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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 the District’s mission is accomplished and for providing public oversight of the District’s business affairs.

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

A: ECHD maintains oversight of El Camino Hospital by:

  • Approving the election of the Directors of the El Camino Hospital Board
  • Approving the selection of the El Camino Hospital CEO
  • Approving annual budget of El Camino Hospital and District.
  • Regaining assets of El Camino Hospital at the end of the lease.

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, they do currently. 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.

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, and in 2017 voted to add two more. 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 did changing the structure change the Hospital Board competencies?

A: The current model allows the appointment of additional subject matter experts, strengthening the competency of the Hospital Board by broadening the knowledge base and helping 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 power and oversight.

Q: How are District tax revenues spent?

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

Q. What is the difference between the District and the Hospital Corporation?

A. The El Camino Hospital District (later changed to El Camino Healthcare District) was established to utilize taxpayer dollars to build the hospital. Day-to-day operations are paid for by the hospital’s patients and their insurance companies, including various governmental programs such as Medicare and Medi-Cal. In the 1980s, the California legislature determined that the District structure made it difficult for Health Care District hospitals to compete effectively with for-profit and nonprofit healthcare organizations, threatening their very existence. Therefore, the Legislature enacted Health and Safety Code 32121(p), which gave Health Care Districts the power to engage in certain transactions with a nonprofit corporation.The District Board exists to protect the community’s assets and make sure the taxes are being used to create the healthiest environment for the community, while the Hospital Corporation Board oversees the day-to-day operations of the nonprofit, 501(c)(3) hospital.

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 powers. 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: Are Hospital Board and Committee meetings open to the public?

A: Yes, board meetings and committee meetings are 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.