BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1094
                                                                  Page  1

          Date of Hearing:   August 6, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                    SB 1094 (Lara) - As Amended:  August 4, 2014 

          Policy Committee:                             HealthVote:11-6

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill provides an additional 30 days for the Attorney  
          General (AG) to review proposed transactions involving  
          non-profit health facilities, and allows the AG to amend the  
          conditions of an agreement or transaction involving a non-profit  
          health facility if a party to the transaction or agreement made  
          material misrepresentations to the AG, or violated the  
          conditions set forth by the AG.

           FISCAL EFFECT  

          Negligible state fiscal effect.  Although this bill allows the  
          AG to use additional enforcement mechanisms, it should not  
          increase costs to the Department of Justice.  

           COMMENTS  

           1)Purpose  . According to the author, this bill seeks to further  
            protect the interests and welfare of communities by  
            maintaining access to crucial hospital services and holding  
            health facilities accountable for agreements made when  
            transferring control or operation of the facility. The author  
            further states the process for reviewing proposed transactions  
            is complex and time intensive. 

            The author notes the AG is currently prevented from amending  
            conditions or imposing new conditions related to proposed  
            nonprofit hospital transaction agreements that would be in the  
            public's interest, even if the parties to the transaction  
            withheld material information from the AG during the review  
            process, or acted against the conditions set forth by the AG  
            when the transaction was approved. For instance, the AG cites  








                                                                  SB 1094
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            a recent case involving sale of a non-profit hospital to a  
            for-profit corporation where conditions were violated, and  
            where the AG's office believed it lacked sufficient  
            enforcement authority to assure outcomes that were most  
            beneficial to the affected community.  
             
             This bill is sponsored by the AG.

           2)Background  .  Current law requires the AG to review and approve  
            transactions involving non-profit health facilities. The AG  
            assesses the impact on access to health services on affected  
            communities, among other factors, and may impose conditions on  
            its approval of a transaction, such as requiring critical  
            medical services be maintained at the facility for a period of  
            time.  Certain hospital services, such as emergency, trauma,  
            burn treatment, and psychiatric care may be at heightened risk  
            of elimination in a transaction because they are costly to  
            provide and may be less remunerative than other services.   
            Reproductive services have also been eliminated or limited in  
            some transactions.  

           3)Opposition  . Hospitals oppose this bill, contending the AG  
            already has broad authority to review, approve, reject, and  
            impose conditions on transactions.  They see this bill as  
            granting unilateral authority to the AG to unwind previously  
            approved transactions, and believe this exposes transactions  
            to unnecessary risk. They also believe this bill limits their  
            due-process rights, arguing that the right to a writ of  
            mandate offers some protection, but fails to guarantee full  
            due process protection.   The Securities Industry and  
            Financial Markets Association, who represents securities  
            firms, banks, and asset managers, also opposes this bill,  
            indicating the uncertainty created by this bill would be  
            viewed unfavorably in capital markets and that it may be  
            costly to health care institutions, limit their capital  
            access, and potentially deter necessary transactions.  

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081