BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 364
                                                                  Page  1

          Date of Hearing:   July 1, 2010

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                     SB 364 (Florez) - As Amended:  June 30, 2010

           SENATE VOTE :  Not relevant
           
          SUBJECT  :  Health facilities: patient impact report.

           SUMMARY  :  Establishes the Joint Task Force on Hospital  
          Conversion and Patient Care (Task Force) to study the governance  
          structure of medical foundations and the current oversight of  
          hospital conversions.  Specifically,  this bill  :  

          1)Requires the Task Force to conduct a study that will do the  
            following:

             a)   Study the governance structure of medical foundations  
               and changes in the corporate status of health care entities  
               that may result in light of the federal health care reform;

             b)   Gather information on models of care that produce  
               cost-effective outcomes as well as the impact of statutory  
               changes on physicians and hospitals; 

             c)   Review current oversight of corporate conversions, the  
               fiscal consequences of conversions on the state, and issues  
               of access for financially vulnerable communities in order  
               to preserve and improve health care delivery; and,

             d)   Consider establishing additional mechanisms of oversight  
               that are consistent with federal health care reform in  
               order to maintain patient protection in health care  
               delivery and to ensure responsible corporate conversions of  
               health care entities in the state.

          2)Requires the Task Force to include the following membership:

             a)   The Chair of the Assembly Committee on Health;
             b)   The Chair of the Senate Committee on Health;
             c)   The President pro Tempore of the Senate or his or her  
               designee; and,
             d)   The Speaker of the Assembly or his or her designee.









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          3)Permits the Task Force to seek input from the appropriate  
            stakeholders, including but not limited to, hospitals, patient  
            advocates, and organized labor.

          4)Permits the Task Force to use existing legislative funds or  
            funds the Task Force has solicited from public and private  
            foundations to support its activities.

          5)Prohibits the Task Force from beginning the study until it has  
            certified that sufficient funds are available to conduct the  
            study.

          6)Requires the Task Force to complete and submit the study to  
            the Legislature within 12 months after the date the Task Force  
            provides the certification of sufficient funding.

           EXISTING LAW  :  

          1)Requires any nonprofit corporation that operates or controls a  
            health facility, as defined, or operates or controls a  
            facility that provides similar health care, to provide written  
            notice to, and to obtain the written consent of, the  
            California State Attorney General (AG) prior to: a) entering  
            into any agreement or transaction to sell, transfer, lease,  
            exchange, option, convey, or otherwise dispose of, its assets  
            to a for-profit corporation or entity or to a mutual benefit  
            corporation or entity when a material amount of the assets of  
            the nonprofit corporation are involved in the agreement or  
            transaction; or, b) transferring control, responsibility, or  
            governance of a material amount of the assets or operations of  
            the nonprofit corporation to any for-profit corporation or  
            entity or to any mutual benefit corporation or entity. 

          2)Requires the AG, within 60 days of the receipt of the required  
            written notice, to notify the public benefit corporation in  
            writing of the decision to consent to, give conditional  
            consent to, or not consent to the agreement or transaction.   
            Authorizes the AG to extend this period, as specified.  

          3)Requires the AG, prior to issuing any decision, as required in  
            2) above, to conduct one or more public meetings, at least one  
            in the county in which the facility is located, to hear  
            comments from interested parties.  Authorizes the AG to  
            conduct additional hearings if there are any changes to the  
            proposed agreement or transaction.  








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          4)Allows the AG, in making its decision as required in 2) above,  
            to consider any factors that it deems relevant including, but  
            not limited to, whether: 

             a)   The terms and conditions of the agreement or transaction  
               are fair and reasonable to the nonprofit corporation; 
             b)   The agreement or transaction will result in inurement to  
               any private person or entity; 
             c)   The agreement or transaction is at fair market value; 
             d)   The proposed use of the proceeds from the agreement or  
               transaction is consistent with the charitable trust;  
             e)   The agreement or transaction may create a significant  
               effect on health care services to the affected community;  
               and, 
             f)   Whether the proposed agreement or transaction is in the  
               public interest.  

          5)Prohibits the AG from consenting to a health facility  
            agreement or transaction in which the seller restricts the  
            type or level of medical services that may be provided at the  
            health facility that is the subject of the agreement or  
            transaction.

           FISCAL EFFECT  :  The current version of this bill has not yet  
          been analyzed by a fiscal committee.

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  According to the author, this bill is  
            designed to assess the impact on both the quality and  
            cost-effectiveness of patient care when a hospital seeks a  
            change in its ownership or re-organizes in a manner that  
            potentially changes how patient care is delivered.  The author  
            maintains that this bill will allow the state an opportunity  
            to determine if the re-organization or re-classification might  
            have an economic impact on state budgets and if so, at what  
            cost and for what public benefit.  The author argues that  
            local governments and developers are required to issue  
            environmental impact reports when there are land-use changes  
            and that it only makes sense that the same is asked of  
            hospitals to inform patients when there are changes in  
            providing health services.
           
          2)NONPROFIT HOSPITAL CONVERSIONS  .  Nonprofit hospital  








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            conversions typically occur when a nonprofit hospital comes  
            under the control of a for-profit company, through either an  
            acquisition or a joint-venture arrangement.  Conversions take  
            on many forms and include outright sales of the facility and  
            other assets (or a portion of them), transfers of leases,  
            joint ventures, mergers, affiliations, acquisitions, the  
            creation of for-profit subsidiaries and holding companies, or  
            other deals that effectively change the mission of the  
            nonprofit hospital or transform it into a for-profit  
            corporation.  Policy makers and community leaders have raised  
            concerns over whether these conversions lead to reductions in  
            the type of community benefits that nonprofit hospitals have  
            traditionally provided, particularly charity care.  This  
            concern has contributed to state legislative initiatives to  
            regulate nonprofit conversions.  

