BILL NUMBER: AB 2546 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 26, 2014
AMENDED IN SENATE JUNE 10, 2014
AMENDED IN ASSEMBLY MAY 15, 2014
AMENDED IN ASSEMBLY APRIL 29, 2014
AMENDED IN ASSEMBLY MARCH 28, 2014
INTRODUCED BY Assembly Member Salas
FEBRUARY 21, 2014
An act to amend Section 31468 of, and to add Section 31552.5
to, the Government Code, and to add Chapter 5.5 (commencing
with Section 101852) to Part 4 of Division 101 of the Health and
Safety Code, relating to public health.
LEGISLATIVE COUNSEL'S DIGEST
AB 2546, as amended, Salas. Kern County 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.
This bill would authorize the board of supervisors of the County
of Kern to establish, by ordinance, the Kern County Health
System Hospital Authority to manage, administer,
and control the Kern Medical Center and for the operation of
additional programs, clinics and other facilities, care
organizations, physical practice plans, and delivery systems that may
be affiliated or consolidated with the medical center. The bill
would also authorize the establishment of the authority to
manage, administer, and control the managed care plan established by
Kern Health Systems in order to ensure the substantial participation
of the disproportionate share hospital in the county and the safety
net providers with which it is affiliated and to negotiate
and enter into contracts to provide or arrange, or provide directly,
on a fee-for-service, capitated, or other basis, health
care services to specified individuals.
The bill would require the board of supervisors, in the enabling
ordinance, to establish the terms and conditions of the transfers to
the authority from the county and Kern Health Systems, which
includes, among other things, any transfer of real and personal
property. The bill would require the authority to be governed by a
board of trustees, governors, and would
require the board of supervisors, in the enabling ordinance, to
specify, among other things, the number of members and
composition of membership of the board trustees
of governors and the qualifications of members.
The bill would grant to the authority, among other powers, the
duties, privileges, immunities, rights, liabilities, and limitations
of a local unit of government within the state. The bill would
specify that the transfer to the authority of the management,
administration, and control of the medical center does not affect the
eligibility of the county for, but authorizes the authority to
participate in and receive, various sources of funding, as specified,
including various Medi-Cal programs. The bill would require the
board of supervisors to adopt, and the authority to implement, a
personnel transition plan that requires specified actions, including
ongoing communication to employees and recognized employee
organizations regarding the impact of the transition on certain
existing employees and employee classifications.
The bill would authorize the board of supervisors to find and
declare that the authority ceases to exist, and in that event, the
bill would require the board of supervisors to provide for the
disposition of the authority's assets, obligations, and
liabilities. liabilities, as specified.
Existing law, the County Employees Retirement Law of 1937,
authorizes counties to establish retirement systems, as specified, in
order to provide pension benefits to county, city, and district
employees. Existing law defines a district for these purposes as a
district, formed under the laws of the state, located wholly or
partially within the county other than a school district.
This bill would include the authority within the definition of
district and would authorize employees of the authority to
participate in the Kern County Employees' Retirement Association, as
specified.
Existing constitutional provisions require that a statute that
limits the right of access to the meetings of public bodies or the
writings of public officials and agencies be adopted with findings
demonstrating the interest protected by the limitation and the need
for protecting that interest.
This bill would make legislative findings to that effect.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 31468 of the
Government Code is amended to read:
31468. (a) "District" means a district, formed under the laws of
the state, located wholly or partially within the county other than a
school district.
(b) "District" also includes any institution operated by two or
more counties, in one of which there has been adopted an ordinance
placing this chapter in operation.
(c) "District" also includes any organization or association
authorized by Chapter 26 of the Statutes of 1935, as amended by
Chapter 30 of the Statutes of 1941, or by Section 50024, which
organization or association is maintained and supported entirely from
funds derived from counties, and the board of any retirement system
is authorized to receive the officers and employees of that
organization or association into the retirement system managed by the
board.
(d) "District" also includes, but is not limited to, any sanitary
district formed under Part 1 (commencing with Section 6400) of
Division 6 of the Health and Safety Code.
(e) "District" also includes any city, public authority, public
agency, and any other political subdivision or public corporation
formed or created under the constitution or laws of this state and
located or having jurisdiction wholly or partially within the county.
(f) "District" also includes any nonprofit corporation or
association conducting an agricultural fair for the county pursuant
to a contract between the corporation or association and the board of
supervisors under the authority of Section 25905.
(g) "District" also includes the Regents of the University of
California, but with respect only to employees who were employees of
a county in a county hospital, who became university employees
pursuant to an agreement for transfer to the regents of a county
hospital or of the obligation to provide professional medical
services at a county hospital, and who under that agreement had the
right and did elect to continue membership in the county's retirement
system established under this chapter.
(h) "District" also includes the South Coast Air Quality
Management District, a new public agency created on February 1, 1977,
pursuant to Chapter 5.5 (commencing with Section 40400) of Part 3 of
Division 26 of the Health and Safety Code.
(1) Employees of the South Coast Air Quality Management District
shall be deemed to be employees of a new public agency occupying new
positions on February 1, 1977. On that date, those new positions are
deemed not to have been covered by any retirement system.
(2) No retirement system coverage may be effected for an employee
of the South Coast Air Quality Management District who commenced
employment with the district during the period commencing on February
1, 1977, and ending on December 31, 1978, unless and until the
employee shall have elected whether to become a member of the
retirement association established in accordance with this chapter
for employees of Los Angeles County or the retirement association
established in accordance with this chapter for employees of San
Bernardino County. The election shall occur before January 1, 1980.
Any employee who fails to make the election provided for herein shall
be deemed to have elected to become a member of the retirement
association established in accordance with this chapter for the
County of Los Angeles.
(3) The South Coast Air Quality Management District shall make
application to the retirement associations established in accordance
with this chapter for employees of Los Angeles County and San
Bernardino County for coverage of employees of the South Coast Air
Quality Management District.
(4) An employee of the South Coast Air Quality Management District
who commenced employment with the district during the period
commencing on February 1, 1977, and ending on December 31, 1978, and
who has not terminated employment before January 1, 1980, shall be
covered by the retirement association elected by the employee
pursuant to paragraph (2). That coverage shall be effected no later
than the first day of the first month following the date of the
election provided for in paragraph (2).
