In our previous letter, we questioned why the Imperial Valley Healthcare District (IVHD) is so intent on handing over management of the new district to UCSD Health. Given UCSD’s poor track record running ECRMC for nearly the past decade, it makes no sense. Remember, it’s the “imminent financial collapse” of ECRMC that made implementing AB918 so urgent.
Well, let’s back up a second
In 2022—well before AB918 was introduced—Pioneers Memorial Healthcare District applied to expand its district via LAFCO, the local board that governs agency boundaries. The purpose was simple and reasonable: to provide better access to quality healthcare for more people. Immediately, ECRMC/El Centro (under management by UCSD Health) filed a challenge in court arguing that this expansion somehow violated the California Environmental Quality Act (CEQA). Their argument was nonsensical; the proposed adjustment only changed lines on a map and wouldn’t have disturbed so much as a single blade of grass. But of course the real agenda was for UCSD and ECRMC/El Centro to delay or obstruct the expansion of PMHD.
Then in early 2023 Assemblymember Garcia introduced “urgent” legislation purportedly to save the county from the implosion of its healthcare system. One might think this odd, since there in fact did exist a financially stable healthcare district which was AT THE VERY SAME TIME trying to expand to serve more people.
But just months later, in comes AB 918 and rewrites all the boundaries and forces a unitary district, wiping out two districts altogether—notably without requiring any CEQA findings or discussions. This time, however, nothing but crickets from UCSD/ECRMC/El Centro and their legal team…because this time it benefits them.
The path to takeover
In our last article we talked about how IVHD is looking to UCSD to manage all aspects of the new district. The less-than-a-year-old Board has apparently rigged a non-competitive process without any other qualified bidders.
But it gets worse. Consider that UCSD is also concurrently in the middle of the negotiations for IVHD to acquire ECRMC. It certainly appears that UCSD—and its aggressive legal team—is on both sides of the proverbial negotiating table. How did that happen?
- Earlier this year, IVHD—freshly appointed and with no significant hospital management experience or expertise—floated the idea of a management contract (a Joint Powers Agreement, or JPA) with an outside entity. Given the lack of expertise, this seems reasonable at first glance…
- In July, ECRMC announced a miraculous turnaround in its finances, despite the rather dire situation just months earlier (note that their self-reported financial statements have yet to be audited).
- In August, ASM Garcia and Senator Padilla deployed an eleventh-hour gut-and-amend bill to handwave away the IVHD’s obligation to seek public approval on funding the district by the November election. The Governor signs it, but it’s opposed by the California Association of Local Agency Formation Commissions.
- At the September meeting of the IVHD, the board’s legal counsel mentioned casually that discussion of a Joint Powers Agreement with UCSD will be discussed in October. This was a surprise: it was not on the public agenda. She further says they have the existing ECRMC/ UCSD JPA to use as a model.
This brings us to present day and PMHD’s filing of an injunction to slow the implementation of AB918 and the dissolution of the ONE financially stable healthcare district in the county.
For UCSD, the deal could amount to a complete takeover of Imperial Valley healthcare and perhaps be worth millions annually. Again, this is the same UCSD that has been managing ECRMC for nearly a decade with less than stellar financial performance with higher operating costs and increasing transfers of patients out of ECRMC to their own hospitals. This is the UCSD that led ECRMC to “imminent financial collapse” as cited in AB918.
And now suddenly (or maybe, not so much) UCSD is being looked as the only potential option to manage the new IVHD?
One has to wonder if AB918 was at all times just the vehicle for UCSD to take over our healthcare facilities and patients—to fill the massive investments UCSD has made in San Diego.
It may be hard to draw any other conclusion. Certainly, there’s more to come.