BILL ANALYSIS Ó SENATE COMMITTEE ON GOVERNANCE AND FINANCE Senator Robert M. Hertzberg, Chair 2015 - 2016 Regular ------------------------------------------------------------------ |Bill No: |AB 72 |Hearing | 9/10/15 | | | |Date: | | |----------+---------------------------------+-----------+---------| |Author: |Bonta |Tax Levy: |No | |----------+---------------------------------+-----------+---------| |Version: |9/9/15 |Fiscal: |No | ------------------------------------------------------------------ ----------------------------------------------------------------- |Consultant|Weinberger | |: | | ----------------------------------------------------------------- EDEN TOWNSHIP HEALTHCARE DISTRICT: SPECIAL TAXES: AUTHORIZATION Allows the Eden Township Healthcare District to impose special taxes. Background and Existing Law The Eden Township Healthcare District (ETHD) formed in 1948 to serve the Alameda County communities of Castro Valley, Hayward, San Leandro, and San Lorenzo. In 1954, ETHD opened Eden Medical Center (EMC) hospital. In 1997, ETHD's voters approved a merger agreement between ETHD and Sutter Health, which allowed the ETHD to sell EMC to Sutter Health. In 2004, the ETHD purchased San Leandro Hospital and leased it to EMC to operate. In 2008, ETHD entered into an agreement with Sutter Health to replace EMC with a newly-constructed hospital that would comply with the state's seismic safety law. The 2008 agreement also gave Sutter the option to purchase San Leandro Hospital. On December 21, 2011, an appellate court ruled in favor of Sutter in litigation over the terms of the 2008 agreement. On October 31, 2013, Sutter transferred San Leandro Hospital to the Alameda Health System, the public health authority that operates Alameda County's health care system. San Leandro Hospital is a 93-bed facility that provides a wide AB 72 (Bonta) 9/9/15 Page 2 of ? range of medical services, including 24-hour emergency services, critical care, a full complement of skilled surgeons, rehabilitation services, and ancillary services to a population of 265,000 people. St. Rose Hospital is a 150-bed independent community hospital in Hayward, which provides a range of services including cardiology, emergency, diagnostics, and women's services to residents of Hayward and the surrounding community. Both San Leandro Hospital and St. Rose Hospital are located within ETHD's jurisdictional boundaries. Some Alameda County officials are concerned that fiscal challenges confronting San Leandro Hospital and St. Rose Hospital threaten their ability to continue providing vital health care services to their surrounding communities. As officials struggle to find additional financial support for those two hospitals, ETHD is considering seeking voter-approval of a parcel tax to generate some of that additional funding. However, state law allows a health care district to impose special taxes, with two-thirds voter approval, only if the district owns and operates its own hospitals (AB 3596, Hauser, Chapter 1345, Statutes of 1988). Because ETHD no longer owns and operates its former hospitals, it cannot impose special taxes under current law. ETHD officials want the Legislature to allow the district to impose special taxes regardless of whether it owns or operates a hospital. Proposed Law Assembly Bill 72 allows the Eden Township Healthcare District, until January 1, 2026, to impose special taxes within the district, pursuant to procedures established in state law. AB 72 requires the district's board of directors to determine the basis and nature of a special tax and its manner of collection. AB 72 defines "special taxes," for purposes of the bill's provisions, as special taxes that apply uniformly to all taxpayers or all real property within the district. AB 72 (Bonta) 9/9/15 Page 3 of ? This bill declares the Legislature's intent that funds from a tax enacted pursuant to this section must be used to support the purposes of the district, including support of nonprofit and public hospitals and other health care providers in the communities served by the district. State Revenue Impact No estimate. Comments 1. Purpose of the bill . The 1988 statute authorizing local health care districts to impose parcel taxes within a district's boundaries taxes limited the special tax power only to those districts that own and operate a hospital. Despite having recently owned San Leandro Hospital, ETHD is prohibited by state law from imposing a parcel tax to support that hospital, which provides vital medical services, including emergency room care, to district residents. ETHD has provided financial support from its existing revenues to St. Rose hospital, but is prohibited from imposing a parcel tax to help keep that hospital open. AB 72 would give ETHD the same taxing authority that state law already grants to many other local health care districts. This bill does not require ETHD to seek approval for a parcel tax and leaves the ultimate decision in the hand of district voters, who must approve any proposed parcel tax by a two-thirds vote. AB 72 simply provides ETHD officials with another tool to use to support hospitals and health facilities that serve district residents and are confronting severe fiscal challenges. 