(5) Each electing employee shall receive credit for all service
with the South Coast Air Quality Management District. However, the
elected retirement association may require, as a prerequisite to
granting that credit, the payment of an appropriate sum of money or
the transfer of funds from another retirement association in an
amount determined by an enrolled actuary and approved by the elected
retirement association's board. The amount to be paid shall include
all administrative and actuarial costs of making that determination.
The amount to be paid shall be shared by the South Coast Air Quality
Management District and the employee. The share to be paid by the
employee shall be determined by good faith bargaining between the
district and the recognized employee organization, but in no event
shall the employee be required to contribute more than 25 percent of
the total amount required to be paid. The elected retirement
association's board may not grant that credit for that prior service
unless the request for that credit is made to, and the required
payment deposited with, the elected retirement association's board no
earlier than January 1, 1980, and no later than June 30, 1980. The
foregoing shall have no effect on any employee's rights to reciprocal
benefits under Article 15 (commencing with Section 31830).
(6) An employee of the South Coast Air Quality Management District
who commenced employment with the district after December 31, 1978,
shall be covered by the retirement association established in
accordance with this chapter for employees of San Bernardino County.
That coverage shall be effected as of the first day of the first
month following the employee's commencement date.
(7) Notwithstanding paragraphs (2) and (4) above, employees of the
South Coast Air Quality Management District who were employed
between February 1, 1977, and December 31, 1978, and who terminate
their employment between February 1, 1977, and January 1, 1980, shall
be deemed to be members of the retirement association established in
accordance with this chapter for the employees of Los Angeles County
commencing on the date of their employment with the South Coast Air
Quality Management District.
(i) "District" also includes any nonprofit corporation that
operates one or more museums within a county of the 15th class, as
described by Sections 28020 and 28036 of the Government Code, as
amended by Chapter 1204 of the Statutes of 1971, pursuant to a
contract between the corporation and the board of supervisors of the
county, and that has entered into an agreement with the board and the
county setting forth the terms and conditions of the corporation's
inclusion in the county's retirement system.
(j) "District" also includes any economic development association
funded in whole or in part by a county of the 15th class, as
described by Sections 28020 and 28036 of the Government Code, as
amended by Chapter 1204 of the Statutes of 1971, and that has entered
into an agreement with the board of supervisors and the county
setting forth the terms and conditions of the association's inclusion
in the county's retirement system.
(k) "District" also includes any special commission established in
the Counties of Tulare and San Joaquin as described by Section
14087.31 of the Welfare and Institutions Code, pursuant to a contract
between the special commission and the county setting forth the
terms and conditions of the special commission's inclusion in the
county's retirement system with the approval of the board of
supervisors and the board of retirement.
( l ) (1) "District" also includes the retirement
system established under this chapter in Orange County.
(2) "District" also includes the retirement system established
under this chapter in San Bernardino County at such time as the board
of retirement, by resolution, makes this section applicable in that
county.
(m) "District" also includes the Kern County Hospital Authority, a
public agency that is a local unit of government established
pursuant to Chapter 5.5 (commencing with Section 101852) of Part 4 of
Division 101 of the Health and Safety Code.
SEC. 2. Section 31552.5 is added to the
Government Code , to read:
31552.5. Employees and officers of the Kern County Hospital
Authority, a public agency that is a local unit of government
established pursuant to Chapter 5.5 (commencing with Section 101852)
of Part 4 of Division 101 of the Health and Safety Code, shall not
automatically become members of the Kern County Employees' Retirement
Association, but shall have their eligibility for membership in the
Kern County Employees' Retirement Association be established pursuant
to the provisions of that chapter.
SECTION 1. SEC. 3. Chapter 5.5
(commencing with Section 101852) is added to Part 4 of Division 101
of the Health and Safety Code, to read:
CHAPTER 5.5. KERN COUNTY HEALTH SYSTEM
HOSPITAL AUTHORITY ACT
Article 1. General Provisions
101852. (a) This chapter shall be known and may be cited as the
Kern County Health System Hospital
Authority Act.
(b) The Legislature finds and declares all of the following:
(1) Kern Medical Center, an acute care hospital currently operated
as a constituent department of the County of Kern, 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.
(2) Kern Health Systems, a separate public entity from the County
of Kern, is a special county health authority formed pursuant to
Section 14087.38 of the Welfare and Institutions Code to address
problems of delivery of publicly assisted medical care in the County
of Kern, and currently operates the local initiative, as defined in
subdivision (w) of Section 53810 of Title 22 of the California Code
of Regulations, in the county.
(2) Counties are authorized under current law to integrate their
county hospital services with those of other hospitals into a system
of community service that offers free choice of hospitals to those
requiring hospital care, with the objective of eliminating
discrimination or segregation based on economic disability, so that
the county hospital and other hospitals in the community share in
providing services to paying patients and to those who qualify for
care in public medical care programs. However, in a new era of health
care delivery, it is necessary to pursue approaches that transition
beyond acute care-centric orientations.
(3) The ongoing evolution of the health care environment
is a catalyst for requires public entities
providing or arranging health care service entities
services to pursue innovative health care
delivery models that proactively improve the quality of patient care
services and patient experience, efficiently and effectively increase
access to needed health care services across the care continuum,
provide services in a patient-centered manner, and moderate the rate
of growth of health care expenditures.
(4) In order for The board of supervisors
of the County of Kern and Kern Health Systems to
further their common mission of improving the health status of the
people of the County of Kern through has determined
that providing access to affordable, high quality
high-quality health care services, and
to help ensure ensuring the full engagement
and viability of the health care safety net in the
county, county are essential for
improving the health status of the people of the County of Kern. To
further this imperative, it is necessary that they be
permitted to combine resources and consolidate efforts towards an
integrated delivery system to achieve health plan and provider
alignment by enabling the operation of both Kern Medical Center and
the local initiative operated by Kern Health Systems under a new
special health system authority. the Kern Medical
Center, while continuing as a designated public hospital and
maintaining its mission, is provided with an organizational and
operational structure that facilitates and improves its ability to
function with flexibility, responsiveness, and innovation to promote
a patient-centric system of care delivery featuring community-based
care. This can best be accomplished by allowing the
operation of the Kern Medical Center, along with other health
-related resources, under a new hospital authority that is able
to pursue efforts towards a delivery system that embraces population
heal th management strategies, is effectively positioned
for health plan provider alignment, and maximizes opportunities for
employees and enhancement of staff morale.
(5) Because there is no general law under which this public health
system authority could be formed for these purposes, the adoption of
this act authorizing formation of a special authority by the
Legislature is required.
