BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  AB 334
          Author:   Buchanan (D)
          Amended:  8/11/14 in Senate
          Vote:     27 - Urgency

           
          PRIOR VOTES NOT RELEVANT


           SUBJECT  :    Alameda Health System hospital authority

           SOURCE  :     Author


           DIGEST  :    This bill expands a provision of law restricting the  
          ability of a hospital authority in Alameda County from  
          contracting out physician services to private entities by  
          clarifying that the hospital authority is also prohibited from  
          contracting out physician services to a subsidiary or other  
          entity established by the hospital authority.

           Senate Floor Amendments  of 8/11/14 delete the contents of the  
          bill, and instead add the current language.

           ANALYSIS  :    

          Existing law:

          1.Establishes a hospital authority as a separate public agency,  
            established by the Board of Supervisors of Alameda County to  
            manage, administer, and control the Alameda County Medical  
            Center (doing business as the AHS).

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          2.Requires the hospital authority to be governed by a board that  
            is appointed by the Board of Supervisors of the County of  
            Alameda, and requires its mission to be the management,  
            administration, and other control of the group of public  
            hospitals, clinics, and programs that comprise AHS in a manner  
            that ensures appropriate, quality, and cost-effective medical  
            care.

          3.Requires the hospital authority to have the power to sue or be  
            sued, to employ personnel, and to contract for services  
            required to meet its obligations.

          4.Prohibits, prior to January 1, 2024, AHS from entering into  
            any contract with any private person or entity to replace  
            services being provided by physicians and surgeons who are  
            employed by AHS, and in a recognized collective bargaining  
            unit as of March 31, 2013, without clear and convincing  
            evidence that the needed medical care can only be delivered  
            cost-effectively by a private contractor.

          This bill:

          1.Revises a provision of law prohibiting AHS, prior to January  
            1, 2024, from contracting with private entities to replace  
            services provided by physicians who were employed by AHS and  
            in a recognized collective bargaining unit as of March 31,  
            2013, by expanding this provision to prohibit AHS from  
            contracting these services to "any other person or entity,  
            including, but not limited to, a subsidiary or other entity  
            established by the authority."

          2.Includes an urgency clause that will make this bill take  
            effect immediately in order to protect, at the earliest  
            possible time, the employment status of represented doctors at  
            AHS, which has incorporated a nonprofit public benefit  
            corporation called Alameda Health Partners.

           Comments
           
          According to the author's office, this bill is necessary to  
          clarify the protections afforded to the physicians employed by  
          AHS.  AB 1008 (Buchanan, Chapter 311), which was chaptered last  
          year, required that, prior to contracting with a private entity  
          to deliver medical services, the hospital authority demonstrate  

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          the cost effectiveness of that service, negotiate with the  
          representative of the physicians over the decision to privatize,  
          and submit unresolved disputes to arbitration. 

          This bill clarifies that the provisions against unilateral  
          contracting of medical services apply to all third parties,  
          including a wholly owned subsidiary of AHS.  

          This bill is an urgency measure as it is necessary to protect,  
          at the earliest possible time, the jobs of represented  
          physicians and surgeons at AHS and ensure continued medical  
          services to the community.  

           Alameda Health System  .  AHS is an integrated public health care  
          system with more than 800 beds and 1,000 physicians across nine  
          major facilities located throughout Alameda County.  The largest  
          campus in AHS is Highland Hospital, located in Oakland, with 236  
          inpatient beds, a regional trauma center, and an affiliation  
          with University of California, San Francisco medical school with  
          10 residency slots for physician training.

          In addition to Highland Hospital, AHS also includes the  
          following:

           San Leandro Hospital, a 93-bed medical facility in central  
            Alameda County; 

           John George Psychiatric Hospital, with 80 licensed beds in San  
            Leandro;

           Fairmont Hospital, with a 50-bed Acute Rehabilitation Center  
            as well as a 109-bed skilled nursing facility; and

           A network of community clinics, called Wellness Centers, which  
            include Highland Wellness Center in Oakland, Eastmont Wellness  
            Center in Oakland, Hayward Wellness Center, and Newark  
            Wellness Center.

           Creation of the hospital authority  .  In response to growing  
          budget problems, the Alameda County Board of Supervisors  
          sponsored legislation in 1996 (AB 2374 Bates, Chapter 816,  
          Statutes of 1996) to authorize the County of Alameda to  
          establish a hospital authority to manage the hospitals and  
          county programs operating as the AHS.  The bill required the  

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          governing structure of the hospital authority to be separate and  
          apart from the County for the purpose of affecting a transfer of  
          the management, administration and control of the AHS.  The bill  
          required the hospital authority's governing body to be appointed  
          by the Board of Supervisors.

           Prior Legislation
           
          SB 1352 (Hancock, Chapter 46, Statutes of 2014) replaced  
          outdated statutory references to the Alameda County Medical  
          Center with references to the Alameda Health System (AHS).  The  
          bill made additional technical and conforming changes to state  
          law and includes legislative findings and declarations regarding  
          AHS. 

          SB 1008 (Buchanan, Chapter 311, Statutes of 2013) made findings  
          regarding the agreement between Sutter Health and AHS to  
          transfer ownership of San Leandro Hospital to AHS, and specified  
          how employees of a facility acquired by, or merged into, AHS  
          shall be treated with regard to their retirement benefits.  The  
          bill also prohibits the AHS from privatizing any work performed  
          by its employed physicians as of March 31, 2013, without clear  
          and convincing evidence that the needed medical care can only be  
          delivered cost-effectively by a private contractor.

          AB 2374 (Bates, Chapter 816, Statutes of 1996) authorized the  
          Alameda County Board of Supervisors to establish a hospital  
          authority to manage the hospitals and county programs operating  
          as the AHS.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No   Local:  
           No

           SUPPORT :   (Verified  8/12/14)

          AFSCME
          Union of American Physicians and Dentists



          JL:k  8/12/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE


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