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The hospital district is better known as the Paynesville Area Health Care System, the trade name it uses. PAHCS started as a city hospital in Paynesville in 1956. The Koronis Manor was added in 1964.

Now the district operates a 30-bed acute-care hospital, five clinics (including ones in Eden Valley, Paynesville, and Richmond), three nursing homes (totaling over 175 beds, though some beds will soon be shifted to assisted living), and a 30-unit congregate housing facility for seniors in Paynesville (700 Stearns Place).

The Paynesville Area Hospital District was formed in June of 1992. The reasons for forming the district were twofold and remain reasons for its expansion. Before the district was formed, the hospital was owned by the city of Paynesville and decisions were made in a cumbersome fashion: first approval needed to be granted by the hospital board and then from the city council.

Second, in order to finance necessary expansion, the district needed a larger tax base than the city of Paynesville provided - not to actually levy taxes, but as a basis for the amount, and the rates, that the hospital could borrow.

The original hospital district, which needed to be contiguous, included the cities of Paynesville, Regal, and St. Martin and the townships of Paynesville, Roseville, Union Grove, and Zion. It received the assets of the Paynesville Hospital from the city of Paynesville on Oct. 1, 1992.

Since then, the hospital district has added four cities: Eden Valley in 1995, Richmond and Roscoe in 1999, and Lake Henry in 2000.

Prior to its initial formation, in September 1992, voters in Eden Lake Township voted on whether to join the district and rejected it soundly. The vote at that time was 192-66 against joining the hospital district.

Interest in joining the district has since resurfaced, and last April, after an informational meeting with PAHCS administrators, the Eden Lake Township Board of Supervisors approved putting the question to voters again. That vote will be taken on Tuesday, Nov. 5, at the general election.

David Thielen has lived in Eden Lake Township all his life and has served as the Eden Valley Fire Chief for three years. He believes it's in the township's best interest to join the hospital district. "I think we should belong," he said. "I think it's important to have a well-equipped hospital nearby."

"For what they do for the rescue squad, I think we certainly should join the hospital district," added Jim Rademacher, who has lived in Eden Lake Township since 1963 and served on the Eden Valley Rescue Squad for 18 years. He currently is the chief of the rescue squad.

PAHCS - largely through its ambulance corps - has provided the rescue squad with CPR and first-responder training. Dr. Bob Gardner, who is on the medical staff at PAHCS and is the prime practitioner at the Eden Valley Area Medical Clinic, also serves as the rescue squad's medical director.

The Eden Valley Rescue Squad goes on around 90 calls per year, estimated Rademacher. Of these, only 10 percent use a Paynesville ambulance and the rest use the Watkins ambulance. Still, over half of the transports are brought to the hospital in Paynesville, said Rademacher. While they do allow patients to request a preferred medical facility, especially in dire emergencies, he said, "We always want to get them to the nearest facility."

Thielen also appreciates the training that PAHCS has provided as well as Gardner's help.

Both Rademacher and Thielen agree that the prospect of taxation is the biggest fear in joining the district, one that may influence a lot of "no" votes. The sticking point may be the tax risk that the township would accept by joining the district."As far as I know, that's the only thing holding it back," said Thielen. "I haven't heard anything else."

The fear of taxation comes in the face of the fact that PAHCS has always been self-sufficient and has never taxed. Since the hospital was built in 1956, it has always been self-funded through operating revenue. The city never taxed for the hospital, and the hospital district has never taxed in ten years of existence.

"It is not our intention to tax," said Steve Moburg, the new CEO of PAHCS, continuing the policy set by retiring CEO Willie LaCroix and other administrators before him.

Due to its recent expansion, including purchasing two additional nursing homes and funding a $7.5 million remodeling project at its main campus in Paynesville, PAHCS is watching its finances closely at present. Administration has looked at refinancing its debt to help its financial position and a new foundation is considering conducting a $1 million fund-raising campaign for capital for further expansion projects.

Should Eden Lake Township vote to join the district, they would increase the district's borrowing capacity and enable the district to get better rates, since the district would be a surer risk to lenders.

It would also give township residents a voice in hospital district decisions, said Moburg, since the township would have a representative on the board of directors. And it makes the township part owners in the hospital.

"It keeps quality health care close to home," said Moburg. "Our organization is committed to providing the latest state-of-the-art services to the area."