There are only two options for voters in the Tulare Local Heath Care District (TLHCD) who will either approve or deny Measure H on the November 6 ballot. It’s a simple choice, yet the future of the city’s hospital hangs in the balance.
No on H,
No on Hospital
If voters approve the measure, the district will be allowed to grant Adventist Health a lease of up to 30 years to operate the shuttered Tulare Regional Medical Center (TRMC). TRMC closed in October of last year and reopened on October 15, just weeks ahead of polling, with staff from Adventist providing medical services under a temporary operating agreement.
TRMC faced an October 29 deadline to reopen or be permanently closed. That deadline has now been extended to the end of March. As the original deadline approached, Adventist loaned the District $10 million to cover costs associated with reopening, and placed 40 full-time staff members at TRMC to prepare for the reopening.
If voters say no to Measure H, Tulare will likely never have its own hospital again, says District President Kevin Northcraft.
“We have no money,” said Northcraft. “Unless somebody steps in and says here’s millions of dollars, we won’t be able to reopen.”
Council Supports H
In a unanimous vote, the Tulare City Council gave Measure H its endorsement. Mayor David Macedo says getting TRMC back in business has deeper consequences for the city than just providing care.
“I’ve already signed a letter of support. It was a 5-0 vote,” he said. “We need this hospital up and running for so many reasons.”
Chief among them, he says, is increased tax revenue and commerce. While putting a staff back to work will drive immediate and direct increases in sales tax for Tulare, having TRMC up and running will also ensure future growth, Macedo says. Adequate medical facilities are something investors look for when assessing a region for possible growth.
“When they come and look in your city, they’ll ask about public safety, they’ll ask about schools, and they’ll ask about your hospital,” Macedo said. “There are certain services they’re looking for. That’s a check mark we can put back.”
An Obvious Choice
TLHCD Board Member Steve Harrell, who addressed the Council prior to its vote of support, says the selection voters should make is clear: They should vote yes.
“Measure H is very simple. It’s actually two questions,” he said. “The first one would be: Do you want a good, quality hospital in Tulare that will provide outstanding medical care, emergency care, everything that you would expect out of a good hospital? I say the answer would be, ‘Yes.’”
It’s also approval for the company the board has selected to run Tulare Regional. Adventist, the TLHCD Board maintains, is the only viable option. They’ve had no other offers.
“The second part of that is would be a yes to approve the lease for Adventist, because that’s who’s going to apply this outstanding medical care for this community, hopefully for a long time to come,” Harrell said.
Yet some of those who fought to save TRMC when it was foundering now have concerns with the new lease agreement.
Last week, the board agreed to accept $2.3 million a year for the lease of the Tulare Regional Medical Center campus. Should voters approve the board’s decision, the lease to Adventist would extend for up to 30 years, and the TLHCD would not be allowed to compete against Adventist.
This has brought complaints from those who fought to wrest control of TLHCD and TRMC from the previous management company, Health Care Conglomerate Associates. Dr. Patty Drilling-Phelps, who helped lead Citizens for Hospital Accountability’s efforts, is concerned the lease ties the district’s hands, leaving it unable to raise revenue by providing health care or by providing additional services.
Deanne Martin-Soares, another member of Accountability group and a former TLHCD Board member, also objected to the deal, saying the public has yet to see the fair-market value of TRMC’s campus. She’s concerned the district will be unable to pay its past debts and pay for future seismic upgrades under the terms of the 30-year agreement.
Hospital campuses have unusually low resale values compared to other properties. In 2008, Tenet Healthcare sold seven hospital campuses in Southern California, all of them larger than TRMC. The average sale price was $3.3 million.
Despite Drilling-Phelps and Martin-Soares’ concerns, the board approved sending the lease for voter approval unanimously. Voters will OK or nix the lease on November 6.