(5) This chapter is necessary to allow the formation of a public
hospital authority for the purposes described above.
101852.1. For purposes of this chapter, the following definitions
shall apply:
(a) "Authority" means the Kern County Health
Hospital System Authority established pursuant to this
chapter.
(b) "Board of supervisors" means the board of supervisors of the
County of Kern.
(c) "Board of trustees" governors
" means the governing body of the authority.
(d) "County" means the County of Kern.
(e) "Enabling ordinance" means the county ordinance enacted
by the board of supervisors pursuant to this chapter to
establish the authority, as it may be amended from time to
time.
(f) "Kern Health Systems" means the public entity that operates
the managed care plan organized by the county pursuant to Section
14087.38 of the Welfare and Institutions Code in the County of Kern.
(g) "Managed care plan" means the health plan licensed pursuant to
the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2
(commencing with Section 1340) of Division 2), which was established
by Kern Health Systems and serves as the local initiative, as defined
in subdivision (w) of Section 53810 of Title 22 of the California
Code of Regulations, in the County of Kern, and includes all plan
assets and operations that exist or are later established.
(h)
(f) "Medical center" means the assets and liabilities
comprising the Kern Medical Center , including,
without limitation, a licensed acute care hospital and related
public health care programs, facilities, care organizations,
physician practice plans and delivery systems, which may be
hospital-based or nonhospital-based, that now exist or are
established in the future. as specified by the board
of supervisors or the authority now or in the future, as the case may
be, depending on which entity controls the medical center.
Article 2. Establishment of the Kern County Health
System Hospital Authority
101853. (a) Pursuant to this chapter, the board of supervisors
may establish by ordinance the Kern County Health System
Hospital Authority, which shall be a public
agency that is a local unit of government separate and apart from the
county and any other public entity for all purposes. The authority
established pursuant to this chapter shall file the statement
required by Section 53051 of the Government Code, and is a public
entity for purposes of Division 3.6 (commencing with Section 810) of
Title 1 of the Government Code.
(b) The purpose of the authority shall be to do all of the
following:
(1) Provide management, administration, and other controls
consistent with this chapter for as needed to
operate the medical center to continue to operate
and maintain its status as a designated public
hospital, as defined in subdivision (d) of Section 14166.1 of the
Welfare and Institutions Code, and for the operation of additional
programs, clinics and other facilities, care
organizations, health care service and physician practice
plans, and delivery systems that may be affiliated or consolidated
with the medical center, to 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.
(2) Provide management, administration, and other controls
consistent with this chapter for the managed care plan to
continue to operate as a local initiative, as defined in subdivision
(w) of Section 53810 of Title 22 of the California Code of
Regulations, to ensure the substantial participation of the
disproportionate share hospital in the county and the safety net
providers with which it is affiliated, and to negotiate and
enter into contracts to provide or arrange, or provide directly,
on a fee-for-service, capitated, or other basis
, health care services to individuals including, but not
limited to, those covered under Subchapters XVIII (commencing with
Section 1395), XIX (commencing with Section 1396), and XXI
(commencing with Section 1397aa) of Chapter 7 of Title 42 of the
United States Code, those entitled to coverage under private group
coverage, private individual coverage, including without limitation,
coverage through Covered California, other publicly supported
programs, those employed by public agencies or private businesses,
and uninsured or indigent individuals.
(c) Subject to the requirements of this chapter, the authority
shall have and be charged with authority for
the management, administration, and control of the medical center and
the managed care plan. other health
-related resources. The State Department of Health Care
Services and Department of Managed Health Care
shall take all necessary steps to ensure all of the following:
(1) The authority is permitted to operate the medical
center and the managed care plan. center.
(2) The medical center continues its status as a designated public
hospital. hospital to at least the same
extent as it would be designated in the absence of its transfer to
the authority pursuant to this chapter.
(3) The managed care plan continues to operate as a local
initiative.
(4)
(3) The authority may participate as a contributing
public agency for all of the purposes of
specified in Section 433.51 of Title 42 of the
Code of Federal Regulations. Regulations, to
the extent permitted by federal law.
(d) The board of supervisors, in the enabling ordinance, shall
establish the terms and conditions of the transfers
transfer to the authority from the
county and Kern Health Systems, county,
including, but not limited to, all of the following:
(1) Any transfer of real and personal property, assets and
liabilities, including, but not limited to, liabilities of the
medical center determined and assigned by the county for county funds
previously advanced , but not repaid or otherwise recovered,
to fund the operations of the medical center.
(2) Transfer of employees, including any necessary personnel
transition plan, as specified in Section 101853.1.
101853.1, and assignment of title to
funded pension assets and responsibility for any unfunded pension
liabilities.
(3) Maintenance Maintenance,
operation , and management or ownership of the medical
center and managed care plan. center.
(4) Transfer of licenses.
(5) Any other matters as the board of supervisors deems necessary,
appropriate or convenient for the conduct of the authority's
activities activities.
(e) (1) Upon establishment of the authority, all assets and
liabilities comprising the managed care plan, and all operations and
governance of the managed care plan, shall be transferred to the
authority pursuant to the terms and conditions specified in the
enabling ordinance. The effective date of the transfer shall be as
prescribed in the enabling ordinance. The managed care plan shall
provide at least 30 days advance notice for change of ownership to
the Department of Managed Health Care in the form of a notice of
material modification.
(2) The notice of material modification shall describe any changes
in the governing body or higher management of the managed care plan,
and, notwithstanding any other law, shall be deemed approved upon
receipt. Any other changes to plan operations, governance, or
financial status shall be made after the change of ownership, and
shall be subject to the requirements of the Knox-Keene Health Care
Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340)
of Division 3).
(3) Upon the transfer of the maintenance, operation, and
management or ownership of the managed care plan to the authority,
the board of supervisors shall terminate Kern Health Systems by
ordinance. The board of supervisors shall notify the State Department
of Health Care Services 30 days prior to the effective date of the
termination.
(4) The provisions set forth in paragraph (5) of subdivision (t)
of, and subdivisions (v) and (x) of, Section 14087.38 of the Welfare
and Institutions Code shall not apply to the termination of Kern
Health Systems made pursuant to this chapter.
(5) Any liabilities of Kern Health Systems shall not become
obligations of the county upon termination of Kern Health Systems.
(6) With respect to the maintenance, operation, and management or
ownership of the managed care plan, the authority shall comply with
the applicable requirements of the Knox-Keene Health Care Service
Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of
Division 3).
