BILL NUMBER: AB 276	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 22, 2012
	AMENDED IN SENATE  AUGUST 7, 2012
	AMENDED IN SENATE  JUNE 19, 2012
	AMENDED IN SENATE  JUNE 4, 2012
	AMENDED IN SENATE  AUGUST 18, 2011
	AMENDED IN ASSEMBLY  APRIL 4, 2011

INTRODUCED BY   Assembly Member Alejo

                        FEBRUARY 7, 2011

   An act to add Chapter 2.5 (commencing with Section 101655) to Part
4 of Division 101 of the Health and Safety Code, relating to public
health.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 276, as amended, Alejo. Central Coast Hospital Authority.
   Existing law authorizes the board of supervisors of certain
counties to establish a hospital authority for the management,
administration, and control of certain medical facilities. Existing
law authorizes the Board of Supervisors of the County of Monterey to
establish a special health care authority with prescribed powers and
duties.
   This bill would authorize the Board of Supervisors of the County
of Monterey to establish, by ordinance, the Central Coast Hospital
Authority to manage, administer, and control the Natividad Medical
Center and other health care facilities, as defined, in the county,
as specified. This bill would prohibit establishing the hospital
authority until the medical center affiliates or consolidates with at
least one other health care facility, as specified. This bill would
grant to the authority the duties, privileges, immunities, rights,
liabilities, and limitations of a local unit of government within the
state. This bill would also grant to the authority, among other
things, the power to incur debt, borrow money, and issue bonds, as
specified, and the power to request that the board of supervisors
levy a tax on behalf of the authority, as prescribed. The bill would
specify that the transfer to the authority of the management,
administration, and control of the medical center and another health
facility shall not affect the eligibility of the county or the
governing board of another health care facility for, and shall
authorize the authority to participate in and receive, various
sources of funding, as specified.
   This bill would provide various protections for the benefits of
the permanent employees of the medical center. The bill would require
the authority to  become a contracting agency of 
 contract with  the Public Employees' Retirement System 
, as specified, and with exceptions,  and would require the
authority to maintain retirement benefits, as specified.
   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.  Chapter 2.5 (commencing with Section 101655) is added
to Part 4 of Division 101 of the Health and Safety Code, to read:
      CHAPTER 2.5.  CENTRAL COAST HOSPITAL AUTHORITY



      Article 1.  General Provisions


   101655.  This chapter shall be known and may be cited as the
Central Coast Hospital Authority Act.
   101656.  The Legislature finds and declares the following:
   (a) Natividad Medical Center, currently a constituent department
of the County of Monterey, is a designated public hospital, as
defined in subdivision (d) of Section 14166.1 of the Welfare and
Institutions Code, and a critical component of the state's health
care safety net.
   (b) In an era of health care reform and a constantly evolving
competitive health care environment, in order to carry out its
mission of improving the health status of the people of the county
through access to affordable, high-quality health care services, it
is necessary that the medical center continues to improve its ability
to function with flexibility, responsiveness, and innovation.
   (c) The Board of Supervisors of the County of Monterey has
determined that the needs of the citizens of the county would best be
served if the medical center, while continuing as a designated
public hospital and maintaining its mission, is affiliated or
consolidated with one or more health care facilities in the County of
Monterey and operated by a separate and distinct public hospital
authority that is separate and apart from the county.
   (d) The board of supervisors has also determined that the creation
of a public hospital authority, to be charged with the management,
administration, and control of the medical center as a designated
public safety net hospital, and the affiliation or consolidation of
the medical center with one or more health care facilities in the
County of Monterey is the best way to fulfill the county's commitment
to its residents, including the low income, medically indigent, and
special needs populations of the county.
   (e) Because there is no general law under which this public
hospital authority could be formed for these purposes, the adoption
of a special act and formation of a special authority by the
Legislature are required, and the Board of Supervisors of the County
of Monterey has requested that the Legislature act.
   101657.  For purposes of this chapter, the following definitions
shall apply:
   (a) "Authority" means the Central Coast Hospital Authority
established pursuant to this chapter.
   (b) "Board of supervisors" means the Board of Supervisors of the
County of Monterey.
   (c) "Board of trustees" means the governing body of the authority.

   (d) "County" means the County of Monterey.
   (e) "Governing board" means the governing body of any other health
care facility, as defined in subdivision (g).
   (f) "Medical center" means the Natividad Medical Center and
related  public  health care programs, facilities, care
organizations, and delivery systems that exist or are established by
the board of trustees.
   (g) "Other health care facility" or "other health care facilities"
means one or more health care facilities, districts, or systems in
the County of Monterey, including, but not limited to, 
public or private  general acute care hospitals, public
hospital districts, and related health care programs, facilities,
care organizations, and delivery systems, but does not include the
medical center.

