Questions, answered straight.

Yes. The text levies the tax until voters repeal it, with no sunset written in. Two guardrails sit around that. The rate cannot go above 111 dollars a year without another vote of the people. The money can be spent only on the purposes the measure lists, in a dedicated account that an independent auditor examines every year. A hospital has no expiration date either, and a sunset clause would mean running another two-thirds election in a decade while the same bills keep arriving. Voters keep the power to repeal a local tax by initiative, which takes a signature drive and another election.

Nobody plans to use an emergency room. It has to be open before you need it, for you, for your kids, for your parents, or for the stranger in the other car. You are paying for a place to be open at two in the morning in August when your neighbor's chest hurts. If Pioneers or El Centro Regional cuts back, the ambulance drives farther with everyone in it, including you.

Renters do not get a bill. The county charges Measure N to the owner of each taxable parcel on the secured roll. A landlord may pass some of it along in rent, and 111 dollars a year across a whole parcel is about 30 cents a day. A renter who calls an ambulance is taken to the same two hospitals an owner is.

The measure writes in no exemption for seniors or for low-income owners, and that is the weakest part of it. The only relief in the text is discretionary: the board may exempt a specific parcel when the taxpayer requests it. The measure hands the board that discretion without a written procedure, so relief reaches whoever knows to ask for it. A board can adopt a written exemption procedure, with published criteria and a simple form, without going back to the ballot. I will push the board to take that up in my first year.

You check. Measure N puts the money in a dedicated account under Government Code section 50075.1, requires the chief financial officer to report collections and spending to the board by January 1 every year under section 50075.3, and requires an independent audit every year. The measure leaves out a citizens' oversight committee, which many California parcel taxes include. The board can create one by its own vote, and I will push for it.

Here is where I stand: crack down on executive pay where it is excessive, and grow leadership from inside this valley instead of paying outside executives who leave after three years. The board is the only body that can do that. It sets executive pay and goals and it evaluates the chief executive. I want those goals written down, reviewed in open session, and tied to whether care here improves. Directors themselves are nearly unpaid: state law caps them at 100 dollars a meeting and six paid meetings a month, and only if the board votes to allow any payment at all.

The cutting already happened, and you have seen it. El Centro Regional closed labor and delivery in January 2023 after 67 years, and no voter was consulted. That is what cost-cutting looks like at a hospital with this payer mix: it comes out of services, because about 81 percent of Pioneers' net revenue and 88 percent of El Centro Regional's comes from Medi-Cal and Medicare at rates the hospital cannot change. There are unglamorous savings to find in procurement, in billing, in how referrals get processed, and in the information systems the staff have to work around, and I intend to chase them. It will not cover an earthquake retrofit estimated at 75 million to 100 million dollars.

That is the sharpest question on this list. Pioneers did finish fiscal year 2023-24 with 6.7 million dollars of operating income. Four things sit behind the need anyway. The retrofit at Pioneers is a capital cost that no operating margin covers. El Centro Regional's unaudited fiscal year 2024-25 figures show a 9 million dollar operating loss, with cash down to 6.3 million dollars at June 30, 2025. The 56 million dollars in state loans comes due in full around 2030. And roughly one dollar in eight of Pioneers' revenue comes from supplemental state programs that the 2025 federal budget law puts on a phase-down. A good year does not make a stable district.

It helped twice, and neither one is permanent. In October 2023 each hospital took a 28 million dollar state loan, 56 million combined, interest free. A loan gets repaid, and this one comes due in full around 2030 after the state already extended it a year and forgave a year of El Centro Regional's payments. In June 2026 El Centro Regional won an 11 million dollar state distressed hospital grant, which is good work by the people who chased it and is money that arrives once. Neither closes a gap of 7 million to 12.5 million dollars every year.

It might. The transfer agreement was signed August 1, 2025, and closing has waited on bondholder consent since then, with agreement reached with the majority holder by August 2026, and the outside deadline runs to October 31, 2026, three days before the election. The closing does not depend on Measure N passing, so a yes vote does not decide whether the merger goes through. And if the transfer does not close, the district still owns Pioneers, and the 2030 retrofit there still has to be paid for. What the board would owe the public in that case is a public accounting of what changes in the spending plan, before it spends a dollar.

The tax would keep running until voters repealed it, and you would have every right to be furious. I am not going to promise you an outcome I cannot control from one seat out of seven. What I can tell you is what makes closure likelier: borrowed money coming due around 2030, a retrofit with no financing plan, a hospital in El Centro down to 6.3 million dollars of cash, and a specialist bench that lost one of the valley's two oncologists in August 2026. Measure N does not guarantee the hospitals survive. Without it the district has no revenue plan at all, and that is the choice on the ballot.

Backup options exist, and every one of them is slower. It would mean going back to Sacramento for another special law, working with the state and the Local Agency Formation Commission so Brawley and Calexico, whose property taxes already send a share to this district, are not carrying more than everyone else, and looking at ideas like the lithium excise tax that need their own legislative fixes. Each of those starts with a signature drive, a bill, or another election. In the meantime the pressure lands on services. That is how we lost the maternity ward. The longer answer is here.

Everyone in Imperial County votes on Measure N. The board seats are elected by zone, so only voters in District 3 can vote for me. District 1 had a single candidate file, so no District 1 contest appears on the November 3, 2026 ballot at all. If you are not sure which zone you live in, the Registrar of Voters will tell you, and it takes about a minute.

Timing and priority. Gas and groceries cost more every month, and voters will say yes to one new tax this year. Seven revenue measures appear on Imperial County ballots on November 3, 2026, and no single voter sees all seven, but every one of them competes for the same wallet, and a special tax needs two-thirds. You can outrun a fire or deal with an intruder. Nobody outruns a heart attack on their own. Emergency care is survival, and everything else on the ballot can wait a cycle.

Every agency in this county has known since 2024 that the hospital district had to bring voters a permanent funding measure this November. They put their own taxes on the same ballot anyway. Whether that was carelessness or a way to get even over the merger law, the hospitals should not be the ones who pay for it.

Five things, and you can hold me to the list.

• Move the board to adopt written, measurable goals for the chief executive in open session, with progress reported at a public meeting on a set schedule.
• Finish the revenue verification I started. The state Board of Equalization produced its records on September 8, 2026, and my Public Records Act request to the county, filed August 28, 2026, is past the ten-day deadline the law gives the county. I will bring the answer to a public meeting whichever way it comes out.
• Ask for the district's audit calendar and the written cost range for the earthquake safety work at Pioneers, then report back in plain language on what both documents say.
• Ask the board to set recruitment and retention targets for specialists and nursing staff, with the pay data in the board packet before the vote instead of after it.
• Vote against suspending or closing any service until the board has held a noticed public hearing and put the costs and the alternatives on the record. What happened in January 2023 should not happen quietly again.