Community Outreach Community Outreach & & Gaining Your Input Gaining Your Input DRAFT 2017 1
We are your Safety Net for Emergency Services (Treating 10,400 patients per year). We are your ‘go to’ for Emergency Surgery (131 patients had emergency surgery last year). We deliver your babies, close to home. We are your Ambulance Service provider (doing 1,689 transfers per year). We are your Home Health & Hospice provider (having more that 100 patients on our list). We are a 25 bed Hospital. We provide care through 94,000 outpatient encounters (i.e. visits) per year. 2
In this location for more than 46 years. We always have the doors open for you, 24/7/365. We have 70 Physicians on Staff. When you needed a specialist. When you needed immediate Care instead of an ER visit. When our Community Health Needs Assessment led us to improve cancer screening. Recognizing our responsibility to address the OPIOID crisis. 3
Volunteering to be Accredited by the Joint Commission. Asking our Physicians to be in charge of Quality Improvements. Performing better than UVMC on recent healthcare metrics. Achieving a 3 Star CMS rating in 2017. Naming North Coast Family Health Center (NCFHC) a high performer in quality outcomes. Improving our Patient Experience scores over 20% in the past 24 months. 4
Providing $2 million dollars of payroll to the community every month. Employing 320 of your neighbors. Making a Positive Difference in health care on the Mendocino Coast. Working hard to improve all aspects of our Emergency Department. 5
80% of our patients’ insurance (MediCal/Medicare) does not pay the cost of their care. Unfortunately, the cost of providing care will always be higher than what we are reimbursed by Medicare, Medi-Cal and Uninsured Patients. Emergency Department shortfall was $728,000 last year and $1.7 million the year prior. Shortfall for OBGYN was over $1.5 million last year and $1.2 million the year prior. Only 4 departments in the Hospital have revenue greater than expenses. 6
MCDH Future “Big Ticket” Items Existing Debt 12,056,294 • Capital Needs 19,495,884 • Geo Technical Study 75,000 • Architect & Professional fees for Building 8,000,000 • OSHPD fees for Building 1,280,000 • Replacement Facility 80,000,000 • TOTAL 120,857,178 • 7
Mendocin cino Co Coast D District rict Ho Hospital ital So Sonoma Va Valley lley Ho Hospit ital al He Heald aldsburg D rg District rict Ho Hospital ital MCDH MCDH SVH SVH HDH DH $0 $0 Parcel Parcel Tax Tax $195 $195 Parcel Parcel Tax Tax $150 $150 Parcel Parcel Tax Tax 8
2017 2017 MCDH - MCDH - Estimat stimate SVH VH - Estima stimate HDH DH - Estim stimate Net Revenues $ 53,403,299 $ 57,359,132 $ 45,000,000 Operating Expenses $ (53,928,768) $ (61,720,170) $ (47,000,000) Operating Income (Loss) $ (525,469) $ (4,361,038) $ (2,000,000) -0.98% -7.60% -4.44% PARCEL TAX INCOME $ - $ 2,949,529 $ 3,375,000 2016 2016 MCDH - MCDH - Audit udit SVH SVH - Audit Audit HDH DH - Audit udit Net Revenues $ 53,856,371 $ 55,013,096 $ 44,095,112 Operating Expenses $ (51,740,800) $ (58,352,771) $ (45,809,315) Operating Income (Loss) $ 2,115,571 $ (3,339,675) $ (1,714,203) 3.93% -6.07% -3.89% PARCEL TAX INCOME $ - $ 2,967,517 $ 3,358,819 2015 2015 MCDH - Audi MCDH - udit SVH - Audi SVH Audit Audi udit-201 015 Net Revenues $ 47,655,251 $ 51,394,060 $ 41,757,093 Operating Expenses $ (51,016,118) $ (55,073,510) $ (43,494,172) Operating Income (Loss) $ (3,360,867) $ (4,679,450) $ (1,737,079) -7.05% -9.11% -4.16% PARCEL TAX INCOME $ - $ 2,924,785 $ 3,383,671 9
PARCEL TAX Approximately 12,000 Parcels, estimated revenue, • potentially limited number of years (requires 66.7% voter approval) BOND FINANCING $80 Million total authorization, projected annual • tax rate of $100 per $100,000 of taxable value (requires 66.7% voter approval) AFFILIATION Strengths/Weaknesses • Significant community engagement and a vote of • the District required 10
(1) (2) (3) (4) Open E nded S ingle Parcel Tax Multiple '$10-$10-$60' Parcel Tax for S pecific Uses Parcel Tax Measures GO Bond Voter Approval Two-Thirds Required $80 Million $1,080,000 to $1,800,000 annually To be determined Amount of Proceeds from 2018 to 2024 $100 per $100,000 $90 to $150 per parcel annually Cost to Taxpayers To be determined of Assessed Value annually First series could be issued Likely received twice a year, after tax has been levied, Timing of Funds approximately six months typically beginning in December after election Potentially Potential Uses Many Many Capital facilities E R AND OB Offset expected and Revenue supplement to S ustain and improve To be determined unexpected capital needs, Benefits operating budget E R AND OB short and long term Diminished enthusiasm Challenging without Potentially too high of a May be too large a number Other for each measure and more specifying services to be required tax rate AND does not directly create challenging for voters to vote Considerations funded to meet needs revenue 'YE S ' twice 11
PROCESS Planning committee work • Community meetings with stakeholders and • local organizations Gauge opinion of residents up and down the • Mendocino Coast District Survey (support for parcel tax, bond) • Board makes decision • 12
MENDOCINO COAST DISTRICT HOSPITAL UPDATED Potential Ballot Measure Election Timeline: J une 5th, 2018 Ongoing Community Contact Series of Press Releases about the Hospital Presentations to Community Groups About Challenges & Options Conversations with Major Stakeholders & Other Residents Continue Assessing Fiscal Needs (Budgetary & Capital) & Options (Parcel Tax, Bond, Both, Etc.) Develop Potential Plans Potential Plans are Shared with Board & Community Prepare & Conduct Additional, More Detailed Voter Opinion Survey Present Voter Opinion Survey Results to Board Amend and Refine Plan, if Required Finalize Plan Present to Board & Community Conduct Further Community Meetings to Review & Gather Input Board Adopts Resolution Calling Election (Due to County at Least 88 Days Prior to Election Day: March 9th, 2018*) Board Submits Ballot Argument & Rebuttal, if Required Volunteer Committee Conducts Campaign County Issues Vote by Mail (VBM) Ballots Election Day: J une 5th, 2018 Already Ongoing Oct Nov Dec J an Feb Mar April May J une 2017 2018 *Certain ballot measures require additional public notice and hearing prior to adoption of the Resolution. Also, Mendocino County Registrar of Voters often requires the Resolution itself at least 10 days in advance of E-88, and should be consulted the moment the District officially begins considering calling an election 13
We want your stories, experiences and feedback! Please share now – or feel free to contact the Hospital CEO Bob Edwards at bob.edwards@mcdh.net Thank you! 14
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