AB 1350: Kern County Hospital Authority.
- Session Year: 2015-2016
- House: Assembly
- Latest Version Date: 2015-10-11
The Kern County Hospital Authority Act authorizes the board of supervisors of the County of Kern to, among other things, establish, by ordinance, the Kern County Hospital Authority to manage, administer, and control the Kern Medical Center and for the operation of additional programs, clinics and other facilities, care organizations, physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center. Existing law requires the board of supervisors to adopt, and the authority to implement, a personnel transition plan that requires specified actions, including acknowledgment that the authority, to the extent permitted by federal and state law, is required to be bound by the terms of the memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date the county adopts the enabling ordinance. Existing law subjects the authority to other employment and retirement provisions.
This bill would revise and recast those provisions to make technical changes to provisions relating to the transfer of control of the medical center by the county to the Kern County Hospital Authority, as specified. The bill would clarify that the authority is empowered with the maintenance, operation, management, control, ownership, or lease of the medical center, as provided by the enabling ordinance, as specified. The bill would make changes to the personnel transition plan to instead provide that the memoranda of understanding that apply to the authority are those in effect on the date of the transfer of control of the medical center to the authority, as specified, and if the memoranda of understanding has expired, that the most recent memoranda is binding unless modified by mutual agreement with each of the exclusive employee representatives. The bill would make other changes to related provisions to further reflect that certain actions be taken on the date of the transfer of control of the medical center to the authority, rather than the date the county adopts the enabling ordinance. The bill would make other changes to provisions related to, among others, retirement provisions, debt instruments, and contract provisions. The bill would authorize the board of supervisors to contract on behalf of the authority.
Existing law provides that certain employees of the authority may participate in the Kern County Employees Retirement Association, as specified.
The bill would require new obligations between the county and the authority regarding employer contributions to employee retirement plans.
The bill would provide that legacy employees, as defined, would be deemed county employees only for purposes of participation in a benefit plan administered by the Kern County Employees Retirement Association. The county would assume primary financial responsibility, and the authority would assume supplemental financial responsibility, for employer contributions that fund benefits for legacy employees, upon the transfer of control of the medical center to the authority.
The bill would provide that the authority would assume primary financial responsibility, and the county would assume supplemental financial responsibility, for employer contributions that fund benefits for new employees, as defined. However, if the authority fails to make required contributions for new employees, the county would be required to make employer contributions upon notice and demand from the Kern County Employees Retirement Association, as specified
The Kern County Hospital Authority Act authorizes the board of supervisors of the County of Kern to, among other things, establish, by ordinance, the Kern County Hospital Authority to manage, administer, and control the Kern Medical Center and for the operation of additional programs, clinics and other facilities, care organizations, physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center. Existing law requires the board of supervisors to adopt, and the authority to implement, a personnel transition plan that requires specified actions, including acknowledgment that the authority, to the extent permitted by federal and state law, is required to be bound by the terms of the memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date the county adopts the enabling ordinance. Existing law subjects the authority to other employment and retirement provisions.
This bill would revise and recast those provisions to make technical changes to provisions relating to the transfer of control of the medical center by the county to the Kern County Hospital Authority, as specified. The bill would clarify that the authority is empowered with the maintenance, operation, management, control, ownership, or lease of the medical center, as provided by the enabling ordinance, as specified. The bill would make changes to the personnel transition plan to instead provide that the memoranda of understanding that apply to the authority are those in effect on the date of the transfer of control of the medical center to the authority, as specified, and if the memoranda of understanding has expired, that the most recent memoranda is binding unless modified by mutual agreement with each of the exclusive employee representatives. The bill would make other changes to related provisions to further reflect that certain actions be taken on the date of the transfer of control of the medical center to the authority, rather than the date the county adopts the enabling ordinance. The bill would make other changes to provisions related to, among others, retirement provisions, debt instruments, and contract provisions. The bill would authorize the board of supervisors to contract on behalf of the authority.
Existing law provides that certain employees of the authority may participate in the Kern County Employees Retirement Association, as specified.
The bill would require new obligations between the county and the authority regarding employer contributions to employee retirement plans.
The bill would provide that legacy employees, as defined, would be deemed county employees only for purposes of participation in a benefit plan administered by the Kern County Employees Retirement Association. The county would assume primary financial responsibility, and the authority would assume supplemental financial responsibility, for employer contributions that fund benefits for legacy employees, upon the transfer of control of the medical center to the authority.
The bill would provide that the authority would assume primary financial responsibility, and the county would assume supplemental financial responsibility, for employer contributions that fund benefits for new employees, as defined. However, if the authority fails to make required contributions for new employees, the county would be required to make employer contributions upon notice and demand from the Kern County Employees Retirement Association, as specified
The Kern County Hospital Authority Act authorizes the board of supervisors of the County of Kern to, among other things, establish, by ordinance, the Kern County Hospital Authority to manage, administer, and control the Kern Medical Center and for the operation of additional programs, clinics and other facilities, care organizations, physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center. Existing law requires the board of supervisors to adopt, and the authority to implement, a personnel transition plan that requires specified actions, including acknowledgment that the authority, to the extent permitted by federal and state law, is required to be bound by the terms of the memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date the county adopts the enabling ordinance. Existing law subjects the authority to other employment and retirement provisions.
This bill would revise and recast those provisions to make technical changes to provisions relating to the transfer of control of the medical center by the county to the Kern County Hospital Authority, as specified. The bill would clarify that the authority is empowered with the maintenance, operation, management, control, ownership, or lease of the medical center, as provided by the enabling ordinance, as specified. The bill would make changes to the personnel transition plan to instead provide that the memoranda of understanding that apply to the authority are those in effect on the date of the transfer of control of the medical center to the authority, as specified, and if the memoranda of understanding has expired, that the most recent memoranda is binding unless modified by mutual agreement with each of the exclusive employee representatives. The bill would make other changes to related provisions to further reflect that certain actions be taken on the date of the transfer of control of the medical center to the authority, rather than the date the county adopts the enabling ordinance. The bill would make other changes to provisions related to, among others, retirement provisions, debt instruments, and contract provisions. The bill would authorize the board of supervisors to contract on behalf of the authority.
Existing law provides that certain employees of the authority may participate in the Kern County Employees Retirement Association, as specified.
The bill would require new obligations between the county and the authority regarding employer contributions to employee retirement plans.
The bill would provide that legacy employees, as defined, would be deemed county employees only for purposes of participation in a benefit plan administered by the Kern County Employees Retirement Association. The county would assume primary financial responsibility, and the authority would assume supplemental financial responsibility, for employer contributions that fund benefits for legacy employees, upon the transfer of control of the medical center to the authority.
The bill would provide that the authority would assume primary financial responsibility, and the county would assume supplemental financial responsibility, for employer contributions that fund benefits for new employees, as defined. However, if the authority fails to make required contributions for new employees, the county would be required to make employer contributions upon notice and demand from the Kern County Employees Retirement Association, as specified
The Kern County Hospital Authority Act authorizes the board of supervisors of the County of Kern to, among other things, establish, by ordinance, the Kern County Hospital Authority to manage, administer, and control the Kern Medical Center and for the operation of additional programs, clinics and other facilities, care organizations, physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center. Existing law requires the board of supervisors to adopt, and the authority to implement, a personnel transition plan that requires specified actions, including acknowledgment that the authority, to the extent permitted by federal and state law, is required to be bound by the terms of the memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date the county adopts the enabling ordinance. Existing law subjects the authority to other employment and retirement provisions.
This bill would revise and recast those provisions to make technical changes to provisions relating to the transfer of control of the medical center by the county to the Kern County Hospital Authority, as specified. The bill would clarify that the authority is empowered with the maintenance, operation, management, control, ownership, or lease of the medical center, as provided by the enabling ordinance, as specified. The bill would make changes to the personnel transition plan to instead provide that the memoranda of understanding that apply to the authority are those in effect on the date of the transfer of control of the medical center to the authority, as specified. specified, and if the memoranda of understanding has expired, that the most recent memoranda is binding unless modified by mutual agreement with each of the exclusive employee representatives. The bill would make other changes to related provisions to further reflect that certain actions be taken on the date of the transfer of control of the medical center to the authority, rather than the date the county adopts the enabling ordinance. The bill would make other changes to provisions related to, among others, retirement provisions, debt instruments, and contract provisions. The bill would authorize the board of supervisors to contract on behalf of the authority.
The Kern County Hospital Authority Act authorizes the board of supervisors of the County of Kern to, among other things, establish, by ordinance, the Kern County Hospital Authority to manage, administer, and control the Kern Medical Center and for the operation of additional programs, clinics and other facilities, care organizations, physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center. The act makes related findings and declarations. Existing law requires the board of supervisors to adopt, and the authority to implement, a personnel transition plan that requires specified actions, including acknowledgment that the authority, to the extent permitted by federal and state law, is required to be bound by the terms of the memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date the county adopts the enabling ordinance. Existing law subjects the authority to other employment and retirement provisions.
This bill would make nonsubstantive, technical changes to those findings and declarations.
This bill would revise and recast those provisions to make technical changes to provisions relating to the transfer of control of the medical center by the county to the Kern County Hospital Authority, as specified. The bill would clarify that the authority is empowered with the maintenance, operation, management, control, ownership, or lease of the medical center, as provided by the enabling ordinance, as specified. The bill would make changes to the personnel transition plan to instead provide that the memoranda of understanding that apply to the authority are those in effect on the date of the transfer of control of the medical center to the authority, as specified. The bill would make other changes to related provisions to further reflect that certain actions be taken on the date of the transfer of control of the medical center to the authority, rather than the date the county adopts the enabling ordinance. The bill would make other changes to provisions related to, among others, retirement provisions, debt instruments, and contract provisions. The bill would authorize the board of supervisors to contract on behalf of the authority.
The Kern County Hospital Authority Act authorizes the board of supervisors of the County of Kern to, among other things, establish, by ordinance, the Kern County Hospital Authority to manage, administer, and control the Kern Medical Center and for the operation of additional programs, clinics and other facilities, care organizations, physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center. The act makes related findings and declarations.
This bill would make nonsubstantive, technical changes to those findings and declarations.
(a)This chapter shall be known, and may be cited, as the Kern County Hospital Authority Act.
(b)The Legislature finds and declares all of the following:
(1)Kern Medical Center, an acute care hospital currently operated as a constituent department of the County of Kern, is a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and a critical component of the states health care safety net.
(2) A county is authorized under existing law to integrate its county hospital services with those of other hospitals into a system of community service that offers free choice of hospitals to those requiring hospital care, with the objective of eliminating discrimination or segregation based on economic disability, so that the county hospital and other hospitals in the community share in providing services to paying patients and to those who qualify for care in public medical care programs. However, in a new era of health care delivery, it is necessary to pursue approaches that transition beyond acute care-centric orientations.
(3)The ongoing evolution of the health care environment requires public entities providing or arranging health care services to pursue innovative health care delivery models that proactively improve the quality of patient care services and patient experience, efficiently and effectively increase access to needed health care services across the care continuum, provide services in a patient-centered manner, and moderate the rate of growth of health care expenditures.
(4)The board of supervisors of the County of Kern has determined that providing access to affordable, high-quality health care services, and ensuring the full engagement and viability of the health care safety net in the county are essential for improving the health status of the people of the County of Kern. To further this imperative, it is necessary that the Kern Medical Center, while continuing as a designated public hospital and maintaining its mission, is provided with an organizational and operational structure that facilitates and improves its ability to function with flexibility, responsiveness, and innovation to promote a patient-centric system of care delivery featuring community-based care. This can best be accomplished by allowing the operation of the Kern Medical Center, along with other health-related resources, under a new hospital authority that is able to pursue efforts towards a delivery system that embraces population health management strategies, is effectively positioned for health plan-provider alignment, and maximizes opportunities for employees and enhancement of staff morale.
(5)This chapter is necessary to allow the formation of a new political subdivision, a public hospital authority, for the purposes described above.
SEC. 2.Section 101852.1 of the Health and Safety Code is amended to read:101852.1.For purposes of this chapter, the following definitions shall apply:
(a)Authority means the Kern Hospital System Authority established pursuant to this chapter.
(b)Board of supervisors means the board of supervisors of the County of Kern.
(c)Board of governors means the governing body of the authority.
(d)County means the County of Kern.
(e)Enabling ordinance means the county ordinance enacted by the board of supervisors pursuant to this chapter to establish the authority, as it may be amended from time to time.
(f)Legacy employees means employees of the county who retired from the medical center prior to the date of transfer of control of the medical center, employees of the county who are initially transferred to the authority on the date of transfer of control of the medical center, and employees first hired by or retired from the authority during the 24-month period following the date of transfer of control of the medical center.