(7) The board of supervisors may contract with the authority to
provide indigent care services on behalf of the county. The contract
shall specify that county policies, as may be modified from time to
time and 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.
Any contract executed by and between the county and the authority
shall provide for the indemnification of the county by the authority
for liabilities as specifically set forth in the contract, except
that the contract shall include a provision that the county shall
remain liable for its own negligent acts. Indemnification by the
authority shall not be construed as divesting the county from its
ultimate responsibility for compliance with Section 17000 of the
Welfare and Institutions Code.
(f)
(e) (1) A Notwithstanding any
other law, a transfer of maintenance, operation, and management
or ownership or lease of the medical center to the authority may be
made made, with or without the payment
of a purchase price by the authority
authority, and otherwise upon the terms and conditions as found
necessary by the board of supervisors and specified in the enabling
ordinance to ensure that the transfer will constitute an ongoing
material benefit to the county and its residents.
(2) A transfer of the maintenance, operation, and management
, or ownership or lease of the medical center to the authority
shall not be construed as empowering the authority to transfer any
ownership interest of the county in any portion of the
medical center except as otherwise approved by the board of
supervisors.
(3) The authority shall not transfer the maintenance, operation,
and management or ownership or lease of the medical center to any
other person or entity without the prior written approval
of the board of supervisors. This paragraph shall not prevent
the county, by ordinance, from allowing the disposal of obsolete or
surplus equipment, supplies, or furnishings of the medical center by
the authority.
(4) With respect to the maintenance, operation, and management or
ownership or lease of the medical center, the authority
shall conform to both of the following requirements:
(A) Comply with any applicable requirements o f
Section 14000.2 of the Welfare and Institutions Code.
(B) Comply with any applicable requirements of Section 1442.5.
(5) The board of supervisors may retain control of the medical
center physical plant and facilities except as otherwise
facilities, as specifically provided for in the
enabling ordinance or other lawful agreements entered into by the
board of supervisors. Any lease agreement or other agreement
between the county and the authority may
shall provide that county premises shall not be sublet
without the approval of the board of supervisors.
(6) Notwithstanding any other provision of this chapter, and
whether or not accompanied by a change in licensing, the authority's
responsibility for the maintenance, operation, and management of
the medical center, or any ownership or
leasehold interest of the authority in the medical
center , does
not relieve the county of the ultimate responsibility for indigent
care pursuant to Section 17000 of the Welfare and Institutions Code.
(7) For purposes of Article 12 (commencing with Section 17612.1)
of Chapter 6 of Part 5 of Division 9 of the Welfare and Institutions
Code, and the definition set forth in subdivision (f) of Section
17612.2 of the Welfare and Institutions Code, the medical center,
excluding components that provide predominately public health
services, and the county are affiliated governmental entities.
(f) The board of supervisors may contract with the authority for
the provision of indigent care services on behalf of the county. The
contract shall specify that county policies, as may be modified from
time to time and 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. Any contract executed by and between the county and
the authority shall provide for the indemnification of the county by
the authority for liabilities as specifically set forth in the
contract, except that the contract shall include a provision that the
county shall remain liable for its own negligent acts.
Indemnification by the authority shall not divest the county from its
ultimate responsibility for compliance with Section 17000 of the
Welfare and Institutions Code.
(g) Unless otherwise agreed to by the authority and the board of
supervisors, 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. An obligation of the authority, statutory, contractual,
or otherwise, shall not be the obligation of the state.
(h) 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).
(i) The authority is not 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.
(j) The authority is a "district"
within the meaning set forth in the County Employees Retirement Law
of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of
Division 4 of Title 3 of the Government Code). Employees
of the authority are eligible to become members or maintain
membership, as applicable, in the Kern County Employees' Retirement
Association, to the extent described in subdivision (g) of Section
101853.1.
101853.1. (a) In exercising its powers to employ personnel, the
authority shall implement, and the board of supervisors shall adopt,
a personnel transition plan. The personnel transition plan shall
require all of the following:
(1) Ongoing communication to employees and recognized employee
organizations regarding the impact of the transition on existing
managed care plan, medical center, county, and
other health care facility employees and employee classifications.
(2) Meeting and conferring with representatives of affected
bargaining unit employees on both of the following issues:
(A) A timeframe for which the transfer of personnel shall occur.
(B) Specified periods of time during which county or medical
center employees affected by the establishment of the authority may
elect to be considered for appointment and exercise
reinstatement rights, if applicable, to funded, equivalent,
vacant county positions, and exercise reinstatement rights,
positions for which they are qualified and
eligible. An employee who first elects to remain with the
county, but who county may subsequently
seeks employment seek reinstatement with the
authority within 30 days of this election,
the election to remain with the county and shall be subject to
the requirements of this article.
(3) Acknowledgment that the authority, to the extent permitted by
federal and state law, shall be bound by the terms of the
memoranda of understanding executed between the county and its
exclusive employee representatives that are or will be
in effect as of on the date
the county adopts the enabling ordinance pursuant to this
article. chapter. Subsequent memoranda of
understanding with exclusive employee representatives shall
be subject to approval only by the board of trustees, and
not the county. board of governors.
(b) The implementation Implementation
of this chapter shall not be a cause for the modification of
the level of medical center, county, or
Kern Health Systems center or county employment
benefits. Upon the execution of the enabling ordinance, employees
who serve or work for of the medical
center, county, or Kern Health Systems immediately prior to
the implementation of this chapter, and center or
county on the date of execution, who become authority
employees, 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 care,
retiree health benefits, and deferred compensation plans. The
transfer of an employee from the medical center or county shall not
constitute a termination of employment for purposes of Section 227.3
of the Labor Code, or employee benefit plans and arrangements
maintained by the medical center or county , except as
otherwise provided in t he enabling ordinance or personnel
transition plan, nor shall it be counted as a break in uninterrupted
employment for purposes of Section 31641 of the Government Code with
respect to the Kern County Employees' Retirement Association, or
state service for purposes of the Public Employees' Retirement System
(Part 3 (commencing with Section 20000) of Division 5 of Title 2 of
the Government Code).
(c) The Subject to applicable
state law, the authority shall recognize as
the exclusive employee representatives of those authority
employees who perform functions are
transferred from the county or medical center to the
authority, authority pursuant to this
chapter, the employee organizations that represented the employees at
the county or medical center performing those functions at the time
of transfer. chapter.