      Article 2.  Establishment of the Central Coast Hospital
Authority


   101658.  (a) Pursuant to this chapter, the board of supervisors
may establish, subject to the limitations of paragraph (1) of
subdivision (c), the Central Coast Hospital Authority, which shall,
for all purposes, be a public entity separate and apart from the
county and any other public entity. The authority established
pursuant to this chapter shall file the statement required by Section
53051 of the Government Code, and shall be considered a public
entity for purposes of Division 3.6 (commencing with Section 810) of
Title 1 of the Government  Code and a public agency for
purposes of Part 3 (commencing with Section 20000) of Division 5 of
Title 2 of the Government  Code.
   (b) (1) The purpose of the authority shall be to do all of the
following:
   (A) Provide management, administration, and other controls,
consistent with this chapter, for the medical center to continue to
serve as a designated public hospital and ensure the viability of the
health care safety net in the county in a manner consistent with the
county's requirements under Section 17000 of the Welfare and
Institutions Code.
   (B) Provide management, administration, and other controls for the
continued operation of one or more other health care facilities that
may be affiliated or consolidated with the medical center pursuant
to this chapter.
   (2) Subject to the requirements of this chapter, the authority
shall be charged with the management, administration, and control of
the medical center, other health care facilities, and related
services and facilities.
   (c) (1) Except as specifically set forth in this chapter, the
authority shall not be established, transact business, exercise
powers, or undertake duties and responsibilities pursuant to this
chapter until an agreement is reached to affiliate or consolidate the
medical center with at least one other health care facility as set
forth in this subdivision. In order for the authority to be
established, transact any business, exercise its powers, or undertake
its duties and responsibilities, the board of supervisors and at
least one governing board shall reach agreement, on terms and
conditions satisfactory to the parties, regarding the affiliation or
consolidation. This agreement may include, but is not limited to, a
transfer of the following:
   (A) Real and personal property, and assets and liabilities from
the county and the other health care facility to the authority.
   (B) Employees from the county and the other health care facility
to the authority.
   (C) Maintenance, operation, and management or ownership of the
medical center, in accordance with Section 14000.2 of the Welfare and
Institutions Code.
   (D) Maintenance, operation, and management or ownership of the
other health care facility.
   (E) Other matters that the board of supervisors and the governing
board deem necessary or appropriate.
   (2) If the board of supervisors and the governing board reach
agreement on the matters set forth in this subdivision, the terms and
conditions of the agreement shall be binding upon the authority.
After the agreement is reached, the board of supervisors shall adopt
an ordinance to establish the authority and authorize the authority
to exercise the powers and duties pursuant to this chapter, and the
board of supervisors and the governing board shall appoint a board of
trustees as set forth in Section 101659. The agreement set forth in
this section may be amended from time to time upon the mutual consent
of the authority and the governing board or the board of
supervisors, or both, as appropriate. 
   (3) (A) The agreement shall provide that upon the effective date
of the establishment ordinance described in paragraph (2), the
authority shall do all of the following:  
   (i) Take title to all assets associated with the medical center,
including, but not limited to, all real and personal property, funded
pension assets, and accounts receivable.  
   (ii) Assume, or immediately extinguish, defease, or satisfy, all
obligations and liabilities directly or indirectly associated with
the medical center, including, but not limited to, related or
associated debt, accounts payable, accrued liabilities, unfunded
pension liabilities, or financial or contractual obligations of any
kind.  
   (iii) Take any other actions necessary so that the county has no
continuing financial obligation or responsibility with respect to the
authority or its operations.  
   (B) A contract between the authority and the Public Employees'
Retirement System shall be a separate contract and not a joint
contract with the county.  
   (C) The authority's funds shall not remain or be kept on deposit
with the county, or otherwise be in the custody or control of the
county, and the authority shall not be permitted to deposit funds
with the county, including within the county's treasury investment
pool.  
   (D) The contractual provisions described in this paragraph are
mandatory. 
   (d) An agreement concerning the transfer of personnel shall
include a transition plan that requires all the following:
   (1) Ongoing communication to employees and recognized employee
organizations regarding the impact of the transition on existing
medical center and other health care facility employees and employee
classifications.
   (2) Meeting and conferring by the county and the other health care
facility with affected employee bargaining units on both of the
following issues:
   (A) The timeframe for which the transfer of personnel shall occur.