(g)Medical center means the assets and liabilities comprising the Kern Medical Center, including, without limitation, a licensed acute care hospital and related public health care programs, facilities, care organizations, physician practice plans and delivery systems, which may be hospital-based or nonhospital-based, as specified by the board of supervisors or the authority now or in the future, as the case may be, depending on which entity controls the medical center.
(h)New employees means employees first hired by the authority after the 24-month period following the date of transfer of control of the medical center.
(i)Transfer of control of the medical center means the transfer by the county to the authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
SEC. 3.Section 101853 of the Health and Safety Code is amended to read:101853.(a)Pursuant to this chapter, the board of supervisors may establish by ordinance the Kern County Hospital Authority, which shall be a public agency that is a local unit of government separate and apart from the county and any other public entity for all purposes. The authority established pursuant to this chapter shall file the statement required by Section 53051 of the Government Code, and is a public entity for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code.
(b)The purpose of the authority shall be to do all of the following:
(1)Provide management, administration, and other controls consistent with this chapter as needed to operate the medical center and maintain its status as a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and for the operation of additional programs, clinics and other facilities, care organizations, health care service and physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center, to ensure the viability of the health care safety net in the county in a manner consistent with the countys requirements under Section 17000 of the Welfare and Institutions Code.
(2)Provide management, administration, and other controls consistent with this chapter to negotiate and enter into contracts to provide or arrange, or provide directly, on a fee-for-service, capitated, or other basis, health care services to individuals including, but not limited to, those covered under Subchapters XVIII (commencing with Section 1395), XIX (commencing with Section 1396), and XXI (commencing with Section 1397aa) of Chapter 7 of Title 42 of the United States Code, those entitled to coverage under private group coverage, private individual coverage, including without limitation, coverage through Covered California, other publicly supported programs, those employed by public agencies or private businesses, and uninsured or indigent individuals.
(c)Subject to the requirements of this chapter, the authority shall have, and be charged with, authority for the maintenance, operation, management, control, ownership, or lease of the medical center and other health-related resources, as provided by the enabling ordinance. The State Department of Health Care Services shall take all necessary steps to ensure all of the following:
(1)The authority has all of the licenses, permits, and approvals needed to operate the medical center.
(2)The medical center continues its status as a designated public hospital to at least the same extent as it would be designated in the absence of its transfer to the authority pursuant to this chapter.
(3)The authority may participate as a contributing public agency for all of the purposes specified in Section 433.51 of Title 42 of the Code of Federal Regulations, to the extent permitted by federal law.
(d)The board of supervisors, in the enabling ordinance, shall establish the terms and conditions of the transfer to the authority from the county, including, but not limited to, all of the following:
(1)Any transfer of real and personal property, assets, and liabilities, including, but not limited to, liabilities of the medical center determined and assigned by the county for county funds previously advanced, but not repaid or otherwise recovered, to fund the operations of the medical center.
(2)Transfer of employees, including any necessary personnel transition plan, as specified in Section 101853.1, allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities under the Kern County Employees Retirement Association, as specified in paragraph (7) of subdivision (g) of Section 101853.1, or other retirement plans, and funding of the accrued benefits of employees of the authority in the event of withdrawal from the plan or dissolution of the authority. Any allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities with respect to the Kern County Employees Retirement Association must be approved by its governing board of retirement after consideration of legal and actuarial analysis, and no such allocation may be made that would jeopardize the qualified status of the Kern County Employees Retirement Association under the federal Internal Revenue Code.
(3)Maintenance, operation, management, control, ownership, or lease of the medical center.
(4)Transfer of licenses.
(5)Whether funds of the authority shall be deposited in the custody of, and paid out solely through, the county treasurers office.
(6)Any other matters as the board of supervisors deems necessary, appropriate, or convenient for the conduct of the authoritys activities.
(e)(1)Notwithstanding any other law, a transfer of control of the medical center to the authority may be made, with or without the payment of a purchase price by the authority, and otherwise upon the terms and conditions as found necessary by the board of supervisors and specified in the enabling ordinance to ensure that the transfer will constitute an ongoing material benefit to the county and its residents.
(2)A transfer of control of the medical center to the authority shall not be construed as empowering the authority to transfer any ownership interest of the county in any portion of the medical center except as otherwise approved by the board of supervisors.
(3)The authority shall not transfer the maintenance, operation, management, control, ownership, or lease of the medical center to any other person or entity without the prior written approval of the board of supervisors. This paragraph shall not prevent the county, by ordinance, from allowing the disposal of obsolete or surplus equipment, supplies, or furnishings of the medical center by the authority.
(4)With respect to its maintenance, operation, management, control, ownership, or lease of the medical center, the authority shall conform to both of the following requirements:
(A)Comply with any applicable requirements of Section 14000.2 of the Welfare and Institutions Code.
(B)Comply with any applicable requirements of Section 1442.5.
(5)The board of supervisors may retain control of the medical center physical plant and facilities, as specifically provided for in the enabling ordinance or other lawful agreements entered into by the board of supervisors. Any lease agreement between the county and the authority shall provide that county premises shall not be sublet without the approval of the board of supervisors.
(6)Notwithstanding any other provision of this chapter, and whether or not accompanied by a change in licensing, the authoritys responsibility for the maintenance, operation, management, or control of the medical center, or any ownership or leasehold interest of the authority in the medical center, does not relieve the county of the ultimate responsibility for indigent care pursuant to Section 17000 of the Welfare and Institutions Code.
(7)For purposes of Article 12 (commencing with Section 17612.1) of Chapter 6 of Part 5 of Division 9 of the Welfare and Institutions Code, and the definition set forth in subdivision (f) of Section 17612.2 of the Welfare and Institutions Code, the medical center, excluding components that provide predominately public health services, and the county are affiliated governmental entities.
(f)The board of supervisors may contract with the authority for the provision of indigent care services on behalf of the county. The contract shall specify that county policies, as may be modified from time to time and consistent with the countys obligations under Section 17000 of the Welfare and Institutions Code, shall be applicable. Notwithstanding any other provision of this chapter, the authority shall not undertake any of the countys obligations under Section 17000 of the Welfare and Institutions Code, nor shall the authority have an entitlement to receive any revenue for the discharge of the countys obligations, without a written agreement with the county. Any contract executed by and between the county and the authority shall provide for the indemnification of the county by the authority for liabilities as specifically set forth in the contract, except that the contract shall include a provision that the county shall remain liable for its own negligent acts. Indemnification by the authority shall not divest the county from its ultimate responsibility for compliance with Section 17000 of the Welfare and Institutions Code.
(g)Unless otherwise agreed to by the authority and the board of supervisors or as otherwise provided by this chapter, an obligation of the authority, statutory, contractual, or otherwise, shall be the obligation solely of the authority and shall not be the obligation of the county or any other entity, and any contract executed by and between the county and the authority, or any other entity and the authority, shall contain a provision that liabilities or obligations of the authority with respect to its activities pursuant to the contract shall be the liabilities or obligations of the authority and shall not be or become the liabilities or obligations of the county or the other entity, respectively. An obligation of the authority, statutory, contractual, or otherwise, shall not be the obligation of the state.
(h)The authority shall not be a person subject to suit under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code).
(i) The authority is not subject to the jurisdiction of a local agency formation commission pursuant to the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code), or any successor statute.
(j)The authority is a district within the meaning set forth in the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code). Employees of the authority are eligible to become members or maintain membership, as applicable, in the Kern County Employees Retirement Association, to the extent described in subdivision (g) of Section 101853.1.
(k)Any determination with respect to the manner in which the authority qualifies as a governmental plan sponsor under Section 414(d) of the Internal Revenue Code shall be limited to relevant employee benefits purposes of that code only, and shall not change or otherwise modify the authoritys status as a public agency that is a local unit of government for other purposes specified in this chapter.
SEC. 4.Section 101853.1 of the Health and Safety Code is amended to read:101853.1.(a)In exercising its powers to employ personnel, the authority shall implement, and the board of supervisors shall adopt, a personnel transition plan. The personnel transition plan shall require all of the following:
(1)Ongoing communication to employees and recognized employee organizations regarding the impact of the transition on existing medical center, county, and other health care facility employees and employee classifications.
(2)Meeting and conferring with representatives of affected bargaining unit employees on both of the following issues:
(A)A timeframe for which the transfer of personnel shall occur.
(B)Specified periods of time during which county or medical center employees affected by the establishment of the authority may elect to be considered for appointment and exercise reinstatement rights, if applicable, to funded, equivalent, vacant county positions for which they are qualified and eligible. An employee who first elects to remain with the county may subsequently seek reinstatement with the authority within 30 days of the election to remain with the county and shall be subject to the requirements of this article.
(3)Acknowledgment that the authority, to the extent permitted by federal and state law, and consistent with paragraph (3) of subdivision (d), shall be bound by the terms of those memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date of the transfer of control of the medical center to the authority. Subsequent memoranda of understanding with exclusive employee representatives shall be subject to approval only by the board of governors.
(4)Communication to the Board of Retirement of the Kern County Employees Retirement Association or other retirement plan of any personnel transition plan, memoranda of understanding, or other arrangements that are related to the participation of the authoritys employees or the addition of new employees in the retirement plan.
(b)Implementation of this chapter shall not be a cause for the modification of the medical center or county employment benefits. Employees of the medical center or county on the date of transfer, who become authority employees, shall retain their existing or equivalent classifications and job descriptions upon transfer to the authority, comparable pension benefits (if permissible pursuant to relevant plan terms), and their existing salaries and other benefits that include, but are not limited to, accrued and unused vacation, sick leave, personal leave, health care, retiree health benefits, and deferred compensation plans. The transfer of an employee from the medical center or county shall not constitute a termination of employment for purposes of Section 227.3 of the Labor Code, or employee benefit plans and arrangements maintained by the medical center or county, except as otherwise provided in the enabling ordinance or personnel transition plan, nor shall it be counted as a break in uninterrupted employment for purposes of Section 31641 of the Government Code with respect to the Kern County Employees Retirement Association, or state service for purposes of the Public Employees Retirement System (Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code).
(c)Subject to applicable state law, the authority shall recognize the exclusive employee representatives of those authority employees who are transferred from the county or medical center to the authority pursuant to this chapter.
(d)In order to stabilize labor and employment relations and provide continuity of care and services to the people of the county, and notwithstanding any other law, the authority shall do all of the following for a period of 24 months after the effective date of the transfer of control of the medical center to the authority:
(1)Continue to recognize each exclusive employee representative of each bargaining unit.
(2)Continue to provide the same level of employee benefits to authority employees, whether the obligation to provide those benefits arise out of a memorandum of understanding, or other agreements or law.
(3)Extend and continue to be bound by any existing memoranda of understanding covering the terms and conditions of employment for employees of the authority, including the level of wages and benefits, and any county rules, ordinances, or policies specifically identified and incorporated by reference in a memoranda of understanding for 24 months or through the term of the memorandum of understanding, whichever shall be the longer, unless modified by mutual agreement with each of the exclusive employee representatives. The authority shall continue to provide those pension benefits specified in any memoranda of agreement as long as doing so does not conflict with any Kern County Employee Retirement Association plan provisions, or federal or state law including the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code and the federal Internal Revenue Code). If a memoranda of understanding is expired on the date of the transfer of control of the medical center, then the authority shall continue to be bound by the terms and conditions of the most recent memoranda of understanding, unless modified by a mutual agreement with each of the exclusive employee representatives, and the benefits and wages of transferred employees shall be retained consistent with subdivision (b).
(4)Meet and confer with the exclusive employee representatives to develop processes and procedures to address employee disciplinary action taken against permanent employees. If the authority terminates, suspends, demotes, or reduces the pay of a permanent employee for disciplinary reasons, those actions shall only be for cause consistent with state law, and an employee shall be afforded applicable due process protections granted to public employees under state law. Permanent employees laid off by the authority within six months of the date of the transfer of control of the medical center shall remain on the county reemployment list for two years. Inclusion on the county reemployment list is not a guarantee of reemployment. For the purposes of this paragraph, the term permanent employees excludes probationary employees, temporary employees, seasonal employees, provisional employees, extra help employees, and per diem employees.
(5)To the extent layoffs occur, and provided that all other previously agreed upon factors are equal, ensure that seniority shall prevail. The authority shall meet and confer with the exclusive employee representatives to address layoff procedures and the manner in which, and the extent to which, seniority shall be measured for employees who transfer from the medical center or county.
(e)Permanent employees of the medical center or county on the effective date of the transfer of control of the medical center to the authority, shall be deemed qualified for employment in equivalent positions at the authority, and no other qualifications shall be required except as otherwise required by state or federal law. Probationary employees on the effective date of the transfer, as set forth in this paragraph, shall retain their probationary status and rights and shall not be required to serve a new probationary period or extend their probationary period by reason of the transfer. To the extent possible, employees who transfer to equivalent positions at the authority shall retain their existing classifications and job descriptions, but if there is a dispute over this issue, the authority agrees to meet and confer with the exclusive employee representatives of the transferred employees.
