BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1094
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          SENATE THIRD READING
          SB 1094 (Lara)
          As Amended August 13, 2014
          Majority vote

           SENATE VOTE  :21-15  
           
           HEALTH              11-6        APPROPRIATIONS      11-6        
           
           ----------------------------------------------------------------- 
          |Ayes:|Pan, Bonilla, Bonta,      |Ayes:|Gatto, Bocanegra,         |
          |     |Chesbro, Gomez, Gonzalez, |     |Bradford,                 |
          |     |Roger Hern�ndez,          |     |Ian Calderon, Campos,     |
          |     |Lowenthal, Ridley-Thomas, |     |Eggman, Gomez, Holden,    |
          |     |Rodriguez, Wieckowski     |     |Pan, Quirk, Weber         |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Maienschein, Ch�vez,      |Nays:|Bigelow, Donnelly, Jones, |
          |     |Mansoor, Waldron,         |     |Linder, Ridley-Thomas,    |
          |     |Patterson, Wagner         |     |Wagner                    |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  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.  Requires the amended conditions  
          to be substantially related to the material misrepresentation.   
          Specifically,  this bill  :

          1)Extends the time in which the AG must notify a non-profit  
            corporation in writing of the decision to consent or not  
            consent to a proposed transaction from 60 days to 90 days.

          2)Permits the AG to enforce conditions imposed on the AG's  
            approval of an agreement or transaction involving a nonprofit  
            health facility and to require the transferee to fulfill all  
            representations made during the application process, including  
            those regarding levels of care.

          3)Allows the AG to amend the conditions of an agreement after  
            the AG's decision has been issued if an entity required to  








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            comply with the conditions contained in the transaction or  
            agreement made material misrepresentations to the AG; or, an  
            entity required to comply with the conditions contained in the  
            transaction or agreement violated the conditions set forth in  
            the AG's decision.  

          4)Requires an amended condition to be made within 10 years of  
            the completion of an agreement or transaction. 

          5)Specifies that amended conditions imposed by the AG pursuant  
            to 4) above, must be substantially related to the material  
            misrepresentation or the violation made by the entity to the  
            transaction, and shall be necessary to mitigate and provide  
            restitution for the effects of the violation. 

          6)Provides that an amended condition is subject to judicial  
            review. 

          7)Further clarifies that the parties' waiver of their rights to  
            judicial relief pertaining to the original agreement does not  
            apply to an amended condition imposed by the AG.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, 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  :  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  
          that the process for reviewing proposed transactions is complex  
          and time intensive.  Finally, the author notes that 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.

          This bill is sponsored by the AG, which states that since the  
          AG's role in overseeing non-profit health facility transactions  








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          was first conceptualized, the proposed transactions have become  
          more complex and numerous, including a notable spike observed in  
          recent years.  This has resulted in an increased amount of time  
          needed for review by the AG.  In addition, the AG states that  
          recent cases have revealed scenarios in which the AG's inability  
          to revisit approved transactions following significant new  
          developments seriously hinders its ability to preserve the level  
          of access to care for patients in accordance with the public  
          trust.  The AG states that this bill is designed to provide  
          modest but crucial updates to the AG's oversight authority to  
          account for these developments. 

          The California Hospital Association (CHA) opposes this bill  
          because it eliminates certainty in transactions involving the  
          sale or transfer of nonprofit hospitals by allowing the AG to  
          unilaterally impose post-transaction conditions.  CHA contends  
          that any allegation by a third-party, justified or otherwise,  
          that certain representations were made that contradict the  
          actual terms of the agreement, even if it was made by an  
          unauthorized representative or outside of the formal proceedings  
          and record, would allow the AG to unilaterally change the terms  
          of a deal.  Finally, CHA concludes that this bill would have a  
          chilling effect on these transactions because it eliminates any  
          certainty at the end of this negotiation and approval process  
          and hospitals will be unable to obtain financing because of the  
          lack of finality.  


           Analysis Prepared by  :    Lara Flynn / HEALTH / (916) 319-2097 


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