   (B) A specified period of time during which employees of the
county affected by the establishment of the authority may elect to be
considered for appointment to vacant positions, and exercise
reinstatement rights, for which they are qualified and eligible. An
employee who first elects to remain with the county, but who
subsequently seeks employment with the authority within 30 days of
this election, shall be subject to the requirements of this article.
   (3) Acknowledgment that the authority  , to the extent
permitted by federal law,  shall be bound by the terms of the
memoranda of understanding executed between the county and its
exclusive employee representatives  and between the other
health care facility and its respective employee organizations
 that are or will be in effect as of the date the county
adopts the ordinance pursuant to this article. Subsequent memoranda
of understanding shall be subject to approval only by the authority.
   (e) (1) Notwithstanding any other provision of this chapter, and
whether or not accompanied by a change in licensing, an agreement for
the maintenance, operation, and management or ownership of the
medical center shall not relieve the county of the ultimate
responsibility for indigent care pursuant to Section 14000.2 of the
Welfare and Institutions Code.
   (2) An agreement for the maintenance, operation, and management or
ownership of the medical center shall conform to the following
requirements:
   (A) Shall comply with Section 14000.2 of the Welfare and
Institutions Code.
   (B) May be made upon the terms and conditions that the board of
supervisors and governing board may mutually agree, including those
terms and conditions found necessary by the board of supervisors to
ensure that the transfer of the medical center shall constitute an
ongoing benefit to the county and its residents.
   (C) Shall provide that the county shall ensure that any applicable
requirements of Section 1442.5 are met.
   (3) An agreement for the maintenance, operation, and management or
ownership of the other health care facility may be made upon the
terms and conditions that the board of supervisors and the governing
board may mutually agree, including those terms and conditions found
necessary by the governing board to ensure that the transfer shall
constitute an ongoing benefit to the other health care facility and
its constituents.
   (f) The authority shall not be subject to the jurisdiction of a
local agency formation commission pursuant to the
Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000
(Division 3 (commencing with Section 56000) of Title 5 of the
Government Code), or any successor statute.
   101659.  (a) Permanent employees of the medical center on the
effective date of affiliation shall be deemed qualified for
employment or retention and no other qualifications shall be
required. Probationary employees on the effective date of affiliation
shall retain their probationary status and rights and shall not be
deemed to have transferred so as to require serving a new
probationary period.
   (b) Employment seniority of an employee of the medical center on
the effective date of affiliation shall be counted toward seniority
in the authority. The authority shall provide for the maintenance of
benefits that accompany seniority  ,  including, but not
limited to, preference in vacations and scheduling, when applicable.
All time spent in the same, equivalent, or higher classification
shall be counted toward classification seniority.
   (c) The implementation of this chapter shall not be a cause for
the modification of the level of medical center employment benefits.
Upon consolidation or affiliation of the medical center with at least
one other health care facility, employees who serve or work for the
medical center immediately prior to the implementation of this
chapter shall retain their existing or equivalent classifications and
job descriptions upon transfer to the authority,  comparable
pension benefits,  and at least their existing salaries and 
other  benefits that include, but are not limited to, accrued
and unused vacation, sick leave, personal leave, health  and
pension plans   care  , retiree health benefits,
and deferred compensation plans. 
   (d) The authority shall become a contracting agency of the Public
Employees' Retirement System consistent with the requirements of
Section 20508 and other applicable law for the purpose of continuing
or providing membership in the Public Employees' Retirement System
for those authority employees represented by the exclusive
representative of the former medical center employees who transferred
to the authority. This action shall be taken prior to completing the
transfer of medical center employees to the authority. The authority
shall provide for the continued membership of medical center
employees in the Public Employees' Retirement System, except that the
authority and the employees' exclusive representatives may mutually
agree to an alternative pension plan.  
   (d) Subject to subdivision (h), and to the extent permitted by
federal law, the authority shall contract with the Public Employees'
Retirement System, consistent with the requirements of Section 20508
and other applicable provisions of Part 3 (commencing with Section
20000) of Division 5 of Title 2 of the Government Code, for the
purpose of providing membership in the Public Employees' Retirement
System for authority employees. If the authority contracts with the
Public Employees' Retirement System, the authority, to the extent
permitted by federal law, shall provide for the continued membership
of medical center employees in the Public Employees' Retirement
System. If permitted under federal law, the authority and the
employees' exclusive representatives may mutually agree to terminate
any contract that the authority enters into with the Public Employees'
Retirement System, and mutually agree to an alternative pension
plan. 
   (e) Any transfer of functions from county employee classifications
to authority employees established pursuant to this article shall
result in the recognition by the hospital authority of the exclusive
representative of the classifications performing those functions at
the time of transfer.
   (f) In order to stabilize labor and employment relations and
provide continuity of care and services to the people of the county,
and notwithstanding any other provision of law, the authority shall
do all of the following for 24 months after the term end date of any
medical center memorandum of understanding in existence when the
county establishes the authority:
   (1) Continue to recognize each exclusive representative of each
bargaining unit.
   (2) Continue to provide at least the same level of employee
benefits to authority employees, who were medical center employees,
that had been provided to these employees, whether these benefits
arise out of a memorandum of understanding or other agreement or law.