(d) 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 law, the authority shall do all of the
following for a period of 24 months after the effective date of the
transfer of the medical center to the authority:
(1) Continue to recognize each exclusive employee
representative of each bargaining unit.
(2) Continue to provide at least the same level
of employee benefits to authority employees, who were
medical center, county, or managed care plan employees, that had been
provided to these employees, whether those whether
the obligation to provide those benefits arise out of a
memorandum of understanding, or other agreements or law.
(3) Roll over Extend and continue to
be bound by any existing medical center or county
memoranda of understanding covering the terms and condition
conditions of employment for employees of the
authority , including the level of wages and benefits,
of transferred employees for 24 months after the term end date of
any memoranda of agreement, and any county
rules, ordinances, or policies specifically identified and
incorporated by reference in a memoranda of understanding for 24
months or through the term of the memorandum of understanding,
whichever shall be the longer, unless modified by mutual
agreement with each of the employees' exclusive
representatives, and only to the extent that continuing
employee representatives. The authority shall continue
to provide those pension benefits specified in any memoranda
of agreement as long as doing so does not conflict with
any Kern County Employees' Employee
Retirement Association 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 employee
representatives. bylaws, or federal or state law
including the County Employees Retirement Law of 1937
(Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of
Title 3 of the Government Code).
(4) Meet and confer with the exclusive employee representatives to
develop processes and procedures to address employee disciplinary
action taken against permanent employees. If the authority
terminates, suspends, demotes, or reduces the pay of a permanent
employee for disciplinary reasons, those actions shall only be for
cause consistent with state law, and an employee shall be afforded
applicable due process protections granted to public employees under
state law. Permanent employees laid off by the authority within six
months of the date the ordinance is adopted shall remain on the
county reemployment list for two years. Inclusion on the county
reemployment list is not a guarantee of reemployment. For the
purposes of this paragraph, the term "permanent employees" excludes
probationary employees, temporary employees, seasonal employees,
provisional employees, extra help employees, and per diem employees.
(5) To the extent layoffs occur, and provided that all other
previously agreed upon factors are equal, ensure that seniority shall
prevail. The authority shall meet and confer with the exclusive
employee representatives to address layoff procedures and the manner
in which, and the extent to which, seniority shall be measured for
employees who transfer from the medical center or county.
(e) Permanent employees of the medical center, county, or
Kern Health Systems center or county on the
effective date of the transfer of the medical center and the
managed care plan, as applicable, to the authority, shall
be deemed qualified for employment or retention in
equivalent positions at the authority, and no other qualifications
shall be required except as otherwise required by state or federal
law. Probationary employees on the effective date of ,
the transfer, as set forth in this paragraph,
shall retain their probationary status and rights and shall not be
deemed to have transferred so as to require serving
required to serve a new probationary
period. or extend their probationary period by reason
of the transfer. To the extent possible, employees who transfer
to equivalent positions at the authority shall retain their existing
classifications and job descriptions, but to the extent
if there is a dispute on
over this issue, the authority agrees to meet and confer with
the exclusive employee representatives of the transferred
employees exclusive authorized representative.
employees.
(f) Employees who transfer from the medical center,
county, or Kern Health Systems center or county
to the authority shall retain the seniority they earned from
their previous employers. The authority shall continue to provide
for the maintenance of any benefits that accompany seniority, if they
existed, prior to the transfer. All time served in the same,
equivalent, or higher classification shall be counted toward
classification seniority. at the medical center or
county and any benefits or privileges based on the
seniority.
(g) Notwithstanding any other law, employees of the authority may
participate in the Kern County Employees' Retirement Association,
operated pursuant to the County Employees Retirement Law of 1937
(Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of
Title 3 of the Government Code), as follows:
(1) Employees transferred from the county or medical center to the
authority who are subject to a memorandum of understanding between
the authority and an exclusive employee representative, as described
in paragraphs (2) and (3) of subdivision (d), and who were members of
the Kern County Employees' Retirement Association at the time of
their transfer of employment, shall continue to be a member of the
Kern County Employees' Retirement Association, retaining service
credit earned to the date of transfer, to the extent provided for in
the applicable memorandum of understanding.
(2) Employees transferred from the county or medical center to the
authority who are subject to a memorandum of understanding between
the authority and an exclusive employee representative, as described
in paragraphs (2) and (3) of subdivision (d), and who were not
members of the Kern County Employees' Retirement Association at the
time of their transfer of employment, shall subsequently become a
member of the Kern County Employees' Retirement Association only to
the extent provided for in the applicable memorandum of
understanding.
(3) Employees transferred from the county or medical center to the
authority who are not subject to a memorandum of understanding
between the authority and an exclusive employee representative, as
described in paragraphs (2) and (3) of subdivision (d), and who were
members of the Kern County Employees' Retirement Association at the
time of their transfer of employment, shall continue to be a member
of the Kern County Employees' Retirement Association, retaining
service credit earned to the date of transfer, as provided in the
enabling ordinance or the personnel transition plan.
(4) Employees transferred from the county or medical center to the
authority who are not subject to a memorandum of understanding
between the authority and an exclusive employee representative, as
described in paragraphs (2) and (3) of subdivision (d), and who were
not members of the Kern County Employees' Retirement Association at
the time of their transfer of employment, shall subsequently become a
member of the Kern County Employees' Retirement Association only to
the extent provided in the enabling ordinance or the personnel
transition plan.
(5) Employees hired by the authority on or after the effective
date of the enabling ordinance shall become a member of the Kern
County Employees' Retirement Association only to the extent provided
in the enabling ordinance or personnel transition plan described in
subdivision (a), or, if subject to a memorandum of understanding
between the authority and an exclusive employee representative as
described in paragraphs (2) and (3) of subdivision (d), to the extent
provided for in the applicable memorandum of understanding.
(6) Notwithstanding any other law, for purposes of California
Public Employees' Pension Reform Act of 2013 (Article 4 (commencing
with Section 7522) of Chapter 21 of Division 7 of Title 1 of the
Government Code), an individual who was employed by the county or the
medical center when it was a constituent department of the county,
and is a member of the Kern County Employees' Retirement Association
or the Public Employees' Retirement System, as set forth in Part 3
(commencing with Section 20000) of Division 5 of Title 2 of the
Government Code, prior to January 1, 2013, and who transfers,
directly or after a break in service of less than six months, to the
authority, in which the individual continues to be a member of either
the Kern County Employees' Retirement Association or the Public
Employees' Retirement System, as applicable, shall not be deemed to
be a new employee or a new member within the meaning of Section
7522.04 of the Government Code, and shall continue to be subject to
the same defined benefit formula, as defined in Section 7522.04 of
the Government Code, as it would have been available to members of
the Kern County Employees' Retirement Association or the Public
Employees' Retirement System who were first employed by the county or
medical center and as a result of the employment became a member of
a public retirement system, on or before December 31, 2012.
