BILL NUMBER: AB 1350 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 28, 2015
AMENDED IN ASSEMBLY MARCH 26, 2015
INTRODUCED BY Assembly Member Salas
FEBRUARY 27, 2015
An act to amend Sections 101852, 101852.1, 101853, 101853.1,
101855, and 101855.1 of the Health and Safety Code, relating to
hospital authorities.
LEGISLATIVE COUNSEL'S DIGEST
AB 1350, as amended, Salas. Kern County Hospital Authority.
The Kern County Hospital Authority Act authorizes the board of
supervisors of the County of Kern to, among other things, establish,
by ordinance, the Kern County Hospital Authority to manage,
administer, and control the Kern Medical Center and for the operation
of additional programs, clinics and other facilities, care
organizations, physician practice plans, and delivery systems that
may be affiliated or consolidated with the medical center. Existing
law requires the board of supervisors to adopt, and the authority to
implement, a personnel transition plan that requires specified
actions, including acknowledgment that the authority, to the extent
permitted by federal and state law, is required to be bound by the
terms of the memoranda of understanding executed between the county
and its exclusive employee representatives that are in effect on the
date the county adopts the enabling ordinance. Existing law subjects
the authority to other employment and retirement provisions.
This bill would revise and recast those provisions to make
technical changes to provisions relating to the transfer of control
of the medical center by the county to the Kern County Hospital
Authority, as specified. The bill would clarify that the authority is
empowered with the maintenance, operation, management, control,
ownership, or lease of the medical center, as provided by the
enabling ordinance, as specified. The bill would make changes to the
personnel transition plan to instead provide that the memoranda of
understanding that apply to the authority are those in effect on the
date of the transfer of control of the medical center to the
authority, as specified. specified, and if
the memoranda of understanding has expired, that the most
recent memoranda is binding unless modified by mutual agreement with
each of the exclusive employee representatives. The bill would
make other changes to related provisions to further reflect that
certain actions be taken on the date of the transfer of control of
the medical center to the authority, rather than the date the county
adopts the enabling ordinance. The bill would make other changes to
provisions related to, among others, retirement provisions, debt
instruments, and contract provisions. The bill would authorize the
board of supervisors to contract on behalf of the authority.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 101852 of the Health and Safety Code is amended
to read:
101852. (a) This chapter shall be known, and may be cited, as the
Kern County 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) A county is authorized under existing law to integrate its
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 requires
public entities providing or arranging health care 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) The board of supervisors of the County of Kern has determined
that providing access to affordable, high-quality health care
services, and ensuring the full engagement and viability of the
health care safety net in the county are essential for improving the
health status of the people of the County of Kern. To further this
imperative, it is necessary that 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 health management
strategies, is effectively positioned for health plan-provider
alignment, and maximizes opportunities for employees and enhancement
of staff morale.
(5) This chapter is necessary to allow the formation of a new
political subdivision, a public hospital authority, for the purposes
described above.
SEC. 2. Section 101852.1 of the Health and Safety Code is amended
to read:
101852.1. For purposes of this chapter, the following definitions
shall apply:
(a) "Authority" means the Kern 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 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) "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, 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.
(g) "Transfer of control of the medical center" means the transfer
by the county to the authority of the maintenance, operation,
management, and personnel of the medical center, whether by lease,
transfer of ownership, or other means, as provided by, and subject
to, any conditions and limitations specified by the board of
supervisors in the enabling ordinance.
SEC. 3. Section 101853 of the Health and Safety Code is amended to
read:
101853. (a) Pursuant to this chapter, the board of supervisors
may establish by ordinance the Kern County 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 as needed to operate the medical center
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 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 maintenance,
operation, management, control, ownership, or lease of the medical
center and other health-related resources, as provided by the
enabling ordinance. The State Department of Health Care Services
shall take all necessary steps to ensure all of the following:
(1) The authority has all of the licenses, permits, and approvals
needed to operate the medical center.
