(endorsed) Cami*

R1b

will not be implemented because it is not warranted and is not reasonable. The District will not be implementing Recommendation lb because the law and voters have entrusted the proposal of ballot questions to the elected Board of Directors. Proposed ballot measures and their ballot questions are already vetted by various parties who are knowledgeable about the District's needs and the various legal requirements specific to election and healthcare district law. This includes District legal counsel review of proposed ballot questions to ensure compliance with Elections Code section 13119, referenced above. Additionally, by law, the Board of Directors must place measures on the ballot at a public meeting. This gives the public an opportunity to provide input, comment and even criticism of a ballot question before the measure is placed on the ballot. Further, the law referenced above already provides interested parties with an opportunity to legally challenge ballot questions in court for being false, misleading or for otherwise violating the Elections Code. This additional step proposed by the Grand Jury may create timing challenges for the District, as ballot measures already must be submitted at least 88 and sometimes as many as 90 days prior to the date of the election. Factoring in the time required for an already busy County Counsel to approve the ballot question may require the District to determine the language before all of the necessary data for drafting the measure is even available. For the reasons above, this additional step would be burdensome and unwarranted. Report Recommendation Ic: Governing entities within Santa Clara County should, by March 31, 2023, adopt their own resolution or ordinance to require submission of their ballot questions to the County Counsel for review prior to submission to the Registrar of Voters, unless and until Recommendations Id and le are implemented. Board Response to Recommendation 1c: Recommendation Ic will not be implemented because it is not warranted and is not reasonable. As discussed in our response to Recommendation lb above, submitting ballot questions to County Counsel for review is not warranted and is not reasonable. Therefore, the District will not adopt a resolution or ordinance to require submission to County Counsel prior to submission to the Registrar of Voters. Dedicated to improving the health and well-being of the people in our community. CAMI 2500 Grant Road Mountain View, CA 94040 Phone: 650-940-7300 www.elcaminohealthcaredistrict.org BOARD OF DIRECTORS: Peter C. Fung, MD | Julia E. Miller | Carol A. Somersille, MD | George O. Ting, MD | John L. Zoglin Report Recommendation le: Governing entities within Santa Clara County should submit their ballot questions for review by the Good Governance in Ballots Commission pursuant to Recommendation Id. Board Response to Recommendation le: Recommendation le will not be implemented because it is not warranted and is not reasonable. Recommendation le is problematic because the "Good Governance in Ballots Commission" does not currently exist, and the Report does not give any indication that a proposed "Good Governance in Ballots Commission" would be comprised of individuals knowledgeable about healthcare or election law. The proposed Commission would have the power to review and to reject language that it finds to be "false", "misleading", "biased" or "partial". Under California law, that is a power reserved to the courts. In addition, individuals on such a Commission lacking expertise in these matters could easily disagree on proposed ballot measure language, and a consensus could be difficult to reach. This would further impact the election timeline and impede the District's ability to place a measure on the ballot. As noted above, the law entrusts the elected Board of Directors to prepare ballot questions which comply with the Elections Code and it intends to continue doing so. Please feel free to contact us if you seek additional information or have any questions regarding this response. Sincerely, Corol a Somwalk Carol Somersille, MD Secretary/Treasurer, El Camino Healthcare District Dedicated to improving the health and well-being of the people in our community.

R1c

Recommendation Ic will not be implemented because it is not warranted and is not reasonable. As discussed in our response to Recommendation lb above, submitting ballot questions to County Counsel for review is not warranted and is not reasonable. Therefore, the District will not adopt a resolution or ordinance to require submission to County Counsel prior to submission to the Registrar of Voters. Dedicated to improving the health and well-being of the people in our community. CAMI 2500 Grant Road Mountain View, CA 94040 Phone: 650-940-7300 www.elcaminohealthcaredistrict.org BOARD OF DIRECTORS: Peter C. Fung, MD | Julia E. Miller | Carol A. Somersille, MD | George O. Ting, MD | John L. Zoglin Report Recommendation le: Governing entities within Santa Clara County should submit their ballot questions for review by the Good Governance in Ballots Commission pursuant to Recommendation Id. Board Response to Recommendation le: Recommendation le will not be implemented because it is not warranted and is not reasonable. Recommendation le is problematic because the "Good Governance in Ballots Commission" does not currently exist, and the Report does not give any indication that a proposed "Good Governance in Ballots Commission" would be comprised of individuals knowledgeable about healthcare or election law. The proposed Commission would have the power to review and to reject language that it finds to be "false", "misleading", "biased" or "partial". Under California law, that is a power reserved to the courts. In addition, individuals on such a Commission lacking expertise in these matters could easily disagree on proposed ballot measure language, and a consensus could be difficult to reach. This would further impact the election timeline and impede the District's ability to place a measure on the ballot. As noted above, the law entrusts the elected Board of Directors to prepare ballot questions which comply with the Elections Code and it intends to continue doing so. Please feel free to contact us if you seek additional information or have any questions regarding this response. Sincerely, Corol a Somwalk Carol Somersille, MD Secretary/Treasurer, El Camino Healthcare District Dedicated to improving the health and well-being of the people in our community.