BILL ANALYSIS                                                                                                                                                                                                    �



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          SENATE THIRD READING
          SB 134 (Corbett)
          As Amended March 31, 2011
          Majority vote

           SENATE VOTE  :23-14  
           
           HEALTH              13-5        LOCAL GOVERNMENT           5-3  
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Alejo, Bradford, Campos,  |
          |     |Bonilla, Eng, Gordon,     |     |Gordon, Hueso             |
          |     |Hayashi,                  |     |                          |
          |     |Roger Hern�ndez, Bonnie   |     |                          |
          |     |Lowenthal, Mitchell, Pan, |     |                          |
          |     |V. Manuel P�rez, Williams |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Logue, Garrick, Mansoor,  |Nays:|Smyth, Knight, Norby      |
          |     |Silva, Smyth              |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Imposes conditions on transfer agreements, when a 
          health care district (district) transfers more than 50% of the 
          district's assets at less than fair market value to other 
          entities to operate one or more health facilities owned by the 
          district.  Specifically,  this bill :    

          1)Provides that, when a district transfers more than 50% of the 
            district's assets at less than fair market value to other 
            entities to operate one or more health facilities owned by the 
            district, 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.

          2)Requires the appraisal for fair market value, referenced in 1) 
            above to be conducted by an independent consultant with 
            expertise in methods of appraisal and valuation and in 
            accordance with applicable governmental and industry standards 
            for appraisal and valuation of any asset transfer.

          3)Requires that the appraisal referenced in 1) above is 
            performed within the six months preceding the date on which 








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            the district approves the transfer agreement.

          4)Requires the district board, before the district transfers 50% 
            or more of the district's assets to other entities, to submit 
            a resolution to the district's voters that identifies the 
            asset proposed to be transferred, its appraised fair market 
            value, and the amount under consideration that the district is 
            to receive in exchange for the transfer.

           EXISTING LAW  :  

          1)Establishes the Local Health Care District Law which 
            authorizes communities to form special districts to construct 
            and operate hospitals and other health care facilities to meet 
            local needs.

          2)Authorizes, until January 1, 2011, a district to transfer 
            ownership, at fair market value, of any part of its assets to 
            one or more corporations to operate and maintain the assets.  
            Prior to the district transfer of 50% or more of the 
            district's assets to one or more corporations, requires the 
            elected district board to submit to the voters of the district 
            a measure proposing the transfer.

          3)Requires, after January 1, 2011, the provisions in 2) above to 
            restrict these transfers to only nonprofit corporations. 

          4)Authorizes a district to transfer, at less than fair market 
            value, any part of the assets of the district to one or more 
            nonprofit corporations to operate and maintain the assets, if 
            the transfer benefits the communities served by the district.  
            Requires that for a transfer of 50% or more of a district's 
            assets to be deemed to benefit a district's communities, a 
            district must:

             a)   Fully discuss the transfer agreement in at least five 
               properly noticed public meetings before the district 
               board's decision to transfer the assets;

             b)   Provide, in the transfer agreement, that the district 
               must approve all initial board members of the nonprofit 
               corporation and any subsequent board members as may be 
               specified in the transfer agreement;









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             c)   Provide, in the transfer agreement, that specified 
               assets are to be transferred back to the district upon 
               termination of the transfer agreement;

             d)   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; and,

             e)   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.

          5)Requires the district to report to the California Attorney 
            General (AG), within 30 days of any lease of district assets 
            to one or more corporations, the type of transaction and the 
            entity to whom the assets were leased.

           FISCAL EFFECT  :  None

          COMMENTS  :  According to the author, this bill is intended to 
          provide the public with more information about the value of 
          district assets that are proposed to be sold or transferred to 
          one or more corporations for less than fair market value.  The 
          author maintains that current law authorizes a district to 
          transfer its assets, for the benefit of the communities it 
          serves, to one or more nonprofit corporations at less than fair 
          market value.  However, under current law, according to the 
          author, for a transfer of 50% or more of a district's assets to 
          be deemed to benefit a district's communities, a district must 
          meet specified conditions, including approval of the transfer 
          agreement by district voters, but does not require an 
          independent appraisal of the fair market value of the assets 
          that are proposed to be transferred.  The author argues that 
          unfortunately, in too many cases, these relationships end with 
          assets being transferred out of the district to the benefit of 
          the contracting private corporation and to the detriment of the 
          local community.  The author maintains that of the 85 districts 
          that have formed since 1945, almost a third have closed, leased, 
          or sold their hospitals.  Some, according to the author, have 
          declared bankruptcy and many have changed or expanded their 
          historic role as providers of acute care.  This bill, the author 
          asserts, addresses the growing concern that some districts are 








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          entering into contracts that reduce the district's assets and 
          financial security.  The author states that this bill intends to 
          protect district assets when district hospitals are operated by 
          an outside entity and cites the following incidents as examples 
          of the need for this bill:

          1)Eden Township Health Care District.  The Eden Township Health 
            Care District was formed in 1948 to serve the Alameda County 
            communities of San Leandro, San Lorenzo, Hayward, and Castro 
            Valley.  In 1954, the Eden District opened Eden Township 
            Hospital.  In 1997, the Eden District's voters approved a 
            merger agreement between the Eden District and Sutter Health.  
            Under the 1997 agreement, the Eden District created a 
            nonprofit, in conjunction with Sutter Health, known as the 
            Eden Medical Center (EMC), to operate the hospital.   

          In 2004, the Eden District purchased San Leandro Hospital and 
            leased it to EMC to operate.  The amended hospital lease and 
            operating agreement stated that Sutter Health could assign its 
            interests, or any portion of its interest, in the purchase 
            option without the landlord's consent. 

          In 2008, the Eden 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 Health the option to purchase San 
            Leandro Hospital.  The purchase option allowed Sutter Health 
            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 Health to exercise its purchase 
            option with no balance due.  The Eden District and Sutter 
            Health are currently litigating the terms of the 2008 
            agreement.

          2)Marin Healthcare District.  The Marin Healthcare District 
            built Marin General Hospital (MGH), which opened in 1952.  In 
            1985, the Marin District entered into a 30-year lease for the 
            operation of the hospital by the MGH Corporation, a nonprofit 
            corporation created in conjunction with Sutter Health of which 
            Sutter Health was the sole corporate member.  According to an 
            August 2010 article in the North Bay Business Journal, it is 
            alleged that between 2006 and June 2010 Sutter Health 
            transferred more than $120 million out of MGH jeopardizing the 
            hospital's financial stability and hindering MGH's operations. 








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             A settlement and transfer agreement returned control of MGH 
            to the Marin District on June 30, 2010.  The Marin District is 
            currently the sole corporate member of the nonprofit 
            corporation.


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


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