Eric Madrid says he's inclined to support a $485 million bond that would expand hospitals in Sun City and Hemet, but doubts many in his situation -- 30somethings with young children -- will vote for it.

"I think a lot of us are very frustrated with the high taxes that we do pay," said the Temecula physician and Menifee resident who manages the popular Web site, www.cityofmenifee.com. "So, I think it's going to be tough, because everyone is being taxed out to the max.

"And frankly, we need to see more results with the money that we (pay). We ask, 'Where's it going?' I still don't have a stoplight at Menifee and Scott roads."

Valley Health System officials, however, say their expansion plans for Menifee Valley Medical Center in Sun City specifically target Madrid's very demographic. Yet, 30something parents seem the least likely to support the bond, called Measure I, a hospital board member acknowledges.

With two weeks to go for people to return their mail ballots, community leaders say Sun City's seniors appear to be more apt to support the bond -- even though many of the proposed new services are geared to the younger residents, including maternity, obstetrics and gynecology, and pediatrics.

Officials who also oversee Hemet Valley Medical Center and Moreno Valley Community Hospital contend that an expanded Sun City hospital is as necessary as roadway and freeway improvements -- particularly for a valley whose exploding population is greatly attributed to young families moving in.

Growth across SoCal

Across the entire 882-square-mile district -- which encompasses Menifee and Hemet valleys -- hospital officials predict that they could be serving about 500,000 people by 2020, double what they do now.

Yet, Menifee Valley Medical Center has the same number of emergency room beds -- 12 -- it had in 1990.

An estimated $135 million of the proposed bond would be pumped into the Sun City hospital, officials say. The money would be used to double emergency room beds to 24 and increase the number of hospital beds from 84 to 214.

Valley Health isn't the only area public hospital district to float a bond in the past year to address growth needs.

In June, voters in the Tri-City district -- which spans Oceanside, Carlsbad and Vista -- narrowly rejected a $596 million bond to build a new hospital on the site of its existing facility in Oceanside.

Voters in the Palomar Pomerado Health System -- which serves Poway, Escondido and San Marcos -- approved a $496 million bond last November. That bond will help pay for a $753 million expansion and renovation of that district's facilities, and cover the costs of a new hospital in Escondido.

Valley Health's bond, which needs two-thirds support to pass, would tax hospital district homeowners by an average of $18 per year for every $100,000 of assessed valuation over 30 years. The election is being conducted by mail; the 113,106 ballots sent to voters from northern Murrieta to San Jacinto are due no later than Sept. 19. The results are expected to be announced that evening.

Perceptions

One of the biggest problems hospital officials may be facing is public perception. If they're aware of the medical center at all -- tucked into the northeastern corner of Sun City -- some of the area's newer residents question whether the hospital meets their needs or whether the bond will resolve that.

Menifee resident Antoinette D'Silva, 51, says emergency room staff at the Sun City hospital turned away her 25-year-old son in late July when he sought assistance for a dislocated jaw. The staff, she said, directed him to a county hospital in Riverside.

"They said to not even come again because they're only equipped for geriatrics," D'Silva said.

Darren Magness, a Valley Health board director, couldn't address D'Silva's case specifically, but said it isn't supposed to happen that way. Riverside County Regional Medical Center in Moreno Valley is "set up for the indigent population," Magness added.

"At times, you don't take in the indigent, or you treat them in the E.R. then transfer them to county hospital," Magness said. "That's no different than Inland Valley (Medical Center in Wildomar) or Rancho Springs (Medical Center in Murrieta)."

Magness also vehemently rejects the contention that Menifee Valley Medical Center is strictly for senior citizens.

"Maybe (the perception is) that senior citizens go there because it's on the border of Sun City," he said. "But it's not … available only to senior citizens. I think the fact that we do have outpatient and inpatient of nonseniors admitted to the hospital shows that it's not just for senior citizens."

Money to solve issues?

Many residents have complained that long lines are common outside Menifee Valley Medical Center's emergency room, a reality that the hospital's administrator, Thomas Dougherty, has acknowledged. It is for precisely that reason that the district wants to double the size of the E.R., officials say.

Menifee resident Robert Forthun, one of the more outspoken opponents of Measure I, contends that the bond won't improve the efficiency of the hospital -- specifically getting an emergency room bed -- asserting that the funds cannot be used for salaries to pay more for more doctors and nurses.

"They say they want to add beds at Hemet, at Menifee, to improve the emergency response," said Forthun, 65. "How is adding beds in the hospital going to improve speed of going from the door to the doctor? Nothing (in Measure I documents) has said anything about improving … that flow."

Magness disagrees.

"We need doctors, but doctors have very little to do with the E.R. wait," he said. "We need more stations, we need staff -- nursing staff that covers those stations -- but we have to have beds because most patients go from E.R. to a monitored bed."

Hospital officials say there will be money for operations -- which could include dollars for new doctors and nurses -- but those funds won't be coming from the bond itself.

