About McCall Hospital District

The McCall Memorial Hospital District and St. Luke’s McCall formalized the terms of their relationship through a Healthcare Services Agreement in 2010, with a restructured agreement in 2016 and a Lease-Option Agreement (Both documents can be found on this website under the Meetings and Documents Tab). The relationship between the District and St. Luke’s McCall was established to ensure high-quality, comprehensive healthcare services for residents and visitors in the McCall area.

Key benefits of entering into the Healthcare Services Agreement and Lease-option Agreement with St. Luke’s include:

• Sustained Local Governance: Through the agreements, St. Luke’s McCall Ltd, a nonprofit corporation, assumed operational responsibilities while the Hospital District retained ownership of the property, assets, facilities, its community representation, and taxing authority to support critical healthcare programs and services. This ensures the community’s voice remains central in healthcare services offered, planning and funding priorities.

• Improved Access to Care: The relationship aligned primary care providers, and expanded access to specialists and advanced services, such as enhanced surgical services including orthopedics and general surgery, wound care, in-house MRI, urgent care and infusion oncology; services that may not otherwise be available in rural communities. While the District has provided funding for select services, St. Luke’s has expanded access to many of these offerings independently, without requiring additional financial support from the Hospital District.

• Improved Patient Transfers: With initial funding provided by the Hospital District, the hospital now has an Air St. Luke’s ambulance stationed onsite to provide critical ground transportation for patients. This includes:
• Transfers to the Treasure Valley for specialized care
• Transport to the McCall Airport for time-sensitive air transfers
• Local support to return patients to their homes or care facilities

Having an ambulance onsite and ready, significantly improves response times when every minute counts. Previously, a St. Luke’s ambulance had to be dispatched from Boise to McCall to pick up patients, resulting in delays.

• Investments in Facilities and Services: As part of the Lease-Option Agreement,
  Luke’s pledged significant investments, initially $20 million, which later grew to more than $70 million to remodel, equip and expand our local hospital. Local donors contributed $5.6 million of that amount while the Hospital District did not fund any portion of the construction of the new hospital.

  The Hospital District’s ownership includes the new hospital facility funded by St. Luke’s and St. Luke’s McCall Foundation. These improvements were made possible through access to broader financial and operational resources via St. Luke’s Health System. The Hospital District could not have provided this investment without passing a bond with considerable long-term debt funded by Hospital District patrons.

• Community Benefit: As a not-for-profit organization, St. Luke’s McCall contributed $15.5 million in community benefit in FY2024. This includes $1.4 million in charity care and $4.8 million in unreimbursed cost of providing care to Medicaid and Medicare patients, grants to local organizations, and support for education and health initiatives aligned with the community’s highest-priority needs. These contributions reflect resources and programs that are unlikely to exist at this level without St. Luke’s presence in the community.

Together, the Hospital District and St. Luke’s remain committed to improving healthcare locally by identifying, prioritizing and funding projects that provide the greatest benefit to the community.

McCall Memorial Hospital District owns the land, buildings, and equipment on the hospital campus. This includes the hospital, Allen Nokes Center, McCall Medical Clinic, Forest Street Center, Lake Street Center, new ambulance shelter and parking lots. The facilities and land are leased to St. Lukes McCall through the Lease-Option Agreement.  A full list of the properties owned by the Hospital District and leased to St. Luke’s McCall can be found on pages 23-24 of the Lease-Option Agreement.

• Buildings and Improvements: Under the terms of the Lease-Option Agreement, St. Luke’s has the option to acquire  the buildings, equipment, assets and other improvements. This reflects the substantial investment St. Luke’s has made in the Hospital District owned facilities and services since the relationship began, including more than $70 million in upgrades, expansion, and equipment in addition to other expenses paid for by St. Luke’s to maintain the facilities and assets that are defined in the Lease Option Agreement.
• Land Ownership: The land the hospital facility is built on and other facilities are included in the Lease-Option agreement. However, the Agreement does not grant St. Lukes an option to acquire the land; only the buildings, equipment and improvements.
• Consequences of Dissolution of the District: According to Idaho law (Idaho Code §§ 39-1325C and 63-4105), any assets belonging to the Hospital District at dissolution, including the land, would be vested in the Valley County Board of County commissioners as custodians.  The Idaho Statutes authorize the County Commissioners to manage the disposition of hospital district assets, which may include transferring them to a successor public entity, disposing of the property at public or private sale or pursuing other lawful options as provided under Idaho law. It is unclear whether the property would transfer to the County subject to St. Lukes McCall’s existing option to acquire the buildings, improvements and equipment. Under the current Agreements, which do not include a St. Lukes McCall Option to acquire the land, the land would be subject to disposal by the County Commissioners.

In recent years, the amount collected through the tax levy has ranged between $1.3 million and $1.5 million annually, depending on property values and the amount the Board elects to levy, limited by Idaho Statutes. The Hospital District Board of Trustees has full discretion to determine whether to levy the maximum amount permitted by law or a lesser amount, or to not make any levy, based on the healthcare needs of the community.