   (3) Roll over and continue to be bound by any existing medical
center memorandum of understanding or agreement covering the terms
and conditions, including the level of wages and benefits, of those
employees for 24 months after the term end date of any memorandum of
agreement, unless modified by mutual agreement with each of the
exclusive representatives  , and only to the extent that
continuing to provide those pension benefits specified in any
memorandum of understanding does not conflict with any Public
Employees' Retirement System regulation or federal law  . Any
conflicts in the existing agreements as to wages and other terms and
conditions of employment shall be resolved only by mutual agreement
between the authority and each of the exclusive representatives.
   (g) Except as provided in the transfer agreement described in
subdivision (d) of Section 101658, subdivision (m) of Section 101661,
and this section, nothing in this chapter shall be construed as
prohibiting the authority from determining the number of employees,
the number of full-time equivalent positions, job descriptions, the
nature and extent of classified employment positions, and salaries of
employees. 
   (h) Notwithstanding any other law, the authority and employees of
the authority shall not participate in the Public Employees'
Retirement System if the Board of Administration of the Public
Employees' Retirement System, in its sole discretion, determines that
their participation could jeopardize the Public Employees'
Retirement System's tax-qualified or governmental plan status under
federal law. 

      Article 3.  Board of Trustees


   101660.  (a) The authority shall be governed by a board of
trustees. The trustees shall reflect both the expertise necessary to
maximize the quality and scope of care at the medical center and the
other health care facility in a fiscally responsible manner and the
communities of interest that the medical center and the other health
care facility serve. The board of trustees shall have the
responsibility to operate the medical center and the other health
care facility in a manner that ensures the provision of appropriate,
quality, and cost-effective medical care through the development of
innovative delivery systems, care arrangements, and contractual
agreements that provide access to affordable, high-quality health
care services.
   (b) (1) The board of trustees shall consist of the following nine
members:
   (A) Three trustees appointed for two-year terms, of which the
governing board shall appoint two and the board of supervisors shall
appoint one.
   (B) Three trustees appointed for three-year terms, of which the
governing board shall appoint one and the board of supervisors shall
appoint two.
   (C) Three trustees appointed for four-year terms, of which the
governing board shall appoint one and the board of supervisors shall
appoint two.
   (2) After the board of trustees is appointed, the governing board
and board of supervisors shall continue to make appointments to those
trustee positions for which they each made initial appointments. The
board of supervisors and the governing board may each remove their
respective appointees, upon a majority vote, only for cause. If the
governing board ceases to exist at any time, the appointing authority
set forth in this subdivision shall be exercised solely by the board
of supervisors. If a vacancy exists for any reason on the board of
trustees, the appointing authority for that trustee shall make an
appointment to fill out the remainder of the term of the vacant
trustee position.
   (3) Notwithstanding paragraphs (1) and (2), either during or after
the formation of the authority, the board of supervisors and each
governing board that has appointing authority may modify the number,
length of terms, and appointing authority of the board of trustees by
means of the agreement entered into pursuant to subdivision (c) of
Section 101658 or amendment to the agreement, or both, by the county
and the governing board that participated in the formation of the
authority, if in existence after this formation, and the governing
board of any other health care facility that becomes affiliated or
merged with the authority, if the following conditions are met:
   (A) The board of trustees consists of at least five members.
   (B) The board of trustees includes appointees of the board of
supervisors and each existing governing board. If no governing board
exists, the board of trustees and the board of supervisors, acting as
the appointing authority pursuant to paragraph (2), may agree to
modify the number or length of terms of the board of trustees.
   (c) The board of trustees shall adopt bylaws for the authority
that, among other things, shall specify the officers of the board of
trustees, the time, place, and conduct of meetings, and other matters
that the board of trustees deems necessary or appropriate to conduct
the authority's activities. The bylaws shall be operative upon
approval by a majority vote of the board of trustees, but may be
amended, from time to time, by a majority vote of the board of
trustees.
   (d) The board of trustees created and appointed pursuant to this
chapter is a duly constituted governing body as used in Section 1250
and Section 70035 of Title 22 of the California Code of Regulations.

