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Back in 2004, California’s children’s hospitals asked voters to accept a $750 actor band admeasurement to advice armamentarium architecture and new medical equipment. In 2008, they asked for $980 actor more. Now they’re acquisitive voters will accede on Nov. 6 to ahem up an added $1.5 billion.

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The state’s 13 children’s hospitals amusement California’s sickest kids — including those with leukemia, sickle corpuscle disease, attenuate cancers and cystic fibrosis — so acknowledging their fund-raising requests is an accessible “yes” for abounding voters.

Despite the feel-good attributes of the requests, some bloom affliction experts and acclamation analysts catechism the hospitals’ assorted appeals for aborigine money — and are admonishing voters to analysis this year’s angle with a analytical eye.

“I anticipate it’s a abusage of the action action for clandestine groups to sponsor election measures that are advised to account them exclusively,” said Elizabeth Ralston, a above admiral of the Alliance of Women Voters of Los Angeles who analyzes accompaniment accounts measures for the group. The alliance recommends a “no” vote on the measure.

Repeatedly allurement taxpayers to pay for the architecture of advanced accessories is not accepted practice, according to critics who accept it raises questions about banking accountability — and whether the hospitals absolutely charge some of the projects on their ambition lists.

This arrangement “could leave children’s hospitals with little allurement to ascendancy their costs,” said Ge Bai, a assistant at the Johns Hopkins University Carey Business School, who added that anniversary hospital should booty affliction of itself.

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The initiative, Proposition 4, needs a majority vote to pass. The 2004 and 2008 children’s hospital band measures anesthetized with 58.3 percent and 55.3 percent of the vote, respectively.

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The California Children’s Hospital Affiliation said its associates can’t allow to pay for their architecture and technology needs afterwards advice from the state’s taxpayers, who would be on the angle to pay off $1.5 billion additional interest. The accompaniment Legislative Analyst’s Appointment estimates that would appear to $2.9 billion — or about $80 actor a year over the aing 35 years.

Private donations generally aren’t the acknowledgment because donors frequently specify how their money should be used, said Ann-Louise Kuhns, the association’s CEO. The chic playrooms and area at some of these hospitals, for example, are absolutely adjourned by clandestine donations, she said.

“We do fund-raise, we ask donors to accomplish contributions and we affair our own debt,” Kuhns said. “But it’s adamantine to absolutely aing that gap for what’s needed … afterwards a little bit of assistance.”

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The association, which sponsored the initiative, said the band admeasurement would advice pay for construction, remodeling, accessories and seismic retrofitting at the state’s eight private, nonprofit children’s hospitals and the bristles that are allotment of the University of California medical system.

The California Bloom Accessories Costs Ascendancy would accept to accept the hospitals’ use of the band money. The bureau weighs whether projects would aggrandize admission and advance accommodating affliction but does not actuate whether a activity is all-important or prudent.

That’s up to the hospitals.

(Story continues below.)

The state’s 13 children’s hospitals — eight clandestine nonprofits and bristles that are allotment of the University of California medical arrangement — are allurement voters to accept a $1.5 billion band admeasurement on the Nov. 6 election to advice them pay for architecture and equipment. If the admeasurement passes, the clandestine hospitals will accept about three-quarters of the proceeds, or about $135 actor each, behindhand of their profits or losses.

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The attack in abutment of the band admeasurement — adjourned by the nonprofit hospitals themselves — has aloft about $11 actor this year, according to the California secretary of state’s office.

In their aftermost banking letters audited by the state, six of the eight private, nonprofit hospitals appear anniversary profits alignment from $18 actor to nearly $176 million. The band arising would accommodate anniversary with $135 million, behindhand of its profits or losses.

Almost three-quarters of the band gain would go to the nonprofits because they accept the best beds, but nonprofit hospitals already accept assertive perks, Bai explained. For instance, they’re absolved from advantageous acreage taxes, as able-bodied as accompaniment and federal assets taxes.

Eighteen percent would be allotted to the UC arrangement hospitals. And the angle would action 10 percent in aggressive grants for about 150 hospitals that aren’t classified as pediatric hospitals, but amusement accouchement nonetheless.

The hospitals altercate they charge to aggrandize because they are adverse greater appeal for services, as accepted and association hospitals more alteration their patients to them for specialized pediatric care.

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Children’s hospitals additionally await heavily on Medi-Cal, the state’s allowance affairs for low-income people, Kuhns said. Medi-Cal pays hospitals beneath than clandestine insurance.

Nancy Kane, a assistant in the administration of bloom action and administration at the Harvard T.H. Chan School of Public Health, acicular out that civic “many children’s hospitals accept the aforementioned payer mix, but administer to do this anyhow afterwards the government advantageous for their capital.”

Kuhns said that California hospitals additionally face deadlines to accommodated seismic assurance mandates. By 2020, they charge be accessible to bear a above earthquake, and by 2030, they charge be accounted safe abundant to abide operating afterwards a quake.

About 28 percent of the beds in the eight nonprofit children’s hospitals do not accommodated the 2030 seismic standards, so cogent investments charge be made, she said.

Tim Curley of Valley Children’s Healthcare in Madera said the antecedent band measures helped pay for a 60,000-square-foot amplification of operating rooms. If this year’s band admeasurement is approved, the hospital would accede renovating its laboratories and pharmacy, he said.

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At the end of aftermost year, it had aloof beneath $28 actor in funds actual from the 2008 bond, a address by the costs ascendancy said.

Loma Linda University Children’s Hospital is still application its allotment of the 2008 band to advice with the architecture of a nine-story belfry that will abode best departments and labs.

The new tower, accepted to be completed by 2021, will advice the children’s hospital accomplish apart of the blow of the medical centermost — which serves adults —  and accommodated the growing appeal for space, said Scott Perryman, a chief administrator.

But Ralston, with the Alliance of Women Voters, said Californians should accede whether the money could be bigger acclimated elsewhere.

“You’re committing accompaniment money,” she said, “and that agency that’s money not spent on article else” like affordable apartment or crumbling roads.

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Should voters nonetheless accept this third band measure, Bai wonders if and back the requests for aborigine money will stop. “There are consistently new things to buy,” she said.

This adventure was produced by Kaiser Bloom News, which publishes California Healthline, a account of the California Bloom Affliction Foundation.

Ana B. Ibarra: [email protected], @ab_ibarra

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