In 2024, the Hospital District levied a tax rate of 0.0001571, which equated to $15.71 per $100,000 of taxable property value. The levy was dedicated to completion of the building to house the District’s ambulance and staff, the construction of workforce housing for healthcare workers and the District’s M&O Budget

Under Idaho Code §§ 39-1331 – 39-1339, the McCall Memorial Hospital District is authorized to levy and collect taxes on all taxable property within the District. The specific tax rate is defined in Idaho Code §39-1333 and §39-1334.  In addition, Idaho Code §63-802(1)(a), allows for an annual increase in the amount levied by the Hospital District of up to 3%.

Funding Process

Through the Health Services Agreement, St. Luke’s may request funding annually from the Hospital District to support, sustain and grow critical healthcare programs and services that are provided by St. Luke’s and/or to construct healthcare facilities.

Before any formal proposal is submitted, potential projects are introduced and thoroughly discussed during the Hospital District Funding Workgroup and public board meetings.  This open, deliberative process enables trustees to evaluate options carefully and consider potential impacts on local healthcare.

The Hospital District Board of Trustees retains sole authority to approve, partially fund, or decline any request based on alignment with community needs, available resources, and the overall value it brings to healthcare access and outcomes in the region.

Oversight and Accountability

After funds are approved, the Hospital District board ensures accountability through multiple layers of oversight. St. Luke’s provides monthly reporting that tracks spending and project status.  In addition, St. Luke’s provides quarterly funding metric reports, highlighting the impact of previously funded Hospital District projects. The monthly and quarterly reports allow the Board of Trustees to track performance and ensure funds are being used effectively to improve access, quality, and patient health outcomes.

To further ensure financial integrity and transparency, the Hospital District engages an independent accounting firm to audit its financial statements annually.

The hospital in McCall has always served a broader region than the boundaries of the Hospital District, providing healthcare services to anyone in need—regardless of their ability to pay.

The Hospital District was originally established to ensure access to essential health care services for local residents. As the nearest or only provider of critical services—such as emergency care, maternity, surgery, clinical care, and specialized treatments—McCall Memorial Hospital and currently St. Luke’s McCall functions as a regional hospital. By serving a wider population, the hospital strengthens its ability to deliver high-quality care, which directly benefits residents within the district.

The hospital’s service area includes Valley County, Adams County, and the community of Riggins in Idaho County. Serving this larger region supports the sustainability of healthcare services and helps maintain the availability of vital resources for everyone, including those within the district.

The majority of patients receiving care at St. Luke’s McCall reside within this broader service area, with more than half living inside the McCall Memorial Hospital District boundaries.

The following chart indicates patient utilization of services in FY2024 by residence: Hospital District, service area, other Idaho cities and outside of Idaho.

The Hospital District’s mission is to ensure access to quality healthcare for our community. One of the biggest challenges currently threatening that access is the severe lack of affordable housing in the region. This shortage directly impacts the ability of St. Luke’s to recruit and retain essential staff, including nurses, technicians, and support personnel, who are critical to delivering care.

The most recent Community Health Needs Assessment (CHNA), a comprehensive review of health-related priorities in our region, identified housing as a top social driver of health. In recent years, numerous highly qualified healthcare professionals have declined job offers or left positions at St. Luke’s due to the inability to secure local housing. The average time to fill open positions has been as high as 160 days, with as many as 60 vacancies at one time, which poses a significant challenge for the hospital’s operations and patient access.

To fill staffing gaps, St. Luke’s has had to rely on contractor “travel” healthcare workers. While these professionals are highly skilled and provide essential short-term coverage, this solution comes with significant challenges. Travel staff are often paid 2–3 times more than permanent employees and the frequent turnover associated with temporary staffing can disrupt team dynamics, increase onboarding burdens, and reduce continuity of care for patients.

The workforce housing project, supported by the Hospital District Board and the St Luke’s McCall Foundation will not only help recruit and retain healthcare staff but will also add to the overall housing inventory in the community.   When healthcare workers can live locally, patients benefit from more timely care, departments remain fully staffed and more efficient, and emergency services are better equipped to respond.

This support is a strategic investment of taxpayer funds to protect and strengthen the health and wellbeing of our region.

The Hospital District Board meets monthly from 7:30 to 9 a.m. on the third Tuesday of each month.  Members of the public are welcome to attend in person or remotely.  Meeting packets are posted on the Hospital District’s website MMHD.info (This Site) and all public meetings are noticed in The Star-News. 

Any community members seeking additional information can contact the Hospital District Board at mccallmemorialhospitaldistrict@gmail.com, by phone at (208) 315-1805, or by mail at P.O. Box 1283, McCall, ID 83638.

The Hospital District extends from the western border of Valley County south to Roseberry and includes Donnelly and the area to the Adams County line. The district boundaries are not the same as the county boundaries.

The yellow section represents the McCall Memorial Hospital District boundaries while together, the red and yellow areas make up Valley County.