Upper San Juan Health Service District TABOR Exemption

The Upper San Juan Health Service District does business as Pagosa Springs Medical Center and runs a critical access hospital, EMS and ambulance services and a rural health clinic. It lies in Archuleta, Hinsdale and Mineral counties. On July 28, 2026, the board members in attendance unanimously adopted Resolution 2026-08, sending this question to district voters on November 3 in an election the Archuleta, Hinsdale and Mineral county clerks conduct. The question appears as Ballot Issue 7A in Hinsdale County and Ballot Issue 7B in Archuleta and Mineral counties.

A yes vote authorizes the district to collect, retain and spend all its revenues in each fiscal year without regard to the revenue and spending limits in the Taxpayer's Bill of Rights (TABOR, Article X, Section 20 of the Colorado Constitution) or section 29-1-301 of the Colorado Revised Statutes. The question sets no tax rate and no end date. A no vote lets the current authorization lapse on December 31, 2026.

According to Resolution 2026-08, district voters in November 2001 approved a maximum mill levy of 3.884 mills and exempted the district's revenue from the levy and from any other source from TABOR's limits through December 31, 2006. In May 2006, voters allowed the levy to be pledged as security for the bonds that financed construction of Pagosa Springs Medical Center. Voters extended the TABOR exemption in November 2006 through December 31, 2016, and in November 2016 through December 31, 2026.

The Colorado Constitution excludes an enterprise from TABOR. The resolution describes one as a government-owned business, authorized to issue revenue bonds, that receives less than 10% of its annual revenue from state and local government sources combined, excluding revenue bond proceeds and other amounts the law excludes. The district states that it meets that test, has issued revenue bonds, and remains outside TABOR while it qualifies.

The resolution gives two reasons for seeking the waiver anyway: to let the district pursue "the maximum amount of available governmental grants" without risking its enterprise status, and to limit the risk of losing that status through changes in the law. At the July 28 meeting, the chief administrative officer told the board in a presentation that more than 90% of the medical center's revenue comes from fees paid for its services, according to the minutes.

In a June 2 editorial on a public presentation by CEO Dr. Rhonda Webb, the Pagosa Daily Post's Bill Hudson wrote that the medical center expected net patient revenue of about $50 million this year and that the district collects about $2.4 million from property taxes. Asked what returning under TABOR's limits in 2027 would do to the budget, Webb could not give an estimate, Hudson wrote the next day.