(h) This chapter shall not prohibit the authority from contracting
with the Public Employees' Retirement System, in accordance with the
requirements of Section 20508 and any 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 employee
participation in that system, or from establishing an alternative or
supplemental retirement system or arrangement, including, but not
limited to, deferred compensation arrangements, to the extent
permitted by law and subject to any applicable agreement between the
authority and the exclusive employee representatives, and as provided
in the enabling ordinance or the personnel transition plan.
(g) Notwithstanding anything to the contrary contained in this
chapter, this chapter
(i) Provided that this is not
inconsistent with anything in this chapter, this chapter does
not prohibit 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.
Article 3. Board of Trustees Governors
101854. (a) The authority established pursuant to this chapter
shall be governed by a board of trustees
governors that is appointed, both initially and continually, by
the board of supervisors. The board of supervisors, in the enabling
ordinance, shall specify the number of members and the
composition of membership of the board of trustees,
governors, the qualifications for individual
members, the manner of appointment, selection, or removal of board of
trustees governors members, their
terms of office, and all other matters that the board of supervisors
deems necessary or convenient for the conduct of the board of
trustees. governors. Notwithstanding
any other law, at the board of supervisors' discretion and as
specified in the enabling ordinance, the board of trustees
governors may consist entirely of members of the
board of supervisors or may include any number of the members of the
board of supervisors. supervisors or county
officers or employees appointed to represent the interest of the
county.
(b) The board of supervisors, either during or after the formation
of the authority, may modify the number, length of terms,
and appointing authority for the board of trustees,
qualifications, method of appointment, and provisions for all
other matters pertaining to the board of trustees
governors by subsequent ordinance.
(c) The board of supervisors shall adopt bylaws for the authority
that, among other things, shall specify the officers of the board of
trustees, governors, the time, place,
and conduct of meetings, and other matters that the board of
supervisors 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 supervisors, but may be amended, from
time to time, by a majority vote of the board of supervisors.
(d) Notwithstanding any other law, a member of the board of
trustees governors shall not be deemed
to be interested in a contract entered into by the authority within
the meaning of Article 4 (commencing with Section 1090) of Chapter 1
of Division 4 of Title 1 of the Government Code if either of the
following apply:
(1) The contract is between the authority and the county or
an agency of the county, and the member is also a member of the
board of supervisors, or is a county officer or employee
appointed to represent the interests of the board of
supervisors. county.
(2) All the following applies to the member:
(A) The member was appointed to represent the interests of
physicians, health care practitioners, hospitals, pharmacies, or
other health care organizations, or beneficiaries.
(B) The contract authorizes the member or the organization the
member represents to provide services to beneficiaries under the
authority's programs.
(C) The contract contains substantially the same terms and
conditions as contracts entered into with other individuals or
organizations that the member was appointed to represent.
(D) The member does not influence or attempt to influence the
health authority or another member of the authority to enter into the
contract in which the member is interested.
(E) The member discloses the interest to the authority and
abstains from voting on the contract.
(F) The board of trustees governors
notes the member's disclosure and abstention in its official records
and authorizes the contract in good faith by a vote of its membership
sufficient for the purpose without counting the vote of the
interested member.
(e) Members of the board of trustees
governors shall not be vicariously liable for injuries caused
by the act or omission of the authority to the extent that protection
applies to members of governing boards of local public entities
generally under Section 820.9 of the Government Code.
(f) The board of trustees governors
created and appointed pursuant to this chapter is a duly constituted
governing body as the term is used in Section 1250 and defined in
Section 70035 of Title 22 of the California Code of Regulations.
(g) In the event of a change of license ownership, the board of
trustees governors 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.
Article 4. Powers and Duties of the Authority
101855. (a) The authority, in addition to any other powers
granted 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, or any successor or
modified Medi-Cal debt service reimbursement program, the
payment of interest on notes and bonds of the authority, the
establishment of reserves to secure these
those 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.
(D) Nothing herein in this section
shall preclude the authority from repayment of its debts or other
liabilities, using funds that are not otherwise encumbered
and do not cause the managed care plan's tangible net equity to drop
below its required level. encumbered.
(8) To pursue its own credit rating.
(9) To enter into a contract or agreement consistent with this
chapter or the laws of this state, including, but not
limited to, contracting with any public or private entity or person
for management or other services and personnel, 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.
(10) To purchase supplies, equipment, materials, property, and
services.
(11) To establish policies relating to its purposes.
(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.
(13) To participate in, contract for, and to accept, gifts,
grants, and loans of funds, property, or other aid or finance
opportunity in any form from the federal government, the state, a
state agency, or other source, or combination thereof, as otherwise
would be available to a public, government, or private entity, and to
comply, subject to this chapter, with the terms and conditions
thereof.
(14) To invest surplus money in its own treasury, manage
investments, and engage third-party investment managers, in
accordance with state law.
(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.
(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.
(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. Notwithstanding any other provision of law, the
authority may enter into a joint powers agreement as described in
Section 6523.5 of the Government Code as though that section applied
to hospitals and other health care facilities in the County of Kern.
(18) To establish nonprofit, for profit, or other entities
necessary to carry out the duties of the authority.
(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.
(20) To use a computerized management information system,
including an electronic health records system, in connection with
its operations, including, without limitation the
administration of its facilities and Medi-Cal managed care
plans. facilities.
(21) To request that the board of supervisors levy a tax on behalf
of the authority. If the board of supervisors approves the proposal
to levy the tax, it shall call the election to seek voter approval
and place the appropriate measure on the ballot for that election.
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
these those taxes, and shall defend, indemnify,
and hold harmless the county from any liability, costs, or expenses
arising from or related to the imposition of these taxes.
(22) Notwithstanding the provisions of this chapter relating to
the obligations and liabilities of the authority, or any other law, a
transfer of control or ownership of the medical center and
the managed care plan to the authority pursuant to
this chapter shall confer onto the authority all the rights
, privileges, and duties authority
set forth in state law with respect to
own, operate, and provide coverage and services through
hospitals, clinics and other health facilities, health
programs, care organizations, physician practice plans, delivery
systems, and health care service plans , and
other coverage mechanisms that may be owned or operated by a
county.
