BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       AB 2115
          AUTHOR:        Alejo
          AMENDED:       May 31, 2012
          HEARING DATE:  June 13, 2012
          CONSULTANT:    Marchand

           SUBJECT  :  Local health care districts: employment contracts.
           
          SUMMARY  :  Requires a written employment agreement if a local 
          health care district employs or contracts with a hospital 
          administrator or chief executive officer.

          Existing law:
          1.Establishes "The Local Health Care District Law," under which 
            a local hospital district may be organized, incorporated and 
            managed.  Permits a district to include incorporated or 
            unincorporated territory, or both, in any one or more 
            counties.

          2.Permits a local hospital district to enter into a contract of 
            employment with a hospital administrator, and limits the 
            duration of this contract to four years, but permits the 
            contract to be renewed periodically upon expiration.

          3.Specifies that any reference to a "hospital administrator" 
            means "chief executive officer (CEO)."
          
          This bill:
          1.Revises provisions of law that permit a local hospital 
            district to enter into a contract of employment with a 
            hospital administrator or chief executive by requiring a 
            written employment agreement if a local district employs or 
            contracts with the hospital administrator or chief executive 
            officer.

          2.Requires, if the Commission on State Mandates determines that 
            this bill contains costs mandated by the state, health care 
            districts to be reimbursed for those costs by the state.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, negligible costs.  This bill provides for 
          reimbursement to local agencies if the Commission on State 
          Mandates determines there are mandated costs, however, there are 
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          not likely to be any such costs.

           PRIOR VOTES  :  
          Assembly Local Government:9- 0
          Assembly Appropriations: 17- 0
          Assembly Floor:          76- 0
           
          COMMENTS  :  
           1.Author's statement.  California law allows local health care 
            districts, like the Salinas Valley Memorial Healthcare System 
            (SVMHS), to enter into a renewable employment contract of up 
            to four years with a hospital administrator. However, current 
            law does not specify that the contracts should be written. The 
            author states that the SVMHS state audit highlighted the fact 
            that the former CEO worked for the hospital for 26 years 
            without a written employment contract. This resulted in an 
            absence of transparency and oversight regarding his 
            compensation. For example, due to the lack of a written 
            contract, board members were unclear about the former CEO's 
            total compensation and what he was entitled to. The board gave 
            the CEO $4.9 million in retirement and severance benefits 
            between 2008 and 2011, most of which were paid to him before 
            he retired. The author states that requiring local health care 
            districts to have written contracts with their administrators 
            will result in clarity, transparency and accountability in 
            terms of employment and compensation.
          
          2.Double referral. This bill is double referred. Should it pass 
            out of this Committee, it will be referred to the Senate 
            Committee on Governance and Finance.

          3.Related legislation.  AB 2180 (Alejo) would prohibit local 
            health care districts from providing any retirement benefit 
            unless the health care district makes the same options 
            available to all employees. AB 2180 is scheduled to be heard 
            in the Committee on Governance and Finance on June 13, 2012. 

          4.State audit of the Salinas Valley Memorial Healthcare System.  
            In March of 2012, the Bureau of State Audits released its 
            report on the fiscal mismanagement of SVMHS, subtitling the 
            report "Increased Transparency and Stronger Controls Are 
            Necessary as It Focuses on Improving Its Financial Situation." 
            SVMHS is an independent special health care district with an 
            elected five-member board of directors that governs its 
            activities. At the core of SVMHS is the Salinas Valley 
            Memorial Hospital, which employed more than 1,700 employees as 




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            of June 20, 2011, and maintains 269 beds. According to the 
            report, "although as a public agency SVMHS's decisions 
            regarding compensation for its top executives should be 
            transparent, this has not been the case for such board 
            decisions." The report goes on to state that in an environment 
            characterized by the lack of an executive compensation policy 
            and limited transparency in executive compensation matters, 
            SVMHS's executives were granted compensation at the upper 
            level of industry practices. The former CEO, who retired in 
            April 2011, received $4.9 million in retirement and severance 
            benefits between 2008 and 2011, the majority of which came 
            from multiple retirement investment plans that SVMHS provided 
            him as part of his overall retirement benefits package.

          The Bureau of State Audits made several recommendations as part 
            of this report, including recommending that SVMHS develop a 
            formal policy that establishes a process for determining 
            executive compensation that clearly documents all executive 
            compensation decisions. Additionally, the report recommended, 
            in order to ensure that the terms of its CEO's employment and 
            compensation are clear and to aid the board in its oversight 
            role, that SVMHS should engage its next permanent CEO in a 
            written employment contract.

          5.Support.  This bill is supported by the Association of 
            California Healthcare Districts (ACHD), which states most 
            district hospitals currently maintain written agreements with 
            their administrators. ACHD believes this bill creates a 
            uniform approach which fosters good governance for all 
            district hospitals and the communities in which they serve. 
            This bill is also supported by the California Nurses 
            Association, which states that this is a simple bill that will 
            result in clarity, transparency and accountability in terms of 
            employment and compensation.


          6.Opposition.  This bill is opposed by the Department of Finance 
            (DOF), which states that it could result in a reimbursable 
            state mandate by requiring local hospital districts to enter 
            into written contracts when hiring hospital administrators. 
            DOF states that the cost of this mandate is currently unknown 
            but may be significant.
          
           SUPPORT AND OPPOSITION  :
          Support:  Association of California Healthcare Districts




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                    California Nurses Association

          Oppose:   Department of Finance

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