The California Legislature created medical districts in 1946 with a mission to improve community health care. A generally elected district director is an elected official whose sole mission is to promote the health and well-being of the residents of the communities served by the district. 37 out of 79 hospitals are not operational (2017 report)

The Health Care District has its roots in the aftermath of World War II. American soldiers returning from war required extensive treatment and often hospitalization. California had a serious shortage of hospital beds. Much of the state lacked access to needed medical services.

Congress responded to this hospital shortage by enacting the Local Hospital District Act. In 1994, it was renamed the “Medical District” to reflect that healthcare was increasingly provided outside the hospital environment. The Health Care District Act allowed communities to form special districts to build and operate hospitals and other health care facilities to meet community needs. Communities, with voter approval, were empowered to impose property tax assessments to subsidize local hospitals and medical services. The first health care districts were established in 1946 and 1947.

As of 2019, there were 79 health care districts. 42 of these 79 districts operated 47 hospitals within their district boundaries. Fifteen health care districts leased or sold hospital facilities to for-profit or non-profit health systems, but still provided health-related services to those within their district boundaries.

Some HCDs are in the spotlight due to competition for scarce property tax dollars, so when the LAFCo (Local Area Formation Commission), a grand jury, or others conclude that they are not serving the public interest , are open to criticism. LAFCo He is responsible for conducting local government service reviews every five years, and MCHCD’s last review was in 2014.

Many of the hospitals owned and operated by the Health Care District are considered local by the State of California. This represents almost 50% of rural hospitals in the state. They are a major source of inpatient, outpatient, and emergency medical care for rural California residents and workers in the farming, fishing, mining, and lumber industries. They provide a significant portion of health-related services to underserved areas of the state. Some districts are “community-based health districts” and do not operate hospitals.

In recent fiscal years, the majority of district hospitals experienced financial losses of $100,000 to over $10,000,000.00. In the past six years, five healthcare districts have filed for public sector bankruptcy (“Chapter 9”) and two hospitals have actually ceased operations.

A district has, and still retains, the power to “do whatever is necessary and in its favor” for health promotion services or medical facilities of any kind. Specifically, school districts can help: Health care facilities, including substance abuse and mental health programs. Programs for older adults, including outpatient services and free clinics, and transportation. nurse training; physician recruitment; ambulance services; health education programs, and a variety of health and rehabilitation activities. In short, the law allows for everything “necessary for the maintenance of physical and mental health in the communities served by the district.”

The Mendocino Coast Health Care District was formed in the early 1970s to build a hospital. Prior to that, he had two hospitals at Fort Bragg (he had four others at Willits and Ukiah). The board of directors is elected by the voters of the district. Health care districts must file annual financial reports with the California Commissioner and follow all state laws governing public records, recordkeeping, elections, and public access to documents.

This school district covers the same area as the two coastal school districts from Westport to Elk. Now, with voter approval, MCHCD leases the hospital to Adventist Health. Leasing information is available on the MCHCD website. Partnering with Adventist Health – Mendocino Coast Health Care District (specialdistrict.org)

— Paula Cohen, Co-President, Mendocino County League of Women Voters