(2) The medical center continues its status as a designated public
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 authority may participate as a contributing public agency
for all of the purposes specified in Section 433.51 of Title 42 of
the Code of Federal 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 transfer to the authority
from the 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, allocation of
credit for funded pension assets and responsibility for any unfunded
pension liabilities under the Kern County Employees' Retirement
Association or other retirement plans, and funding of the accrued
benefits of employees of the authority in the event of withdrawal
from the plan or dissolution of the authority. Any allocation of
credit for funded pension assets and responsibility for any unfunded
pension liabilities with respect to the Kern County Employees'
Retirement Association must be approved by its governing board of
retirement after consideration of legal and actuarial analysis, and
no such allocation may be made that would jeopardize the qualified
status of the Kern County Employees' Retirement Association under the
federal Internal Revenue Code.
(3) Maintenance, operation, management, control, ownership, or
lease of the medical center.
(4) Transfer of licenses.
(5) Whether funds of the authority shall be deposited in the
custody of, and paid out solely through, the county treasurer's
office.
(6) Any other matters as the board of supervisors deems necessary,
appropriate, or convenient for the conduct of the authority's
activities.
(e) (1) Notwithstanding any other law, a transfer of control of
the medical center to the authority may be made, with or without the
payment of a purchase price by the 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 control 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,
management, control, 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 its maintenance, operation, management,
control, ownership, or lease of the medical center, the authority
shall conform to both of the following requirements:
(A) Comply with any applicable requirements of 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, as specifically provided for in
the enabling ordinance or other lawful agreements entered into by
the board of supervisors. Any lease agreement between the county and
the authority 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, management, or control
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.
(k) Any determination with respect to the manner in which the
authority qualifies as a governmental plan sponsor under Section 414
(d) of the Internal Revenue Code shall be limited to relevant
employee benefits purposes of that code only, and shall not change or
otherwise modify the authority's status as a public agency that is a
local unit of government for other purposes specified in this
chapter.
SEC. 4. Section 101853.1 of the Health and Safety Code is amended
to read:
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
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
for which they are qualified and eligible. An employee who first
elects to remain with the county may subsequently seek reinstatement
with the authority within 30 days of 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, and consistent with paragraph (3) of
subdivision (d), shall be bound by the terms of those memoranda of
understanding executed between the county and its exclusive employee
representatives that are in effect on the date of the transfer of
control of the medical center to the authority. Subsequent memoranda
of understanding with exclusive employee representatives shall be
subject to approval only by the board of governors.
(4) Communication to the Board of Retirement of the Kern County
Employees' Retirement Association or other retirement plan of any
personnel transition plan, memoranda of understanding, or other
arrangements that are related to the participation of the authority's
employees or the addition of new employees in the retirement plan.
(b) Implementation of this chapter shall not be a cause for the
modification of the medical center or county employment benefits.
Employees of the medical center or county on the date of transfer,
who become authority employees, shall retain their existing or
equivalent classifications and job descriptions upon transfer to the
authority, comparable pension benefits (if permissible pursuant to
relevant plan terms), and 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 the 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) Subject to applicable state law, the authority shall recognize
the exclusive employee representatives of those authority employees
who are transferred from the county or medical center to the
authority pursuant to this 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 control of the medical center to the authority:
(1) Continue to recognize each exclusive employee representative
of each bargaining unit.
(2) Continue to provide the same level of employee benefits to
authority employees, whether the obligation to provide those benefits
arise out of a memorandum of understanding, or other agreements or
law.
(3) Extend and continue to be bound by any existing memoranda of
understanding covering the terms and conditions of employment for
employees of the authority, including the level of wages and
benefits, 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 exclusive 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 Employee Retirement Association plan
provisions, 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 and the
federal Internal Revenue Code). If a memoranda of understanding
is expired on the date of the transfer of control of the medical
center, then the authority shall continue to be bound by the terms
and conditions of the most recent memoranda of understanding, unless
modified by a mutual agreement with each of the exclusive employee
representatives, and the benefits and wages of transferred
employees shall be retained consistent with subdivision (b).