(f)Employees who transfer from the medical center or county to the authority shall retain the seniority they earned at the medical center or county and any benefits or privileges based on the seniority.
(g)Notwithstanding any other law, employees of the authority may participate in the Kern County Employees Retirement Association, operated pursuant to the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code) as set forth below. However, the authority and employees of the authority, or certain designated parts thereof, shall not participate in the Kern County Employees Retirement Association if the board of retirement, in its sole discretion, determines that their participation could jeopardize the Kern County Employees Retirement Associations tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Chapters 3 (commencing with Section 31450) and 3.9 (commencing with Section 31899) of Part 3 of Division 4 of Title 3 of the Government Code or Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code, and that the board determines would adversely affect the administration of the system. There shall not be any individual employee elections regarding participation in the Kern County Employees Retirement Association or other retirement plans except to the extent such retirement plans provide for elective employee salary deferral contributions in accordance with federal Internal Revenue Code rules.
(1)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, to the extent provided for in the applicable memorandum of understanding.
(2)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided for in the applicable memorandum of understanding.
(3)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, as provided in the enabling ordinance or the personnel transition plan.
(4)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or the personnel transition plan.
(5)Employees hired by the authority on or after the effective date of the transfer of control of the medical center shall become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or personnel transition plan described in subdivision (a), or, if subject to a memorandum of understanding between the authority and an exclusive employee representative as described in paragraphs (2) and (3) of subdivision (d), to the extent provided for in the applicable memorandum of understanding.
(6)(A)Notwithstanding any other law, for purposes of California Public Employees Pension Reform Act of 2013 (Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code), an individual who was employed by the county or the medical center when it was a constituent department of the county, and is a member of the Kern County Employees Retirement Association or the Public Employees Retirement System, as set forth in Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code or a member prior to January 1, 2013, and who transfers, directly or after a break in service of less than six months, to the authority, in which the individual continues to be a member of either the Kern County Employees Retirement Association or the Public Employees Retirement System, as applicable, shall not be deemed to be a new employee or a new member within the meaning of Section 7522.04 of the Government Code, and shall continue to be subject, immediately after the transfer, to the same defined benefit formula, as defined in Section 7522.04 of the Government Code, and plan of replacement benefits offered by the county pursuant to Section 31899.4 of the Government Code and the Kern County Replacement Benefits Plan for retirement benefits limited by Section 415 of Title 26 of the United States Code.
(B)For purposes of subdivision (c) of Section 7522.43 of the Government Code, the authority shall be treated as a public employer that offered a plan of replacement benefits prior to January 1, 2013. The countys plan of replacement benefits that was in effect prior to January 1, 2013, is deemed to also be the authoritys replacement plan for the sole purpose of allowing the authority to continue to offer the plan of replacement benefits, immediately after the transfer, for Kern County Employees Retirement Association members who meet both of the following requirements, and the qualifying survivors or beneficiaries of those members:
(i)The employee was employed as of January 1, 2013, by the county or the medical center when it was a constituent department of the county.
(ii)The employee is part of a member group to which the county offered a plan of replacement benefits prior to January 1, 2013.
(7)(i)Notwithstanding any other law, legacy employees shall be deemed to be county employees for purposes of participation in a benefit plan administered by the Kern County Employees Retirement Association, but only for that purpose, and shall not be employees of the county for any other purpose. Upon the transfer of control of the medical center and thereafter, the county shall include legacy employees in a special county employee group for which the county has primary financial responsibility to fund all employer contributions that, together with contributions by employees and earnings thereon, are necessary to fund all benefits for legacy employees administered by the Kern County Employees Retirement Association, notwithstanding the fact that, following the transfer of control of the medical center, the authority shall commence making periodic employer contributions for legacy employees. In the event the authority fails to make required employer contributions for legacy employees when due and after demand from the Kern County Employees Retirement Association, the county, after receipt of notice and demand from the Kern County Employees Retirement Association, shall be obligated to make those contributions in place of the authority.
(ii)The authority shall be primarily responsible for any employer contributions that, together with contributions by employees and earnings thereon, are necessary to fund all benefits for new employees. In the event the authority fails to make required contributions for new employees, the county shall be obligated to make the required contributions after receipt of notice and demand from the Kern County Employees Retirement Association. The county shall maintain this obligation for new employees until the authority demonstrates, and the Kern County Employees Retirement Associations Board of Retirement determines, that the authority is sufficiently capable financially to fully assume the obligation to make all employer contributions for new employees, based upon the standard of financial capability approved by the Kern County Employees Retirement Association and the county in a plan of participation, and incorporated within a written agreement between the county and the authority. In the event the authority fails to make required contributions for any new employees due to the authoritys dissolution or bankruptcy, the county shall be obligated to make the required contributions after receipt of notice and demand from the Kern County Employees Retirement Association.
(h)This chapter shall not prohibit the authority from contracting with the Public Employees Retirement System, in accordance with the requirements of Section 20508 and any other applicable provisions of Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, for the purpose of providing employee participation in that system, or from establishing an alternative or supplemental retirement system or arrangement, including, but not limited to, deferred compensation arrangements, to the extent permitted by law and subject to any applicable agreement between the authority and the exclusive employee representatives, and as provided in the enabling ordinance or the personnel transition plan. Notwithstanding any other law, the authority and employees of the authority shall not participate in the Public Employees Retirement System if the Board of Administration of the Public Employees Retirement System, in its sole discretion, determines that their participation could jeopardize the Public Employees Retirement Systems tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, and that the board determines would adversely affect the administration of the system.
(i)Provided that this is not inconsistent with anything in this chapter, this chapter does not prohibit the authority from determining the number of employees, the number of full-time equivalent positions, job descriptions, the nature and extent of classified employment positions, and salaries of employees.
SEC. 5.Section 101855 of the Health and Safety Code is amended to read:101855.(a)Subject to any terms, conditions, and limitations as may be imposed by the enabling ordinance, the authority, in addition to any other powers granted pursuant to this chapter, shall have the following powers:
(1)To have the duties, privileges, immunities, rights, liabilities, and limitations of a local unit of government within the state.
(2)To have perpetual existence, subject to Article 5 (commencing with Section 101856).
(3)To adopt, have, and use a seal, and to alter it at its pleasure.
(4)To sue and be sued in the name of the authority in all actions and proceedings in all courts and tribunals of competent jurisdiction.
(5)To purchase, lease, trade, exchange, or otherwise acquire, maintain, hold, improve, mortgage, lease, sell, and dispose of real and personal property of any kind necessary or convenient to perform its functions and fully exercise its powers.
(6)To appoint and employ or otherwise engage a chief executive officer and other officers and employees that may be necessary or appropriate, including legal counsel, to establish their compensation, provide for their health, retirement, and other employment benefits, and to define the power and duties of officers and employees.
(7)(A)To incur indebtedness and to borrow money and issue bonds evidencing the same, including the authority to issue, from time to time, notes and revenue bonds in principal amounts that the authority determines to be necessary to provide sufficient funds for achieving any of its purposes, including, but not limited to, assumption or refinancing of debt service for capital projects eligible for Medi-Cal supplemental payments pursuant to Section 14085.5 of the Welfare and Institutions Code, or any successor or modified Medi-Cal debt service reimbursement program, the payment of principal and interest on notes and bonds of the authority, the establishment of reserves to secure those notes and bonds, and all other expenditures of the authority incident to and necessary or convenient to carry out its purposes and powers.
(B)Any notes, bonds, or other securities issued, and the income from them, including any profit from the sale thereof, shall at all times be free from taxation by the state or any agency, political subdivision, or instrumentality of the state.
(C)Notwithstanding the provisions of subparagraph (A), for any indebtedness, notes, bonds, or other securities that require voter approval pursuant to state law, the prior approval of the board of supervisors shall be required. Notwithstanding the required prior approval of the board of supervisors and except as otherwise provided in this chapter, any indebtedness incurred, or notes, bonds, or other securities issued pursuant to this subparagraph shall be the indebtedness, notes, bonds, or securities of the authority and not of the county, and the credit of the county shall not be pledged or relied upon in any manner in order to incur the indebtedness, or issue the notes, bonds, or other securities, unless the board of supervisors explicitly authorizes the use of the countys credit. The authority shall reimburse the county for all costs associated with the countys consideration of the indebtedness, notes, bonds, or securities, and the authority shall defend, indemnify, and hold harmless the county from any and all liability, costs, or expenses arising from or related to the indebtedness, notes, bonds, or securities.
(D)Nothing in this section shall preclude the authority from repayment of its debts or other liabilities, using funds that are not otherwise encumbered.
(8)To pursue its own credit rating.
(9)To enter into one or more contracts or agreements consistent with this chapter and other applicable laws of this state, including, but not limited to, contracting with any public or private entity or person for management or other services and personnel, and to authorize the chief executive officer to enter into contracts, execute all instruments, and do all things necessary or convenient in the exercise of the powers granted in this chapter.
(10)To purchase supplies, equipment, materials, property, and services.
(11)To establish policies relating to its purposes.
(12)To acquire or contract to acquire, rights-of-way, easements, privileges, and property, and to construct, equip, maintain, and operate any and all works or improvements wherever located that are necessary, convenient, or proper to carry out any of the provisions, objects, or purposes of this chapter, and to complete, extend, add to, repair, or otherwise improve any works or improvements acquired by it.
(13)To participate in, contract for, and to accept, gifts, grants, and loans of funds, property, or other aid or finance opportunity in any form from the federal government, the state, a state agency, or other source, or combination thereof, as otherwise would be available to a public, government, or private entity, and to comply, subject to this chapter, with the terms and conditions thereof.
(14)If not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, the authority may establish its own treasury, invest surplus money in its own treasury, manage investments, and engage third-party investment managers, in accordance with state law.
(15)To arrange for guarantees or insurance of its bonds, notes, or other obligations by the federal or state government or by a private insurer, and to pay the premiums thereof.
(16)To engage in managed care contracting, joint ventures, affiliations with other health care facilities, other health care providers and payers, management agreements, or to participate in alliances, purchasing consortia, health insurance pools, accountable care organizations, alternative delivery systems, or other cooperative arrangements, with any public or private entity.
(17)To enter into joint powers agreements pursuant to Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code. Notwithstanding any other law, the authority may enter into a joint powers agreement as described in Section 6523.5 of the Government Code as though that section applied to hospitals and other health care facilities in the County of Kern.
(18)To establish nonprofit, for-profit, or other entities necessary to carry out the duties of the authority.
(19)To elect to transfer funds to the state and incur certified public expenditures in support of the Medi-Cal program and other programs for which federal financial participation is available.
(20)To use a computerized management information system, including an electronic health records system, in connection with its operations, including, without limitation the administration of its facilities.
(21)To request that the board of supervisors levy a tax on behalf of the authority. If the board of supervisors approves the proposal to levy the tax, it shall call the election to seek voter approval and place the appropriate measure on the ballot for that election. The proceeds of these taxes shall be tax proceeds of the authority and not of the county. The authority shall reimburse the county for all costs associated with the countys consideration of those taxes, and shall defend, indemnify, and hold harmless the county from any liability, costs, or expenses arising from or related to the imposition of these taxes.
(22)Notwithstanding the provisions of this chapter relating to the obligations and liabilities of the authority, or any other law, the authority shall have the same rights, privileges, exemptions, preferences, and authority of a county with respect to owning, operating, and providing coverage and services through hospitals, clinics and other health facilities, health programs, care organizations, physicians and physician practice plans, delivery systems, health care service plans, and other provider types and coverage mechanisms.
(23)To engage in other activities that may be in the best interests of the authority and the persons served by the authority, as determined by the board of governors, in order to respond to changes in the health care industry.
(b)The authority shall conform to the following requirements:
(1)(A)Be a government agency that is a local unit of government separate and apart for all purposes from the county and any other public entity, and shall not be considered to be an agency, division, or department of the county or any other public entity. The authority shall not be governed by or subject to the civil service requirements of the county. Notwithstanding any other law, except as otherwise provided for in the enabling ordinance enacted pursuant to this chapter, and as set forth in Section 101853.1 relating to the personnel transition plan, the authority shall not be governed by, or subject to, other policies or operational rules applicable to the county, the medical center prior to its transfer, or any other public entity, including, but not limited to, those relating to personnel and procurement.
(B)The board of governors shall adopt written rules, regulations, and procedures with regard to basic human resource functions not inconsistent with memoranda of understanding covering employees represented by employee organizations or the provisions of this chapter. Until the time that the board of governors adopts its own rules, regulations, or procedures with regard to these functions, the existing rules, regulations, and procedures set forth in any memoranda of understanding described in Section 101853.1, and the rules and regulations adopted by the county and described in paragraph (4), shall continue to apply.
(2)Be subject to state and federal taxation laws that are applicable to public entities generally.
(3)Except as otherwise specifically provided in this chapter, comply with the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code), the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).
