The Calaveras County Board of Supervisors voted unanimously Tuesday to order a special election allowing staff with Mark Twain Health Care District to submit a measure to voters seeking approval of a new 30-year lease with Dignity Health, the fifth-largest health system in the nation and the largest hospital provider in California.

The health care district measure will be on June 5 ballots in the already scheduled statewide primary election.

County registrar Rebecca Turner said in a staff report the ballot measure will read and appear on ballots like this:

“Shall the Mark Twain Health Care District sign a new lease with the nonprofit Mark Twain Medical Center Corporation and take other actions assuring 10-30 years of hospital operation with substantial investments by Dignity Health in the Mark Twain Medical Center and community services, continuing hospital care, emergency care and other services at the Medical Center, and supporting medical services provided by the District, per terms approved by Resolution 2018-01 adopted January 24, 2018?”

The county Elections Department determined Mark Twain Health Care District staff met all required conditions to put the measure on June 5 ballots, Turner said. The district will reimburse Calaveras County for its respective share of costs for the election.

The next steps for district staff now include submitting to the county elections clerk an argument in favor of the ballot resolution, said Randy Smart, executive director of Mark Twain Health Care District.

District staff will also begin speaking to public groups to educate them about what the resolution means and how it may impact their lives, Smart said. They will also continue thinking about how the district board can better help Calaveras County residents with their health care needs.

The Mark Twain Health Care District board in late January approved a 30-year lease with Dignity Health. The district’s hospital, Mark Twain Medical Center in San Andreas, is the only hospital in Calaveras County. The hospital and its clinics are one of the county’s largest employers with an annual payroll exceeding $30 million.

The health care district is a public agency and its boundaries include all of Calaveras County. Robin Glanville, assistant clerk-recorder with the county elections department, said there were 28,506 registered voters in Calaveras County as of Tuesday.

Contact Guy McCarthy at or (209) 588-4585. Follow him on Twitter @GuyMcCarthy.