(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 of the transfer of control of the medical center
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 or county on the
effective date of the transfer of control of the medical center to
the authority, shall be deemed qualified for employment 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 required to serve a new probationary 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 if there is a dispute over this issue, the
authority agrees to meet and confer with the exclusive employee
representatives of the transferred employees.
(f) Employees who transfer from the medical center or county to
the authority shall retain the seniority they earned 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 set forth below. However, the
authority and employees of the authority, or certain designated parts
thereof, shall not participate in the Kern County Employees'
Retirement Association if the board of retirement, in its sole
discretion, determines that their participation could jeopardize the
Kern County Employees' Retirement Association's tax-qualified or
governmental plan status under federal law, or if a contract or
related contract amendment proposed by the authority contains any
benefit provisions that are not specifically authorized by Chapters 3
(commencing with Section 31450) and 3.9 (commencing with Section
31899) of Part 3 of Division 4 of Title 3 of the Government Code or
Article 4 (commencing with Section 7522) of Chapter 21 of Division 7
of Title 1 of the Government Code, and that the board determines
would adversely affect the administration of the system. There shall
not be any individual employee elections regarding participation in
the Kern County Employees' Retirement Association or other retirement
plans except to the extent such retirement plans provide for
elective employee salary deferral contributions in accordance with
federal Internal Revenue Code rules.
(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 transfer of control of the medical center 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) (A) 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, or current or contingent member of a plan
of replacement for members whose retirement benefits are limited by
Section 415 of Title 26 of the United States Code as provided in
Section 7522.43 of the Government Code, Code or a
member 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
or 7522.43 of the Government Code, and shall
continue to be subject subject, immediately
after the transfer, to the same defined benefit formula, as
defined in Section 7522.04 of the Government Code, or
and plan of replacement benefits for
members whose retirement benefits are limited by Section 415 of Title
26 of the United States Code, as provided in Section 7522.43 of the
Government Code, to which the member was subject immediately prior to
the transfer. offered by the county pursuant to
Section 31899.4 of the Government Code and the Kern County
Replacement Benefits Plan for retirement benefits limited by Section
415 of Title 26 of the United States Code.
(B) For purposes of subdivision (c) of Section 7522.43
of the Government Code, the authority shall be treated as a public
employer that offered a plan of replacement benefits for
members whose retirement benefits are limited by Section 415 of Title
26 of the United States Code prior to January 1, 2013, with respect
to current or contingent members of that plan who were employed by
the county or the medical center when it was a constituent department
of the county prior to January 1, 2013, and who transfer, directly
or after a break in service of less than six months, to the authority
and continue to be a member of either the Kern County Employees'
Retirement Association or the Public Employees' Retirement System, as
applicable. prior to January 1, 2013. The county's
plan of replacement benefits that was in effect prior to January 1,
2013, is deemed to also be the authority's replacement plan for the
sole purpose of allowing the authority to continue to offer the plan
of replacement benefits, immediately after the transfer, for Kern
County Employees' Retirement Association members who meet both of the
following requirements, and the qualifying survivors or
beneficiaries of those members:
(i) The employee was employed as of January 1, 2013, by the county
or the medical center when it was a constituent department of the
county.
(ii) The employee is part of a member group to which the county
offered a plan of replacement benefits prior to January 1, 2013.
(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.
Notwithstanding any other law, the authority and employees of the
authority shall not participate in the Public Employees' Retirement
System if the Board of Administration of the Public Employees'
Retirement System, in its sole discretion, determines that their
participation could jeopardize the Public Employees' Retirement
System's tax-qualified or governmental plan status under federal law,
or if a contract or related contract amendment proposed by the
authority contains any benefit provisions that are not specifically
authorized by Part 3 (commencing with Section 20000) of Division 5 of
Title 2 of the Government Code, and that the board determines would
adversely affect the administration of the system.
(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.
SEC. 5. Section 101855 of the Health and Safety Code is amended to
read:
101855. (a) Subject to any terms, conditions, and limitations as
may be imposed by the enabling ordinance, 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, subject to Article 5 (commencing
with Section 101856).