(4)Be subject to the jurisdiction of the Public Employment Relations Board. Until the authority adopts rules and regulations pursuant to subdivision (a) of Section 3507 of the Government Code, the existing rules adopted by the county and contained in the countys employer-employee relations resolution, as amended, shall apply, modified to account for the creation of the authority, and provided further that the resolution shall not contain any incorporation of the countys civil service rules or county ordinances unless specifically addressed in this chapter.
(5)Carry professional and general liability insurance or programs to the extent sufficient to cover its activities.
(6)Comply with the requirements of Sections 53260 and 53261 of the Government Code.
(7)Maintain financial and accounting records.
(8)Meet all local, state, and federal data reporting requirements.
(c)(1)Subject to any restrictions applicable to public agencies, and subject to any limitations or conditions set forth in the enabling ordinance adopted by the board of supervisors, the authority may borrow money from the county, repay debt it owes to the county, and use the borrowed funds to provide for its operating and capital needs. The county may lend the authority funds and may issue debt instruments, including, without limitation, revenue anticipation notes to obtain funds to provide, by loan or otherwise, amounts necessary for the authority to meet its operating and capital needs.
(2)Notwithstanding paragraph (1), nothing in this chapter shall be construed to limit the borrowing powers the county otherwise has under law for the purposes specified in paragraph (1) or any other purposes.
(d)Open sessions of the authority shall constitute official proceedings authorized by law within the meaning of Section 47 of the Civil Code. The privileges set forth in that section with respect to official proceedings shall apply to open sessions of the authority.
(e)(1)Notwithstanding any other law, the board of governors or board of supervisors, as applicable, may order that a meeting held solely for the purpose of discussion or taking action on authority trade secrets, as defined in subdivision (d) of Section 3426.1 of the Civil Code, or to consider and take action on matters pertaining to contracts and contract negotiations concerning all matters related to rates of payment for health care services arranged or provided by the authority, shall be held in closed session. Trade secrets for purposes of this chapter shall also include information for which the secrecy of the information is necessary for the authority to initiate a new service, program, marketing strategy, business plan, or technology, or to add a benefit or product, and premature disclosure of the trade secret would create a substantial probability of depriving the authority of a substantial economic benefit or opportunity.
(2)The requirements of making a public report of actions taken in closed session and the vote or abstention of every member present may be limited to a brief general description devoid of the information constituting the trade secret or concerning the matters related to rates of payment.
(3)Those records of the authority or board of supervisors, as applicable, that reveal the authoritys trade secrets are exempt from disclosure pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. This exemption shall apply for a period of two years after the service, program, marketing strategy, business plan, technology, benefit, or product that is the subject of the trade secret is formally adopted by the governing body of the authority, provided that the service, program, marketing strategy, business plan, technology, benefit, or product continues to be a trade secret. The board of governors or board of supervisors, as applicable, may delete the portion or portions containing trade secrets from any documents that were finally approved in the closed session that are provided to persons who have made the timely or standing request.
(4)This chapter shall not prevent the board of governors or board of supervisors, as applicable, from meeting in closed session as otherwise provided by law.
(f)Notwithstanding any other law, those records of the authority and of the county that reveal the authoritys rates of payment for health care services arranged or provided by the authority or its deliberative processes, strategies, discussions, communications, or any other portion of the negotiations with providers of health care services or Medi-Cal, health care plans, or other payers for rates of payment, shall not be required to be disclosed pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. However, three years after a contract or amendment to a contract is fully executed, the portion of the contract or amendment containing the rates of payment shall be open to inspection.
(g)The authority shall be a public agency that is a local unit of government for purposes of eligibility with respect to grants and other funding and loan guarantee programs. Contributions to the authority shall be tax deductible to the extent permitted by state and federal law. Nonproprietary income of the authority shall be exempt from state income taxation.
(h)Unless otherwise provided by the board of supervisors by way of resolution, the authority is empowered, or the board of supervisors is empowered on behalf of the authority, to apply as a public agency for one or more licenses for the provision of health care or the operation of a health care service plan pursuant to statutes and regulations governing licensing as currently written or subsequently amended.
(i)The statutory authority of a board of supervisors to prescribe rules that authorize a county hospital to integrate its services with those of other providers into a system of community service that offers free choice of hospitals to those requiring hospital care, as set forth in Section 14000.2 of the Welfare and Institutions Code, shall apply to the authority and the board of governors.
(j)(1)Except as otherwise provided in this chapter, provisions of the Evidence Code, the Government Code, including the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), the Civil Code, the Business and Professions Code, and other applicable law pertaining to the confidentiality of peer review activities of peer review bodies shall apply to the peer review activities of the authority, or any peer review body, as defined in paragraph (1) of subdivision (a) of Section 805 of the Business and Professions Code, formed pursuant to the powers granted to the authority. The laws pertaining to the confidentiality of peer review activities shall be together construed as extending, to the extent permitted by law, the maximum degree of protection of confidentiality.
(2)Notwithstanding Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of law, any peer review body formed pursuant to the powers granted to the authority, may, at its discretion and without notice to the public, meet in closed session, so long as the purpose of the meeting is the peer review bodys discharge of its responsibility to evaluate and improve the quality of care rendered by health facilities and health practitioners. The peer review body and its members shall receive, to the fullest extent, all immunities, privileges, and protections available to those peer review bodies, their individual members, and persons or entities assisting in the peer review process, including those afforded by Section 1157 of the Evidence Code and Section 1370. Peer review proceedings shall constitute an official proceeding authorized by law within the meaning of Section 47 of the Civil Code and those privileges set forth in that section with respect to official proceedings shall apply to peer review proceedings of the authority.
(3)Notwithstanding the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of state or local law requiring disclosure of public records, those records of a peer review body formed pursuant to the powers granted to the authority, shall not be required to be disclosed. The records and proceedings of the peer review body and its individual members shall receive, to the fullest extent, all immunities, privileges, and protections available to those records and proceedings, including those afforded by Section 1157 of the Evidence Code and Section 1370 of the Health and Safety Code.
(4)If the authority is required by law or contractual obligation to submit to the state or federal government peer review information or information relevant to the credentialing of a participating provider, that submission shall not constitute a waiver of confidentiality.
(5)Notwithstanding any other law, Section 1461 shall apply to hearings on reports of hospital medical audit or quality assurance committees.
(k)Except as expressly provided by other provisions of this section, all exemptions and exclusions from disclosure as public records pursuant to this chapter and the California Public Records Act, including, but not limited to, those pertaining to trade secrets and information withheld in the public interest, shall be fully applicable to the authority, and for the board of supervisors, and all state and local agencies with respect to all writings that the authority is required to prepare, produce, or submit, and which shall not constitute a waiver of exemption from disclosure.
(l)The authority and the county, or any combination thereof, may engage in marketing, advertising, and promotion of the medical and health care services made available to the community by the authority.
(m)(1)The board of supervisors may contract for services or purchase items on behalf of the authority.
(2)Unless otherwise provided for, and subject to the limitations and conditions set forth in the enabling ordinance, the board of governors shall have authority over procurement and contracts for the authority and shall adopt written rules, regulations, and procedures with regard to these functions. The authoritys ability to contract for personnel or other services and items it deems necessary, appropriate, or convenient for the conduct of its activities consistent with its purposes shall only be limited by the provisions in this chapter and obligations under the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code).
(3)Contracts by and between the authority and a public agency, and contracts by and between the authority and providers of health care, goods, or services, may be let on a nonbid basis and shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.
(n)The authority may contract with the county for services and personnel upon mutually agreeable terms.
(o)Notwithstanding Article 4.7 (commencing with Section 1125) of Chapter 1 of Division 4 of Title 1 of the Government Code, related to incompatible activities, Section 1099 of the Government Code, related to incompatible offices, or any other law, a member of the authoritys administrative staff shall not be considered to hold an incompatible office or to be engaged in activities inconsistent and incompatible with his or her duties as a result of his or her employment or affiliation with the county or an agency of the county.
(p)The board of governors and the officers and employees of the authority are public employees for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code, relating to claims and actions against public entities and public employees, and shall be protected by the immunities applicable to public entities and public employees governed by Part 2 (commencing with Section 814) of Division 3.6 of Title 1 of the Government Code, except as provided by other statutes or regulations that apply expressly to the authority.
SEC. 6.Section 101855.1 of the Health and Safety Code is amended to read:101855.1.(a)Transfer of control of the medical center, whether or not the transfer includes the surrendering by the county of the existing general acute care hospital license and corresponding application for a change of ownership of the license, shall not affect the eligibility of the county to undertake, and shall authorize the authority, subject to applicable requirements, to do any of the following:
(1)With the written consent of the county, participate in and receive allocations pursuant to the California Health Care for Indigents Program pursuant to Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9 of the Welfare and Institutions Code, or similar programs, as may be identified or earmarked by the county in support of uncompensated services of the type provided by the medical center.
(2)With the written consent of the county, participate in and receive allocations of local revenue fund amounts provided pursuant to Chapter 6 (commencing with Section 17600) of Part 5 of Division 9 of the Welfare and Institutions Code as may be identified or earmarked by the county in support of health care services of the type provided by the medical center to low-income individuals.
(3)Participate in the financing of, as applicable, and receive, Medicaid disproportionate share hospital payments available to a county hospital or designated public hospital, or any other successor or modified payment or funding that is intended to assist hospitals that serve a disproportionate share of low-income patients with special needs. The allocation of Medicaid disproportionate share hospital payments shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(4)Participate in the financing of, as applicable, and receive, Medi-Cal payments and supplemental reimbursements, including, but not limited to, payments made pursuant to Sections 14105.96, 14105.965, 14166.4, 14182.15, and 14199.2 of the Welfare and Institutions Code, payments described in paragraph (4) of subdivision (b) of Section 14301.4 of, and Section 14301.5 of, the Welfare and Institutions Code, and payments made available to a county provider or designated public hospital, or governmental entity with which it is affiliated, under any other successor or modified Medicaid payment system.
(5)Participate in the financing of, as applicable, and receive, safety net care pool funding, stabilization funding, delivery system reform incentive pool payments, and any other funding available to a county provider or designated public hospital, or governmental entities with which it is affiliated under the Medicaid demonstration project authorized pursuant to Article 5.2 (commencing with Section 14166) and Article 5.4 (commencing with Section 14180) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system. The allocation of safety net care pool funds shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(6)Participate in the financing, administration, and provision of services under the Low Income Health Program authorized pursuant to Part 3.6 (commencing with Section 15909) of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system if the authority enters into an agreement with the county concerning the provision of services by, and payment for these services to, the county.
(7)Participate in and receive direct grant and payment allocations pursuant to Article 5.230 (commencing with Section 14169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified direct grant and payment systems funded by hospital or other provider fee assessments.
(8)Receive Medi-Cal capital supplements pursuant to Section 14085.5 of the Welfare and Institutions Code, or any other successor or modified Medi-Cal debt service reimbursement program. Notwithstanding any other law, supplemental payments shall be made to the medical center under those programs for the debt service costs incurred by the county, and, if applicable, by the authority to the extent that debt service responsibility is refinanced, transferred to, or otherwise assumed by, directly or indirectly, the authority.
(9)Receive any other funds, or preference in the assignment of health care plan enrollees, that would otherwise be available to a county health plan, provider, or designated public hospital, or governmental entity with which it is affiliated.
(b)The transfer of control of the medical center to the authority pursuant to this chapter shall not otherwise disqualify the county or the authority from participating in any of the following:
(1)Local, state, and federal funding sources either specific to county or other publicly owned or operated health care service plans, hospitals, or other health care providers, including, but not limited to, ambulatory care clinics, health systems, practices, designated public hospitals, or governmental entities with which they are affiliated, for which there are special provisions specific to those plans, hospitals, ambulatory care clinics, health systems, practices, other health care providers or governmental entities with which they are affiliated.
(2)All funding programs in which the county, by itself or on behalf of the medical center had participated prior to the creation of the authority, or would otherwise be qualified to participate in had the authority not been created, and the maintenance, operation, management, control, ownership, or lease of the medical center not been transferred to the authority pursuant to this chapter.
SEC. 7.Section 101856 of the Health and Safety Code is amended to read:101856.(a)The board of supervisors may find and declare that the authority shall cease to exist. In that event, the board of supervisors shall provide for the disposition of the authoritys assets, obligations, and liabilities, which may include the transfer to the county of the medical center and other operations, or specified components of the medical center and other operations, through ordinance, resolution, or other action. Alternatively, the board of supervisors may order the board of governors to develop a plan of dissolution providing for the disposition of all of the assets and liabilities of the authority, which shall be subject to approval by the board of supervisors. Absent written agreement, or as otherwise provided in this chapter, the county shall not be obligated under any law to assume the authoritys obligations or liabilities, or take title to, or custody or control of, the authoritys assets.
