As a vital part of the healthcare system in Alameda County, Alameda Hospital is not only the sole emergency department on the island but also a world-class stroke center. These services are essential for the health and safety of the community, particularly in times of disaster.

In 2002, the voters of Alameda passed a statute that established the City of Alameda Health Care District (the District) and approved a parcel tax of $298 per parcel to support the hospital. This measure was passed with a 69% majority by the City of Alameda voters.

Following the Northridge earthquake in 1994, California lawmakers enacted a law requiring hospitals to either seismically upgrade their existing buildings or replace them to meet safety standards by 2030. This unfunded state mandate requires that hospitals not in compliance with these earthquake standards must cease operations.

Although Alameda Health System (AHS) operates the hospital, the District owns the buildings and is responsible for maintaining their structural integrity, including the seismic upgrades. The funds generated from the parcel tax will help the District meet the seismic upgrade requirements, ensuring that critical healthcare services remain available at Alameda Hospital.

On January 10, 2024, the AHS Board of Trustees (BOT) agreed to allocate parcel tax funds, totaling approximately $55 million, to the District. The District has used will use these funds to secure a loan for the necessary construction costs. In addition to the parcel tax revenue, AHS has already invested, and continues to invest, $42 million in infrastructure projects that support hospital operations.

The planned project has two primary components:

1. Seismic Retrofits: All buildings will be retrofitted to meet the 2030 seismic standards at an estimated cost of $28.9 million.
2. Operational Upgrades: An area in the South Wing will be upgraded to create an 18-bed short-stay term Skilled Nursing Facility unit. This will facilitate the timely transfer of acute care patients to a more appropriate level of care, at an estimated cost of $25.1 million.

The total construction project is scheduled to be completed by 2028.