      Article 4.  Powers and Duties of the Authority


   101661.  (a) The authority, in addition to any other powers
granted to the authority pursuant to this chapter, shall have the
following powers:
   (1) To have the duties, privileges, immunities, rights,
liabilities, and limitations of a local unit of government within the
state.
   (2) To have perpetual existence.
   (3) To adopt, have, and use a seal, and to alter it at its
pleasure.
   (4) To sue and be sued in the name of the authority in all actions
and proceedings in all courts and tribunals of competent
jurisdiction.
   (5) To purchase, lease, trade, exchange, or otherwise acquire,
maintain, hold, improve, mortgage, lease, sell, and dispose of real
and personal property of any kind necessary or convenient to perform
its functions and fully exercise its powers.
   (6) To appoint and employ a chief executive officer and other
officers and employees that may be necessary or appropriate,
including legal counsel, to establish their compensation, provide for
their health, retirement, and other employment benefits, and to
define the power and duties of officers and employees.
   (7) (A) To incur indebtedness and to borrow money and issue bonds
evidencing the same, including the authority to issue, from time to
time, notes and revenue bonds in principal amounts that the authority
determines to be necessary to provide sufficient funds for achieving
any of its purposes, including, but not limited to, assumption or
refinancing of debt service for capital projects eligible for
Medi-Cal supplemental payments pursuant to Section 14085.5 of the
Welfare and Institutions Code, the payment of interest on notes and
bonds of the authority, the establishment of reserves to secure these
notes and bonds, and all other expenditures of the authority
incident to and necessary or convenient to carry out its purposes and
powers.
   (B) Any notes, bonds, or other securities issued, and the income
from them, including any profit from the sale thereof, shall at all
times be free from taxation by the state or any agency, political
subdivision, or instrumentality of the state.
   (C) Notwithstanding the provisions of subparagraph (A), for any
indebtedness, notes, bonds, or other securities that require voter
approval pursuant to state law, the prior approval of the board of
supervisors shall be required. Notwithstanding the required prior
approval of the board of supervisors, any indebtedness incurred, or
notes, bonds, or other securities issued pursuant to this
subparagraph shall be the indebtedness, notes, bonds, or securities
of the authority and not of the county, and the credit of the county
shall not be pledged or relied upon in any manner in order to incur
the indebtedness, or issue the notes, bonds, or other securities,
unless the board of supervisors explicitly authorizes the use of the
county's credit. The authority shall reimburse the county for all
costs associated with the county's consideration of the indebtedness,
notes, bonds, or securities, and the authority shall defend,
indemnify  ,  and hold harmless the county from any and all
liability, costs, or expenses arising from or related to the
indebtedness, notes, bonds, or securities. 
   (8) To pursue its own credit rating.  
   (8) 
    (9)  To enter into any contract or agreement consistent
with this chapter or the laws of this state, and to authorize the
chief executive officer to enter into contracts, execute all
instruments, and do all things necessary or convenient in the
exercise of the powers granted in this chapter, and to secure the
payment of bonds. 
   (9) 
    (10)  To purchase supplies, equipment, materials,
property, and services. 
   (10) 
    (11)  To establish policies relating to its purposes.

   (11) 
    (12)  To acquire or contract to acquire, rights-of-way,
easements, privileges, and property, and to construct, equip,
maintain, and operate any and all works or improvements wherever
located that are 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. 
   (12) 
    (13)  To contract for and to accept gifts, grants, and
loans of funds, property, or other aid in any form from the federal
government, the state, a state agency, or other source, or
combination thereof, and to comply, subject to this chapter, with the
terms and conditions thereof. 
   (13) 
    (14)  To invest surplus money in its own treasury,
manage investments, and engage third-party investment managers, in
accordance with state law. 
   (14) 
    (15)  To arrange for guarantees or insurance of its
bonds, notes, or other obligations by the federal or state government
or by a private insurer, and to pay the premiums thereof. 

   (15) 
    (16)  To engage in managed care contracting, joint
ventures, affiliations with other health care facilities, other
health care providers and payers, management agreements, or to
participate in alliances, purchasing consortia, health insurance
pools, accountable care organizations, alternative delivery systems,
or other cooperative arrangements, with any public or private entity.

   (16) 
    (17)  To enter into joint powers agreements pursuant to
Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of
the Government Code. 
   (17) 
    (18)  To establish nonprofit, for profit, or other
entities necessary to carry out the duties of the authority. 

