San Bernardino Mountains Community Hospital District

#Key findings

• Measure Q is a $61M bond to keep Mountains Community Hospital in Lake Arrowhead open. It runs about $23–25 per $100K of assessed value a year through 2055–56, with about $106M in total repayment. It needs two-thirds. ^[1][2]
• Why now: state seismic rules require the upgrade by 2030 or the hospital loses its license. The district already borrowed $48.5M from the USDA at 3.5% for a $72M project. It says the 2025 federal Medicaid cuts will cost it $4M a year starting in 2028, leaving it unable to make the loan payments from operations. ^[3]
• It's the only emergency room within 45 minutes. No argument against was filed. A district survey found 72% support. ^[4][3]

#Measure Q: $61M hospital seismic and ER bond

What it does: Pays for a replacement inpatient wing and emergency department, conversion of the old unit to long-term care beds, seismic upgrades, and backup power, water and sewer for 72 hours of outages. Dedicated account, annual audits, citizens' oversight committee. Two-thirds to pass. ^[2]

Money and conflicts: The bond would mainly repay the USDA loan, with about $12.5M left as a cushion. The hospital board voted unanimously to place it. ^[3]

Does it solve a lasting problem? Yes, if the alternative is losing the license: the hospital must meet the 2030 seismic deadline either way. The risk is that the bond covers construction debt but not the operating losses the hospital expects from the Medicaid cuts.