2. Revenues and responsibilities . Principles of efficient public administration suggest that the power to raise revenues should be exercised by the same governing body that has the responsibility for deciding how those revenues are going to be spent. AB 72 allows parcel taxes for the support of community hospitals to be imposed by local governments that are not directly responsible for those hospitals. If Alameda County officials want to use parcel tax revenues to support San Leandro Hospital, why not amend state law to allow Alameda County or Alameda Health System to impose the parcel tax, rather than having the revenues pass through ETHD? Or, alternatively, why AB 72 (Bonta) 9/9/15 Page 4 of ? can't Alameda County impose parcel taxes within a county service area established specifically to support San Leandro Hospital? 3. Precedent . ETHD is not the only health care district that continues to exist without actually owning or operating a hospital. Enacting AB 72 may invite similar requests from some of the dozens of other healthcare districts throughout California that do not own or operate hospitals. The continued operation of these healthcare districts without hospitals raises broader policy questions about the need for such districts, and whether they should be dissolved or merged into other local governments. AB 72 appears to move in a different direction by establishing a precedent that those districts should be granted the power to collect new voter-approved taxes. 4. Good intentions . AB 72 declares the Legislature's intent to limit the purposes for which ETHD can spend revenues from parcel taxes imposed pursuant to the bill's provisions. However, this statement of intent, which directs that the district must spend parcel tax revenues "to support the purposes of the district," may be too broad to have any practical effect on the district's use of revenues. ETHD faces its own fiscal challenges, including more than $40 million in outstanding bank loans and more than $17 million in obligations resulting from the legal dispute with Sutter Health. Repaying existing indebtedness or paying for ongoing district expenses appear to be allowable uses for the parcel tax revenues under the bill's current language. The Committee may wish to consider whether AB 72 should more narrowly declare the legislature's intent that ETHD must use parcel tax revenues only to support nonprofit and public hospitals and other health care providers in the communities served by the district. 5. Urgency . Regular statutes take effect on January 1 following their enactment; bills passed in 2014 take effect on January 1, 2015. The California Constitution allows bills with urgency clauses to take effect immediately if they're needed for the public peace, health, and safety. AB 72 contains an urgency clause declaring that it is necessary for its provisions to go into effect immediately to ensure that residents of the Eden Township Healthcare District have continued access to critical health care services. 6. Special legislation . The California Constitution prohibits AB 72 (Bonta) 9/9/15 Page 5 of ? special legislation when a general law can apply (Article IV, §16). AB 72 contains findings and declarations explaining the need for legislation that applies only to the Eden Township Healthcare District. 7. Legislative history . As passed by the Assembly, AB 72 contained provisions requiring the Department of Health Care Services to submit an application to the federal government for a waiver of federal law, to allow the state to make changes to the operation of the Medi-Cal program. The Senate Governance & Finance Committee never heard that version of the bill. The September 4 amendments deleted AB 72's contents and inserted the current language relating to the ETHD's parcel tax powers. Because the new version of the bill falls within the Senate Governance & Finance Committee's policy jurisdiction, the Senate Rules Committee referred the bill to the Governance & Finance Committee for a hearing. Assembly Actions Not relevant to the September 9, 2015 version of the bill Support and Opposition (9/9/15) Support : Association of California Healthcare Districts Opposition : Howard Jarvis Taxpayers Association. -- END --