BILL NUMBER: AB 417 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Blakeslee
FEBRUARY 16, 2007
An act to amend Sections 101675, 101680, 101685, 101690, 101700,
101715, 101720, 101750, 101760, 101775, and 101780 of, and to add
Section 101781 to, the Health and Safety Code, relating to health
authorities.
LEGISLATIVE COUNSEL'S DIGEST
AB 417, as introduced, Blakeslee. Regional health authority: Santa
Barbara and San Luis Obispo Counties.
Existing law authorizes the Board of Supervisors of the County of
Santa Barbara to order the formation of the Santa Barbara Regional
Health Authority that shall include all of the areas of the county,
provides for the provision of medical services by the authority
within a service area, and defines service area to mean Santa Barbara
County and those counties contiguous to Santa Barbara County.
Existing law permits the authority, which is governed by a board of
directors appointed by the Board of Supervisors of Santa Barbara
County, to provide a health care system in a county contiguous to the
County of Santa Barbara when authorized by resolution of the other
county's board of supervisors. Existing law authorizes the Santa
Barbara County Board of Supervisors, after it has adopted a
resolution, to review major administrative decisions of the authority
and to approve, modify, reflect, or repeal those decisions.
This bill would rename the authority as the Santa Barbara San Luis
Obispo Regional Health Authority and would permit the authority,
upon authorization by the Board of Supervisors of San Luis Obispo
County, to provide a health care system in San Luis Obispo County.
The bill would revise the membership of the board of directors of the
authority to reduce the number of directors appointed by the Board
of Supervisors of Santa Barbara County and to add directors appointed
by the Board of Supervisors of San Luis Obispo County and would
specify the qualifications of all the directors. The bill would
authorize the boards of supervisors to review and to approve, modify,
reflect, or repeal major administrative decisions of the authority,
as specified. The bill would also make other conforming technical
changes with respect to the authority.
This bill would state the findings and declarations of the
Legislature concerning the need for special legislation.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares that:
(a) The Santa Barbara Regional Health Authority (SBRHA), a county
organized health system (COHS), began service in the County of Santa
Barbara in 1983, by resolution of the Santa Barbara County Board of
Supervisors.
(b) Through a board of directors representing the community, the
SBRHA administers five health coverage programs serving low-income
residents of Santa Barbara and San Luis Obispo Counties.
(c) The services offered include the Santa Barbara Health
Initiative for Medi-Cal beneficiaries in Santa Barbara County, the
Access for Infants and Mothers Program for low-income mothers and
their newborns in Santa Barbara County, the Healthy Families Program
for children under the age of 19 years in Santa Barbara and San Luis
Obispo Counties, the Healthy Kids Santa Barbara and Healthy Kids San
Luis Obispo for children under the age of 19 years in Santa Barbara
and San Luis Obispo Counties, respectively, and the In-Home
Supportive Services (IHSS) Healthcare for caregiver employees of the
In-Home Supportive Services Public Authority of Santa Barbara County.
(d) Its primary plan, the Santa Barbara Health Initiative (SBHI),
began operations on September 1, 1983, and assumed responsibility for
the Medi-Cal program in Santa Barbara County. The program is now
acknowledged to be the oldest Medicaid managed care program of its
kind in the country.
(e) In 2004, Governor Arnold Schwarzenegger proposed a significant
redesign of the state's Medi-Cal program to include Medi-Cal managed
care, including the expansion of existing COHS delivery models.
(f) In 2005, the County of San Luis Obispo created a Managed Care
Medi-Cal Advisory Committee to make recommendations to the county
health agency as to the establishment of a Medi-Cal delivery system.
(g) The advisory committee determined that there would be a
significant benefit to the Medi-Cal beneficiaries of San Luis Obispo
County through the formation of a two-county COHS plan.
(h) On September 26, 2006, the San Luis Obispo County Board of
Supervisors, pursuant to state law, accepted the county health agency'
s recommendation and passed a resolution endorsing the formation of a
two-county regional COHS with Santa Barbara County, contingent on
adequate funding and passage of legislation.
(i) The Board of Supervisors of Santa Barbara County and the Board
of Directors of the Santa Barbara Regional Health Authority have
also endorsed the formation of a Santa Barbara San Luis Obispo
Regional Health Authority.
SEC. 2. Section 101675 of the Health and Safety Code is amended to
read:
101675. This chapter shall be known , and may be cited
, as the Santa Barbara San Luis Obispo
Regional Health Authority Act.
SEC. 3. Section 101680 of the Health and Safety Code is amended to
read:
101680.
(a) The Board of Supervisors of the County
of Santa Barbara may, by ordinance or resolution, order the formation
of the Santa Barbara Regional Health Authority under this chapter
that shall include, but need not be limited to, all of the
incorporated and unincorporated areas of the county.
