BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                AB 1008
                                                                Page  1

        CONCURRENCE IN SENATE AMENDMENTS
        AB 1008 (Buchanan and Bonta)
        As Amended  September 4, 2013
        2/3 vote.  Urgency
         
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        |ASSEMBLY:  |     |(May 16, 2013)  |SENATE: |35-2 |(September 6,  |
        |           |     |                |        |     |2013)          |
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             (vote not relevant)


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        |COMMITTEE VOTE:  |9-0  |(September 9, 2013) |RECOMMENDATION: |concur    |
        |                 |     |                    |                |          |
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        Original Committee Reference:   JUD.  

         SUMMARY  :  Prohibits the Alameda Health System (AHS) from  
        privatizing services provided by physicians and surgeons, as  
        specified, and establishes eligibility for retirement benefits for  
        employees of a facility that is acquired or merged into AHS.

         The Senate amendments  delete the Assembly version of this bill, and  
        instead:

        1)Prohibit AHS, before January 1, 2024, from entering into a  
          contract with any private person or entity to replace services  
          being provided by physicians and surgeons who are employed by AHS  
          and in a recognized collective bargaining unit as of March 31,  
          2013, with services provided by a private person or entity  
          without clear and convincing evidence that the needed medical  
          care can only be delivered cost-effectively by a private  
          contractor.  

        2)Require AHS, prior to entering into a contract for any of those  
          services, to negotiate with the representative of the recognized  
          collective bargaining unit of its physician and surgeon employees  
          over the decision to privatize and, if unable to resolve any  
          dispute through negotiations, to submit the matter to final  
          binding arbitration.  

        3)Prohibit specified AHS employees from automatically becoming  
          members of the Alameda County Employees' Retirement Association  








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          (ACERA), and establish, on or after the effective date of this  
          bill, the eligibility of an AHS employee to participate in ACERA,  
          as follows:

           a)   Prohibit a person who is an employee of a facility on the  
             date that the facility is acquired or who later becomes an  
             employee of the facility, who is not currently an ACERA  
             member, and who is not subject to an memorandum of  
             understanding (MOU), from becoming a member of ACERA.  Require  
             the employee to instead become a participant in one or more  
             retirement plans adopted by AHS on November 27, 2012, or  
             subsequently amended;

           b)   Allow a person who is an employee of the facility on the  
             date that the facility is acquired or who later becomes an  
             employee of the facility, who is not currently an ACERA  
             member, and is subject to an MOU, to become a member of ACERA  
             or one or more of the retirement plans adopted by AHS on  
             November 27, 2012, or subsequently amended, or in a pension  
             trust sponsored by a third party, dependent on the collective  
             bargaining agreement;  

           c)   Prohibit, upon adoption of a resolution by AHS, a person  
             who is hired by AHS on or after the effective date of this  
             bill and the resolution, who is not an ACERA member, and who  
             is not subject to an MOU from becoming a member of ACERA.   
             Require the employee to instead participate in one or more  
             retirements plans adopted by AHS on November 27, 2012, or  
             subsequently amended; and,  

           d)   Prohibit a person who is employed by AHS on or before the  
             effective date of this bill, and who is not qualified for  
             ACERA membership at that time from becoming qualified for  
             membership as a result of subsequent employment with AHS.   
             Require the employee to instead participate in one or more  
             retirement plans adopted by AHS on November 27, 2012, or  
             subsequently amended.  

        4)Include an urgency clause allowing this bill to take effect  
          immediately upon enactment.  

        5)Make findings and declarations about an agreement that has been  
          reached between Sutter Health, operators of San Leandro Hospital,  
          and AHS transferring ownership of San Leandro Hospital to AHS as  
          of October 31, 2012.  








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        6)Make findings and declarations that this bill is necessary to  
          prevent the closure of the San Leandro Hospital in order to  
          ensure the continuation of employment and benefits for the  
          employees of San Leandro Hospital and continuation of care for  
          the residents of Alameda County.  

         EXISTING LAW  :

        1)Authorizes the Alameda County Board of Supervisors to establish a  
          hospital authority separate and apart from the county to manage,  
          administer and control the Alameda County Medical Center.  

        2)Requires the hospital authority to be governed by a board  
          appointed by the Alameda County Board of Supervisors.  

        3)Establishes the following powers for the hospital authority:

           a)   To acquire and possess real or personal property;

           b)   To sue or be sued;

           c)   To employ personnel; and,

           d)   To contract for services required to meet its obligations.   


