About Us
The District Hospital Leadership Forum (DHLF) is the statewide voice for California’s district and municipal public hospitals. DHLF was formed to strengthen representation for these hospitals in the development of Medi-Cal finance policy, supplemental payment programs, and other major state and federal initiatives affecting public hospitals and the communities they serve.
DHLF brings together public hospital leaders to advocate for policies that protect local access to care, support financial stability, and recognize the unique role district and municipal hospitals play in California’s health care system.
DHLF’s roots trace back to the mid-2000s, when district hospitals participated in broader hospital financing, discussions related to California’s 2005 Medi-Cal waiver. During that process, it became clear that district hospitals did not have sufficient representation and were ultimately left out of key funding opportunities available to other public hospitals. In response, an informal group first came together to focus on these issues and build a stronger voice for district hospitals.
In 2009, district hospital leaders began working toward the formation of a dedicated association focused specifically on district hospital financial and reimbursement matters. Their goal was to create an organization led by district hospital executives and independent from other entities, with a clear mission to advocate for equitable treatment in state and federal programs. DHLF was officially established as a 501(c)(6) corporation in 2011.
From the beginning, DHLF has focused on improving access to public funding opportunities and strengthening the policy voice of district and municipal hospitals. Early on, DHLF pursued legislation to address Medi-Cal fee-for-service inpatient payment shortfalls, helping secure passage of Assembly Bill 113, creating the Nondesignated Public Hospital Intergovernmental Transfer Program and generating approximately $30 million in new annual funding for district hospitals. This early success helped establish DHLF’s collaborative “all for one, one for all” approach to advocacy.
Since then, DHLF has played a key role in expanding district and municipal hospital access to major Medi-Cal waiver and supplemental payment programs. Beginning with inclusion in the 2015 Medi-Cal waiver and continuing through subsequent waiver and managed care payment structures, DHLF has worked to ensure its members are recognized as public hospitals and included in critical financing opportunities.
Today, DHLF continues to advocate for policies that strengthen financial stability, protect access to care, and ensure district and municipal hospitals are treated equitably in state and federal health care programs.
DHLF represents all 33 district and municipal public hospitals across California. These community-based public hospitals that are essential to local access, rural health care infrastructure, emergency care, and regional economic stability.
More than two-thirds of DHLF members are rural hospitals, and 18 hold Critical Access Hospital status, underscoring the organization’s strong focus on preserving access to care in rural and underserved communities.
DHLF is led by hospital executives and focuses on the policy, financing, and operational issues that matter most to its members and the communities they serve.