Quick Take
Measure N seeks to implement a new tax and raise $116 million for publicly owned Watsonville Community Hospital; however, the campaign will need to rely on the support of a voter base that struggles to turn out.
Less than two years ago, Watsonville Community Hospital, entering bankruptcy under its private ownership, stood at the edge of financial ruin. The failure of a critical safety net that accepts 33,000 emergency room visits per year would have not only caused pain to local residents, but it would have spread exponentially more pressure across the region’s health care system.
The hospital needed a Hercules, and a Hercules it received. Words such as heroic and miraculous are often employed when describing the community-led effort to form a governance structure, raise $64 million, rescue the hospital from bankruptcy and return it to public ownership. For those involved, the hospital saga felt like the center of gravity: media across the Central Coast covered it step by step. And at a time when rural community hospitals are facing similar straits, legislators from up and down California look upon the Watsonville Community Hospital story as a model for what can go right.
It’s an epic of possibility and momentum that local leaders hoped would galvanize voters to support Measure N, the proposed property tax to raise $116 million for the hospital. Yet, it’s a story that, today, many voters are surprised to hear, creating a major hurdle for the campaign as it approaches Tuesday’s vote.
“For a lot of people, this campaign has been the first point of contact from the hospital in the last 10 years,” Tony Nuñez, head of campaign communications and a director on the Pajaro Valley Health Care District board, said. “So they’re like, ‘We didn’t even know the hospital was going to go out of business; I didn’t even know you were going to shut down.’”
And yet, this communication void is but one dimension of the steep, uphill climb in securing support for this new tax. The population base of the Pajaro Valley Health Care District, which stretches from Pajaro in Monterey County to just north of Rio Del Mar, encompasses some of the lowest-income neighborhoods of Santa Cruz County and northern Monterey County, with many seniors and those on fixed incomes. It’s also an area with exceptionally low voter turnout, and a March primary election with little else on the ballot is unlikely to draw big numbers to the polls.
Looming over all of this is the requirement that, as a new tax, it must receive support from two-thirds of voters, 66.7%, in order to pass.
“The challenge is people not knowing, not caring, not being informed about this stuff,” Nuñez said. “Two-thirds and apathy: That’s really tough.”
Watsonville Community Hospital is still financially hobbled and suffers a backlog of deferred maintenance and upgrades, and its services beyond the emergency room are few compared to other health centers on the Central Coast. However, it’s no longer flirting with bankruptcy, and a failure of Measure N will not mean a failure of the hospital. But opportunities to expand and improve its services, such investing in new CT scanners and hiring more physicians, would be handicapped.
The most significant financial stricture is the nearly $3 million it spends on rent each year. Although the governing Pajaro Valley Health Care District owns the hospital, it does not own the land beneath it.
If successful, the first order of the Measure N funds will be to exercise an option the district has to purchase the property from its Alabama-based landlord, Medical Properties Trust. Yet, that option expires in December 2025, and a Measure N failure would require yet another herculean effort to fundraise the hospital’s way out of a financial straits. But how many miracles does one community have up its sleeve?
A few Saturdays ago, Marcus Pimentel, one of five elected directors on the health care district’s board, stood at an Aptos farmers market, educating anyone who would listen about the measure and what it would do for the hospital. He caught the ear of one man, handed him some campaign literature, and began explaining what the tax would do for Watsonville Community Hospital and how the health care district stood to benefit. Five minutes in, Pimentel said the conversation turned into something like this:
Man: So, you’re building a new hospital?
Pimentel: No, this is for the existing hospital.
Man: Which one?
Pimentel: It’s the Watsonville Hospital.
Man: Where is it located?
Pimentel: It’s the one near the airport.
Only then did a lightbulb go off. “Oh! The one by the airport!” the man replied. Pimentel said not only was this the first time the man heard about the measure, but he also had no idea that the hospital almost shut down, nor that the community had purchased it.
“That’s the case with more than half of the people I’ve spoken with,” Pimentel said. “It’s surprising for someone like me who has been so in the weeds with this thing. I feel like it was all over the news and the newspapers covered it well. But so many people had no idea.”
Despite what has proved to be a steep learning curve, the data shows that once people are informed, they are highly likely to be supportive. In August, the health care district polled 400 likely voters on their willingness to accept a measure that would impose a new annual property tax of $24 per $100,000 of a property’s assessed value. The polling included a briefing on how the money would be used and what it would mean to the hospital.
About 76% of those polled said they would support it, a number strong enough to instill a confidence in the district’s board that a ballot measure could be successful. On Nov. 29, the board voted to place the measure on the March 5 primary ballot.
At face value, choosing the March primary over the November general election is a risky bet. Turnout in primary elections is not only substantially lower but the demographics sway older, more broadly conservative, less tax-friendly. This year’s ballot includes an intriguing U.S. Senate race, but it’s unlikely to draw the same numbers in Santa Cruz County as if the Democrats were choosing a presidential candidate. The Watsonville City Council hosts its election in November, and the next District 4 county supervisor race is in 2026. The only other local election in front of much of South County is Measure K, a county sales tax increase.
