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SR-10-A (39) ~ /0- A DE C:- 19S3 .{ CMD:LM:br:cscda2/word.pobas council Meeting of December 14, 1993 city of Santa Monica TO: Mayor and City council FROM: city staff SUBJECT: Recommendation to Adopt a Resolution Approving an Installment Purchase Tax-Exempt Financing to be Undertaken by the California statewide Communities Development Authority to Assist Saint John's Hospital and Health Center to Finance certain Health Care Facilities INTRODUCTION sisters of Charity of Leavenworth Health Services corporation, a Kansas not-for-profit corporation (the "corporation"), which owns saint John's Hospital and Health Center (the "Health Center"), has requested the California Statewide communi ties Development Authority (CSeDA) to act as issuer in connection with a tax-exempt financing with a principal amount not to exceed $65.0 million (the "Financing") for the purpose of financing certain capital projects at the Health Center. For the CSCDA to so act as issuer, the City of Santa Monica is required to hold a pUblic hearing with respect to the Financing on the issuance of the obligations and approve the Financing. This staff report recommends that the city council take these actions. - 1 - Dte ; : jj~j J 0-14. BACKGROUND The CSCDA was initially established in 1987 by the California state Association of Counties (CSAC) and various counties as a joint powers entity, named the California Counties Industrial Development Authority. In 1988, the League of California cities joined as a sponsor of the Authority, membership was expanded to include cities and the name was changed to the CSCDA. The purpose of the CSCDA is to pursue programs that improve the quality of life and economic vitality of communities throughout the state. One of the programs offered by the CSCDA is the issuance of tax-exempt obligations on behalf of non-prOfit 501 (c) (3) organizations located in member jurisdictions to reduce financing costs (the IICSCDA 501 (c) (3) Program"). To date, the CSCDA has issued over $2 billion in financing for a number of 501(c) (3) non-profit corporations. The City joined CSCDA in connection with the CSCDA financing to benefit Santa Monica Hospital and Medical Center last summer. Presently, about 40 counties, 100 other cities and 35 districts are also CSCDA members. For a non-profit corporation within the boundaries of Santa Monica to participate in CSCDA's 501(c) (3) Program, CSCDA's joint powers agreement and the Federal Internal Revenue Code requires that the city approve the Financing. There are no financial obligations or risks associated with the City'S membership in the CSCDA, or any tax-exempt obligations issued by - 2 - the CSCDA. For a non-profit corporation to secure financing through the CSCDA, the non-profit corporation must demonstrate a strong credit rating and that its project will result in a public benefit. ST. JOHN'S HOSPITAL AND ITS SERVICES TO THE COMMUNITY The Corporation is a Kansas not-for-profit corporation qualified to do business in California. The Corporation owns eight hospitals in four states including saint John's Hospital and Health Center in Santa Monica. The Corporation is the "parent" corporation of a California nonprofit public corporation which operates the Health Center. The Corporation has consistently maintained an Aa rating with Moody's Investors Service since 1985. As part of its Community Service Plan, saint John's provides services to vulnerable populations including the children, elderly, homeless and poor of the Santa Monica community. saint John's deploys a variety of resources to fulfill community needs including: o direct financial assistance for acute medical and psychiatric carei underwriting portions of community-based agencies; the care provided by o o subsidies of health center educational, screening and medical programs for those programs for those programs which cannot pay for themselves. - 3 - The following is a brief outline of some of these services. with respect to services to the children and families of the Santa Monica community, Saint John's has established the Thera- peutic Preschool as part of its Child Study Center. The program is aimed at preparing children, who were prenatally exposed to drugs, and to integrate them into the public school system by offering specialized preschool educational programs in concert with its program for developmentally disabled preschool children. Throughout grades K-6 in the Santa Monica-Malibu Unified School District, Saint John's sponsors a Health Champions Programs which has as its purpose to teach children about health issues, to screen for health problems and to encourage healthy habits for youngsters. Additionally, Saint John's conducts, free of charge, mental health counseling and therapy programs for adolescents and families. with respect to the homeless, indigent and poor, Saint John's offers several specialized charitable programs. In concert with westside Women's Health Center, Saint John's provides maternity services to Santa Monica women who lack health insurance. Donated services include comprehensive prenatal care, counseling, delivery and after care. The profile of these women can be described as the "working poor" with incomes less than $15,000; ninety percent are Hispanic and the average age is 23. The Venice Clinic, a free clinic that serves as the "family doctor" for those without access to private physicians, refers patients requiring outpatient diagnostic or treatment services to Saint John's for free care. saint John's Homeless Mentally III - 4 - Outreach Program, which is staffed with mental health professionals, seeks out homeless people with mental disabilities and stabilizes their circumstances via psychiatric treatment, shelter, medical care and financial assistance. In addition to maintaining an active speakers bureau for health issues related to senior citizens, saint John's annually provides free flu shots and prostate screening for senior citizens. saint John's also provides free lab and x-ray services to elderly patients referred by the Senior Health and Peer Counseling Center. Finally, the Health Center is also a center for the care of senior citizens, with approximately 60% of the Health Center's patient service revenue coming from Medicare and Medicare- sponsored HMO's. In total, for the above non-traditional charity programs, the Health Center has contributed approximately $2.1 million in community support for its 1993 fiscal year. Saint John's has provided charity care in 1993 and 1992 of approximately $3.173 and $3.761 million, respectively. In addition, charges un- collected under terms of governmental indigent programs were $2.539 and $2.834 million in 1993 and 1992, respectively. THE PROPOSED FINANCING The purpose of the proposed Financing, not to exceed $65.0 million, is to fund a portion of the anticipated capital expenditures required during fiscal years 1994-1996 to renovate and upgrade portions of the existing facilities, and to replace existing equipment as it reaches obsolescence or becomes - 5 - technologically deficient. In addition, Saint John's is currently in the planning process with respect to a new centralized ambulatory care center. Proceeds of the Financing may be used in connection with the development of that center. At the present time, saint John's expects to construct and equip that center with donated funds, with proceeds of the Financing being used to reimburse the Corporation for funds expended to purchase land for, and design costs of, the center. REQUIRED PUBLIC HEARING The Federal Internal Revenue Code requires that a public hearing be held concerning the Financing, and the nature of the proposed uses of the proceeds of the Financing. The required hearing has been publicly noticed. Upon conclusion of the public hearing, it is recommended that Council approve the attached resolution approving the Financing. STRUCTURE OF THE FINANCING AND CITY BUDGET/FINANCIAL IMPACT The Financing will be structured in a certificates of participation format virtually identical to the CSCDA/UniHealth- Santa Monica Hospital and Medical Center transaction previously approved by Council on April 27, 1993. The City of Santa Monica will not be directly or contingently obligated in any pecuniary fashion by the Financing. The Financing will not create any direct or contingent liability for the City of Santa Monica. - 6 - RECOMMENDATION It is recommended that the council adopt the attached Resolution approving an installment purchase financing to benefit saint John'S Hospital and Health Center. Prepared By: Mike Dennis, Director of Finance Linda Moxon, Deputy City Attorney - 7 -