Of the $485 million, about $79 million is earmarked to refinance existing debt, which collected over the years as a patient tower was built at Hemet Valley Medical Center, and the Menifee and Moreno Valley hospitals.

The district has been paying about $9 million a year to retire that debt. Refinancing it will make that money available to hire new employees for its medical facilities -- if the bond passes.

"One thing that we know is that we are below market in terms of employee wages, in terms of nurses and technicians," Magness said. "Will some of that ($9 million) go to new employees? Without a doubt."

Seniors support bond's merits

Not all Menifee residents are even aware that there's a hospital in Sun City. By either default or preference, some opt for Rancho Springs or Inland Valley.

Sun City's large senior community favors the bond, said Valley Health System Trustee Bob O'Donnell, a longtime Sun City resident.

"I've been in on the phone banks for the last couple of weeks. Between 70 (percent) and 80 percent are saying 'yes' in the Sun City area," said O'Donnell, the community's former postmaster and a Menifee Union School District trustee.

Quail Valley's residents appear to be less resolute. Rita Peters, one of the more outspoken Quail Valley residents, says she won't support the measure.

"It's ridiculous," she said of the bond. "I really think we should have federally funded health (care)."

Peters, also a Menifee school trustee, said she suspects many Quail Valley residents also will vote against the bond. Her friend Patricia Collins, a senior citizen, isn't so sure.

"There's a need for it," said Collins of the proposed hospital expansion. "Population is coming in fast. … It's streaming in."

Collins said she's more likely to visit a Kaiser Permanente facility because of her insurance, but the Sun City hospital helped her granddaughter when she needed medical attention.

"I'm on the border," she said. "I would like to see a facility like that expanded, but I'm on a fixed income. I don't know."

Not as supportive

Madrid doubts younger residents who are of voting age will match seniors' support for the bond.

Even O'Donnell acknowledges that Madrid's theory likely will prove true, adding that younger families have been less interested during the Measure I campaign than seniors despite the focus of the expansion.

"Demographics have changed," O'Donnell said of Menifee Valley. "If it's just Sun City alone, it would pass. They're more up in age and health is on their mind. But if you're younger … you're not thinking about those things. I know with younger people, it's just not on their radar."

Despite indications that younger voters aren't as supportive, O'Donnell is cautiously optimistic that the bond will pass -- partially because of their habits.

"Sometimes, young people don't vote," he said. "The older people are going to vote, and they might carry the day."

Joe Daugherty, a Menifee accountant, suspects a majority of young voters will support the $485 million measure.

"Sometimes, the freeways are shut down to make it to (hospitals in) Wildomar, Murrieta, wherever," he said.

Why $485 million?

Hospital officials predict that of the $135 million earmarked for the Sun City medical center, about $10 million would cover an emergency room expansion, $10 million would renovate the existing fourth floor currently used for storage, $100 million would go for a new four-story patient tower, and $15 million would be used for outpatient services.

Much of the rest of the funds would be directed toward renovating and modernizing Hemet Valley Medical Center, which hospital officials say needs to be retrofitted to protect against an earthquake.

Yet, Forthun contends the delineation of funds is too vague.

"Why do they need half a billion dollars? I don't know. And they haven't successfully answered that question for me," said Forthun, who believes many of the improvements are merely cosmetic.

He suspects the new patient tower may not be used entirely for patients. He's worried that the first two floors could be used for offices and machines.

"This is a big smokescreen … to get this money," Forthun said.

Magness said the hospital district has clearly delineated what would be done with the bond funds.

"It's not for offices and machines, it's for clinical departments, labs and radiology … departments for patient care," Magness said. "There are no patient beds (in the plans for the first two floors). For hospitals, some of the most important places are the diagnostic areas to perform the clinical diagnoses."

Limited services

Daugherty, also a Perris Union High School District trustee, says he isn't the biggest fan of bonds, but feels it may be unavoidable in this case.

"The bottom line is that we all complain about lack of services, and also complain about having to pay for it," he said. "But if we're going to get something -- parks, roads, colleges, hospitals -- somebody's going to have to pay for it, and I would guess it would be the people we have to serve."

O'Donnell believes residents in the district are more inclined to back the hospital bond than the voters who recently nixed a proposed $720 million bond to expand and build new campuses for Mt. San Jacinto College -- even though the districts overlap in the Menifee, San Jacinto and Hemet areas.

"Our surveys say that health care is No. 1," O'Donnell said.

Abe Ibrahim, who was named honorary mayor by the Menifee-Sun City Chamber of Commerce, says most business owners and residents he's spoken with plan to vote for the bond.

Menifee Valley Medical Center, Ibrahim said, has had to serve emergency room patients in hallways.

"We need to expand this hospital," he said.

- Contact staff writer Brian Eckhouse at (951) 676-4315, Ext. 2626, or beckhouse@californian.com.