(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,
governors, in order to respond to changes in the health care
industry.
(b) The authority shall conform to the following requirements:
(1) (A) Be a government agency that is a local unit of government
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 civil service
requirements of the county. Except as otherwise provided for in the
enabling ordinance consistent with this chapter, and as set forth in
Section 101853.1, 101853.1 relating to the
personnel transition plan, the authority shall not be governed
by, or subject to, other policies or operational rules of the county,
medical center, or any other public entity, including, but not
limited to, those relating to personnel and procurement.
(B) The board of trustees governors
shall adopt written rules, regulations, and procedures with regard to
basic human resource functions not inconsistent with
employees' memoranda of understanding covering
employees represented by employee organizations or the
provisions of this chapter. Until the time that the board of
trustees governors adopts its own rules,
regulations, or procedures with regard to these functions, the
existing rules, regulations, and procedures set forth in any
memoranda of understanding described in Section 101853.1 and
the enabling ordinance shall 101853.1, and the rules
and regulations adopted by the county and described in paragraph (4),
shall continue to apply.
(2) Be subject to state and federal taxation laws that are
applicable to public entities generally.
(3) Except as otherwise specifically provided in this chapter,
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 (Chapter 9 (commencing with Section
54950) of Part 1 of Division 2 of Title 5 of the Government
Code).
(4) Be subject to the jurisdiction of the Public Employment
Relations Board. Until the authority adopts local
rules and regulations pursuant to subdivision (a) of
Section 3507 of the Government Code, the Public Employment
Relations Board's regulations apply. existing rules
adopted by the county and contained in the county's employer-employee
relations resolution, as amended, shall apply, modified to account
for the creation of the authority, and provided further that the
resolution shall not contain any incorporation of the county's civil
service rules or county ordinances unless specifically addressed in
this chapter.
(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) Maintain financial and accounting records.
(7)
(8) Meet all local, state, and federal data reporting
requirements.
(c) The Subject to any restrictions
applicable to public agencies, and subject to any limitations or
conditions set forth in the enabling ordinance adopted by the board
of supervisors, the authority may borrow money from
the county, repay debt and otherwise it owes
to the county, and use the borrowed funds to provide
and arrange for medical services. for its operating
and capital needs. The county may lend the authority funds or
issue revenue anticipation notes to obtain those funds necessary to
operate the medical center and managed care plan.
meet its operating or capital needs.
(d) 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.
(e) (1) Notwithstanding any other law, the board of
trustees governors may order that a meeting held
solely for the purpose of discussion or taking action on authority
trade secrets, as defined in subdivision (d) of Section 3426.1 of the
Civil Code, shall be held in closed session. Trade secrets for
purposes of this chapter shall also include information for which the
secrecy of the information is necessary for the authority to
initiate a new service, program, marketing strategy, business plan,
or technology, or to add a benefit or product, and premature
disclosure of the trade secret would create a substantial probability
of depriving the authority of a substantial economic benefit or
opportunity.
(2) The requirements of making a public report of actions taken in
closed session and the vote or abstention of every member present
may be limited to a brief general description devoid of the
information constituting the trade secret.
(3) Those records of the authority that reveal the authority's
trade secrets are exempt from disclosure pursuant to the California
Public Records Act (Chapter 3.5 (commencing with Section 6250) of
Division 7 of Title 1 of the Government Code), or any similar local
law requiring the disclosure of public records. This exemption shall
apply for a period of two years after the service, program, marketing
strategy, business plan, technology, benefit, or product that is the
subject of the trade secret is formally adopted by the governing
body of the health authority, provided that the
service, program, marketing strategy, business plan, technology,
benefit, or product continues to be a trade secret. The board of
trustees governors may delete the
portion or portions containing trade secrets from any documents that
were finally approved in the closed session that are provided to
persons who have made the timely or standing request.
(4) This section chapter shall not
prevent the board of trustees governors
from meeting in closed session as otherwise provided by law.
(f) Notwithstanding any other law, those records of the authority
and of the county that reveal the authority's rates of payment for
health care services for the managed care plan, the rates of
payment for health care services arranged or
provided by the medical center, or the authority's
authority or its deliberative processes, strategies,
discussions, communications, or any other portion of the
negotiations with providers of health care services or Medi-Cal,
health care plans or other payors for rates of payment, shall not be
required to be disclosed pursuant to the California Public Records
Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of
Title 1 of the Government Code), or any similar local law requiring
the disclosure of public records. However, three years after a
contract or amendment to a contract is fully executed, the portion of
the contract or amendment containing the rates of payment shall be
open to inspection.
(g) The authority shall be a public agency that is a local unit of
government 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.
(h) Unless otherwise provided by the board of supervisors by way
of resolution, the authority is empowered, or the board of
supervisors is empowered on behalf of the authority, to apply as a
public agency for one or more licenses for the provision of health
care or the operation of a health care services
service plan pursuant to statutes and regulations
governing licensing as currently written or subsequently amended.
(i) 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.
governors.
(j) (1) Except as otherwise provided in this chapter, 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, or any peer
review body, as defined in paragraph (1) of subdivision (a) of
Section 805 of the Business and Professions Code, formed pursuant to
the powers granted to the authority. 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 Article 9 (commencing with Section 11120) of
Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9
(commencing with Section 54950) of Part 1 of Division 2 of Title 5
of, the Government Code, or any other provision of law, any peer
review body formed pursuant to the powers granted to the authority,
may, at its discretion and without notice to the public, meet in
closed session, so long as the purpose of the meeting is the peer
review body's discharge of its responsibility to evaluate and improve
the quality of care rendered by health facilities and health
practitioners. The peer review body and its members shall receive, to
the fullest extent, all immunities, privileges, and protections
available to those peer review bodies, their individual members, and
persons or entities assisting in the peer review process, including
those afforded by Section 1157 of the Evidence Code and Section 1370.
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.
