Tulare Local Health Care District Board of Directors Special Meeting Agenda. Monday, May 2, 2016 Board Convenes at 8:00 a.m.

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Tulare Local Health Care District Board of Directors Special Meeting Agenda Monday, May 2, 2016 Board Convenes at 8:00 a.m. Evolution s Fitness & Wellness Center Conference Room 1425 E. Prosperity Ave. Tulare, CA I. CALL TO ORDER -Chair of the Board II. CITIZEN REQUESTS/PUBLIC COMMENTS - Pursuant to Government Code section 54954.3(a), public comment at special board meetings is limited to those items described on the agenda for such meeting. III. OPEN SESSION AGENDA A. Board of Director Action Items Board Chair 1. General Obligation Bond Election Resolution 848, a copy of which is attached hereto as and incorporated herein by this reference, calling for an election within the District to authorize the issuance of general obligation bonds in the amount of $55 Million, shall be presented to the Board for adoption and approval. Proposed Action: Acceptance and adoption of Resolution 848. IV. ADJOURNMENT Board of Directors: Sherrie Bell Parmod Kumar, MD Richard Torrez Linda Wilbourn Laura Gadke Chairman and President Vice Chairman Treasurer Board Member Board Member Tulare Regional Medical Center is a Division of Tulare Local Health Care District

NOTICE TO THE PUBLIC Tulare Regional Medical Center does not discriminate against any person on the basis of gender, religion, race, color, national origin, disability, or age in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact: Bruce Greene of Baker & Hostetler LLP at telephone number (310) 442-8834 or by e-mail at bgreene@bakerlaw.com. PUBLIC COMMENT PERIOD FOR REGULAR MEETINGS At this time, members of the public may comment on any item of interest to the public that is within the subject matter jurisdiction of the Board (Gov t Code, 54954.3(a)). Provided, however, the Board shall not take action on any item not appearing on the agenda unless the action is otherwise authorized by law. Any person addressing the Board will be limited to a maximum of three (3) minutes so that all interested parties have an opportunity to speak. OPEN SESSION AGENDA ITEMS All writings, materials and information provided to the Board for their consideration relating to any Open Session Agenda item of the meeting are available for public inspection during regular business hours at the Administration Office of the District located at 869 Cherry Street, Tulare, California. CLOSED SESSION AGENDA ITEMS As provided in the Ralph M. Brown Act, Government Code 54950 et seq., the Board may meet in closed session with members of its staff, employees and its attorneys. These sessions are not open to the public and may not be attended by members of the public. The matters the Board will meet on in closed session are identified in the Regular Meeting agenda. Any public reports of action taken in the closed session will be made in accordance with Government Code 54957.1. COMPLIANCE WITH ADA This agenda shall be made available upon request in alternative formats to persons with a disability, as required by the Americans with Disabilities Act of 1990 (42 U.S.C. 12132) and the Ralph M. Brown Act (Cal. Gov t Cod. 54954.2). Persons requesting a disability related modification or accommodation in order to participate in the meeting, should contact the Executive Office at (559) 685-3462, during regular business hours. Board of Directors: Sherrie Bell Parmod Kumar, MD Richard Torrez Linda Wilbourn Laura Gadke Chairman and President Vice Chairman Treasurer Board Member Board Member 608789695.1

