September 22, 2026
Measure Q: Investing in the Hospital Our Mountain Community Can’t Afford to Lose
With ballots for the November 3, 2026, election scheduled to be mailed beginning October 5, Residents for Measure Q is sharing information about why the Hospital District moved forward with Measure Q and how the proposed financing plan was developed.
Mountains Community Hospital is in the middle of a $72 million seismic improvement and modernization project designed to address mandatory seismic requirements while creating a safer, more modern hospital for the mountain community.
The growing crisis in rural healthcare
When the project began a couple of years ago, the Hospital District had a financing plan in place that was designed to move the project forward without asking local taxpayers to fund the hospital’s construction.
The plan included a $48.5 million low-interest USDA loan at approximately 3.5% interest over 35 years, combined with hospital savings, grants and philanthropic support. The USDA loan requires approximately $2.4 million in annual payments, which the hospital originally expected to support through ongoing operations and other planned funding sources.
Since then, however, the financial environment for rural hospitals has changed significantly. The One Big Beautiful Bill Act, signed into federal law in July 2025, includes significant reductions to Medicaid (Medi-Cal). Mountains Community Health is particularly affected by these reductions because nearly 50% of our patients rely on Medi-Cal for their healthcare coverage.
The hospital has projected that changes in federal healthcare funding could reduce annual revenue by approximately $4 million. That reduction is greater than the hospital’s current bottom-line margin and would put the hospital in a negative cash-flow position. Under those circumstances, the original USDA financing would no longer be sustainable because the hospital would not have sufficient cash flow to make the required debt payments.
Our new plan: Measure Q
The Hospital District Board voted to place Measure Q on the November 3 ballot. If approved by at least two-thirds of voters within the hospital district—from Twin Peaks through Green Valley Lake—the measure would authorize up to $61 million in general obligation bonds.
Measure Q would allow the District to preserve the benefit of the $48.5 million USDA financing while providing a financial cushion for unexpected costs that are common with major hospital construction projects. The District would not necessarily have to issue the full amount authorized. If less financing is needed, less debt would be issued and the associated tax burden would be lower.
Bond proceeds would be restricted to the hospital construction and modernization project. They could not be used for employee salaries or the hospital’s operating expenses. An independent citizens’ oversight committee would monitor bond expenditures and help ensure funds are used only for the purposes authorized by Measure Q.
An Investment in the Mountain Community
“Everyone seems to know someone whose life was saved at our hospital,” said Bob Mattison, chair of Residents for Measure Q. “But our hospital is about more than emergency care. It’s about having access to the healthcare services our community needs, close to home, at every stage of life. Whether it’s an emergency, caring for an aging parent, getting treatment for an illness, or simply having a place to turn when you need medical care, our hospital is here for our community.”
Mattison also said the hospital contributes to the community’s broader economic stability and quality of life. “A hospital is part of what makes a community viable,” he said. “It helps keep people here, supports local jobs and services, and contributes to the value of our properties. We also have to consider what our community would look like if we didn’t have one.”
What the Project Will Provide
The hospital was built in the 1950s, when healthcare and patient needs were very different. Today, the aging facility lacks the space, infrastructure and systems needed to support modern patient care, technology and emergency preparedness.
The modernization project includes:
Major seismic improvements designed to help keep the hospital operational following a major disaster
A new, larger Emergency Department with better patient privacy and improved patient flow
A new Acute Care Wing with larger rooms, private bathrooms and a modern nurse call system
Expanded Skilled Nursing capacity with 13 additional beds
Together, these improvements will create a safer, more modern hospital designed to serve the mountain community for decades to come.
What Would Measure Q Cost?
Measure Q is currently estimated to result in an annual property tax of approximately $25 per $100,000 of assessed property value for properties within the hospital district. Importantly, the calculation is based on a property’s assessed value, not its current market value. For example, a property with an assessed value of $400,000 would have an estimated annual tax of $100 in the first year. The bond term is 30 years.
What Happens If Measure Q Does Not Pass?
With the expected federal funding reductions and resulting negative cash flow, our ability to continue operating a full-service Emergency Department and Acute Care hospital would be at significant risk. The required seismic work would still need to be completed, but the remaining modernization and expansion work would have to be reconsidered and could potentially be halted. Under our changed financial circumstances, the USDA financing would no longer be sustainable.
Vote Yes on Measure Q and Save Our Hospital
Residents for Measure Q is an independent community campaign separate from the Hospital District. Hospital District resources cannot be used to advocate for or against a ballot measure.
With ballots scheduled to be mailed October 5, the campaign is encouraging residents to learn about the measure, understand the proposed cost and share accurate information with neighbors, friends and family.
For more information about Measure Q, the project and the proposed financing plan, visit:
https://www.residentsforq.com/
