LWVSJ Observer Corps: SJC Public Hospital District #1 Special Meeting, April 17, 2025

Commissioner Frazier presented a financial analysis looking at available cash, cash flow, working capital needs and reserves. The PHD has four service lines –EMS, care provider subsidies, the Village at the Harbor, and the Village at Home. He noted that 53% of the district’s revenue is taxes collected twice a year. Other sources are ambulance billing, assisted living and home health care fees, miscellaneous i.e. interest and donations. Beginning cash in 2025 was about $900 each for EMS and PHD, is not all cash reserves; about half is working capital to cover expenses in months without tax revenue. The remaining cash constitutes reserves available to cover shortfalls in revenue and/or unexpected expenses, as well as new projects. There are capital reserves specifically set aside for a new ambulance. The general recommendation is that organizations have at least two months’ expenses in reserves for emergency spending, which would be about $1 million. With the current economic uncertainty, especially around Social Security and Medicaid, and expected high inflation, he cautioned that as the Commission makes decisions about what projects to fund, they keep these things in mind.

EMS capital needs are for a new ambulance and a new EMS building. Cash saved from 2024 would pay for a new ambulance, and the commission will likely approve that purchase. An ambulance will take up to a year to be delivered once an order is placed. The 13-year-old EMS building is not big enough for newer, larger ambulances, and current ambulances barely fit with highly exact parking. With new shift arrangements accommodations for EMTs are inadequate, with only two sleeping rooms, one bathroom, and no AC. Though the PHD could cover the interest on a bond from current revenue, Superintendent Butler recommended they put a bond out to voters, or to renew the current levy and add the 1-2 cent cost into the levy renewal. The commission discussed perhaps having a bond cover more than one building project.

The Village At Home is operating with 7-8 part-time employees instead of fewer full-time employees. Its fixed costs are $15,000 per month. It serves 216 patients a month, which is not enough to break even.  The 16-month-old project needs a business plan with financial goals and milestones. There are many variables involved in moving forward with expansion plans for The Village at the Harbor and the commission decided it is not a project to launch in 2025. Housing help and support for staff has a high priority. They need short-term, interim housing solutions. Plans to build housing is tied to partnership with PeaceHealth. Recently, PHD experimented with renting properties, starting with a small house for five months for travelling nurses working at Village at the Harbor. Another priority is health care collaboration.

The League of Women Voters, a nonpartisan organization encourages informed participation in government. The Observer Corps attends and takes notes at government meetings to expand public understanding of public policy and decisions. The notes do not necessarily reflect the views of the League or its members.