EXHIBIT A TULARE LOCAL HEALTH CARE DISTRICT RESOLUTION NO. 848 RESOLUTION OF THE BOARD OF DIRECTORS OF THE TULARE LOCAL HEALTH CARE DISTRICT ORDERING AN ELECTION TO AUTHORIZE THE ISSUANCE OF GENERAL OBLIGATION BONDS, ESTABLISHING SPECIFICATIONS OF THE ELECTION ORDER, AND CERTAIN RELATED MATTERS WHEREAS, in the judgment of the Board of Directors (the Board ) of the Tulare Local Health Care District (the District ), it is advisable to call an election to submit to the electors of the District the question whether general obligation bonds of the District shall be issued and sold for the purpose of raising money for the expansion, improvement, acquisition, construction, equipping and renovation of health facilities of the District; WHEREAS, Article XIII A, Section 1(b), of the California Constitution ( Article XIII A ) provides an exception to the limit on ad valorem property taxes for bonded indebtedness for the acquisition or improvement of real property approved by two-thirds (2/3) of the votes cast by the voters voting on the proposition; WHEREAS, the Board is specifically authorized to pursue the authorization and issuance of bonds by a two-thirds (2/3) vote of the electorate on the question of whether bonds of the District shall be issued and sold for specified purposes, pursuant to section 32300 et seq. of the California Health and Safety Code (being California s Local Health Care District Law) (the Law ); WHEREAS, pursuant to section 10403 et seq. of the California Elections Code, it is appropriate for the Board to request the Tulare County Registrar of Voters to perform required election services for the District; WHEREAS, certain provisions of the California Government Code (sections 53410 et seq.) require that a local agency submitting a bond measure to the voters provide specific accountability measures; and WHEREAS, it is the intent of the Board to set forth by this Resolution the specified accountability measures with respect to the proceeds of the bonds to be authorized by the election called pursuant to this Resolution; NOW, THEREFORE, THE BOARD OF DIRECTORS OF TULARE LOCAL HEALTH CARE DISTRICT DOES HEREBY RESOLVE, DETERMINE AND ORDER AS FOLLOWS:

Section 1. Call for Election. The Board hereby orders an election and submits to the electors of the District the question of whether general obligation bonds (the Bonds ) of the District shall be authorized to be issued and sold in a principal amount not to exceed $55,000,000 for the purpose of financing and refinancing the expansion, improvement, acquisition, construction, equipping and renovation of health facilities of the District, and to pay costs incident thereto (the Project ), as set forth more fully in the ballot proposition approved pursuant to Section 3 of this Resolution. This Resolution constitutes the order of the District to call such election. Section 2. Election Date. The Board hereby calls a mailed ballot election for August 30, 2016, to be held within the boundaries of the District in accordance with section 4108 of the California Elections Code. Section 3. Purpose of Election; Ballot Measure. The purpose of the election shall be for the voters in the District to vote on a ballot measure, a copy of which is attached hereto and marked, containing the question of whether the District shall issue the Bonds to finance the Project, which is hereby approved and adopted by the Board. The Board hereby determines to include within the ballot pamphlet the Full Ballot Text attached hereto as Exhibit B, which is hereby approved and adopted by the Board. The Tulare County Registrar of Voters is hereby requested to reprint the measure in its entirety (the Full Ballot Text located in Exhibit B) in the voter information pamphlet to be distributed to voters, together with the tax rate information (attached as Exhibit C) required by the Law. The Chief Executive Officer, the Chief Financial Officer, and each of them, or their respective designee(s), are hereby authorized and directed to make any changes to the text of the ballot measure as required to conform to any requirements of Article XIII A, the Law, the California Elections Code, the Tulare County Registrar of Voters. Section 4. Authority for Election. The authority for ordering the election and for the specification of this election order are contained in section 32301 of the Law and Article XIII A, Section 1(b)(2), of the California Constitution. The District hereby finds that the bonded indebtedness proposed herein, together with all outstanding bonded indebtedness of the District, shall not exceed 2.5% of the assessed value of all taxable property in the District, as shown by the last equalized assessment role of Tulare County in accordance with section 32308 of the Law. Section 5. Terms of the Bonds upon Approval by the Electorate. As required under section 32302 of the Law, in the event two-thirds (2/3) of the voters voting in the District approve the issuance of the Bonds, the Board shall cause the Bonds to be issued in one or more series in an aggregate principal amount not to exceed $55,000,000; provided that such aggregate maximum amount shall be equal to the par amount of the Bonds, which shall not include any premium at which the Bonds or any series thereof may be issued. The Bonds shall bear interest payable at a rate not exceeding the legal limit (at the current time eight percent (8%) per annum), and any series of which shall have a maturity date no later than thirty (30) years following the date of issuance of such series. The Board shall apply the Bond proceeds only to the specific purposes stated in the ballot measure, shall cause

