1. Grossmont Healthcare District Joint Meeting: GHD and GHC Boards Major Activities – July 2014 to June 2015

2. Brief GHD History 1952 – Public Vote to form Grossmont Hospital District 1955 – Opening of Grossmont Hospital 1970s – Major Expansions Completed 1980s – Change in CA Law to Allow Hospital Leases 1991 – Lease of Hospital to Grossmont Hospital Corporation 1995 – Hospital District becomes a Healthcare District 2002 – GHD Offices, Conference Center, Library open 2006 – Prop G passes with over 77% of the vote 2009 – Completion of Critical Care Floors in ED/CCU 2014 – Prop H Lease Extension passes – over 86%

3. Mission Statement As stewards of the public trust, your Grossmont Healthcare District will preserve and protect those resources entrusted to its care. To maintain and improve the physical and behavioral health of its constituents, we will: Monitor the health care services provided at Grossmont Hospital. Anticipate and recognize the unmet health care needs of the communities we serve and support suitable services to the greatest extent possible consistent with available resources.

4. Health and Safety Code 32121.9 “ A district that leases or transfers its assets to a corporation…shall act as an advocate for the community to the operating corporation…and report to the community on the progress made in meeting the community’s health needs.” GHD Designees to the GHC Board Monthly Reports from GHC to the Board Annual Sharp Grossmont Community Benefits Report Independent Citizens’ Bond Oversight Committee Annual Report to the Community Quarterly Facilities Inspections / State of the Facilities

5. Grants FY 2014-15 $2 million in grant funding awarded, including: $1 million Inter-Governmental Transfer (IGT) to benefit Sharp Grossmont – Matched w/ $2 million going to Hospital GUHSD Healthcare Career Pathways – $168,000 Over $250K to Community Clinics – Volunteers in Medicine, Mountain Health, La Maestra Family Health Over $88K for Developmentally Disabled Services – Home of Guiding Hands, St. Madeleine Sophie’s, Noah Homes $72,000 for Senior Services – Alzheimer’s Association, ElderHelp $32,750 for Sharp efforts – Heart Walk, ThinkFirst, Grossmont Hospital Foundation $128K in add’l health scholarships, career pathways efforts

6. July 2014 – Execution of Extended Lease Agreement July 2014 – Randy Lenac appointed to Board Summer 2014 – Commenced work on final Prop G bond sale September 2014 – Acceptance of clean General Fund, Prop G Audits for FY 2013-14 October 2014 – Approved $1 million in IGT funding to benefit Grossmont Hospital November 2014 – Directors Chadwick, Lenac win re- election/election to Board December 2014 – Board discontinues plans for HOTC project, starts effort to assess other uses for related $7.5 million in Prop G funds March 2015 – New District website launched Major Events for the Fiscal Year

7. April 2015 – Annual Report to the Community from Bond Oversight Committee April 2015 – Board Budget Workshop / Public Hearing / Board approval of final Prop G bond sale and refunding of existing bonds May 2015 – Bond sale closes May 2015 – Board approves Prop G Master Budget update, applying $4 million in interest earned and unused “cost of issuance” fees to Hospital projects Year-long effort – Extended lease required a change in financial reporting from an enterprise fund to a general government format (effective 7/1/14, reflected in year-end audit now underway) Major Events, continued

8. Bond Sale and Refunding Final of three bond transactions resulting from the $247 million approved by voters in 2006 as Proposition G This was the remaining $24,510,000 in new funds Also, $200,490,000 in refunding debt (from prior 2007, 2011 bond transactions) $28.6 million in debt service savings for taxpayers from the refinancing $14.9 million in net present value savings achieved Closed May 2015 – Accounts for all Prop G building fund receipts

9. Prop G Highlights Central Plant/Co-Gen, East Tower, Heart & Vascular projects well underway Preparing to bid H&V Surgery Floor Build-Out project, Pre- qualifications in process. FY 2014-15 – $41.5 million in Building Fund expenditures ($44.6 million in FY 13/14 and $34.4 million in FY 12/13) September 2014 – Notice of Completion on South Loading Dock/Level B Seismic Upgrade project December 2014 – Occupancy of third floor of the East Tower May 2015 – East Tower fourth floor Occupancy Continued significant Partnership between GHD and Sharp via the Design & Construction Services Team

11. Available Funds vs. Worst Case Forecast

12. Looking Ahead A focus on completing the Prop G projects – the highest priority! State of CA – In recent years, some legislation has focused on healthcare districts. The State has viewed local governments as a potential source of tax dollars to fund its deficits. GHD continues to monitor this closely. Property Taxes – Property tax revenues have stabilized after a decline in the 2009-2012 timeframe. General Fund property tax receipts exceeded $6.2 million last FY. Community Needs – The District continues to see an increase in needs for community non-profits and safety net providers, themselves impacted by state cuts and economic declines. 2016 Election – Three of the District’s Board seats will appear on the November ballot for four-year terms, those of Bob Ayres, Michael Emerson and Betty Stieringer.

13. Questions?