   (18) 
    (19)  To elect to transfer funds to the state and incur
certified public expenditures in support of the Medi-Cal program and
other programs for which federal financial participation is
available. 
   (19) 
    (20)  To use a computerized management information
system, including an electronic health records system, in connection
with the administration of its facilities. 
   (20) 
    (21)  To request that the board of supervisors levy a
tax on behalf of the  authority; provided, however, that if
  authority. If  the board of supervisors approves
the proposal to levy the tax, the board shall call the election
 at which   to seek  voter approval
 shall be considered, and, on behalf of the authority, cause
  and place  the appropriate measure  to be
placed  on the ballot for that election. 
Notwithstanding the foregoing, the   The  proceeds
of these taxes shall be tax proceeds of the authority and not of the
county. The authority shall reimburse the county for all costs
associated with the county's consideration of  this tax
  these taxes  , and  the authority
 shall defend, indemnify  ,  and hold harmless the
county from any liability, costs, or expenses arising from or related
to the imposition of these taxes. 
   (21) 
    (22)  To contract with the county for the provision of
indigent care services on behalf of the county. The contract shall
specify that county policies consistent with the county's obligations
under Section 17000 of the Welfare and Institutions Code shall be
applicable. Notwithstanding any other provision of this chapter, the
authority shall not undertake any of the county's obligations under
Section 17000 of the Welfare and Institutions Code, nor shall the
authority have an entitlement to receive any revenue for the
discharge of the county's obligations, without a written agreement
with the county. 
   (22) 
    (23)  To engage in other activities that may be in the
best interests of the authority and the persons served by the
authority, as determined by the board of trustees, in order to
respond to changes in the health care industry.
   (b) The authority shall conform to the following requirements:
   (1) Be a government entity separate and apart for all purposes
from the county and any other public entity, and shall not be
considered to be an agency, division, or department of the county or
any other public entity. The authority shall not be governed by, or
subject to, the policies or operational rules of the county or any
other public entity.
   (2) Be subject to state and federal taxation laws that are
applicable to public entities generally, except that the authority
may, to the extent permitted by federal law, apply for an exemption
from social security taxation if there is a mutual agreement with the
exclusive representatives of the affected employees.
   (3) Comply with the Meyers-Milias-Brown Act (Chapter 10
(commencing with Section 3500) of Division 4 of Title 1 of the
Government Code), the Public Records Act (Chapter 3.5 (commencing
with Section 6250) of Division 7 of Title 1 of the Government Code),
and the Ralph M. Brown Act (Chapter 10 (commencing with Section 3500)
of Division 4 of Title 1 of the Government Code). 
   (4) Assume the liabilities for California Public Employees'
Retirement System benefits, workers' compensation, and other employee
benefits and liabilities with respect to employees of the authority,
unless otherwise agreed to by the authority, the county, and the
governing board.  
   (4) To the extent the authority is permitted by federal law to
participate in the Public Employees' Retirement System, assume the
assets and liabilities for Public Employees' Retirement System
benefits, consistent with the requirements of Section 20508 and other
applicable provisions of Part 3 (commencing with Section 20000) of
Division 5 of Title 2 of the Government Code and assume workers'
compensation liabilities and other employee benefits and liabilities
with respect to employees of the authority, unless otherwise agreed
to by the authority, the county, and the governing board. 
   (5) Carry professional and general liability insurance or programs
to the extent sufficient to cover its activities.
   (6) Comply with the requirements of Sections 53260 and 53261 of
the Government Code.
   (7) Meet all local, state, and federal data reporting
requirements.
   (8) Be subject to the jurisdiction of the Public Employment
Relations Board.
   (c) Open sessions of the authority shall constitute official
proceedings authorized by law within the meaning of Section 47 of the
Civil Code. The privileges set forth in that section with respect to
official proceedings shall apply to open sessions of the authority.
   (d) The authority shall be a public agency for purposes of
eligibility with respect to grants and other funding and loan
guarantee programs. Contributions to the authority shall be tax
deductible to the extent permitted by state and federal law.
Nonproprietary income of the authority shall be exempt from state
income taxation.
   (e) The authority shall not be a "person" subject to suit under
the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part
2 of Division 7 of the Business and Professions Code).
   (f) The statutory authority of a board of supervisors to prescribe
rules that authorize a county hospital to integrate its services
with those of other providers into a system of community service that
offers free choice of hospitals to those requiring hospital care, as
set forth in Section 14000.2 of the Welfare and Institutions Code,
shall apply to the authority and the board of trustees.
   (g) Unless otherwise agreed to by the authority and the board of
supervisors, or the authority and a governing board, an obligation of
the authority, statutory, contractual or otherwise, shall be the
obligation solely of the authority and shall not be the obligation of
the county or any other entity, and any contract executed by and
between the county and the authority, or any other entity and the
authority, shall contain a provision that liabilities or obligations
of the authority with respect to its activities pursuant to the
contract shall be the liabilities or obligations of the authority and
shall not be or become the liabilities or obligations of the county
or the other entity, respectively.
   (h) An obligation of the authority, statutory, contractual or
otherwise, shall be the obligation solely of the authority and shall