(b)Upon the disposition of the liabilities of the authority and distribution of any remaining assets, as applicable, the board of supervisors shall rescind the ordinance that established the authority, and the authority shall cease to exist. The board of supervisors shall notify the State Department of Health Care Services 30 days prior to the effective date of the dissolution, and include in the notice whether the county intends for either or both, or specified components of, the medical center or other operations to be transferred to the county upon the effective date of dissolution of the authority.
(a)This chapter shall be known, and may be cited, as the Kern County Hospital Authority Act.
(b)The Legislature finds and declares all of the following:
(1)Kern Medical Center, an acute care hospital currently operated as a constituent department of the County of Kern, is a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and a critical component of the states health care safety net.
(2) A county is authorized under existing law to integrate its county hospital services with those of other hospitals into a system of community service that offers free choice of hospitals to those requiring hospital care, with the objective of eliminating discrimination or segregation based on economic disability, so that the county hospital and other hospitals in the community share in providing services to paying patients and to those who qualify for care in public medical care programs. However, in a new era of health care delivery, it is necessary to pursue approaches that transition beyond acute care-centric orientations.
(3)The ongoing evolution of the health care environment requires public entities providing or arranging health care services to pursue innovative health care delivery models that proactively improve the quality of patient care services and patient experience, efficiently and effectively increase access to needed health care services across the care continuum, provide services in a patient-centered manner, and moderate the rate of growth of health care expenditures.
(4)The board of supervisors of the County of Kern has determined that providing access to affordable, high-quality health care services, and ensuring the full engagement and viability of the health care safety net in the county are essential for improving the health status of the people of the County of Kern. To further this imperative, it is necessary that the Kern Medical Center, while continuing as a designated public hospital and maintaining its mission, is provided with an organizational and operational structure that facilitates and improves its ability to function with flexibility, responsiveness, and innovation to promote a patient-centric system of care delivery featuring community-based care. This can best be accomplished by allowing the operation of the Kern Medical Center, along with other health-related resources, under a new hospital authority that is able to pursue efforts towards a delivery system that embraces population health management strategies, is effectively positioned for health plan-provider alignment, and maximizes opportunities for employees and enhancement of staff morale.
(5)This chapter is necessary to allow the formation of a new political subdivision, a public hospital authority, for the purposes described above.
SEC. 2.Section 101852.1 of the Health and Safety Code is amended to read:101852.1.For purposes of this chapter, the following definitions shall apply:
(a)Authority means the Kern Hospital System Authority established pursuant to this chapter.
(b)Board of supervisors means the board of supervisors of the County of Kern.
(c)Board of governors means the governing body of the authority.
(d)County means the County of Kern.
(e)Enabling ordinance means the county ordinance enacted by the board of supervisors pursuant to this chapter to establish the authority, as it may be amended from time to time.
(f)Legacy employees means employees of the county who retired from the medical center prior to the date of transfer of control of the medical center, employees of the county who are initially transferred to the authority on the date of transfer of control of the medical center, and employees first hired by or retired from the authority during the 24-month period following the date of transfer of control of the medical center.
(g)Medical center means the assets and liabilities comprising the Kern Medical Center, including, without limitation, a licensed acute care hospital and related public health care programs, facilities, care organizations, physician practice plans and delivery systems, which may be hospital-based or nonhospital-based, as specified by the board of supervisors or the authority now or in the future, as the case may be, depending on which entity controls the medical center.
(h)New employees means employees first hired by the authority after the 24-month period following the date of transfer of control of the medical center.
(i)Transfer of control of the medical center means the transfer by the county to the authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
SEC. 3.Section 101853 of the Health and Safety Code is amended to read:101853.(a)Pursuant to this chapter, the board of supervisors may establish by ordinance the Kern County Hospital Authority, which shall be a public agency that is a local unit of government separate and apart from the county and any other public entity for all purposes. The authority established pursuant to this chapter shall file the statement required by Section 53051 of the Government Code, and is a public entity for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code.
(b)The purpose of the authority shall be to do all of the following:
(1)Provide management, administration, and other controls consistent with this chapter as needed to operate the medical center and maintain its status as a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and for the operation of additional programs, clinics and other facilities, care organizations, health care service and physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center, to ensure the viability of the health care safety net in the county in a manner consistent with the countys requirements under Section 17000 of the Welfare and Institutions Code.
(2)Provide management, administration, and other controls consistent with this chapter to negotiate and enter into contracts to provide or arrange, or provide directly, on a fee-for-service, capitated, or other basis, health care services to individuals including, but not limited to, those covered under Subchapters XVIII (commencing with Section 1395), XIX (commencing with Section 1396), and XXI (commencing with Section 1397aa) of Chapter 7 of Title 42 of the United States Code, those entitled to coverage under private group coverage, private individual coverage, including without limitation, coverage through Covered California, other publicly supported programs, those employed by public agencies or private businesses, and uninsured or indigent individuals.
(c)Subject to the requirements of this chapter, the authority shall have, and be charged with, authority for the maintenance, operation, management, control, ownership, or lease of the medical center and other health-related resources, as provided by the enabling ordinance. The State Department of Health Care Services shall take all necessary steps to ensure all of the following:
(1)The authority has all of the licenses, permits, and approvals needed to operate the medical center.
(2)The medical center continues its status as a designated public hospital to at least the same extent as it would be designated in the absence of its transfer to the authority pursuant to this chapter.
(3)The authority may participate as a contributing public agency for all of the purposes specified in Section 433.51 of Title 42 of the Code of Federal Regulations, to the extent permitted by federal law.
(d)The board of supervisors, in the enabling ordinance, shall establish the terms and conditions of the transfer to the authority from the county, including, but not limited to, all of the following:
(1)Any transfer of real and personal property, assets, and liabilities, including, but not limited to, liabilities of the medical center determined and assigned by the county for county funds previously advanced, but not repaid or otherwise recovered, to fund the operations of the medical center.
(2)Transfer of employees, including any necessary personnel transition plan, as specified in Section 101853.1, allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities under the Kern County Employees Retirement Association, as specified in paragraph (7) of subdivision (g) of Section 101853.1, or other retirement plans, and funding of the accrued benefits of employees of the authority in the event of withdrawal from the plan or dissolution of the authority. Any allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities with respect to the Kern County Employees Retirement Association must be approved by its governing board of retirement after consideration of legal and actuarial analysis, and no such allocation may be made that would jeopardize the qualified status of the Kern County Employees Retirement Association under the federal Internal Revenue Code.
(3)Maintenance, operation, management, control, ownership, or lease of the medical center.
(4)Transfer of licenses.
(5)Whether funds of the authority shall be deposited in the custody of, and paid out solely through, the county treasurers office.
(6)Any other matters as the board of supervisors deems necessary, appropriate, or convenient for the conduct of the authoritys activities.
(e)(1)Notwithstanding any other law, a transfer of control of the medical center to the authority may be made, with or without the payment of a purchase price by the authority, and otherwise upon the terms and conditions as found necessary by the board of supervisors and specified in the enabling ordinance to ensure that the transfer will constitute an ongoing material benefit to the county and its residents.
(2)A transfer of control of the medical center to the authority shall not be construed as empowering the authority to transfer any ownership interest of the county in any portion of the medical center except as otherwise approved by the board of supervisors.
(3)The authority shall not transfer the maintenance, operation, management, control, ownership, or lease of the medical center to any other person or entity without the prior written approval of the board of supervisors. This paragraph shall not prevent the county, by ordinance, from allowing the disposal of obsolete or surplus equipment, supplies, or furnishings of the medical center by the authority.
(4)With respect to its maintenance, operation, management, control, ownership, or lease of the medical center, the authority shall conform to both of the following requirements:
(A)Comply with any applicable requirements of Section 14000.2 of the Welfare and Institutions Code.
(B)Comply with any applicable requirements of Section 1442.5.
(5)The board of supervisors may retain control of the medical center physical plant and facilities, as specifically provided for in the enabling ordinance or other lawful agreements entered into by the board of supervisors. Any lease agreement between the county and the authority shall provide that county premises shall not be sublet without the approval of the board of supervisors.
(6)Notwithstanding any other provision of this chapter, and whether or not accompanied by a change in licensing, the authoritys responsibility for the maintenance, operation, management, or control of the medical center, or any ownership or leasehold interest of the authority in the medical center, does not relieve the county of the ultimate responsibility for indigent care pursuant to Section 17000 of the Welfare and Institutions Code.
(7)For purposes of Article 12 (commencing with Section 17612.1) of Chapter 6 of Part 5 of Division 9 of the Welfare and Institutions Code, and the definition set forth in subdivision (f) of Section 17612.2 of the Welfare and Institutions Code, the medical center, excluding components that provide predominately public health services, and the county are affiliated governmental entities.
(f)The board of supervisors may contract with the authority for the provision of indigent care services on behalf of the county. The contract shall specify that county policies, as may be modified from time to time and consistent with the countys obligations under Section 17000 of the Welfare and Institutions Code, shall be applicable. Notwithstanding any other provision of this chapter, the authority shall not undertake any of the countys obligations under Section 17000 of the Welfare and Institutions Code, nor shall the authority have an entitlement to receive any revenue for the discharge of the countys obligations, without a written agreement with the county. Any contract executed by and between the county and the authority shall provide for the indemnification of the county by the authority for liabilities as specifically set forth in the contract, except that the contract shall include a provision that the county shall remain liable for its own negligent acts. Indemnification by the authority shall not divest the county from its ultimate responsibility for compliance with Section 17000 of the Welfare and Institutions Code.
(g)Unless otherwise agreed to by the authority and the board of supervisors or as otherwise provided by this chapter, an obligation of the authority, statutory, contractual, or otherwise, shall be the obligation solely of the authority and shall not be the obligation of the county or any other entity, and any contract executed by and between the county and the authority, or any other entity and the authority, shall contain a provision that liabilities or obligations of the authority with respect to its activities pursuant to the contract shall be the liabilities or obligations of the authority and shall not be or become the liabilities or obligations of the county or the other entity, respectively. An obligation of the authority, statutory, contractual, or otherwise, shall not be the obligation of the state.
(h)The authority shall not be a person subject to suit under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code).
(i) The authority is not subject to the jurisdiction of a local agency formation commission pursuant to the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code), or any successor statute.
(j)The authority is a district within the meaning set forth in the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code). Employees of the authority are eligible to become members or maintain membership, as applicable, in the Kern County Employees Retirement Association, to the extent described in subdivision (g) of Section 101853.1.
(k)Any determination with respect to the manner in which the authority qualifies as a governmental plan sponsor under Section 414(d) of the Internal Revenue Code shall be limited to relevant employee benefits purposes of that code only, and shall not change or otherwise modify the authoritys status as a public agency that is a local unit of government for other purposes specified in this chapter.
SEC. 4.Section 101853.1 of the Health and Safety Code is amended to read:101853.1.(a)In exercising its powers to employ personnel, the authority shall implement, and the board of supervisors shall adopt, a personnel transition plan. The personnel transition plan shall require all of the following:
(1)Ongoing communication to employees and recognized employee organizations regarding the impact of the transition on existing medical center, county, and other health care facility employees and employee classifications.
(2)Meeting and conferring with representatives of affected bargaining unit employees on both of the following issues:
(A)A timeframe for which the transfer of personnel shall occur.
(B)Specified periods of time during which county or medical center employees affected by the establishment of the authority may elect to be considered for appointment and exercise reinstatement rights, if applicable, to funded, equivalent, vacant county positions for which they are qualified and eligible. An employee who first elects to remain with the county may subsequently seek reinstatement with the authority within 30 days of the election to remain with the county and shall be subject to the requirements of this article.
(3)Acknowledgment that the authority, to the extent permitted by federal and state law, and consistent with paragraph (3) of subdivision (d), shall be bound by the terms of those memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date of the transfer of control of the medical center to the authority. Subsequent memoranda of understanding with exclusive employee representatives shall be subject to approval only by the board of governors.
(4)Communication to the Board of Retirement of the Kern County Employees Retirement Association or other retirement plan of any personnel transition plan, memoranda of understanding, or other arrangements that are related to the participation of the authoritys employees or the addition of new employees in the retirement plan.
(b)Implementation of this chapter shall not be a cause for the modification of the medical center or county employment benefits. Employees of the medical center or county on the date of transfer, who become authority employees, shall retain their existing or equivalent classifications and job descriptions upon transfer to the authority, comparable pension benefits (if permissible pursuant to relevant plan terms), and their existing salaries and other benefits that include, but are not limited to, accrued and unused vacation, sick leave, personal leave, health care, retiree health benefits, and deferred compensation plans. The transfer of an employee from the medical center or county shall not constitute a termination of employment for purposes of Section 227.3 of the Labor Code, or employee benefit plans and arrangements maintained by the medical center or county, except as otherwise provided in the enabling ordinance or personnel transition plan, nor shall it be counted as a break in uninterrupted employment for purposes of Section 31641 of the Government Code with respect to the Kern County Employees Retirement Association, or state service for purposes of the Public Employees Retirement System (Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code).