(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 or otherwise engage 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 principal and
interest on notes and bonds of the authority, the establishment of
reserves to secure 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 in this section shall preclude the authority from
repayment of its debts or other liabilities, using funds that are not
otherwise encumbered.
(8) To pursue its own credit rating.
(9) To enter into one or more contracts or agreements consistent
with this chapter and other applicable 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) If not otherwise required pursuant to the enabling ordinance
to deposit its funds in the county treasury, the authority may
establish its own treasury, 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 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.
(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 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 of the medical center to the authority
pursuant to this chapter shall confer onto the authority
all shall have the same
rights, privileges, exemptions, preferences, and authority
set forth in state law to own, operate, and provide
of a county with respect to owning, operating, and
providing coverage and services through hospitals, clinics and
other health facilities, health programs, care organizations,
physicians and physician practice plans, delivery systems,
health care service plans, and other provider types and
coverage mechanisms that may be owned or operated by a
county. mechanisms.
(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 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. Notwithstanding any other law, except as
otherwise provided for in the enabling ordinance enacted pursuant to
this chapter, and as set forth in Section 101853.1 relating to the
personnel transition plan, the authority shall not be governed by, or
subject to, other policies or operational rules applicable to the
county, the medical center prior to its transfer, or any other public
entity, including, but not limited to, those relating to personnel
and procurement.
(B) The board of governors shall adopt written rules, regulations,
and procedures with regard to basic human resource functions not
inconsistent with memoranda of understanding covering employees
represented by employee organizations or the provisions of this
chapter. Until the time that the board of 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
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 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 rules and regulations
pursuant to subdivision (a) of Section 3507 of the Government Code,
the 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.
(8) Meet all local, state, and federal data reporting
requirements.
(c) (1) 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 it owes to the county,
and use the borrowed funds to provide for its operating and capital
needs. The county may lend the authority funds and may issue debt
instruments, including, without limitation, revenue anticipation
notes to obtain funds to provide, by loan or otherwise, amounts
necessary for the authority to meet its operating and capital needs.
(2) Notwithstanding paragraph (1), nothing in this chapter shall
be construed to limit the borrowing powers the county otherwise has
under law for the purposes specified in paragraph (1) or any other
purposes.
(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 governors
or board of supervisors, as applicable, 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, or to consider and take action on matters
pertaining to contracts and contract negotiations concerning all
matters related to rates of payment for health care services arranged
or provided by the authority, 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 or concerning the matters
related to rates of payment.
(3) Those records of the authority or board of supervisors,
as applicable, 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
authority, provided that the service, program, marketing strategy,
business plan, technology, benefit, or product continues to be a
trade secret. The board of governors or board of supervisors, as
applicable, 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 chapter shall not prevent the board of governors or
board of supervisors, as applicable, 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 arranged or provided by the 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 payers 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 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 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) (1) The board of supervisors may contract for services or
purchase items on behalf of the authority.
(2) Unless otherwise provided for, and subject to the limitations
and conditions set forth in the enabling ordinance, the board of
governors shall have authority over procurement and contracts for the
authority and shall adopt written rules, regulations, and procedures
with regard to these functions. The authority's ability to contract
for personnel or other services and items it deems necessary,
appropriate, or convenient for the conduct of its activities
consistent with its purposes shall only be limited by the provisions
in this chapter and obligations under the Meyers-Milias-Brown Act
(Chapter 10 (commencing with Section 3500) of Division 4 of Title 1
of the Government Code).
(3) 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 his or her
employment or affiliation with the county or an agency of the county.
(p) The board of 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.
SEC. 6. Section 101855.1 of the Health and Safety Code is amended
to read:
101855.1. (a) Transfer of control 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 in support of
uncompensated 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 in
support of health care services of the type provided by the
medical center. center to low-income
individuals.
(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, 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, 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 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) The transfer of control of the medical center to the authority
pursuant to this chapter shall not otherwise disqualify the county
or the 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 governmental 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 governmental entities with
which they are affiliated.
(2) All funding programs in which the county, by itself or on
behalf of the medical 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,
management, control, ownership, or lease of the medical center not
been transferred to the authority pursuant to this chapter.