The completion of the Tower is a critical priority for ensuring the hospital's compliance with earthquake safety standards mandated by the State of California. With the deadline set for January 1, 2030, it's imperative for the Tulare Local Healthcare District to expedite the completion of the Tower to meet these regulatory requirements. 

The estimated cost is $100 million for completing the entire Tower.

Focusing on key areas such as surgical suites, emergency services, and medical imaging aligns with ensuring that the Tower project addresses the most pressing needs of the community. By prioritizing the completion of the first and second floors for approximately $65 million, the District can efficiently allocate resources to areas that have the greatest impact on patient care and outcomes.

Option 1 - Use of District Revenue: Utilizing unencumbered revenue from rents and tax distributions is a sensible strategy, however, it's important to note that this option comes with limitations, particularly in terms of borrowing capabilities. The estimated borrowing ceiling of approximately $50 million through the issuance of Revenue Bonds may restrict the scope of the project or necessitate prioritization of certain phases, such as focusing on the completion of the second floor where surgical suites are located.

Option 2 - General Obligation Bonds: Seeking approval from the voters in the District to issue GO Bonds is a significant decision that involves community participation and support. This option provides a potential avenue for securing additional funding needed to complete the Tower.

1. Hospital Stability: Physicians seeking to relocate are more likely to choose a community with a stable hospital environment. The completion of the Tower and the commitment to maintaining and upgrading infrastructure signal stability and a long-term investment in the healthcare system, which can be appealing to prospective physicians.
2. State-of-the-Art Facilities: The state-of-the-art operating rooms in the new Tower offer significant advantages compared to the current facilities. These modern amenities can accommodate more complex cases and provide a better working environment for physicians, ultimately enhancing patient care and satisfaction.
3. Attraction of Newer Buildings: Physicians are often drawn to newer buildings with modern amenities. The upgraded facilities in the Tower can make their jobs easier and more satisfying, contributing to a positive work environment and potentially attracting more physicians to the community.

This resolution provides the District with valuable flexibility in addressing the financial needs associated with the Tower project.

The ability to replenish cash spent on the Tower through Revenue Bonds, without a strict requirement to do so, offers the District a degree of financial maneuverability. This flexibility allows the District to manage its financial resources more effectively while still pursuing the completion of critical infrastructure projects like the Tower.

As the District evaluates its financing options and considers the best approach to meet its objectives, the flexibility provided by Resolution 920 becomes a key factor in the decision-making process. This flexibility enables the District to adapt its financial strategy based on evolving circumstances and priorities, contributing to more informed decision-making and strategic planning.