And, of course, for a campaign like Measure N’s that bases its success on voter education, a three-month window is a tight timeline to complete its most important work: informing the public.
Nuñez said the choice was strategic.
“Likely voters in the March election are older homeowners, and older folks who tend to think they need a hospital in their backyard,” Nuñez said. “Everyone needs a hospital, but for the older population, it’s more likely they’ve visited a hospital in the last month or year. In March, you have a population that understands the importance of a hospital. In November, the population is going to tilt younger, and they will be more approving of additional taxes, but the hospital might be more abstract.”
For the older population, Nuñez said, it’s an easier sell when the money from the tax is going toward a service they more likely consider an immediate need such as health care, as opposed to trying to convince younger people to invest in something they might need 10 years from now.
Ballot fatigue was another risk in choosing November. Despite a guaranteed higher turnout in the general election, Nuñez called the fall ballot a “crap shoot” as it’s impossible to know how many other measures could be put to voters. For the March primary, Gov. Gavin Newsom has prioritized passing the statewide Proposition 1, and discouraged other statewide measures, ensuring a slimmed-down ballot.
“In terms of giving us our best opportunity to be successful, the board of directors decided it was March,” Nuñez said.
With only three months to galvanize an often uninspired voter base, success would require reaching deep into the community, and rather quickly, which means a skilled and robust ground game.
On an afternoon in late February, Ramon Gomez marched through the street grid of Meadows Manor Mobile Home Park in Watsonville. With each step, an over-the-shoulder messenger bag stuffed with campaign literature swung against his right hip. At the foot of each driveway, he consulted his compendium of likely voters and their preferences.
Since his first volunteer campaign gig 36 years ago, Gomez has developed a reputation as a ground-game expert. For Measure N, he’s taken on the role of volunteer coordinator. After he dropped campaign literature off at one doorstep, two young, inexperienced volunteers appeared from the street. Dispatched by former Watsonville mayor Francisco Estrada, the local men will learn block-walking strategy from Gomez and help carry the campaign through its final stretch.
As Gomez approached a porch with the two eager volunteers in tow, the first tip he imparted dealt with dogs. A double knock on the front drew a chorus of barking dogs that hit both high and low octaves. Gomez handed off the campaign materials and moved on. “Usually, you think you need to watch out for the big dogs, but the smaller ones tend to be more bitey.”
With less than two weeks until election day, Gomez said about 85% of the people he talks to have shown strong support. The challenge is translating that support into a cast ballot. That means regularly knocking on doors up until election day.
“We just bug them, and offer what we can, you know? Do they need a ride to the polling place? Do they need someone to watch their kids?” Gomez said. He admits no one has personally taken him up on the child care offer, but he has driven people to the polls. Now, however, everyone has received a ballot in the mail, so part of getting out the vote is reminding them that they can just fill it out and send it in.
However, the Pajaro Valley Health Care District is not a monolith. The district stretches north to include areas like Larkin Valley, Rio Del Mar and Seascape, where voter turnout and incomes tend to be higher, but the visibility of Watsonville Community Hospital is lower.
Over lunch one afternoon in late February at Ella’s at the Airport, a stone’s throw from the hospital, Nuñez discussed the strategy for the campaign’s final stretch, and said ultimately it comes down to two priorities: convincing people in the Mid-County communities to vote yes, and convincing people in South County and Pajaro to get out and vote.
“It’s the reality of it, and it’s really a data question of how many registered voters there are and which issues they come out to vote for,” Nuñez said. The 2020 election turned out record numbers in South County; however, absent a showdown like Trump vs. Biden on the March ballot, Nuñez said it’s “really difficult” to get people feeling passionate enough to cast a ballot.
“The problem [in Mid-County] is, at this point, a lot of people have already made their mind up,” Nuñez said. “I’m not sure there is much swaying to do in this final stretch. Those are high-propensity voters who are typically overachievers who get their ballots and return them right away.”
For Pimentel, he has noticed Mid-County voters asking more questions about the fiscal impact of the tax, where South County voters want to know more about what kind of services the money will help provide.
The lack of information voters had about the hospital at the start of the election cycle has actually allowed the campaign to more accurately measure the success of its message. During a mid-January afternoon of block walking in east Watsonville, Nuñez said a majority of the people were hearing about Measure N and the hospital’s saga for the first time, and wanted more time and information before landing on whether to support the tax. Last week, a text messaging campaign surveyed support in that area. Out of 200 texts, Nuñez said over 170 people responded saying they support the measure.
“The general sense is that we’re doing the work we need to be doing,” Nuñez said. However, he said the need to get two-thirds support still concerned him, no matter how clear and robust the campaign’s messaging has been. “You do all the prep, you do all the work and all the stuff you have to do, and then you live with the results. I don’t think we could be doing anything else, or anything more than what we’re already doing.”
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