Whether it's the global coronavirus pandemic or steep challenges facing local hospitals, the normally quiet El Camino Healthcare District has some unusual competition this election season. Five candidates have filed with intent to run for the district board this November, while one incumbent is calling it quits.

As of Thursday, incumbents Julia Miller and John Zoglin confirmed they are running for reelection this year, both saying they have the experience needed to guide El Camino Hospital through the coronavirus pandemic. The third incumbent, Gary Kalbach, said he does not intend to run for reelection this November.

In contrast to the incumbents with a long history of hospital leadership, three challengers -- all of whom have a health care background -- are seeking a change of pace. Dr. Jane Lombard, a physician and longtime cardiologist; Dr. Carol Ann Somersille, an obstetrician and gynecologist; and Dr. Meghan Fraley, a clinical psychologist, have all recently filed for candidacy.

The El Camino Healthcare District is one of the few public agencies left in the state that still has oversight of an independent community hospital. This gives elected members of the board a rare ability to oversee both a large nonprofit corporation with a $1 billion budget as well as millions of dollars in taxpayer funds, which are redistributed each year to public health programs.

Lombard, a Los Altos Hills resident, has worked as a clinician in the Bay Area for 30 years, recently parting ways with the Palo Alto Medical Foundation to work full time at a women's heart center at El Camino's Mountain View campus. She said it's the only cardiology center specializing in women's health in the area outside of large academic institutions like Stanford.

Lombard said she wants to join the health care district board because of her passion for social justice in health care, and the potential for El Camino to leverage its power as a public agency to help underserved communities. Diabetes, hypertension and obesity are all serious issues in the region, and it only stands to get worse with unemployment through the roof.

Particularly in light of COVID-19 and its disproportionate effects on communities of color, Lombard said the focus needs to be on population health and preventing people from needing to go to the hospital in the first place.

"The hospital really is the last place you need to go, and you hope to keep everyone out of the hospital and healthy," she said. "We need a comprehensive approach to health care."

Carol Ann Somersille, who pulled nomination papers this week, is a Mountain View resident who has lived in the same neighborhood as the hospital for nearly two decades. She has largely spent her career as an independent physician with a practice on the Peninsula and in the South Bay since the 1990s, but also spent time working at a community clinic providing care for underserved residents.

Somersille did not respond to a request for comment. When she vied for an appointed seat on the board in 2017, Somersille said she wanted to take a balanced approach as a board member for the health care district, maintaining the financial health of the hospital while also supporting the needs of the community.

"These two goals may seem at odds with each other," she said at the time. "They don't have to be."

Fraley has spent the last eight years as a psychologist and clinical director working with patients from all walks of life, particularly teens and college students experiencing depression and anxiety. She has also been a vocal advocate on issues affecting Mountain View, including raising the minimum wage and opposing the city's recent oversized vehicle ban.

Fraley said the mental health care system has been broken for a very long time, and people have been forced to go without care because of poor public investment in mental health services. The health care district could become a leader in fixing these problem in a holistic way -- promoting things like telehealth and preventative programs -- but there needs to be willpower on the part of its board of directors.

"We are currently facing a huge mental health crisis, and as a clinical psychologist and community advocate, I think it's necessary to have mental health expertise on the board and someone who is connected to the community," Fraley said.

One of the district's big roles in the community is to collect taxpayer dollars and spend the majority of it on grants for public health initiatives, which this year totaled $7.3 million. Fraley said that money goes to fund good programs and services, but the health care district should take a much more proactive role than collecting and redistributing tax funds.

"I think our community benefits program does give money to needy organizations, but I think we can do more than write checks," she said. "We can be working on the state level working with legislators, collaborating and creating new policies to rebuild and improve the mental health structure."

Two incumbents seeking reelection

Julia Miller is seeking her third term on the health care district board this year. A former Sunnyvale city councilwoman, Miller said she sees herself as an important liaison between the community and the hospital, and believes that kind of connection will be important during the coronavirus pandemic.

Miller said she's proud of her last eight years on the board, and that strategic decisions and investments have kept the independent and relatively small hospital financially solid going into the pandemic. While it has taken a hit in recent months with the loss of elective surgeries, which generate significant revenue, she said it's only resulted in small reductions to salaries and vacation time.

"People still have their jobs," she said.

Miller said she was particularly proud of supporting the creation of a new behavioral health building for mental health patients, which she said was a dire need in the community. Miller said she believes her work with the El Camino Hospital Foundation has helped the hospital raise millions of dollars over her terms in office.

John Zoglin, the longest serving board member, was appointed to the health care district in 2007 and has been reelected three times since then. Zoglin has worked for large tech companies in the area, but also owns a small business as a Sylvan Learning Center franchise owner.

Zoglin said he is running for another term this November, and believes that his experience will be crucial in supporting community health at a time when the country is grappling with the coronavirus pandemic. But he also flagged long-term problems in the world of health care that El Camino has an obligation to address.

Amid rising health care costs, Zoglin said he believes the hospital "must do whatever it can" to keep services as affordable as possible, including pumping the brakes on price increases to stay below inflation. The hospital can't just tout high-quality services, it must also keep the costs of those services down when possible, he said.

Zoglin said the hospital has also made progress with price transparency, also a sticking point in the world of health care and consumer advocacy. The pricing structure remains opaque, but he pointed to the hospital's estimator tool as a step in the right direction.

Board chair Gary Kalbach, who was appointed in 2018, said he does not plan to run for reelection. Kalbach has had a presence at El Camino for years, helping to found the Fogarty Institute and later serving on the hospital's governance and finance committees.

Kalbach's background includes 40 years as a venture capitalist, starting companies and serving on hospital boards and nonprofits throughout the Peninsula. He said he enjoys the challenge of strategic planning and working on creative ways to approach the hospital's finance and quality of care, but that he hasn't really liked the political stuff that comes with elected office.

"I'm not a fan of politics," he said. "I don't intend to run again."