(3) Notwithstanding the California Public Records Act (Chapter 3.5
(commencing with Section 6250) of Division 7 of Title 1 of the
Government Code), or Article 9 (commencing with Section 11120) of
Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9
(commencing with Section 54950) of Part 1 of Division 2 of Title 5
of, the Government Code, or any other provision of state or local law
requiring disclosure of public records, those records of a peer
review body formed pursuant to the powers granted to the authority,
shall not be required to be disclosed. The records and proceedings of
the peer review body and its individual members shall receive, to
the fullest extent, all immunities, privileges, and protections
available to those records and proceedings, including those afforded
by Section 1157 of the Evidence Code and Section 1370 of the Health
and Safety Code.
(4) 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.
(5) Notwithstanding any other law, Section 1461 shall apply to
hearings on reports of hospital medical audit or quality assurance
committees.
(k) Except as expressly provided by other provisions of this
section, all exemptions and exclusions from disclosure as public
records pursuant to this chapter and the California Public Records
Act, including, but not limited to, those pertaining to trade secrets
and information withheld in the public interest, shall be fully
applicable to the authority, and for the board of
supervisors, and all state and local agencies with respect to all
writings that the authority is required to prepare, produce, or
submit, and which shall not constitute a waiver of exemption from
disclosure.
(l) The authority and the county, 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 governors
shall have authority over procurement and contracts for the
authority. The board of trustees governors
shall adopt written rules, regulations, and procedures with
regard to these functions. Contracts by and between the authority and
a 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.
(n) The authority may contract with the county for services and
personnel upon mutually agreeable terms.
(o) 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, Section 1099 of
the Government Code, related to incompatible offices, or any other
law, a member of the authority's administrative staff shall not
be considered to hold an incompatible office or to be
engaged in activities inconsistent and incompatible with his or her
duties as a result of prior his or her
employment or affiliation with the county or Kern Health
Systems. or an agency of the county.
(p) The board of trustees governors
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.
101855.1. (a) Transfer by the county to the authority of the
maintenance, operation, and management or ownership of the medical
center, whether or not the transfer includes the surrendering by the
county of the 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 to undertake, and
shall authorize the authority, subject to applicable requirements, to
do any of the following:
(1) 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.
(2) 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.
(3) Participate in the financing of , as applicable,
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.
(4) Participate in the financing of , as applicable,
and receive, Medi-Cal payments and supplemental
reimbursements, including, but not limited to, payments made pursuant
to Sections 14105.96, 14105.965, 14166.4, and 14182.15
14182.15, and 14199.2 of the Welfare and
Institutions Code, payments described in paragraph (4) of subdivision
(b) of Section 14301.4 of, and Section 14301.5 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.
(5) Participate in the financing of, as applicable, 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.
(6) 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.
(7) Participate in and receive direct grant and payment
allocations pursuant to Article 5.230 (commencing with Section
14169.50) 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.
(8) Receive Medi-Cal capital supplements pursuant to Section
14085.5 of the Welfare and Institutions Code.
Code, or any other successor or modified Medi-Cal debt service
reimbursement program. Notwithstanding any other law,
supplemental payments shall be made to the medical center under
Section 14085.5 of the Welfare and Institutions Code
those programs 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.
(9) Receive any other funds , or preference in the
assignment of health care plan enrollees, that would otherwise
be available to a county health plan, provider ,
or designated public hospital, or governmental entity with
which it is affiliated.
(b) A transfer described in subdivision (a)
The transfer of the medical center to the authority
pursuant to this chapter shall not otherwise disqualify the
county or the board of trustees, or in the case of a change
in license ownership, the authority, authority
from participating in any of the following:
(1) Local, state, and federal funding sources either specific to
county or other publicly owned or operated health care service plans,
hospitals, or other health care providers including, but not limited
to, ambulatory care clinics, health systems, practices, designated
public hospitals, or government entities with which they are
affiliated, for which there are special provisions specific to those
plans, hospitals, ambulatory care clinics, health systems,
practices, other health care providers or government entities with
which they are affiliated.
(2) Funding All funding
programs in which the county, by itself or on behalf of the medical
center, or in which Kern Health Systems
center 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 or managed care plan
not been
transferred to the authority pursuant to this chapter.
Article 5. Termination Dissolution
of the Authority
101856. (a) The board of supervisors may
find and declare that the authority shall cease to exist. In that
event, the board of supervisors shall provide for the disposition of
the authority's assets, obligations, and liabilities.
liabilities, which may include the transfer to the
county of the medical center and other operations, or specified
components of the medical center and other operations, through
ordinance, resolution, or other action. Alternatively, the
board of supervisors may order the board of governors to develop a
plan of dissolution providing for the disposition of all of the
assets and liabilities of the authority, which shall be subject to
approval by the board of supervisors. 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
(b) Upon the disposition of the
authority's assets and liabilities,
liabilities of the authority and distribution of any remaining
assets, as applicable, 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. exist. The board of supervisors shall
notify the State Department of Health Care Services 30 days prior to
the effective date of the termination. The notice may also
include a statement of the board of supervisors' intent to have
dissolution, and include in the notice whether the
county intends for either or both, or specified components of,
the medical center and the managed care plan
or other operations to be transferred to the county upon the
effective date of termination di
ssolution of the authority.
101856.1. In the event that the authority votes to file a
petition of bankruptcy, or the board of supervisors notifies the
State Department of Health Care Services of its intent to terminate
the authority, the provisions set forth in paragraphs (5) and (6) of
subdivision (t) of Section 14087.38 of the Welfare and Institutions
Code shall apply unless the board of supervisors has notified the
State Department of Health Care Services of its intent to have the
medical center and the managed care plan transferred to the county.
SEC. 2. SEC. 4. The Legislature
finds and declares that Section 1 3 of
this act, which adds Chapter 5.5 (commencing with Section 101852) to
Part 4 of Division 101 of the Health and Safety Code, imposes a
limitation on the public's right of access to the meetings of public
bodies or the writings of public officials and agencies within the
meaning of Section 3 of Article I of the California Constitution.
Pursuant to that constitutional provision, the Legislature makes the
following findings to demonstrate the interest protected by this
limitation and the need for protecting that interest:
In order to enable the Kern County Health System
Hospital Authority to successfully operate
both the Kern Medical Center and managed care plan as an
integrated a delivery system that increases
access to health care in the community and proactively improves the
quality of patient care services and patient experience, it is
imperative that the authority's discussions, deliberative processes,
writings, and other communications pertaining to trade secrets or
other strategic planning actions, its rates of payments for providing
or arranging for health care services, and its peer review functions
by which it discharges its responsibility to evaluate and improve
the quality of care be protected as confidential information.
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CORRECTIONS Text--Pages 8, 10, and 16.
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