A Daly City Catholic hospital is spending big to influence San Mateo County voters on Measure A, a half-cent increase to the sales tax that would generate about $60 million in annual revenues for 10 years for county government. The money would go toward public health and safety, and care for the poor and elderly, proponents say.

The campaign raised $991,000 as of Sept. 30, according to finance reports. The biggest donor: $887,000 from the Los Altos-based Daughters of Charity of St. Vincent de Paul, which manages the Seton Medical Center. The total includes $50,200 in non-monetary contributions of consultant work and staff time.

Asked about Seton's public health profile, Supervisor Don Horsley said the hospital cares for 40 percent of the county's state MediCal patients, many from the north part of the county where the need is great.

Seton also runs the only emergency room and skilled nursing facility on the Coastside. National healthcare reform is expected to increase the public health burden in San Mateo County by about 50,000 people, Mr. Horsley said. If the hospital closed, the county would inherit an obligation of $30 million to $50 million to replace sub-acute care services alone, he said.

"They're losing money so we want to make sure that Seton Hospital continues to be viable," he said. "If Seton were to close ... it would be devastating to our health plan."

Because Measure A revenues would go to the county's general fund, passage needs just a simple majority of 50 percent plus one, a county spokesman said.

Other major donors to the campaign: $100,000 from the Sacramento-based California State Council of Service Employees Issues Committee, and $5,000 from Labor Organization Local No. 467, in Burlingame. All gifts went to the "Coalition to Protect Critical San Mateo County Services for Children, Families and Seniors, Yes on Measure A," based in San Rafael.

Making do
The county's expenses for MediCal care exceed state reimbursements, Mr. Horsley said. The county recently cut annual expenses by $9 million by outsourcing management of a long-term care facility in Burlingame to a provider who rehired the 200 county workers, he said. (Some 500 other employees have left county government since 2008 and have not been replaced, he added.)

Measure A's opponents -- including libertarians and the Silicon Valley Taxpayers Association -- argue that the supervisors cut county staff and services rather than employee compensation, which is the real issue, they say, and "out of control." And, they add, sales tax increases fall hardest on the poor. The county, they argue, should tighten its belt like everyone else.

County Manager John Maltbie notes in his budget message that compensation is the "single largest expense item in the budget." Employees haven't had cost-of-living increases for four years, he said. Tax revenues "were essentially flat," an unsustainable situation, he added. Salaries and benefits have to be consistent with revenues and with comparable jobs in the community, he said.

Will campaign literature be a factor? The flier for Measure A lists services that it would pay for but not what is being sought: a half-cent increase in the sales tax for 10 years. Asked to explain, campaign spokesman Fred Muir said the ballot language "makes it pretty clear what this measure is. It's a sales tax."

The media isn't talking about county obligations, he said. "Those are the things voters need to know about," he said. "There's an art and a science to communicating in a campaign."

Asked about the flier's omissions, Mr. Horsley essentially agreed with Mr. Muir. "I would say that the voter handbook is pretty clear. I have a lot of confidence in the average voter and I think they pretty much know it's a funding measure."

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