(b) The Board of Supervisors of the County of San Luis Obispo may,
by ordinance or resolution, authorize the provision of medical
services by the authority within San Luis Obispo County and may
participate on the board of directors of the authority as provided in
this chapter.
SEC. 4. Section 101685 of the Health and Safety Code is amended to
read:
101685. Unless the context otherwise requires, this article
governs the construction of this chapter. As used in this chapter:
(a) "Authority" means the Santa Barbara San Luis Obispo
Regional Health Authority.
(b) "Board" means the Santa Barbara San Luis Obispo
Regional Health Authority Board of Directors.
(c) "County" means the County of Santa Barbara.
(d)
(c) "Health care system" means any system
established to arrange for the provision of medical services.
(e)
(d) "Public agency" means the United States, the State
of California, any political subdivision, county, municipality,
district, or agency of the State of California or of the United
States and any department, bureau , or commission of the
State of California or of the United States.
(f)
(e) "Person" means any individual, firm, partnership,
association, corporation, limited liability company, trust, business
trust, or the receiver or trustee or conservator for any of the
above, but does not include a public agency.
(g)
(f) "Professional advisory boards" means the boards
appointed by the board of directors of the authority pursuant to its
rules which shall consist of a representative cross-section of
professional providers of health care services within the
county service area .
(h)
(g) "Community advisory boards" means advisory boards
to the authority's board appointed by the board of directors of the
authority which shall consist of persons who represent community and
consumer interests and who do not directly earn their income from the
provision of medical health services.
(i)
(h) "Service area" means the county
Santa Barbara County , and those counties that
are contiguous with the county Santa Barbara
County .
SEC. 5. Section 101690 of the Health and Safety Code is amended to
read:
101690. The governing body of the authority shall be vested in a
board of directors that shall consist of 11
13 members . Eight members shall be appointed by the
county's board of supervisors as Board of
Supervisors of Santa Barbara County and five members shall be
appointed by the Board of Supervisors of San Luis Obispo County.
(a) The Board of Supervisors of Santa
Barbara County shall appoint members to the board of directors as
follows:
(a)
(1) Three members shall be elected or appointed
officers or employees of the county Santa
Barbara County , at least one of whom shall be a member of the
board of supervisors.
(b) Three
(2) Two members shall be
county residents consisting of
Santa Barbara County, one who of whom
shall be either a recipient of Medi-Cal, provided
for under Sections 14000 and following,
Chapter 7 (commencing with Section 14000) of Part 3 of Division 9
of the Welfare and Institutions Code, one of whom
shall be a recipient of Medicare, provided for under Title
XVIII of the federal Social Security Act, or a resident eligible
to receive benefits and services under both Medi-Cal and MediCare,
and one of whom the other member
shall be a representative of a community business that does not
provide health care.
(c) Five
(3) Three members shall be
representatives of providers of health care services in the county
including: (1) two physicians, one of whom
(A) one physician who shall be appointed from a list
established by the Santa Barbara County Medical
Society and the other from a list established by the
hospitals within the county. One of the appointed physicians shall be
a resident of and in practice in the fourth or fifth supervisorial
district of the county; (2) two hospital administrators, one from
hospitals located in either the first, second or third supervisorial
districts of the county and the other from either the fourth or fifth
supervisorial districts ; (B) one hospital
administrator ; and (3) (C) one
nonhospital or nonphysician health care provider.
(b) The Board of Supervisors of San Luis Obispo County shall
appoint members to the board of directors as follows:
(1) Two members shall be elected or appointed officers or
employees of San Luis Obispo County, at least one of whom shall be a
member of the board of supervisors.
(2) One member shall be a resident of San Luis Obispo County and
shall be either a recipient of Medi-Cal, provided for under Chapter 7
(commencing with Section 14000) of Part 3 of Division 9 of the
Welfare and Institutions Code, a recipient of Medicare, provided for
under Title XVIII of the federal Social Security Act, or a resident
eligible to receive benefits and services under both Medi-Cal and
Medicare.
(3) Two members shall be representatives of providers of health
care services in San Luis Obispo County, including one physician who
shall be appointed from a list established by the San Luis Obispo
County Medical Society, and one hospital administrator who shall be
appointed from a list established by the local hospital council.
(c) Each hospital administrator appointed to the board of
directors shall be unaffiliated with the hospital group, network, or
corporate entity of the other hospital board appointee. Each
physician appointee to the board of directors shall be unaffiliated
with the group, network, or corporate entity of the other physician
board appointee.
(d) With regard to appointments made pursuant to paragraph (2) of
subdivision (a) and paragraph (2) of subdivision (b), the
appointments shall not result in two members who are both recipients
of Medi-Cal only or both recipients of Medicare only.