the continuation or creation of funds and accounts into which Bond proceeds shall be deposited; and shall cause the preparation of an annual report pursuant to sections 53410-53411 of the California Government Code. Section 6. Accountability Provisions. (a) No Money For Administrators Salaries. Proceeds from the sale of the Bonds authorized by this proposition shall be used only for costs incurred in connection with funding of the Project and the cost of the issuance of the Bonds, and not for any other purpose, including staff and administrator salaries and other operating expenses. (b) Special Bond Proceeds Account; Annual Audit And Report to Board. The Board hereby directs that a separate account shall be established for deposit of proceeds of the sale of the Bonds if the measure is approved by District voters. For so long as any proceeds of Bonds remain unexpended, the chief financial officer of the District (the Chief Financial Officer ) shall cause a report to be filed with the Board no later than five (5) months after the end of each fiscal year, commencing with the first fiscal year during which any proceeds of Bonds authorized by this measure shall have been received. The report shall state (1) the amount of Bond proceeds received and expended in such fiscal year and (2) the status of any projects funded or to be funded from the proceeds of Bonds authorized to be issued by this measure. The report may be incorporated into or filed with the audit or other appropriate routine report provided to the Board. Audited financial statements of the District will continue to be made available in accordance with applicable requirements. Section 7. Request for All-Mail Ballot; Costs. (a) The District requests that the Tulare County Registrar of Voters take all steps necessary to hold the election by all-mail ballot pursuant to Division 4 (commencing with section 4000) of the California Elections Code. (b) The District hereby agrees to reimburse Tulare County for actual costs incurred by it for the District s election, as set forth in the current election cost allocation procedures of Tulare County. Section 8. Delivery of this Resolution. The Clerk is hereby directed to file (or cause to be filed) a certified copy of this Resolution no later than the close of business on February 5, 2016, with the Tulare County Registrar of Voters and the Clerk of the Tulare County Board of Supervisors. Section 9. Impartial Analysis; Ballot Arguments; Further Authorization. The Tulare County Counsel is hereby requested to prepare the impartial analysis of the ballot measure in accordance with section 9160 of the California Elections Code and transmit it to the Tulare County election officer. Any and all members of the Board, the Chief Executive Officer and the Chief Financial Officer of the District, or any of their respective designees, are hereby authorized to act as an author of any ballot argument prepared in connection

with the election, including a rebuttal argument. Each of the President and Vice President of the Board, and the Chief Executive Officer and the Chief Financial Officer of the District, or any of their respective designees, are each hereby authorized, empowered, and directed, for and on behalf of the District, to execute any and all documents, and to perform any and all acts necessary or appropriate to place the Bond measure on the ballot. Section 10. Effective Date. This resolution shall take effect immediately on and after its adoption. * * * * * * * * PASSED AND ADOPTED this 2nd day of May, 2016, by the following vote: AYES: NAYS: ABSENT: ATTEST: Sherrie Bell President, Board of Directors Tulare Local Health Care District Secretary, Board of Directors Tulare Local Health Care District

CERTIFICATION I,, Secretary of the Board of Directors of Tulare Local Health Care District, Tulare County, California, do hereby certify that the foregoing is a full, true and correct copy of Resolution No. 848 passed and adopted by said Board of Directors at a meeting held on the 2nd day of May, 2016, and that the minutes of said Board of Directors show that ( ) members of said Board voted for, and ( ) members of said Board voted against, the adoption of said Resolution (with ( ) member absent), and the said Resolution is now spread upon the minutes of said Board. Secretary of the Board of Directors Tulare Local Health Care District

EXHIBIT A BALLOT MEASURE To pay for the District s infrastructure projects that includes completion of the Tower One building with addition of earthquake compliant expanded Emergency Department space, labor and delivery suites, and alignment of the District building needs, including refinancing outstanding debt related to construction, shall the Tulare Local Healthcare District issue $55,000,000 in bonds, with 100% of the bond proceeds being used for construction-related costs and with no bond proceeds being used for hospital administrative costs or to refinance any debt supporting hospital operational costs?

