The Children’s Hospital Bond Act of 2018

California’s children’s hospitals receive over one million visitors a year.  Many children come with complex and life-threatening illnesses like cancer or pediatric heart disease because they know these facilities are capable of healing the most severe conditions.  Others are flown in by helicopter after experiencing traumas like gunshots, near-drownings, and burns.  Still others are seen in the specialty outpatient clinics that treat rare conditions, like sickle cell and cystic fibrosis, when community doctors lack the expertise to treat them.  Children’s hospitals are here to provide the sickest children in the state the best health care in the world.

Children’s hospitals serve all children, regardless of ability to pay.  Medicaid covers nearly sixty-six percent of all patient stays in a children’s hospital.  That is almost twice as much as the average community hospital.  With recurring threats to Medicaid funding at the federal level, and the lack of new money at the state level, it is difficult for children’s hospitals to make necessary investments in infrastructure to meet the unique needs of children in California.

California’s children’s hospitals must update all of their buildings to meet strict state seismic safety rules, to protect patients in the event of an earthquake.  In addition, these hospitals must use highly specialized equipment that is made specifically for children – and this equipment can be costly.  Finally, new breakthroughs in medicine and technology are making it possible for children’s hospitals to heal children less invasively and sometimes using technology, like telemedicine, so that patients can be treated closer to home while still accessing the specialty doctors they need to treat their illnesses.  However, these new technologies can also be costly to install.

This is why the children’s hospital bond of 2018 was so important.  This bond measure, also known as Proposition 4, was approved by over 62% of California voters in November 2018, and will provide California’s children’s hospitals and pediatric programs at other non-profit and public hospitals with $1.5 billion in support to enable construction and renovation of older facilities, and to purchase new technology to allow these hospitals to continue healing children.   Funds generated by the bond measure will be used to build capacity in specialty areas where the need is growing, like cardiac labs so that wait times for surgery are reduced, and to make sure that all hospital facilities meet the most stringent standards for seismic safety.  They will also be used to ensure that children’s hospitals have the most up-to-date information technology so that children’s medical records can be appropriately accessed and secured.

This bond measure builds on the success of two earlier children’s hospital bonds:  Proposition 3, which raised $750 million for children’s hospitals in 2004 and Proposition 61, which raised $980 million for children’s hospitals in 2008.  Thanks to the funds from Proposition 3 and Proposition 61, children’s hospitals have made substantial progress in modernizing facilities throughout the state.  Nevertheless, rising construction costs and improvements in medical technology require additional support.  Proposition 4 will ensure that children’s hospitals can continue to meet the needs of California’s growing pediatric population cost-effectively.