          Under California law, AB 3101 (Isenberg), Chapter 1105, Statutes  
            of 1996, requires the AG to review and consent to any sale or  
            transfer of a health facility owned or operated by a nonprofit  
            corporation whose assets are held in public trust.  This  
            requirement covers health facilities that are licensed to  
            provide 24-hour care such as hospitals and skilled nursing  
            facilities.

          The current AG review process includes public meetings and, when  
            necessary, preparation of expert reports.  The AG's decision  
            often requires the continuation of existing levels of charity  
            care, continued operation of emergency rooms and other actions  
            necessary to avoid adverse effects on healthcare in the local  
            community.

          The AG, through various adminsitrations, has excercised its  
            authority over hosital conversions.  In 2007, the AG rejected  
            the sale of Anaheim Memorial Medical Center, finding that the  
            sale was not in the best interest of the community.  The AG  
            has also required a buyer to maintain specified levels of  
            patient care, charity care, community benefit programs and  
            investment in infrastructure improvements.  For example, in  
            2005, the AG approved the sale of Sherman Oaks Hospital on the  
            condition that the new buyer maintain a burn center and a  
            Specialty Ambulatory Geriatric Evaluation Program and in 2009,  
            the sale of South Coast Medical Center was approved with  
            numerous detailed conditions, such as maintaing services at a  
            Women's Wellness Center and to fund cancer services through a  
            seperate foundation.








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           3)MEDICAL FOUNDATION MODEL  .  A medical foundation is a model  
            commonly used in California to allow hospitals and physicians  
            to partner in the development of an integrated health care  
            delivery system.  Specifically, a medical foundation is a  
            tax-exempt 501 (c) (3) nonprofit corporation that provides  
            health care to its patients through a group of 40 or more  
            physicians, representing 10 board-certified specialists, not  
            less than two-thirds of whom practice on a full-time basis  
            with the medical foundation.  A medical foundation cannot  
            directly employ physicians in California, but instead must  
            contract with one or more medical groups.  There are a number  
            of medical foundation models currently operating in the state.  
             The medical foundation was formally recognized by the  
            California Legislature by the adoption of California Health  
            and Safety Code Section 1206 (l), which exempts from licensure  
            clinics operated by medical foundations that satisfy the  
            requirements of Section 1206 (l). 

          According to recent news articles, there are a growing number of  
            California hospitals that are contemplating moving towards a  
            foundation model as the new health reform law starts to take  
            effect.  The health reform law reflects a growing push towards  
            "integrated health care" models, which encourage physicians  
            and facilities to work together to reduce unnecessary hospital  
            tests and admissions.  A May 14, 2010, Wall Street Journal  
            article reported that the Hospital Association of Southern  
            California (HASC) has proposed a plan to create a single  
            foundation of multiple facilities to contract with physician  
            groups.  Under the proposal, a joint medical foundation would  
            contract with physician groups that each would be affiliated  
            with and retain privileges at an individual hospital.   
            According to the article, the HASC Foundation also would  
            operate clinics and centralize billing and electronic health  
            records.  HASC maintains that this partnership between  
            hospitals and physicians would increase care coordination,  
            reduce costs, and improve quality and outcomes.  The Los  
            Angeles Daily Journal also reported in a recent article that  
            officials at City of Hope Medical Center in Duarte, California  
            are considering a similar model in which physicians would work  
            for a not-for-profit foundation partly controlled by the  
            hospital.  

          Some physicians have criticized such models over concern that  
            they could lead to financial decisions overriding medical  








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            assessments.  However, HASC claims in the Wall Street Journal  
            article that their proposal does not call for one centralized  
            contracting structure and that hospitals and physicians would  
            negotiate deals individually.

           4)OPPOSE UNLESS AMENDED  .  The California Hospital Association  
            (CHA) is opposed unless amended to this bill.  CHA states that  
            the Legislature already has the authority to conduct  
            informational hearings on matters such as those covered in  
            this bill and that this bill is unnecessary.  CHA further  
            argues that California already has a rigorous nonprofit  
            hospital conversion review process that was enacted by AB 3101  
            (Isenberg) and that AB 3101 received bi-partisan support and  
            created a robust and public review process that has given the  
            AG effective powers to protect the public interest.  CHA  
            maintains that if the Legislature concludes a study bill is  
            necessary, it would be more meaningful to focus on various  
            options for clinical integration of health care delivery in  
            light of federal health care reform.  CHA's suggested amends  
            are to focus the proposed study by the Task Force on state  
            laws that affect access to physicians and hospitals and  
            clinical integration.

           5)PREVIOUS LEGISLATION  .

             a)   AB 2276 (Cedillo), Chapter 801, Statutes of 2000,  
               requires the AG to prepare a plan for an evaluation of  
               whether additional standards for charitable care and  
               community benefits should be established for private,  
               not-for profit corporations that operate or control a  
               general acute care hospital, as specified, to be submitted  
               to the appropriate policy and fiscal committees of the  
               Legislature by March 1, 2001. This report was submitted in  
               April 2001.

             b)   AB 254 (Cedillo), Chapter 850, Statutes of 1999,  
               requires nonprofit health facilities to obtain the consent  
               of the AG prior to the sale, transfer or lease of a  
               material amount of assets to another nonprofit corporation.

             c)   AB 3101 requires a public benefit corporation, that is a  
               non-health maintenance organization health facility, to  
               obtain the approval of the AG before selling or  
               transferring the control of a material portion of its  
               charitable assets to a for-profit business or mutual  








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               benefit entity.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          None on file.
           
            Opposition 
           
          California Hospital Association


           Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916)  
          319-2097