(c)Subject to applicable state law, the authority shall recognize the exclusive employee representatives of those authority employees who are transferred from the county or medical center to the authority pursuant to this chapter.
(d)In order to stabilize labor and employment relations and provide continuity of care and services to the people of the county, and notwithstanding any other law, the authority shall do all of the following for a period of 24 months after the effective date of the transfer of control of the medical center to the authority:
(1)Continue to recognize each exclusive employee representative of each bargaining unit.
(2)Continue to provide the same level of employee benefits to authority employees, whether the obligation to provide those benefits arise out of a memorandum of understanding, or other agreements or law.
(3)Extend and continue to be bound by any existing memoranda of understanding covering the terms and conditions of employment for employees of the authority, including the level of wages and benefits, and any county rules, ordinances, or policies specifically identified and incorporated by reference in a memoranda of understanding for 24 months or through the term of the memorandum of understanding, whichever shall be the longer, unless modified by mutual agreement with each of the exclusive employee representatives. The authority shall continue to provide those pension benefits specified in any memoranda of agreement as long as doing so does not conflict with any Kern County Employee Retirement Association plan provisions, or federal or state law including the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code and the federal Internal Revenue Code). If a memoranda of understanding is expired on the date of the transfer of control of the medical center, then the authority shall continue to be bound by the terms and conditions of the most recent memoranda of understanding, unless modified by a mutual agreement with each of the exclusive employee representatives, and the benefits and wages of transferred employees shall be retained consistent with subdivision (b).
(4)Meet and confer with the exclusive employee representatives to develop processes and procedures to address employee disciplinary action taken against permanent employees. If the authority terminates, suspends, demotes, or reduces the pay of a permanent employee for disciplinary reasons, those actions shall only be for cause consistent with state law, and an employee shall be afforded applicable due process protections granted to public employees under state law. Permanent employees laid off by the authority within six months of the date of the transfer of control of the medical center shall remain on the county reemployment list for two years. Inclusion on the county reemployment list is not a guarantee of reemployment. For the purposes of this paragraph, the term permanent employees excludes probationary employees, temporary employees, seasonal employees, provisional employees, extra help employees, and per diem employees.
(5)To the extent layoffs occur, and provided that all other previously agreed upon factors are equal, ensure that seniority shall prevail. The authority shall meet and confer with the exclusive employee representatives to address layoff procedures and the manner in which, and the extent to which, seniority shall be measured for employees who transfer from the medical center or county.
(e)Permanent employees of the medical center or county on the effective date of the transfer of control of the medical center to the authority, shall be deemed qualified for employment in equivalent positions at the authority, and no other qualifications shall be required except as otherwise required by state or federal law. Probationary employees on the effective date of the transfer, as set forth in this paragraph, shall retain their probationary status and rights and shall not be required to serve a new probationary period or extend their probationary period by reason of the transfer. To the extent possible, employees who transfer to equivalent positions at the authority shall retain their existing classifications and job descriptions, but if there is a dispute over this issue, the authority agrees to meet and confer with the exclusive employee representatives of the transferred employees.
(f)Employees who transfer from the medical center or county to the authority shall retain the seniority they earned at the medical center or county and any benefits or privileges based on the seniority.
(g)Notwithstanding any other law, employees of the authority may participate in the Kern County Employees Retirement Association, operated pursuant to the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code) as set forth below. However, the authority and employees of the authority, or certain designated parts thereof, shall not participate in the Kern County Employees Retirement Association if the board of retirement, in its sole discretion, determines that their participation could jeopardize the Kern County Employees Retirement Associations tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Chapters 3 (commencing with Section 31450) and 3.9 (commencing with Section 31899) of Part 3 of Division 4 of Title 3 of the Government Code or Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code, and that the board determines would adversely affect the administration of the system. There shall not be any individual employee elections regarding participation in the Kern County Employees Retirement Association or other retirement plans except to the extent such retirement plans provide for elective employee salary deferral contributions in accordance with federal Internal Revenue Code rules.
(1)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, to the extent provided for in the applicable memorandum of understanding.
(2)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided for in the applicable memorandum of understanding.
(3)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, as provided in the enabling ordinance or the personnel transition plan.
(4)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or the personnel transition plan.
(5)Employees hired by the authority on or after the effective date of the transfer of control of the medical center shall become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or personnel transition plan described in subdivision (a), or, if subject to a memorandum of understanding between the authority and an exclusive employee representative as described in paragraphs (2) and (3) of subdivision (d), to the extent provided for in the applicable memorandum of understanding.
(6)(A)Notwithstanding any other law, for purposes of California Public Employees Pension Reform Act of 2013 (Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code), an individual who was employed by the county or the medical center when it was a constituent department of the county, and is a member of the Kern County Employees Retirement Association or the Public Employees Retirement System, as set forth in Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code or a member prior to January 1, 2013, and who transfers, directly or after a break in service of less than six months, to the authority, in which the individual continues to be a member of either the Kern County Employees Retirement Association or the Public Employees Retirement System, as applicable, shall not be deemed to be a new employee or a new member within the meaning of Section 7522.04 of the Government Code, and shall continue to be subject, immediately after the transfer, to the same defined benefit formula, as defined in Section 7522.04 of the Government Code, and plan of replacement benefits offered by the county pursuant to Section 31899.4 of the Government Code and the Kern County Replacement Benefits Plan for retirement benefits limited by Section 415 of Title 26 of the United States Code.
(B)For purposes of subdivision (c) of Section 7522.43 of the Government Code, the authority shall be treated as a public employer that offered a plan of replacement benefits prior to January 1, 2013. The countys plan of replacement benefits that was in effect prior to January 1, 2013, is deemed to also be the authoritys replacement plan for the sole purpose of allowing the authority to continue to offer the plan of replacement benefits, immediately after the transfer, for Kern County Employees Retirement Association members who meet both of the following requirements, and the qualifying survivors or beneficiaries of those members:
(i)The employee was employed as of January 1, 2013, by the county or the medical center when it was a constituent department of the county.
(ii)The employee is part of a member group to which the county offered a plan of replacement benefits prior to January 1, 2013.
(7)(i)Notwithstanding any other law, legacy employees shall be deemed to be county employees for purposes of participation in a benefit plan administered by the Kern County Employees Retirement Association, but only for that purpose, and shall not be employees of the county for any other purpose. Upon the transfer of control of the medical center and thereafter, the county shall include legacy employees in a special county employee group for which the county has primary financial responsibility to fund all employer contributions that, together with contributions by employees and earnings thereon, are necessary to fund all benefits for legacy employees administered by the Kern County Employees Retirement Association, notwithstanding the fact that, following the transfer of control of the medical center, the authority shall commence making periodic employer contributions for legacy employees. In the event the authority fails to make required employer contributions for legacy employees when due and after demand from the Kern County Employees Retirement Association, the county, after receipt of notice and demand from the Kern County Employees Retirement Association, shall be obligated to make those contributions in place of the authority.
(ii)The authority shall be primarily responsible for any employer contributions that, together with contributions by employees and earnings thereon, are necessary to fund all benefits for new employees. In the event the authority fails to make required contributions for new employees, the county shall be obligated to make the required contributions after receipt of notice and demand from the Kern County Employees Retirement Association. The county shall maintain this obligation for new employees until the authority demonstrates, and the Kern County Employees Retirement Associations Board of Retirement determines, that the authority is sufficiently capable financially to fully assume the obligation to make all employer contributions for new employees, based upon the standard of financial capability approved by the Kern County Employees Retirement Association and the county in a plan of participation, and incorporated within a written agreement between the county and the authority. In the event the authority fails to make required contributions for any new employees due to the authoritys dissolution or bankruptcy, the county shall be obligated to make the required contributions after receipt of notice and demand from the Kern County Employees Retirement Association.
(h)This chapter shall not prohibit the authority from contracting with the Public Employees Retirement System, in accordance with the requirements of Section 20508 and any other applicable provisions of Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, for the purpose of providing employee participation in that system, or from establishing an alternative or supplemental retirement system or arrangement, including, but not limited to, deferred compensation arrangements, to the extent permitted by law and subject to any applicable agreement between the authority and the exclusive employee representatives, and as provided in the enabling ordinance or the personnel transition plan. Notwithstanding any other law, the authority and employees of the authority shall not participate in the Public Employees Retirement System if the Board of Administration of the Public Employees Retirement System, in its sole discretion, determines that their participation could jeopardize the Public Employees Retirement Systems tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, and that the board determines would adversely affect the administration of the system.
(i)Provided that this is not inconsistent with anything in this chapter, this chapter does not prohibit the authority from determining the number of employees, the number of full-time equivalent positions, job descriptions, the nature and extent of classified employment positions, and salaries of employees.
SEC. 5.Section 101855 of the Health and Safety Code is amended to read:101855.(a)Subject to any terms, conditions, and limitations as may be imposed by the enabling ordinance, the authority, in addition to any other powers granted pursuant to this chapter, shall have the following powers:
(1)To have the duties, privileges, immunities, rights, liabilities, and limitations of a local unit of government within the state.
(2)To have perpetual existence, subject to Article 5 (commencing with Section 101856).
(3)To adopt, have, and use a seal, and to alter it at its pleasure.
(4)To sue and be sued in the name of the authority in all actions and proceedings in all courts and tribunals of competent jurisdiction.
(5)To purchase, lease, trade, exchange, or otherwise acquire, maintain, hold, improve, mortgage, lease, sell, and dispose of real and personal property of any kind necessary or convenient to perform its functions and fully exercise its powers.
(6)To appoint and employ or otherwise engage a chief executive officer and other officers and employees that may be necessary or appropriate, including legal counsel, to establish their compensation, provide for their health, retirement, and other employment benefits, and to define the power and duties of officers and employees.
(7)(A)To incur indebtedness and to borrow money and issue bonds evidencing the same, including the authority to issue, from time to time, notes and revenue bonds in principal amounts that the authority determines to be necessary to provide sufficient funds for achieving any of its purposes, including, but not limited to, assumption or refinancing of debt service for capital projects eligible for Medi-Cal supplemental payments pursuant to Section 14085.5 of the Welfare and Institutions Code, or any successor or modified Medi-Cal debt service reimbursement program, the payment of principal and interest on notes and bonds of the authority, the establishment of reserves to secure those notes and bonds, and all other expenditures of the authority incident to and necessary or convenient to carry out its purposes and powers.
(B)Any notes, bonds, or other securities issued, and the income from them, including any profit from the sale thereof, shall at all times be free from taxation by the state or any agency, political subdivision, or instrumentality of the state.
(C)Notwithstanding the provisions of subparagraph (A), for any indebtedness, notes, bonds, or other securities that require voter approval pursuant to state law, the prior approval of the board of supervisors shall be required. Notwithstanding the required prior approval of the board of supervisors and except as otherwise provided in this chapter, any indebtedness incurred, or notes, bonds, or other securities issued pursuant to this subparagraph shall be the indebtedness, notes, bonds, or securities of the authority and not of the county, and the credit of the county shall not be pledged or relied upon in any manner in order to incur the indebtedness, or issue the notes, bonds, or other securities, unless the board of supervisors explicitly authorizes the use of the countys credit. The authority shall reimburse the county for all costs associated with the countys consideration of the indebtedness, notes, bonds, or securities, and the authority shall defend, indemnify, and hold harmless the county from any and all liability, costs, or expenses arising from or related to the indebtedness, notes, bonds, or securities.
(D)Nothing in this section shall preclude the authority from repayment of its debts or other liabilities, using funds that are not otherwise encumbered.
(8)To pursue its own credit rating.
(9)To enter into one or more contracts or agreements consistent with this chapter and other applicable laws of this state, including, but not limited to, contracting with any public or private entity or person for management or other services and personnel, and to authorize the chief executive officer to enter into contracts, execute all instruments, and do all things necessary or convenient in the exercise of the powers granted in this chapter.
(10)To purchase supplies, equipment, materials, property, and services.
(11)To establish policies relating to its purposes.
(12)To acquire or contract to acquire, rights-of-way, easements, privileges, and property, and to construct, equip, maintain, and operate any and all works or improvements wherever located that are necessary, convenient, or proper to carry out any of the provisions, objects, or purposes of this chapter, and to complete, extend, add to, repair, or otherwise improve any works or improvements acquired by it.
(13)To participate in, contract for, and to accept, gifts, grants, and loans of funds, property, or other aid or finance opportunity in any form from the federal government, the state, a state agency, or other source, or combination thereof, as otherwise would be available to a public, government, or private entity, and to comply, subject to this chapter, with the terms and conditions thereof.
(14)If not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, the authority may establish its own treasury, invest surplus money in its own treasury, manage investments, and engage third-party investment managers, in accordance with state law.
(15)To arrange for guarantees or insurance of its bonds, notes, or other obligations by the federal or state government or by a private insurer, and to pay the premiums thereof.
