BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1008
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          Date of Hearing:   September 9, 2013

                       ASSEMBLY COMMITTEE ON LOCAL GOVERNMENT
                           K.H. "Katcho" Achadjian, Chair
                 AB 1008 (Buchanan) - As Amended:  September 4, 2013
           
          SUBJECT  :   Alameda County Medical Center hospital authority.

           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 (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,  








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               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.  

          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  








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            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  
            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  








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          court and upon judges in chambers when requested.  

           FISCAL EFFECT  :  None

           COMMENTS  :  

          1)Following the passage of AB 2374 (Bates) 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).  

          2)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 impact the jobs of the employed  
            physicians at AHS."

            Second, this bill prohibits specified employees, including  








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            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  
            Committee 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.  

           3)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.  

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Alameda Health Systems (Alameda County Medical Center) [SPONSOR]
          American Federation of State, County and Municipal Employees  
          [SPONSOR]
          Union of American Physicians and Dentists [SPONSOR]
          California Nurses Association
          International Union of Operating Engineers
          Local 29, Office & Professional Employees International Union  
          AFL-CIO
          National Nurses United 
          Service Employees International Union (SEIU)








                                                                  AB 1008
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          Warehouse Union Local 6, International Longshoreman's &  
          Warehousemen's Union

           Opposition 
           
          None

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