Health Facility Financing

Distressed Hospital Loan Program

The Distressed Hospital Loan Program (Program) was established through Chapter 6, Statutes of 2023 (Assembly Bill 112). The legislation requires the Department of Health Care Access and Information (HCAI) and the California Health Facilities Financing Authority (CHFFA) to collaboratively develop the Distressed Hospital Loan Program to offer interest-free, working capital loans to non-profit and publicly-operated financially distressed hospitals, including hospitals that belong to integrated health care systems with no more than two separately licensed hospitals in California that are facing a risk of closure, while they implement turnaround strategies to regain financial viability.

HCAI will contract with CHFFA through an Inter-Agency Agreement to administer the loan program. HCAI and CHFFA are developing a loan application and criteria to make loans to financially distressed hospitals seeking assistance. Some details of the Program are as follows:

  • The legislation authorizes up to $150 million in one-time funding to implement the Program, including administrative costs.
  • Loans will be offered at zero-percent interest.
  • Loans are repayable over 72-months, with an initial 18-month grace period at the beginning of the loan term.
  • Lending parameters will be focused on financially distressed hospitals in areas where demand for services and service adequacy are of concern.
  • The Program will sunset on December 31, 2031.
  • Loans are secured using Medi-Cal checkwrite payments for participating hospitals.

The legislation also includes provisions for requiring hospitals to submit quarterly financial data to HCAI, for use in monitoring the financial health of hospitals throughout the state. This will enable HCAI to better prepare for and identify developing fiscal challenges at hospitals statewide.

Loan Determinations

See the HCAI press release about the Distressed Hospital Loan Program loan awards through the link below:

Press Release and List of Loan Awards

Additional Information

The list of activities below outlines the activities HCAI and CHFFA will undertake to meet the requirements of AB112 and open the Program for application submittals and loan issuance.

Program ActivitiesGoal Completion DateOwner
Interest survey distributed to all hospitals to inquire on interest for the ProgramWeek of May 15HCAI
Draft evaluation methodology posted online for Program applicationsWeek of May 22HCAI
Stakeholder webinar to receive feedback on draft evaluation methodologyWeek of May 22HCAI
CHFFA Board meeting to approve authorizing loan administrationMay 25, 2023CHFFA
Loan applications go live for submittalJune 2023CHFFA
Informational webinar about the Program to interested applicantsJune 2023CHFFA
Optional Preliminary Application for Program Eligibility Submission DeadlineJune 30, 2023CHFFA
Complete Applications Submission DeadlineJuly 31, 2023 CHFFA
Release Loan Award DeterminationsAugust 24, 2023HCAI

Timeframe for Funding

Based on stakeholder responses, applications will be open until July 31 to allow adequate time for hospitals to provide all the information.  If you would like to determine program eligibility, you are encouraged to send all information except the turnaround plan by June 30.  If eligibility is determined, applicants must submit a turnaround plan by July 31.  Applications received after June 30 must contain a turnaround plan.  We will likely fund the loans two-three weeks after applications are awarded. 

Evaluation Methodology

The application evaluation methodology will apply equally to all hospitals and all applications will be reviewed in aggregate after the application deadline.

Payor Mix

Please note that when completing the application, for payor mix, Medicare includes Medicare Fee-for-Service and Managed Care revenues, and Medi-Cal includes Medi-Cal Fee-for-Service and Managed Care revenues.

For assistance with the application process, you may contact HCAI at dhlp@hcai.ca.gov or CHFFA at chffa@treasurer.ca.gov and we will respond to your request.

Additional Resources