        4)Provides that a hospital authority to which the maintenance,  
          operation, management of the medical center is transferred shall  
          be a "district" pursuant to the County Employees Retirement Law  
          of 1937 which governs 20 independent county retirement systems.  

        5)States that employees of the authority are eligible to  
          participate in the County Employees Retirement System to the  
          extent permitted by law.  

        6)Establishes requirements for a personnel transition plan, as  
          specified.  

        7)Provides that the hospital authority is bound by the terms of the  
          MOU executed by and between the county and healthcare and  
          management employee organizations that is in effect at the time  
          of the creation of the authority.  

        8)Provides the hospital authority, upon expiration of the MOU at  








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          the time the hospital authority was created, with sole authority  
          to negotiate subsequent memorandums of understanding with  
          appropriate employee organizations.  

        9)Requires that the MOU to be approved by the hospital authority.  

         AS PASSED BY THE ASSEMBLY  , this bill clarified that a clerk of the  
        superior court must attend every session of the superior court and  
        upon judges in chambers when requested.  

         FISCAL EFFECT  :  None

         COMMENTS  :  Following the passage of AB 2374 (Bates), Chapter 816,  
        Statutes of 1996, the Alameda County Board of Supervisors appointed  
        a board of trustees to separately manage, administer and control  
        the Alameda County Medical Center, now known as the Alameda Health  
        System (AHS).  According to AHS, their integrated public health  
        care system employs more than 3,000 people including 500 physicians  
        throughout Alameda County.  In the 1990s the Highland Hospital, a  
        regional trauma center and teaching hospital, John George  
        Psychiatric Hospital, an acute and emergency care facility,  
        Fairmont Hospital, an acute rehabilitation hospital and skilled  
        nursing facility, and the community wellness centers, in Highland,  
        Newark, Eastmont, and Hayward consolidated as the Alameda County  
        Medical Center.  

        Current law authorizes AHS to employ personnel, to contract for  
        services, and to negotiate MOUs with the appropriate employee  
        organizations.  Current law also authorizes AHS employees to  
        participate in the County Employee Retirement System, the Alameda  
        County Employees' Retirement Association (ACERA).  

        This bill makes two changes to the special act governing AHS.   
        First, the bill prohibits AHS from privatizing any work performed  
        as of March 31, 2013, by physicians and surgeons employed by AHS  
        without clear and convincing evidence that the needed medical care  
        can only be delivered cost-effectively by a private contractor.   
        This bill requires, before those services are privatized, that AHS  
        must negotiate with the representative of its physician and surgeon  
        employees over the decision to privatize.  If any dispute cannot be  
        resolved through negotiations, this bill requires AHS to submit the  
        matter to final binding arbitration.  

        According to the author, "AHS is exploring a move to a Physician  
        Operating Model with a separate governance structure.  This would  








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        impact the jobs of the employed physicians at AHS."

        Second, this bill prohibits specified employees, including those  
        who are employees of a facility that is acquired by or merged into  
        AHS, from automatically becoming members of ACERA.  This bill  
        limits the eligibility of an employee to participate in ACERA, and  
        instead requires that employees participate in a retirement plan  
        adopted by AHS or in a pension trust sponsored by a third party  
        depending on several characteristics which include a person's  
        employment with the acquired or merged facility or AHS, current  
        membership in ACERA, and whether their employment is subject to an  
        MOU. 
        According to the author, AHS has reached an agreement to take over  
        San Leandro Hospital, which is currently operated by Sutter Health.  
         AHS is also planning to acquire Alameda Hospital, currently  
        operated by the City of Alameda.  The Legislature may wish to note  
        that absent a definition for "facility" the bill applies to all  
        employees of a facility that is acquired by or merged into AHS  
        going forward.  

        This bill is an urgency measure and sponsored by AHS, the American  
        Federation of State, County, and Municipal Employees (AFSCME), and  
        the Union of American Physicians and Dentists.  

        Support arguments:  Supporters argue that this bill will allow AHS  
        to protect existing levels of retirement benefits earned by  
        represented employees and ensure access to healthcare for the  
        residents of Alameda County.

        Opposition arguments:  Opposition could argue that some of the  
        provisions of this bill could be negotiated at the local level.  


         Analysis Prepared by  :    Misa Yokoi-Shelton / L. GOV. / (916)  
        319-3958 


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