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LWV League of Women Voters of California Education Fund
Smart Voter
San Diego County, CA November 2, 2004 Election
Proposition BB
Hospital, Emergency Care, Trauma Center Improvement
Palomar Pomerado Health System

General Obligation Bond - 2/3 Approval Required

118303 / 69.84% Yes votes ...... 51090 / 30.16% No votes

See Also: Index of all Propositions

Results as of Dec 15 1:35pm
Information shown below: Fiscal Impact | Full Text

Shall Palomar Pomerado Health (PPH be authorized to issues and sell general obligation bonds up to $496,000,000 ($496 million) in aggregate principal to provide financing or refinancing for hospital and health care facilities projects consisting of the acquisition and improvement of real property for hospital and health care purposes, including renovations and improvements to Palomar Medical Center and Pomerado Hospital and construction or acquisition of additional medical facilities, subject to all of the accountability safeguards specified in this measure?

Fiscal Impact:
The cost to property taxpayers is estimated to be $17.75 per $100,000 of assessed valuation. The average assessed value of property in the hospital district is $275,000. The average property tax bill would increase less than $50.

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Full Text of Proposition BB

Palomar Pomerado Health (PPH), the largest public hospital district in California, spans 850 square miles from the Riverside County line to Scripps Ranch, from Anza Borrego to Vista. Communities include Escondido, Fallbrook, Ramona, San Marcos, Valley Center, Pauma Valley, Rancho Bernardo and Rancho Penasquitos.

PPH has been serving inland North County since the 1950s. Its facilities include the 324-bed Palomar Medical Center (PMC) in Escondido, the 107-bed Pomerado Hospital located in Poway, two skilled nursing facilities, five health centers, and a surgery center. Palomar Medical Center is North County's only trauma center.

North County's growing population is straining community resources, especially healthcare. The district's overall population is expected to grow over 30% by 2030 and the number of residents over age 65, who tend to use more healthcare services than other segments of the population, by 34%. Emergency rooms are overcrowded. PMC's emergency department was built to handle 26,000 patients per year but they see more than 50,000.

In 1994, California State Legislature enacted SB1953, requiring all California hospitals to meet new seismic safety standards. Interim standards must be met by 2008 (the deadline may be extended to 2013 on application and approval), with substantial compliance required by 2030. Failure to meet the standards requires that the buildings be demolished or demoted from acute care hospital service. PPH must replace or vacate approximately 43% of its current inpatient hospital buildings.


This measure authorizes Palomar Pomerado Health, a California Healthcare District, to issue $496 million in general obligation bonds. The funds will be used for land acquisition, and to build, renovate and improve existing or new medical facilities within the healthcare district. The total projected cost of the capital projects is $753 million. The balance will be provided with $210 million in revenue bonds and $47 million from cash reserves and philanthropy.

All bond proceeds must be used for the proposed capital projects. No monies may be used for administrative salaries, materials, equipment or supplies.

The measure establishes a nine-member, unpaid, independent citizens' oversight committee. The members would be appointed by the PPH board of directors.

Bond proceeds and other funding sources would pay for:

A new hospital, "Palomar West Medical Center" ($531 million) with more beds (453), and expanded trauma and emergency services. Renovating Palomar Medical Center ($73 million) to support mental health services, outpatient care and administration Expanding Pomerado Hospital ($139 million). Doubles number of beds from 107 to 211, adds a women's floor, outpatient imaging center, outpatient women's center, and outpatient surgery center. Community Medical Centers ($10 million). Builds urgent care and primary care centers in possibly Ramona, Rancho Penasquitos/Rancho Bernardo, Valley Center and San Marcos.

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Created: December 15, 2004 13:35 PST
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