Standard&Poor's Ratings Services assigned its 'A+' long-term rating to Palomar Pomerado Health District (PPH), Calif.'s $65 million series 2010A general obligation (GO) bonds. Standard&Poor's also affirmed its 'A+' underlying rating (SPUR) on the district's outstanding GO bonds. The ratings reflect our view of the district's: Long-term contract with Kaiser Permanente; Continued very strong direct market share of almost 60% when including the Kaiser contract benefits; Improved operating margins and overall financial performance in fiscals 2009 and 2010 as a result of the district's initiatives to address weakened financials in fiscal 2008; Continued very robust and diverse tax base, although assessed value (AV) experienced slight declines in 2010 and 2011 of 3.4% and 1%, respectively, given the