not be the obligation of the state.
   (i) In the event of a change of license ownership, the board of
trustees shall comply with the obligations of governing bodies of
general acute care hospitals generally as set forth in Section 70701
of Title 22 of the California Code of Regulations, as currently
written or subsequently amended, as well as the terms and conditions
of the license. The authority shall be the responsible party with
respect to compliance with these obligations, terms, and conditions.
   (j) (1) Provisions of the Evidence Code, the Government Code,
including the Public Records Act (Chapter 3.5 (commencing with
Section 6250) of Division 7 of Title 1 of the Government Code), the
Civil Code, the Business and Professions Code, and other applicable
law pertaining to the confidentiality of peer review activities of
peer review bodies shall apply to the peer review activities of the
authority. Peer review proceedings shall constitute an official
proceeding authorized by law within the meaning of Section 47 of the
Civil Code and those privileges set forth in that section with
respect to official proceedings shall apply to peer review
proceedings of the authority. If the authority is required by law or
contractual obligation to submit to the state or federal government
peer review information or information relevant to the credentialing
of a participating provider, that submission shall not constitute a
waiver of confidentiality. The laws pertaining to the confidentiality
of peer review activities shall be together construed as extending,
to the extent permitted by law, the maximum degree of protection of
confidentiality.
   (2) Notwithstanding any other law, Section 1461 shall apply to
hearings on reports of hospital medical audit or quality assurance
committees.
   (k) (1) Any transfer by the county to the authority, or by the
governing board to the authority, of the maintenance, operation, and
management or ownership of the medical center or the other health
care facility, respectively, whether or not the transfer includes the
surrendering by the county or the governing board of any existing
general acute care hospital license and corresponding application for
a change of ownership of the license, shall not affect the
eligibility of the county or the governing board to undertake, and
shall authorize the authority, subject to applicable requirements, to
do, any of the following:
   (A) With the written consent of the county, participate in and
receive allocations pursuant to the California Health Care for
Indigents Program pursuant to Chapter 5 (commencing with Section
16940) of Part 4.7 of Division 9 of the Welfare and Institutions
Code, or similar programs, as may be identified or earmarked by the
county for indigent health care services of the type provided by the
medical center.
   (B) With the written consent of the county, participate in and
receive allocations of local revenue fund amounts provided pursuant
to Chapter 6 (commencing with Section 17600) of Part 5 of Division 9
of the Welfare and Institutions Code as may be identified or
earmarked by the county for indigent health care services of the type
provided by the medical center.
   (C) Participate in the financing of, and receive, Medicaid
disproportionate share hospital payments available to a county
hospital or designated public hospital, or any other successor or
modified payment or funding that is intended to assist hospitals that
serve a disproportionate share of low-income patients with special
needs. The allocation of Medicaid disproportionate share hospital
payments shall be made in consultation with the State Department of
Health Care Services and other designated safety net hospitals.
   (D) Participate in the financing of, and receive, Medi-Cal
supplemental reimbursements, including, but not limited to, payments
made pursuant to Sections 14105.96, 14105.965, 14166.4, and 14182.15
of the Welfare and Institutions Code, payments described in paragraph
(4) of subdivision (b) of Section 14301.4 of the Welfare and
Institutions Code, and payments made available to a county provider
or designated public hospital, or governmental entity with which it
is affiliated, under any other successor or modified Medicaid payment
system.
   (E) Participate in the financing of, and receive, safety net care
pool funding, stabilization funding, delivery system reform incentive
pool payments, and any other funding available to a county provider
or designated public hospital, or governmental entities with which it
is affiliated under the Medicaid demonstration project authorized
pursuant to Article 5.2 (commencing with Section 14166) and Article
5.4 (commencing with Section 14180) of Chapter 7 of Part 3 of
Division 9 of the Welfare and Institutions Code, or under any other
successor or modified Medicaid demonstration project or Medicaid
payment system. The allocation of safety net care pool funds shall be
made in consultation with the State Department of Health Care
Services and other designated safety net hospitals.
   (F) Participate in the financing, administration, and provision of
services under the Low Income Health Program authorized pursuant to
Part 3.6 (commencing with Section 15909) of Division 9 of the Welfare
and Institutions Code, or under any other successor or modified
Medicaid demonstration project or Medicaid payment system if the
authority enters into an agreement with the county concerning the
provision of services by, and payment for these services to, the
county.
   (G) Participate in and receive direct grant and payment
allocations pursuant to Article 5.228 (commencing with Section
14169.1) of Chapter 7 of Part 3 of Division 9 of the Welfare and
Institutions Code, or under any other successor or modified direct
grant and payment systems funded by hospital or other provider fee
assessments.
   (H) Receive Medi-Cal capital supplements pursuant to Section
14085.5 of the Welfare and Institutions Code. Notwithstanding any
other provision of law, supplemental payments shall be made to the
medical center under Section 14085.5 of the Welfare and Institutions
Code for the debt service costs incurred by the county, and, if
applicable, by the authority to the extent that debt service
responsibility is refinanced, transferred to, or otherwise assumed
by, directly or indirectly, the authority.
   (I) Receive any other funds that would otherwise be available to a