EXHIBIT B FULL BALLOT TEXT The following is the full ballot text of the measure to be presented to the voters by Tulare Local Health Care District in the ballot pamphlet: To pay for the District s infrastructure projects that includes completion of the Tower One building with addition of earthquake compliant expanded Emergency Department space, labor and delivery suites, and alignment of the District building needs, including refinancing outstanding debt related to construction, shall the Tulare Local Healthcare District issue $55,000,000 in bonds, with 100% of the bond proceeds being used for construction-related costs and with no bond proceeds being used for hospital administrative costs or to refinance any debt supporting hospital operational costs? Special Bond Account and Mandatory Annual Audits. A separate account shall be established for deposit of proceeds of the sale of the Bonds. This account shall be audited annually and a report shall be made detailing (1) the amount of Bond proceeds received and expended in such fiscal year and (2) the status of any projects funded or to be funded from the proceeds of Bonds authorized to be issued by this measure. No Money For Administrators Salaries. Proceeds from the sale of the Bonds authorized by this proposition shall be used only for costs incurred in connection with funding of the Project and the cost of the issuance of the Bonds, and not for any other purpose, including staff and administrator salaries and other operating expenses. All funds stay local for the benefit of Tulare Local Health Care District Facilities. All bond proceeds shall be used to improve healthcare facilities within the Tulare Local Health Care District for the benefit of healthcare in the local community. No funds may be taken away by the state government, federal government, or other hospital districts or healthcare institutions. Exhibit B

EXHIBIT C TAX RATE STATEMENT An election will be held in the Tulare Local Health Care District (the District ) on August 30, 2016, to authorize the sale of not to exceed $55,000,000 in bonds of the District to finance hospital facilities as described in the ballot measure. If the bonds are approved, the District expects to sell the bonds in three series (but may issue the bonds in more than or fewer than three series). Principal and interest on the bonds will be payable from the proceeds of tax levies made upon the taxable property in the District. The following information is provided in compliance with sections 9400-9404 of the California Elections Code: (1) The best estimate of the tax rate that would be required to be levied to fund the bonds during the first fiscal year after the first sale of the bonds based on estimated assessed valuations available at the time of filing of this statement, is $27.38 per $100,000 of assessed valuation in Fiscal Year 2017-2018. (2) The best estimate of the tax rate that would be required to be levied to fund the bonds during the first fiscal year after the last sale of the bonds, based on estimated assessed valuations available at the time of filing of this statement, is $27.38 per $100,000 of assessed valuation in Fiscal Year 2017-2018. (3) The best estimate of the highest tax rate that would be required to be levied to fund the bonds, based on estimated assessed valuations available at the time of filing of this statement, is $51.97 per $100,000) of assessed valuation in Fiscal Year 2018-2019. (4) The best estimate of the average tax rate which would be required to be levied to fund the bonds during the life of the bonds, based on estimated assessed valuations available at the time of filing of this statement, is $29.88 per $100,000 of assessed valuation. (5) The best estimate of the total debt service, including the principal and interest, that would be required to be repaid if all the bonds are issued and sold is $114,638,500. This estimates is based on assumptions regarding future interest rates and the term, timing, structure and amount of each series of bonds. Voters should note that such estimated tax rates are specific to the repayment of bonds issued under this authorization and are and will be in addition to tax rates levied in connection with other bond authorizations approved or to be approved by the District or any other overlapping public agency. Voters should also note that estimated tax rate is based on the ASSESSED VALUE of taxable property on Tulare County s official tax rolls, not on the property s market value. Property owners should consult their own property tax bills to determine their property s assessed value and any applicable tax exemptions. Exhibit C Page 1

Attention of all voters is directed to the fact that the foregoing information is based upon the District s projections and estimates only, which are not binding upon the District. The actual tax rates and the years in which they will apply may vary from those presently estimated, due to variations from these estimates in the timing of bond sales, the amount of bonds sold and market interest rates at the time of each sale, and actual assessed valuations over the term of repayment of the bonds. The dates of sale and the amount of bonds sold at any given time will be determined by the District based on need for construction funds and other factors. The actual interest rates at which the bonds will be sold will depend on the bond market at the time of each sale. Actual future assessed valuation will depend upon the amount and value of taxable property within the District as determined by the Tulare County Assessor in the annual assessment and the equalization process. Dated: May 2, 2016 Sherrie Bell President, Board of Directors Tulare Local Health Care District Exhibit C Page 2