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Governance Frequently Asked Questions

Q: What is the role of the El Camino Healthcare District Board of Directors?

A: The role of the publicly elected El Camino Healthcare District (ECHD or District) Board of Directors is to oversee the assets of the ECHD, including El Camino Hospital. The ECHD Board is responsible for ensuring District’s mission is accomplished and for providing public oversight of District’s business affairs.

The diagram below represents the structure of ECHD.

Q: What role does the District Board have in hospital operations?

A: ECHD maintains oversight of El Camino Hospital by:

  • Appointing members of El Camino Hospital board
  • Approving annual budget of El Camino Hospital and District
  • Approves the appointment of the El Camino Hospital CEO
  • Regaining assets of El Camino Hospital at end of lease in 2039

The District owns the land (not the Hospital building) and leases the land to El Camino Hospital. The ECHD's elected Board, state laws and board policies protect the assets. ECHD has no employees and pays no salaries. The District Directors, upon a vote of the District Board, may also sit on the Hospital Board; however, it is not required that they be members of both boards.

In addition to providing oversight of El Camino Hospital, the District works to identify and address unmet community health needs through its Community Benefit Program.

Q: Do District Board Directors also sit on the El Camino Hospital Board?

A: Yes, all five District Directors have voted to appoint each other to the Hospital Board.

Q: Why did the District Board vote to expand the El Camino Hospital Board?

A: In 2012, the El Camino Healthcare District (District) Board of Directors expanded the El Camino Hospital Board of Directors to include three subject matter experts. As the healthcare environment continues to change, and in order to maintain the quality of complex medical services, it has become increasingly important to expand strategically beyond District boundaries to engage the broader Silicon Valley population.

An expansion of the education, skills and relevant experience of the Hospital Board aims to provide for the organization’s long-term sustainability, strengthen the competency composition and relevant experience of the Hospital Board, attract and retain top talent in the Hospital executive team and deliver on the organization’s mission and vision to advance the health and well-being of our community.

Q: How does changing the structure change the Hospital Board competencies?

A: Changing the current model to one that allows the appointment of additional subject matter experts strengthens the competency of the Hospital Board by broadening the knowledge base and helps to ensure El Camino Hospital continues to be at the forefront of medicine and technology.

Q: El Camino Hospital seems to do well financially. Why is there a concern for long-term sustainability?

A: The organization continues to experience declines in revenue due to reimbursement changes and insurance constraints, decreased volume in some services, and consumer shifts to outpatient procedures and primary care services. As an independent, nonprofit community hospital, El Camino Hospital is one of the few remaining locally-controlled healthcare institutions.

Q: How are District Directors selected to join the Hospital Board?

A: Upon being elected to the District Board, the District Directors nominate and vote on their Hospital Board appointments.

Q: If all five District Directors are not on the Hospital Board will the District lose its oversight of the Hospital?

A: No. The District retains its reserved rights and oversight.

Q: How are District tax revenues spent?

A: The money raised through property taxes from District residents will continue to be used for repayment of general obligations bonds, capital expenditures and community benefit grants and sponsorships benefitting the El Camino Healthcare District.

Q: What needs to change about the Hospital Board’s competency composition?

A: The Hospital Board needs the requisite competencies to include clinical, technological, healthcare market and population health skills, so as to oversee the evolving complexities and to make and implement appropriate strategic changes.

Q: Will District Board structure change?

A: No. The District Board structure will not change.

Q: Can the hospital be sold if all five District Board members are not on the Hospital Board?

A: No. The District Board retains its reserved rights. A vote of the District Board is required to approve the disposition of all or substantially all of El Camino Hospital’s assets or to approve a merger or dissolution of the hospital. As well, sale of 50% or more of El Camino Hospital assets requires District voter approval per California Health and Safety Code Section 32121.7.

Q: Will Hospital Board and Committee meetings remain open to the public?

A: Yes, board meetings and committee meetings will remain open to the public. Meeting agendas and packets are available in advance on both the hospital and district websites. Board meetings are open to the public, include an opportunity for public comment, and are live-streamed through a link on the hospital and district websites. For more information visit the El Camino Hospital website and the El Camino Healthcare District website.