Marshall Medical Center responds to questions about state seismic aid
PLACERVILLE, Calif. — Marshall Medical Center Interim Chief Executive Officer Martin Entwistle has responded to questions surrounding the hospital’s state seismic funding, its estimated infrastructure needs and the role Measure S could play in financing future improvements.
In a letter to the editor, Entwistle said Marshall was awarded $1.25 million through California’s Small and Rural Hospital Relief Program on May 30, 2025, but emphasized that the hospital has not yet received the money.
The grant includes the $650,000 award referenced in previous coverage, Entwistle said.
“We expect to see these funds paid in the next few months, in the form of reimbursements for expenses already paid,” he wrote.
California’s Health Care Access and Information department administers the Small and Rural Hospital Relief Program, which provides grants to qualifying small, rural and critical-access hospitals for seismic safety compliance projects. Marshall Medical Center is listed by HCAI as an eligible rural hospital.
Grant is not the same as $40 million in remaining needs
Entwistle said the state grant is significant but represents only a fraction of the hospital’s overall seismic requirements.
Marshall estimates that $40 million is needed to meet the state’s seismic compliance requirements, while approximately $125 million in total capital is needed for building work, seismic compliance, aging equipment and other infrastructure needs.
“The grant funds are certainly a step in a positive direction to help meet our funding needs,” Entwistle wrote, “but that number still falls significantly short” of the hospital’s projected requirements.
California law requires acute-care hospitals to meet specified seismic standards by Jan. 1, 2030, unless an authorized extension applies. HCAI says a hospital meets the 2030 standard when its general acute-care buildings meet specified Structural Performance Category requirements and the required Nonstructural Performance Category 5 standard.
The state’s current framework also allows qualifying small and rural hospitals to seek a delay of up to three years under AB 869, subject to eligibility requirements and approval by HCAI. HCAI’s guidance says qualifying hospitals may have an approved delay beyond Jan. 1, 2030, with additional requirements governing compliance plans and milestones.
Marshall says more than $70 million already invested
Entwistle disputed any suggestion that Marshall arrived at its current position without making substantial investments in its facilities.
He said Marshall has spent more than $70 million on work associated with California’s mandated seismic compliance requirements, including construction of the hospital’s South Wing, completed in 2015, as well as engineering, architectural and planning work.
The hospital’s position is that those investments have been necessary but have not eliminated the remaining seismic and infrastructure requirements.
Marshall’s argument comes against a broader backdrop of financial pressure on rural hospitals. HCAI describes the state’s Small and Rural Hospital Relief Program as specifically intended to assist hospitals where seismic requirements create a significant financial burden that could threaten access to health care.
Why Measure S is part of the discussion
The financial question is now intertwined with Measure S, which will appear on the Nov. 3, 2026, general election ballot in El Dorado County.
According to the El Dorado County Elections Department, Measure S would impose a 3/8-cent countywide sales tax for 30 years, generating approximately $13 million annually. The ballot language identifies hospital facilities, equipment and technology, local emergency-room access, wildfire prevention and rapid 911 emergency response as purposes for the revenue.
The measure’s proponents, including Marshall, have argued that aging hospital infrastructure and California’s seismic requirements make additional local funding necessary.
Entwistle said Marshall could continue pursuing other grants and financing if Measure S passes, but he cautioned that there is no guarantee those sources would become available quickly enough to satisfy the 2030 seismic deadline.
That distinction is important: the $1.25 million state grant and Measure S are not interchangeable sources of money. The state grant is a one-time award tied to eligible seismic-related expenses, according to Marshall’s response, while Measure S would provide a long-term local revenue source for specified purposes.
The county’s official ballot description says Measure S revenue would remain subject to local controls, while the measure’s campaign materials say spending would be subject to independent oversight and audits.
Marshall frames hospital as part of county’s emergency network
Entwistle also placed the seismic issue in the context of El Dorado County’s broader public safety system.
He pointed to the county’s wildfire risk and Marshall’s relationships with local fire chiefs, firefighters and wildfire-prevention officials.
The argument is straightforward: During a major wildfire, vehicle collision, medical emergency or other disaster, local hospital capacity can become a public-safety issue rather than simply a health-care issue.
Marshall says maintaining local emergency services reduces the need for residents to travel outside the county for care, particularly when time is critical.
The hospital’s argument also comes as the county prepares to consider how Measure S revenue would be distributed between emergency services and hospital needs.
The $1.25 million question
For residents following the Measure S debate, the most direct answer from Marshall is that the hospital says it did receive a state award — but has not yet received the cash.
Marshall says the $1.25 million award was made May 30, 2025, and is expected to be paid as reimbursement for qualifying expenditures.
The state program itself confirms that Marshall is an eligible rural hospital and that SRHRP grants are intended to support seismic compliance projects.
The larger financial question remains unresolved.
Even after accounting for the state grant, Marshall says it faces tens of millions of dollars in seismic work and an estimated $125 million in total capital needs.
That is the financial gap hospital officials say Measure S is intended to help address.
A decision now moves to voters
Marshall’s request is ultimately a request to El Dorado County voters.
The hospital says the community helped establish and sustain Marshall more than six decades ago and that local support is again necessary to preserve independent health care in the county.
“Ultimately, the community and Marshall are mutually interdependent,” Entwistle wrote.
Marshall was founded in 1959 and remains an independent, nonprofit health-care organization serving El Dorado County. HCAI identifies its main facility at 1100 Marshall Way in Placerville.
Entwistle’s response makes clear that Marshall views the seismic mandate as only one component of a larger infrastructure challenge involving aging buildings, deferred maintenance, medical equipment and technology.
For voters, the central question heading toward November is therefore larger than whether Marshall received state assistance.
It is whether $1.25 million in state aid, more than $70 million already invested by Marshall and other potential funding sources will be enough — or whether local taxpayers should provide another long-term source of capital through Measure S.
The answer will be decided at the ballot box on Nov. 3, 2026.
Source note: This report incorporates Martin Entwistle’s letter provided to Placerville NewsWire, California Health Care Access and Information records and the El Dorado County Elections Department’s official Measure S information. Marshall’s $1.25 million award and its statements regarding expenditures and projected capital needs are attributed to Marshall because those figures were provided by the hospital.