SEC. 6. Section 101700 of the Health and Safety Code is amended to
read:
101700. The board shall establish rules for its proceedings.
There shall be at least four meetings per year. Board members shall
be entitled to one hundred fifty dollars ($100)
($150) remuneration from authority funds, for
each board meeting attended and the authority may pay remuneration to
board members attending meetings of committees of the board except
that remuneration for attending board meetings and board committee
meetings shall not exceed the sum of two hundred dollars ($200) per
month, plus actual expenses incurred in attending meetings at rates
payable to county officers and employees. The per diem rate
remuneration of one hundred fifty
dollars ($100) ($150) may be increased
by the board subject to approval by the board
boards of supervisors.
SEC. 7. Section 101715 of the Health and Safety Code is amended to
read:
101715. Except for initial staggered terms that may be
established by the board, the term of office of each noncounty member
shall be two years and, in addition, time as necessary until the
appointment and qualification of his or her successor. County
officers or employees shall serve at the pleasure of the board of
supervisors that appointed that officer or employee .
SEC. 8. Section 101720 of the Health and Safety Code is amended to
read:
101720. Any vacancy on the board shall be filled for the
unexpired term by the county's board of
supervisors of the county authorized by Section 101690 to make
the appointment to that position .
SEC. 9. Section 101750 of the Health and Safety Code is amended to
read:
101750. The authority is hereby declared to be a body corporate
and politic and it shall have power:
(a) To have perpetual succession.
(b) To sue and be sued in the name of the authority in all actions
and proceedings in all courts and tribunals of competent
jurisdiction.
(c) To adopt a seal and alter it at pleasure.
(d) To take by grant, purchase, gift, devise, or lease, to hold,
use and enjoy, and to lease, convey or dispose of, real and personal
property of every kind, within or without the boundaries of the
authority, necessary or convenient to the full exercise of its
powers. The board may lease, mortgage, sell, or otherwise dispose of
any real or personal property within or without the boundaries of the
authority necessary to the full or convenient exercise of its
powers.
(e) To make and enter into contracts with any public agency or
person for the purposes of this chapter, including, but not limited
to, agreements under Chapter 5 (commencing with Section 6500) of
Division 7 of Title 1 of the Government Code. Members of the board
shall be disqualified from voting on contracts in which they have a
financial interest. Notwithstanding any other provision of law,
members shall not be disqualified from continuing to serve as a
member of the board and a contract may not be avoided solely because
of a member's financial interest.
(f) To appoint and employ an executive director and other
employees as may be necessary, including legal counsel, fix their
compensation and define their powers and duties. The board shall
prescribe the amounts and forms of fidelity bond of its officers and
employees. The cost of these bonds shall be borne by the authority.
The authority may also contract for the services of an independent
contractor.
(g) To incur indebtedness not exceeding revenue in any year.
(h) To purchase supplies, equipment, materials, property, or
services.
(i) To establish policies relating to its purposes.
(j) To acquire or contract to acquire, rights-of-way, easements,
privileges, or property of every kind within or without the
boundaries service area of the authority, and
construct, equip, maintain, and operate any and all works or
improvements within or without the boundaries of the authority
necessary, convenient, or proper to carry out any of the provisions,
objects or purposes of this chapter, and to complete, extend, add to,
repair, or otherwise improve any works or improvements acquired by
it.
(k) To make contracts and enter into stipulations of any nature
upon the terms and conditions that the board finds are for the best
interest of the authority for the full exercise of the powers granted
in this chapter.
(l) To accept gifts, contributions, grants , or loans
from any public agency or person for the purposes of this chapter.
The authority may do any and all things necessary in order to avail
itself of the gifts, contributions, grants , or loans, and
cooperate under any federal or state legislation in effect on March
25, 1982, or enacted after that date.
(m) To manage its moneys and to provide depository and auditing
services pursuant to either of the methods applicable to special
districts as set forth in the Government Code.
(n) To negotiate with service providers rates, charges, fees and
rents, and to establish classifications of health care systems
operated by the authority. Members of the board who are county
officers and employees may vote to approve arrangements and
agreements between the authority and the county as a service provider
and these directors shall not thus be disqualified solely for the
reason that they are employed by the county.
(o) To develop and implement health care delivery systems to
promote quality care and cost efficiency and to provide appeal and
grievance procedures available to both providers and consumers.
(p) To provide health care delivery systems for any or all of the
following:
(1) For all persons who are eligible to receive medical benefits
under the Medi-Cal Act, as set forth in Sections 14000 et
seq., Chapter 7 (commencing with Section 14000) of
Part 3 of Division 9 of the Welfare and Institutions Code in
the service area through waiver, pilot project, or otherwise.
