BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 334
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 334 (Buchanan)
          As Amended  August 11, 2014
          2/3 vote.  Urgency
           
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          |ASSEMBLY:  |     |(April 22,      |SENATE: |     |               |
          |           |     |2013)           |        |     |               |
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               (vote not relevant)                (vote not available)

          Original Committee Reference:   P.E., R. & S.S.  

           SUMMARY  :  Makes changes to existing law that prohibits the  
          Alameda Health System (AHS) from contracting with a private  
          person or entity for physician and surgeon services to specify  
          that the person or entity includes, but is not limited to, a  
          subsidiary or other entity established by AHS.    

           The Senate amendments  delete the Assembly version of this bill,  
          and instead:  

          1)Make changes to existing law that prohibits AHS from  
            contracting with a private person or entity for physician and  
            surgeon services to specify that the person or entity  
            includes, but is not limited to, a subsidiary or other entity  
            established by AHS.  

          2)Add an urgency statute.  

          3)Make other technical and conforming changes.  

           EXISTING LAW  :

          1)Authorizes the Alameda County Board of Supervisors to  
            establish a hospital authority separate and apart from the  
            county to manage, administer and control the Alameda County  
            Medical Center, now known as AHS.  

          2)Prohibits AHS, before January 1, 2024, from entering into a  
            contract with any private person or entity to replace services  
            being provided by specified physicians and surgeons, with  
            services provided by a private person or entity without clear  
            and convincing evidence that the needed medical care can only  
            be delivered cost-effectively by a private contractor.  








                                                                  AB 334
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           FISCAL EFFECT  :  None

           COMMENTS  :   

          1)Background and prior legislation.  Following the passage of AB  
            2374 (Bates), Chapter 816, Statutes of 1996, the Alameda  
            County Board of Supervisors appointed a board of trustees to  
            separately manage, administer and control AHS.  According to  
            AHS, their integrated public health care system employs more  
            than 4,500 people including 1,000 physicians throughout  
            Alameda County.  In the 1990s the Highland Hospital, a  
            regional trauma center and teaching hospital, John George  
            Psychiatric Hospital, an acute and emergency care facility,  
            Fairmont Hospital, an acute rehabilitation hospital and  
            skilled nursing facility, and the community wellness centers,  
            in Highland, Newark, Eastmont, and Hayward consolidated as the  
            Alameda County Medical Center.  
            Current law established by AB 1008 (Buchanan), Chapter 311,  
            Statutes of 2013, prohibits AHS from privatizing services  
            provided by physicians and surgeons, and establishes  
            eligibility for retirement benefits for employees of a  
            facility that is acquired or merged into AHS.   

          2)Purpose of this bill.  This bill builds upon current law  
            established by AB 1008 which prohibits AHS from entering into  
            a 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, with services provided by a private  
            person or entity without clear and convincing evidence that  
            the needed medical care can only be delivered cost-effectively  
            by a private contractor.  This bill specifies that the AHS is  
            prohibited from entering into a contract for physician and  
            surgeon services with any other person or entity, including,  
            but not limited to, a subsidiary or other entity established  
            by AHS.  

          3)Author's statement.  According to the author, "This bill is  
            necessary to clarify the protections afforded to the  
            physicians employed by AHS.  On April 22, 2014, AHS  
            incorporated a wholly owned subsidiary physician's  
            organization, Alameda Health Partners, and is encouraging  
            physicians and surgeons affiliated with the hospital to  
            contract with this organization.  This bill would clarify that  








                                                                  AB 334
                                                                  Page  3

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

          4)Arguments in support.  The American Federation of State,  
            County, and Municipal Employees, co-sponsor of the bill  
            argues, "AHS was able to side-skirt existing law and threaten  
            the job security of represented physicians and surgeons by  
            incorporating a wholly owned subsidiary that encourages the  
            privatization of the services provided by medical and surgical  
            practitioners in the public health system.  This bill will  
            protect the jobs of Alameda County's physicians and surgeons,  
            and ensure the uninterrupted provision of medical services to  
            the community." 

          5)Arguments in opposition.  None

          6)Two-thirds vote.  This bill requires a two-thirds vote of each  
            house because of the urgency clause.

          7)Gut and amend.  The subject matter of this bill has not been  
            heard in any Assembly policy committee this legislative  
            session.


           Analysis Prepared by  :    Misa Yokoi-Shelton / L. GOV. / (916)  
          319-3958 


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