county provider or designated public hospital, or governmental
entity with which it is affiliated.
   (2) A transfer described in paragraph (1) shall not otherwise
disqualify the county or the governing board, or in the case of a
change in license ownership, the authority, from participating in any
of the following:
   (A) Local, state, and federal funding sources either specific to
county or district hospitals, county or district ambulatory care
clinics, designated public hospitals, or government entities with
which they are affiliated, for which there are special provisions
specific to those hospitals, ambulatory care clinics, or government
entities.
   (B) Funding programs in which the county or the governing board,
by themselves or on behalf of the medical center or the other health
care facility, respectively, had participated prior to the creation
of the authority, or would otherwise be qualified to participate in
had the authority not been created, and the maintenance, operation,
and management or ownership of the medical center and the other
health care facility not been transferred by the county and the
governing board to the authority pursuant to this chapter.
   (l) The authority, the county, and the governing board, or any
combination thereof, may engage in marketing, advertising, and
promotion of the medical and health care services made available to
the community by the authority.
   (m) The board of trustees shall have authority over procurement
and contracts for the authority. The board of trustees shall adopt
written rules, regulations, and procedures with regard to these
functions. Contracts by and between the authority and any public
agency, and contracts by and between the authority and providers of
health care, goods, or services, may be let on a nonbid basis and
shall be exempt from Chapter 2 (commencing with Section 10290) of
Part 2 of Division 2 of the Public Contract Code. Notwithstanding any
other provision of this section, the authority shall not subcontract
work performed by classifications represented by employee
organizations without mutual agreement between the authority and the
exclusive representatives, except that a subcontract entered into
prior to the formation of the authority may remain in effect until
its termination or completion and may be modified or renewed to a
later termination or completion date upon agreement between the
authority and the exclusive representatives of the affected
classifications.
   (n) The authority shall be responsible for human resource
functions, including, but not limited to, position classification,
compensation, recruitment, selection, hiring, discipline,
termination, grievance, equal opportunity, performance management,
probationary periods, training, promotion, and maintenance of
records. The board of trustees shall adopt written rules,
regulations, and procedures with regard to these functions. Until the
time that the board of trustees adopts its own rules, regulations,
or procedures with regard to these functions, the existing rules,
regulations, and procedures set forth in any memorandum of
understanding described in subparagraph (D) of paragraph (1) of
subdivision (d) of Section 101658 shall apply. If the memoranda do
not provide for the exercise of these functions, the rules,
regulations, and procedures of the county shall apply.
   (o) The authority may contract with the county or the governing
board for services and personnel upon mutually agreeable terms.
   (p) Notwithstanding Article 4.7 (commencing with Section 1125) of
Chapter 1 of Division 4 of Title 1 of the Government Code, related to
incompatible activities, a member of the authority's administrative
staff shall not be considered to be engaged in activities
inconsistent and incompatible with his or her duties as a result of
prior employment or affiliation with the county or the governing
board.
   (q) The board of trustees and the officers and employees of the
authority are public employees for purposes of Division 3.6
(commencing with Section 810) of Title 1 of the Government Code,
relating to claims and actions against public entities and public
employees, and shall be protected by the immunities applicable to
public entities and public employees governed by Part 2 (commencing
with Section 814) of Division 3.6 of Title 1 of the Government Code,
except as provided by other statutes or regulations that apply
expressly to the authority.
   (r) This   Except for Part 3 (commencing with
Section 20000) of Division 5 of Title 2 of the Government Code, this
 chapter shall prevail over any inconsistent statutes governing
employees of the authority, including, but not limited to, the
Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of
Division 1 of Title 1 of the Government Code). 
   101662.  The board of trustees may, pursuant to this section, find
and declare that the authority shall cease to exist. In that event,
the board of trustees shall request that the board of supervisors and
the governing board, if it still exists, negotiate with the
authority for a disposition of the authority's assets and
liabilities, and for a transfer of the authority's duties,
responsibilities, and obligations under law or contract. The board of
supervisors and the governing board shall have no obligation to
reach agreement on these issues. If the board of trustees, the board
of supervisors, and the governing board reach agreement, the board of
supervisors shall rescind the ordinance that established the
authority, and the authority shall cease to exist upon the date set
forth in the rescinding ordinance. If the governing board no longer
exists, only the agreement of the board of supervisors and the board
of trustees shall be necessary to terminate the authority. 

   101662.  Pursuant to this section, the board of trustees may find
and declare that the authority shall cease to exist. In that event,
the board of trustees shall provide for the disposition of the
authority's assets, obligations, and liabilities. Absent written
agreement, the county shall not be obligated under any law to assume
the authority's obligations or liabilities, or take title to, or
custody or control of, the authority's assets. Upon notification by
the authority of the disposition of the authority's assets and
liabilities, the board of supervisors shall rescind the ordinance
that established the authority, and the authority shall cease to
exist on the date set forth in the rescinding ordinance.