(2) For all persons in the service area who are eligible to
receive medical benefits under both Titles XVIII and XIX of the
federal Social Security Act.
(3) For all persons in the service area who are eligible to
receive medical benefits under Title XVIII of the federal Social
Security Act.
(4) For all persons in the service area who are eligible to
receive medical benefits under publicly supported programs if the
authority, and participating providers acting pursuant to
subcontracts with the authority, agree to hold harmless the
beneficiaries of the publicly supported programs if the contract
between the sponsoring government agency and the authority does not
ensure sufficient funding to cover program benefits.
(q) To insure against any accident or destruction of its health
care system or any part thereof. It may insure against loss of
revenues from any cause. The authority may also provide insurance as
provided in Part 6 (commencing with Section 989) of Division 3.6 of
Title 1 of the Government Code.
(r) To exercise powers that are expressly granted and powers that
are reasonably implied from express powers and necessary to carry out
the purposes of this chapter.
(s) To do any and all things necessary to carry out the purposes
of this chapter.
(t) With respect to services provided outside the county, the
authority may only provide those services to the extent that the
services are authorized by resolution of the board of supervisors of
the county in which the services are to be provided.
SEC. 10 Section 101760 of the Health and Safety Code is amended to
read:
101760. Notwithstanding any other provision of this chapter, the
board of supervisors of the county in which the appellant
resides may review major administrative decisions of the
authority, excluding those involving personnel matters, upon appeal
by the affected person and upon a majority vote of the
that board of supervisors. The
That board of supervisors may either approve,
modify, reflect , or repeal these decisions. The action of
the board of supervisors shall be deemed to constitute a final
administrative remedy after concurrence by the board of
supervisors of the ot her county . The
board of supervisors and the authority shall mutually develop and
agree on rules and regulations setting forth review procedures and
guidelines to determine which decisions of the authority are major so
as to confer appellate jurisdiction upon the board of supervisors.
The board of supervisors shall adopt the mutually agreed upon rules
and regulations by resolution or ordinance.
This section shall not be operative until adopted by resolution by
the board boards of supervisors
of both counties .
SEC. 11. Section 101775 of the Health and Safety Code is amended
to read:
101775. In the formation of the authority pursuant to this
chapter, Chapter 6.6 (commencing with Section
54773 et seq., 54773) of Part 1 of Division 2 of Title
5 of the Government Code is not applicable.
SEC. 12. Section 101780 of the Health and Safety Code is amended
to read:
101780. The board of supervisors Board of
Supervisors of Santa Barbara County may, by ordinance or
resolution, order the dissolution of the authority by declaring that
there is no need for the authority to function in the county. The
dissolution shall become effective 180 days after the date of
adoption of the resolution or ordinance ordering the dissolution.
As of the effective date of the dissolution of the authority, the
authority shall be dissolved, disincorporated and extinguished; its
existence shall be terminated and all of its corporate powers shall
cease, except for winding up the affairs of the authority.
For the purpose of winding up the affairs of the dissolved
authority, the County of Santa Barbara shall be the successor.
Upon the effective date of dissolution, control over all of the
moneys or funds, including on hand and moneys due, but uncollected,
and all property, real or personal, of the authority shall be vested
in the County of Santa Barbara for the purpose of winding up the
affairs of the authority.
The powers of the county in winding up the affairs of the
authority and the distribution of assets of the authority, shall be
in accordance with Article 4 (commencing with Section 56500)
of Chapter 9 of Part 4 of Division 1 of Title 6
Chapter 6 (commencing with Section 57450) of Part 5 of
Division 3 of Title 5 of the Government Code. The liability of
the county County of Santa Barbara as
successor shall be limited to the assets of the authority.
SEC. 13. Section 101781 is added to the Health and Safety Code, to
read:
101781. The Board of Supervisors of either the County of San Luis
Obispo or the County of Santa Barbara, or the board of directors of
the authority, by ordinance or resolution, may terminate the
authority's operation of a health care system or systems in the
County of San Luis Obispo. The termination shall become effective 180
days after the adoption of the ordinance or resolution. If the
termination is made by the board of supervisors of either county, the
terminating county's liability to the authority shall be limited to
the cost of terminating the authority's operations in the County of
San Luis Obispo, including, but not limited to, the costs of
terminating contracts and other obligations for space, services,
employment, health care services, required notices to beneficiaries
and subscribers, and moving expenses.
SEC. 14. Due to the unique circumstances concerning the Counties
of Santa Barbara and San Luis Obispo, the Legislature finds and
declares that a general statute cannot be made applicable within the
meaning of Section 16 of Article IV of the California Constitution.
Therefore, this act is necessarily applicable only to the Counties of
Santa Barbara and San Luis Obispo.