BILL ANALYSIS                                                                                                                                                                                                    �




                     SENATE GOVERNANCE & FINANCE COMMITTEE
                            Senator Lois Wolk, Chair
          

          BILL NO:  SB 134                      HEARING:  3/16/11
          AUTHOR:  Corbett                      FISCAL:  No
          VERSION: 3/9/11                       TAX LEVY: No
          CONSULTANT:  Weinberger               

                          HEALTHCARE DISTRICTS' ASSETS
          

          Requires healthcare districts to appraise the fair market 
          value of assets that they transfer to nonprofit 
          corporations for less than fair market value.


                           Background and Existing Law  

          California's 80 local health care districts are governed by 
          directly elected boards of directors.  As hospitals, they 
          face market pressures to compete with other health care 
          providers.  As local governments, they must follow the 
          Brown Act, the Public Records Act, the Political Reform 
          Act, the public contracting laws, and other statutory 
          restrictions.

          Responding to changes in health care delivery, public 
          hospitals explore economic and organizational alternatives, 
          including leasing or selling their assets to nonprofit 
          corporations or even to for-profit companies.  If a local 
          health care district wants to transfer 50% or more of its 
          assets to any corporation, the transfer needs 
          majority-voter approval (SB 1771, Russell & Kopp, 1992).  

          A health care district may transfer its assets, for the 
          benefit of the communities it serves, to one or more 
          nonprofit corporations at less than fair market value.  For 
          a transfer of 50% or more of a district's assets to be 
          deemed to benefit a district's communities, a district 
          must:

                 Fully discuss the transfer agreement in at least 
               five properly noticed public meetings before the 
               district board's decision to transfer the assets.
                 Provide, in the transfer agreement, that the 
               district must approve all initial board members of the 
               nonprofit corporation and any subsequent board members 




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               as may be specified in the transfer agreement.
                 Provide, in the transfer agreement, that specified 
               assets are to be transferred back to the district upon 
               termination of the transfer agreement.
                 Commit the nonprofit corporation, in the transfer 
               agreement, to operate and maintain the district's 
               health care facilities and its assets for the benefit 
               of the communities served by the district.
                 Require, in the transfer agreement, that any funds 
               a corporation receives from the district be used only 
               for specified activities that would further a valid 
               public purpose if undertaken directly by the district.

          The Eden Township Healthcare District formed in 1948 to 
          serve the Alameda County communities of Castro Valley, 
          Hayward, San Leandro, and San Lorenzo.  In 1954, the 
          District opened Eden Medical Center (EMC) hospital.  In 
          1997, the District's voters approved a merger agreement 
          between the District and Sutter Health.  Under the 1997 
          agreement, the District sold EMC to Sutter Health.  In 
          2004, the District purchased San Leandro Hospital and 
          leased it to EMC to operate.  In 2008, the District 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.  The 
          purchase option allowed Sutter to deduct specified losses 
          and capital expenditures from the hospital's net book value 
          and, if the deductions exceeded the net book value, allowed 
          Sutter to exercise its purchase option with no balance due. 
           The District and Sutter are currently litigating the terms 
          of the 2008 agreement.

          In response to concerns about transfers of publicly-owned 
          assets for significantly less than fair market value, some 
          elected officials want the state to require health care 
          districts to appraise the fair market value of their assets 
          before transferring those assets for less than fair market 
          value.


                                   Proposed Law  

          Senate Bill 134 provides that, when a health care district 
          transfers more than 50% of the district's assets at less 
          than fair market value to one or more nonprofit 





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          corporations, the transfer is deemed to be for the benefit 
          of the communities served by the district only if the 
          transfer agreement includes the appraised fair market value 
          of any asset transferred.  

          SB 134 requires that the appraised fair market value must 
          come from an independent consultant with expertise in 
          methods of appraisal and valuation and must be in 
          accordance with applicable governmental and industry 
          standards for appraisal and valuation.  SB 134 also 
          requires that a resolution to submit a proposed asset 
          transfer to a health care district's voters must identify 
          the asset proposed to be transferred, its appraised fair 
          market value, and the amount of consideration that the 
          district is to receive in exchange for the transfer. 


                               State Revenue Impact
           
          No estimate.


                                     Comments  

          1.   Purpose of the bill  .  SB 134 gives the public important 
          information about the value of public assets that a health 
          care district prepares to sell or transfer to corporations. 
           Health care districts' assets are the product of 
          taxpayers' investing billions of dollars statewide to 
          support vital community health services.  Over the years, 
          the Legislature has enacted a series of voter-approval 
          requirements and other oversight mechanisms to protect the 
          public's interest in these publicly-owned assets.  In 
          response to concerns about some recent transfers of assets 
          between health care districts and private corporations, SB 
          134 makes more information available to help district 
          officials and voters evaluate health care districts' 
          proposed transfers of assets to private corporations.

          2.   Timing is everything  .  Appraising the value of a health 
          care district's assets when a district enters into a 
          transfer agreement or seeks voter approval to transfer 
          assets does not ensure that district officials and 
          residents will know the assets' fair market value when the 
          transfer occurs.  Health care districts can enter into 
          transfer agreements and seek voter approval many years 





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          before they actually transfer ownership of their assets.  
          This lag in time makes it difficult to accurately evaluate 
          the consideration that a district receives from a 
          corporation in comparison to the assets' true value.  The 
          Committee may wish to consider amending SB 134 to require a 
          health care district to get an appraisal of its assets' 
          fair market value not more than 120 days before 
          transferring title to the assets.


                         Support and Opposition  (3/10/11)

           Support  :  Unknown.

           Opposition  :  Unknown.