BILL ANALYSIS �
AB 678
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Date of Hearing: May 15, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 678 (Gordon) - As Amended: April 15, 2013
Policy Committee: Health
Vote: 19-0
Local Government 9-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill requires, every five years, a healthcare district that
leases or transfers its assets to a corporation to conduct a
community health needs assessment and provide opportunities for
the involvement and input of citizens, public agencies, civic
organizations, local agencies and other community groups through
public hearings and other means that the district deems
appropriate. Requires a local agency formation commission
(LAFCO), in conducting a municipal service review (MSR), to
include the community health needs assessment.
FISCAL EFFECT
This bill does not appear to be a reimbursable mandate.
Although select health districts may be eligible for
reimbursement generally under existing law, the community health
assessment only needs to be completed if a district chooses to
lease or transfer its assets, as specified, and the
discretionary nature of that decision excludes it from
reimbursement.
COMMENTS
1)Purpose . The author argues a health needs assessment would
serve several purposes. First, it would provide a district
with an analysis of community needs to help guide investments
and activities, and establish a baseline and framework for
already required annual reports. A second benefit is to
engage the public, enriching the process by generating
community support and raising general awareness of the
AB 678
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district.
2)Support . According to the Association of Healthcare
Districts, 13 healthcare districts will be impacted by these
new requirements. While many of these districts are currently
conducting needs assessments, this bill will ensure districts
are using a formalized and objective process to develop
strategies for addressing community needs.
3)Background . Special districts and other agencies can be
reorganized and modified, including consolidation and
dissolution. Municipal service reviews (MSRs) were added to
LAFCO's responsibilities in 2000. An MSR is a comprehensive
study designed to better inform LAFCO, local agencies and the
community about the provision of municipal services. This
bill also requires LAFCOs in conducting MSRs for healthcare
districts, to include their community health needs assessment.
According to the Association of California Healthcare
Districts, there are currently 74 health care districts, of
which 30 are rural, 20 are critical access, five have
stand-alone clinics, and three have stand-alone skilled
nursing facilities. These institutions provide a significant
portion of the medical care to minority populations and the
uninsured in medically underserved regions of the state and
are mainly funded by Medicare, Medi-Cal and district tax
dollars. Thirty of the districts do not currently operate
hospitals. Some HCDs have never operated a hospital, while
others that previously operated hospitals, no longer operate
them.
Analysis Prepared by : Roger Dunstan / APPR. / (916) 319-2081