
2. Lack of Accountability
When the first bond was proposed, it was passed with gigantic support from the community. People were full of hope and had great expectations of what this new hospital tower could mean for our community. Eleven years later, many of us are still nursing the wounds from being burned. Much of the frustration from the last go around boils down to a lack of transparency and accountability. Were the funds spent appropriately? It depends on who you ask. But we know that the Bond Oversight Committee was definitely kept in the dark; it took a grand jury investigation and nearly an act of congress to get the records that should have been public throughout the process. Our city’s hospital situation is like a joke to people in the surrounding area, and many people in the community are not very trusting right now.
Knowing this, the current board should have built additional accountability measures into the bond, as a show of good faith to the voters. Instead, there is nothing. They have to report their spending once a year, and that’s all they are legally obligated to do. Keep in mind, we are not voting on the promises of politicians in mailers or on websites. We are voting on the actual text of this bond resolution, nothing more. There can be all kinds of talk of “oversight communities” and various forms of transparency, but talk is cheap; and nothing is legally required beyond what is specified in the bond resolution.
The truth is, there is nothing in the actual text of this bond resolution that helps me sleep better at night. Promises mean nothing in today’s world; if it’s not signed on paper, it’s meaningless.
In 2014, the hospital was in a really bad financial place. The TRMC board recognized this and decided to bring in a private management company to manage the hospital. Despite receiving proposals from established, successful companies like Adventist Health and Clovis Community, the TRMC board opted to sign a long term management services contract with a startup group called Health Care Conglomerate Associates (HCCA).
The HCCA deal is a 15 year management contract with automatic 10 year renewals, and gives this private group full control over the day to day operations. Reading through the contract, it appears to give this private group nearly full control over the hospital board as well. They have the unquestioned final say on nearly everything that relates to operating the hospital.
At this point in time, HCCA does not take the profits from the hospital. They definitely control the profits, but do not own them. They do collect a pretty healthy management fee (that escalates over time), and are reimbursed for all of their expenses by the District. But it’s important to note, they are not pocketing the profits of the hospital…yet.
This is where it gets a little bit technical, but I’ll try to make this as brief as possible. Once the funding is secure for the completion of the tower, TRMC and HCCA enter into an “Interim Joint Operating Agreement,” which is really just a temporary measure until the bond debt is paid off, and they can enter into the “Joint Operating Agreement.” Under this agreement, HCCA starts sharing income with TRMC. This ‘profit sharing’ is a little one-sided though: TRMC gets 5%; HCCA gets 95%. All three of these agreements are already signed, sealed and delivered.
We keep hearing that contrary to what some are claiming, HCCA does not own the hospital. And that if they ever decide they want to, they’ll have to pay fair market value for it. This is true. But why would they want to own it when they have total control, are getting paid $3 million per year plus all expenses to manage it, and are working toward a 95% to 5% profit sharing program with all responsibility being born by the taxpayers? I certainly wouldn’t be motivated to buy! They have all the benefits without any of the risk!
Do we still have a public hospital? The answer to that is yes…and no. Technically speaking, the public still own the hospital. But go to the hospital website, take a walk inside the hospital, or look around at anything hospital related (when they’re not asking for $55 million) and you’ll only see one name: HCCA.
I don’t want you to take my word for it. Do your own research, see if the things I’ve said here are true. You’ll have to dig a little bit to get past the propaganda, but it’s all there. You’ll find that in spite of the grandiose claims made by the proponents of this bond, something’s still not right here. And you have to ask yourself: should we give $55 million to a group that has not shown a solid financial plan, has not shown an effort to be transparent and has given the keys of a public hospital to a private company?
That’s a pretty easy answer. Vote NO on Measure I.