(16)To engage in managed care contracting, joint ventures, affiliations with other health care facilities, other health care providers and payers, management agreements, or to participate in alliances, purchasing consortia, health insurance pools, accountable care organizations, alternative delivery systems, or other cooperative arrangements, with any public or private entity.
(17)To enter into joint powers agreements pursuant to Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code. Notwithstanding any other law, the authority may enter into a joint powers agreement as described in Section 6523.5 of the Government Code as though that section applied to hospitals and other health care facilities in the County of Kern.
(18)To establish nonprofit, for-profit, or other entities necessary to carry out the duties of the authority.
(19)To elect to transfer funds to the state and incur certified public expenditures in support of the Medi-Cal program and other programs for which federal financial participation is available.
(20)To use a computerized management information system, including an electronic health records system, in connection with its operations, including, without limitation the administration of its facilities.
(21)To request that the board of supervisors levy a tax on behalf of the authority. If the board of supervisors approves the proposal to levy the tax, it shall call the election to seek voter approval and place the appropriate measure on the ballot for that election. The proceeds of these taxes shall be tax proceeds of the authority and not of the county. The authority shall reimburse the county for all costs associated with the countys consideration of those taxes, and shall defend, indemnify, and hold harmless the county from any liability, costs, or expenses arising from or related to the imposition of these taxes.
(22)Notwithstanding the provisions of this chapter relating to the obligations and liabilities of the authority, or any other law, the authority shall have the same rights, privileges, exemptions, preferences, and authority of a county with respect to owning, operating, and providing coverage and services through hospitals, clinics and other health facilities, health programs, care organizations, physicians and physician practice plans, delivery systems, health care service plans, and other provider types and coverage mechanisms.
(23)To engage in other activities that may be in the best interests of the authority and the persons served by the authority, as determined by the board of governors, in order to respond to changes in the health care industry.
(b)The authority shall conform to the following requirements:
(1)(A)Be a government agency that is a local unit of government separate and apart for all purposes from the county and any other public entity, and shall not be considered to be an agency, division, or department of the county or any other public entity. The authority shall not be governed by or subject to the civil service requirements of the county. Notwithstanding any other law, except as otherwise provided for in the enabling ordinance enacted pursuant to this chapter, and as set forth in Section 101853.1 relating to the personnel transition plan, the authority shall not be governed by, or subject to, other policies or operational rules applicable to the county, the medical center prior to its transfer, or any other public entity, including, but not limited to, those relating to personnel and procurement.
(B)The board of governors shall adopt written rules, regulations, and procedures with regard to basic human resource functions not inconsistent with memoranda of understanding covering employees represented by employee organizations or the provisions of this chapter. Until the time that the board of governors adopts its own rules, regulations, or procedures with regard to these functions, the existing rules, regulations, and procedures set forth in any memoranda of understanding described in Section 101853.1, and the rules and regulations adopted by the county and described in paragraph (4), shall continue to apply.
(2)Be subject to state and federal taxation laws that are applicable to public entities generally.
(3)Except as otherwise specifically provided in this chapter, comply with the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code), the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).
(4)Be subject to the jurisdiction of the Public Employment Relations Board. Until the authority adopts rules and regulations pursuant to subdivision (a) of Section 3507 of the Government Code, the existing rules adopted by the county and contained in the countys employer-employee relations resolution, as amended, shall apply, modified to account for the creation of the authority, and provided further that the resolution shall not contain any incorporation of the countys civil service rules or county ordinances unless specifically addressed in this chapter.
(5)Carry professional and general liability insurance or programs to the extent sufficient to cover its activities.
(6)Comply with the requirements of Sections 53260 and 53261 of the Government Code.
(7)Maintain financial and accounting records.
(8)Meet all local, state, and federal data reporting requirements.
(c)(1)Subject to any restrictions applicable to public agencies, and subject to any limitations or conditions set forth in the enabling ordinance adopted by the board of supervisors, the authority may borrow money from the county, repay debt it owes to the county, and use the borrowed funds to provide for its operating and capital needs. The county may lend the authority funds and may issue debt instruments, including, without limitation, revenue anticipation notes to obtain funds to provide, by loan or otherwise, amounts necessary for the authority to meet its operating and capital needs.
(2)Notwithstanding paragraph (1), nothing in this chapter shall be construed to limit the borrowing powers the county otherwise has under law for the purposes specified in paragraph (1) or any other purposes.
(d)Open sessions of the authority shall constitute official proceedings authorized by law within the meaning of Section 47 of the Civil Code. The privileges set forth in that section with respect to official proceedings shall apply to open sessions of the authority.
(e)(1)Notwithstanding any other law, the board of governors or board of supervisors, as applicable, may order that a meeting held solely for the purpose of discussion or taking action on authority trade secrets, as defined in subdivision (d) of Section 3426.1 of the Civil Code, or to consider and take action on matters pertaining to contracts and contract negotiations concerning all matters related to rates of payment for health care services arranged or provided by the authority, shall be held in closed session. Trade secrets for purposes of this chapter shall also include information for which the secrecy of the information is necessary for the authority to initiate a new service, program, marketing strategy, business plan, or technology, or to add a benefit or product, and premature disclosure of the trade secret would create a substantial probability of depriving the authority of a substantial economic benefit or opportunity.
(2)The requirements of making a public report of actions taken in closed session and the vote or abstention of every member present may be limited to a brief general description devoid of the information constituting the trade secret or concerning the matters related to rates of payment.
(3)Those records of the authority or board of supervisors, as applicable, that reveal the authoritys trade secrets are exempt from disclosure pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. This exemption shall apply for a period of two years after the service, program, marketing strategy, business plan, technology, benefit, or product that is the subject of the trade secret is formally adopted by the governing body of the authority, provided that the service, program, marketing strategy, business plan, technology, benefit, or product continues to be a trade secret. The board of governors or board of supervisors, as applicable, may delete the portion or portions containing trade secrets from any documents that were finally approved in the closed session that are provided to persons who have made the timely or standing request.
(4)This chapter shall not prevent the board of governors or board of supervisors, as applicable, from meeting in closed session as otherwise provided by law.
(f)Notwithstanding any other law, those records of the authority and of the county that reveal the authoritys rates of payment for health care services arranged or provided by the authority or its deliberative processes, strategies, discussions, communications, or any other portion of the negotiations with providers of health care services or Medi-Cal, health care plans, or other payers for rates of payment, shall not be required to be disclosed pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. However, three years after a contract or amendment to a contract is fully executed, the portion of the contract or amendment containing the rates of payment shall be open to inspection.
(g)The authority shall be a public agency that is a local unit of government for purposes of eligibility with respect to grants and other funding and loan guarantee programs. Contributions to the authority shall be tax deductible to the extent permitted by state and federal law. Nonproprietary income of the authority shall be exempt from state income taxation.
(h)Unless otherwise provided by the board of supervisors by way of resolution, the authority is empowered, or the board of supervisors is empowered on behalf of the authority, to apply as a public agency for one or more licenses for the provision of health care or the operation of a health care service plan pursuant to statutes and regulations governing licensing as currently written or subsequently amended.
(i)The statutory authority of a board of supervisors to prescribe rules that authorize a county hospital to integrate its services with those of other providers into a system of community service that offers free choice of hospitals to those requiring hospital care, as set forth in Section 14000.2 of the Welfare and Institutions Code, shall apply to the authority and the board of governors.
(j)(1)Except as otherwise provided in this chapter, provisions of the Evidence Code, the Government Code, including the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), the Civil Code, the Business and Professions Code, and other applicable law pertaining to the confidentiality of peer review activities of peer review bodies shall apply to the peer review activities of the authority, or any peer review body, as defined in paragraph (1) of subdivision (a) of Section 805 of the Business and Professions Code, formed pursuant to the powers granted to the authority. The laws pertaining to the confidentiality of peer review activities shall be together construed as extending, to the extent permitted by law, the maximum degree of protection of confidentiality.
(2)Notwithstanding Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of law, any peer review body formed pursuant to the powers granted to the authority, may, at its discretion and without notice to the public, meet in closed session, so long as the purpose of the meeting is the peer review bodys discharge of its responsibility to evaluate and improve the quality of care rendered by health facilities and health practitioners. The peer review body and its members shall receive, to the fullest extent, all immunities, privileges, and protections available to those peer review bodies, their individual members, and persons or entities assisting in the peer review process, including those afforded by Section 1157 of the Evidence Code and Section 1370. Peer review proceedings shall constitute an official proceeding authorized by law within the meaning of Section 47 of the Civil Code and those privileges set forth in that section with respect to official proceedings shall apply to peer review proceedings of the authority.
(3)Notwithstanding the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of state or local law requiring disclosure of public records, those records of a peer review body formed pursuant to the powers granted to the authority, shall not be required to be disclosed. The records and proceedings of the peer review body and its individual members shall receive, to the fullest extent, all immunities, privileges, and protections available to those records and proceedings, including those afforded by Section 1157 of the Evidence Code and Section 1370 of the Health and Safety Code.
(4)If the authority is required by law or contractual obligation to submit to the state or federal government peer review information or information relevant to the credentialing of a participating provider, that submission shall not constitute a waiver of confidentiality.
(5)Notwithstanding any other law, Section 1461 shall apply to hearings on reports of hospital medical audit or quality assurance committees.
(k)Except as expressly provided by other provisions of this section, all exemptions and exclusions from disclosure as public records pursuant to this chapter and the California Public Records Act, including, but not limited to, those pertaining to trade secrets and information withheld in the public interest, shall be fully applicable to the authority, and for the board of supervisors, and all state and local agencies with respect to all writings that the authority is required to prepare, produce, or submit, and which shall not constitute a waiver of exemption from disclosure.
(l)The authority and the county, or any combination thereof, may engage in marketing, advertising, and promotion of the medical and health care services made available to the community by the authority.
(m)(1)The board of supervisors may contract for services or purchase items on behalf of the authority.
(2)Unless otherwise provided for, and subject to the limitations and conditions set forth in the enabling ordinance, the board of governors shall have authority over procurement and contracts for the authority and shall adopt written rules, regulations, and procedures with regard to these functions. The authoritys ability to contract for personnel or other services and items it deems necessary, appropriate, or convenient for the conduct of its activities consistent with its purposes shall only be limited by the provisions in this chapter and obligations under the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code).
(3)Contracts by and between the authority and a public agency, and contracts by and between the authority and providers of health care, goods, or services, may be let on a nonbid basis and shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.
(n)The authority may contract with the county for services and personnel upon mutually agreeable terms.
(o)Notwithstanding Article 4.7 (commencing with Section 1125) of Chapter 1 of Division 4 of Title 1 of the Government Code, related to incompatible activities, Section 1099 of the Government Code, related to incompatible offices, or any other law, a member of the authoritys administrative staff shall not be considered to hold an incompatible office or to be engaged in activities inconsistent and incompatible with his or her duties as a result of his or her employment or affiliation with the county or an agency of the county.
(p)The board of governors and the officers and employees of the authority are public employees for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code, relating to claims and actions against public entities and public employees, and shall be protected by the immunities applicable to public entities and public employees governed by Part 2 (commencing with Section 814) of Division 3.6 of Title 1 of the Government Code, except as provided by other statutes or regulations that apply expressly to the authority.
SEC. 6.Section 101855.1 of the Health and Safety Code is amended to read:101855.1.(a)Transfer of control of the medical center, whether or not the transfer includes the surrendering by the county of the existing general acute care hospital license and corresponding application for a change of ownership of the license, shall not affect the eligibility of the county to undertake, and shall authorize the authority, subject to applicable requirements, to do any of the following:
(1)With the written consent of the county, participate in and receive allocations pursuant to the California Health Care for Indigents Program pursuant to Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9 of the Welfare and Institutions Code, or similar programs, as may be identified or earmarked by the county in support of uncompensated services of the type provided by the medical center.
(2)With the written consent of the county, participate in and receive allocations of local revenue fund amounts provided pursuant to Chapter 6 (commencing with Section 17600) of Part 5 of Division 9 of the Welfare and Institutions Code as may be identified or earmarked by the county in support of health care services of the type provided by the medical center to low-income individuals.
(3)Participate in the financing of, as applicable, and receive, Medicaid disproportionate share hospital payments available to a county hospital or designated public hospital, or any other successor or modified payment or funding that is intended to assist hospitals that serve a disproportionate share of low-income patients with special needs. The allocation of Medicaid disproportionate share hospital payments shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(4)Participate in the financing of, as applicable, and receive, Medi-Cal payments and supplemental reimbursements, including, but not limited to, payments made pursuant to Sections 14105.96, 14105.965, 14166.4, 14182.15, and 14199.2 of the Welfare and Institutions Code, payments described in paragraph (4) of subdivision (b) of Section 14301.4 of, and Section 14301.5 of, the Welfare and Institutions Code, and payments made available to a county provider or designated public hospital, or governmental entity with which it is affiliated, under any other successor or modified Medicaid payment system.
(5)Participate in the financing of, as applicable, and receive, safety net care pool funding, stabilization funding, delivery system reform incentive pool payments, and any other funding available to a county provider or designated public hospital, or governmental entities with which it is affiliated under the Medicaid demonstration project authorized pursuant to Article 5.2 (commencing with Section 14166) and Article 5.4 (commencing with Section 14180) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system. The allocation of safety net care pool funds shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(6)Participate in the financing, administration, and provision of services under the Low Income Health Program authorized pursuant to Part 3.6 (commencing with Section 15909) of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system if the authority enters into an agreement with the county concerning the provision of services by, and payment for these services to, the county.
(7)Participate in and receive direct grant and payment allocations pursuant to Article 5.230 (commencing with Section 14169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified direct grant and payment systems funded by hospital or other provider fee assessments.
(8)Receive Medi-Cal capital supplements pursuant to Section 14085.5 of the Welfare and Institutions Code, or any other successor or modified Medi-Cal debt service reimbursement program. Notwithstanding any other law, supplemental payments shall be made to the medical center under those programs for the debt service costs incurred by the county, and, if applicable, by the authority to the extent that debt service responsibility is refinanced, transferred to, or otherwise assumed by, directly or indirectly, the authority.
(9)Receive any other funds, or preference in the assignment of health care plan enrollees, that would otherwise be available to a county health plan, provider, or designated public hospital, or governmental entity with which it is affiliated.
(b)The transfer of control of the medical center to the authority pursuant to this chapter shall not otherwise disqualify the county or the authority from participating in any of the following:
(1)Local, state, and federal funding sources either specific to county or other publicly owned or operated health care service plans, hospitals, or other health care providers, including, but not limited to, ambulatory care clinics, health systems, practices, designated public hospitals, or governmental entities with which they are affiliated, for which there are special provisions specific to those plans, hospitals, ambulatory care clinics, health systems, practices, other health care providers or governmental entities with which they are affiliated.
(2)All funding programs in which the county, by itself or on behalf of the medical center had participated prior to the creation of the authority, or would otherwise be qualified to participate in had the authority not been created, and the maintenance, operation, management, control, ownership, or lease of the medical center not been transferred to the authority pursuant to this chapter.
SEC. 7.Section 101856 of the Health and Safety Code is amended to read:101856.(a)The board of supervisors may find and declare that the authority shall cease to exist. In that event, the board of supervisors shall provide for the disposition of the authoritys assets, obligations, and liabilities, which may include the transfer to the county of the medical center and other operations, or specified components of the medical center and other operations, through ordinance, resolution, or other action. Alternatively, the board of supervisors may order the board of governors to develop a plan of dissolution providing for the disposition of all of the assets and liabilities of the authority, which shall be subject to approval by the board of supervisors. Absent written agreement, or as otherwise provided in this chapter, the county shall not be obligated under any law to assume the authoritys obligations or liabilities, or take title to, or custody or control of, the authoritys assets.
(b)Upon the disposition of the liabilities of the authority and distribution of any remaining assets, as applicable, the board of supervisors shall rescind the ordinance that established the authority, and the authority shall cease to exist. The board of supervisors shall notify the State Department of Health Care Services 30 days prior to the effective date of the dissolution, and include in the notice whether the county intends for either or both, or specified components of, the medical center or other operations to be transferred to the county upon the effective date of dissolution of the authority.
(a)This chapter shall be known, and may be cited, as the Kern County Hospital Authority Act.
(b)The Legislature finds and declares all of the following:
(1)Kern Medical Center, an acute care hospital currently operated as a constituent department of the County of Kern, is a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and a critical component of the states health care safety net.
(2) A county is authorized under existing law to integrate its county hospital services with those of other hospitals into a system of community service that offers free choice of hospitals to those requiring hospital care, with the objective of eliminating discrimination or segregation based on economic disability, so that the county hospital and other hospitals in the community share in providing services to paying patients and to those who qualify for care in public medical care programs. However, in a new era of health care delivery, it is necessary to pursue approaches that transition beyond acute care-centric orientations.
(3)The ongoing evolution of the health care environment requires public entities providing or arranging health care services to pursue innovative health care delivery models that proactively improve the quality of patient care services and patient experience, efficiently and effectively increase access to needed health care services across the care continuum, provide services in a patient-centered manner, and moderate the rate of growth of health care expenditures.
(4)The board of supervisors of the County of Kern has determined that providing access to affordable, high-quality health care services, and ensuring the full engagement and viability of the health care safety net in the county are essential for improving the health status of the people of the County of Kern. To further this imperative, it is necessary that the Kern Medical Center, while continuing as a designated public hospital and maintaining its mission, is provided with an organizational and operational structure that facilitates and improves its ability to function with flexibility, responsiveness, and innovation to promote a patient-centric system of care delivery featuring community-based care. This can best be accomplished by allowing the operation of the Kern Medical Center, along with other health-related resources, under a new hospital authority that is able to pursue efforts towards a delivery system that embraces population health management strategies, is effectively positioned for health plan-provider alignment, and maximizes opportunities for employees and enhancement of staff morale.
(5)This chapter is necessary to allow the formation of a new political subdivision, a public hospital authority, for the purposes described above.
SEC. 2.Section 101852.1 of the Health and Safety Code is amended to read:101852.1.For purposes of this chapter, the following definitions shall apply:
(a)Authority means the Kern Hospital System Authority established pursuant to this chapter.
(b)Board of supervisors means the board of supervisors of the County of Kern.
(c)Board of governors means the governing body of the authority.
(d)County means the County of Kern.
(e)Enabling ordinance means the county ordinance enacted by the board of supervisors pursuant to this chapter to establish the authority, as it may be amended from time to time.
(f)Legacy employees means employees of the county who retired from the medical center prior to the date of transfer of control of the medical center, employees of the county who are initially transferred to the authority on the date of transfer of control of the medical center, and employees first hired by or retired from the authority during the 24-month period following the date of transfer of control of the medical center.
(f)
(g)Medical center means the assets and liabilities comprising the Kern Medical Center, including, without limitation, a licensed acute care hospital and related public health care programs, facilities, care organizations, physician practice plans and delivery systems, which may be hospital-based or nonhospital-based, as specified by the board of supervisors or the authority now or in the future, as the case may be, depending on which entity controls the medical center.
(h)New employees means employees first hired by the authority after the 24-month period following the date of transfer of control of the medical center.
(g)
(i)Transfer of control of the medical center means the transfer by the county to the authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
SEC. 3.Section 101853 of the Health and Safety Code is amended to read:101853.(a)Pursuant to this chapter, the board of supervisors may establish by ordinance the Kern County Hospital Authority, which shall be a public agency that is a local unit of government separate and apart from the county and any other public entity for all purposes. The authority established pursuant to this chapter shall file the statement required by Section 53051 of the Government Code, and is a public entity for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code.
(b)The purpose of the authority shall be to do all of the following:
(1)Provide management, administration, and other controls consistent with this chapter as needed to operate the medical center and maintain its status as a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and for the operation of additional programs, clinics and other facilities, care organizations, health care service and physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center, to ensure the viability of the health care safety net in the county in a manner consistent with the countys requirements under Section 17000 of the Welfare and Institutions Code.
(2)Provide management, administration, and other controls consistent with this chapter to negotiate and enter into contracts to provide or arrange, or provide directly, on a fee-for-service, capitated, or other basis, health care services to individuals including, but not limited to, those covered under Subchapters XVIII (commencing with Section 1395), XIX (commencing with Section 1396), and XXI (commencing with Section 1397aa) of Chapter 7 of Title 42 of the United States Code, those entitled to coverage under private group coverage, private individual coverage, including without limitation, coverage through Covered California, other publicly supported programs, those employed by public agencies or private businesses, and uninsured or indigent individuals.
(c)Subject to the requirements of this chapter, the authority shall have, and be charged with, authority for the maintenance, operation, management, control, ownership, or lease of the medical center and other health-related resources, as provided by the enabling ordinance. The State Department of Health Care Services shall take all necessary steps to ensure all of the following:
(1)The authority has all of the licenses, permits, and approvals needed to operate the medical center.
(2)The medical center continues its status as a designated public hospital to at least the same extent as it would be designated in the absence of its transfer to the authority pursuant to this chapter.
(3)The authority may participate as a contributing public agency for all of the purposes specified in Section 433.51 of Title 42 of the Code of Federal Regulations, to the extent permitted by federal law.
(d)The board of supervisors, in the enabling ordinance, shall establish the terms and conditions of the transfer to the authority from the county, including, but not limited to, all of the following:
(1)Any transfer of real and personal property, assets, and liabilities, including, but not limited to, liabilities of the medical center determined and assigned by the county for county funds previously advanced, but not repaid or otherwise recovered, to fund the operations of the medical center.
(2)Transfer of employees, including any necessary personnel transition plan, as specified in Section 101853.1, allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities under the Kern County Employees Retirement Association, as specified in paragraph (7) of subdivision (g) of Section 101853.1, or other retirement plans, and funding of the accrued benefits of employees of the authority in the event of withdrawal from the plan or dissolution of the authority. Any allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities with respect to the Kern County Employees Retirement Association must be approved by its governing board of retirement after consideration of legal and actuarial analysis, and no such allocation may be made that would jeopardize the qualified status of the Kern County Employees Retirement Association under the federal Internal Revenue Code.
(3)Maintenance, operation, management, control, ownership, or lease of the medical center.
(4)Transfer of licenses.
(5)Whether funds of the authority shall be deposited in the custody of, and paid out solely through, the county treasurers office.
(6)Any other matters as the board of supervisors deems necessary, appropriate, or convenient for the conduct of the authoritys activities.
(e)(1)Notwithstanding any other law, a transfer of control of the medical center to the authority may be made, with or without the payment of a purchase price by the authority, and otherwise upon the terms and conditions as found necessary by the board of supervisors and specified in the enabling ordinance to ensure that the transfer will constitute an ongoing material benefit to the county and its residents.
(2)A transfer of control of the medical center to the authority shall not be construed as empowering the authority to transfer any ownership interest of the county in any portion of the medical center except as otherwise approved by the board of supervisors.
(3)The authority shall not transfer the maintenance, operation, management, control, ownership, or lease of the medical center to any other person or entity without the prior written approval of the board of supervisors. This paragraph shall not prevent the county, by ordinance, from allowing the disposal of obsolete or surplus equipment, supplies, or furnishings of the medical center by the authority.
(4)With respect to its maintenance, operation, management, control, ownership, or lease of the medical center, the authority shall conform to both of the following requirements:
(A)Comply with any applicable requirements of Section 14000.2 of the Welfare and Institutions Code.
(B)Comply with any applicable requirements of Section 1442.5.
(5)The board of supervisors may retain control of the medical center physical plant and facilities, as specifically provided for in the enabling ordinance or other lawful agreements entered into by the board of supervisors. Any lease agreement between the county and the authority shall provide that county premises shall not be sublet without the approval of the board of supervisors.
(6)Notwithstanding any other provision of this chapter, and whether or not accompanied by a change in licensing, the authoritys responsibility for the maintenance, operation, management, or control of the medical center, or any ownership or leasehold interest of the authority in the medical center, does not relieve the county of the ultimate responsibility for indigent care pursuant to Section 17000 of the Welfare and Institutions Code.
(7)For purposes of Article 12 (commencing with Section 17612.1) of Chapter 6 of Part 5 of Division 9 of the Welfare and Institutions Code, and the definition set forth in subdivision (f) of Section 17612.2 of the Welfare and Institutions Code, the medical center, excluding components that provide predominately public health services, and the county are affiliated governmental entities.
(f)The board of supervisors may contract with the authority for the provision of indigent care services on behalf of the county. The contract shall specify that county policies, as may be modified from time to time and consistent with the countys obligations under Section 17000 of the Welfare and Institutions Code, shall be applicable. Notwithstanding any other provision of this chapter, the authority shall not undertake any of the countys obligations under Section 17000 of the Welfare and Institutions Code, nor shall the authority have an entitlement to receive any revenue for the discharge of the countys obligations, without a written agreement with the county. Any contract executed by and between the county and the authority shall provide for the indemnification of the county by the authority for liabilities as specifically set forth in the contract, except that the contract shall include a provision that the county shall remain liable for its own negligent acts. Indemnification by the authority shall not divest the county from its ultimate responsibility for compliance with Section 17000 of the Welfare and Institutions Code.
(g)Unless otherwise agreed to by the authority and the board of supervisors, supervisors or as otherwise provided by this chapter, an obligation of the authority, statutory, contractual, or otherwise, shall be the obligation solely of the authority and shall not be the obligation of the county or any other entity, and any contract executed by and between the county and the authority, or any other entity and the authority, shall contain a provision that liabilities or obligations of the authority with respect to its activities pursuant to the contract shall be the liabilities or obligations of the authority and shall not be or become the liabilities or obligations of the county or the other entity, respectively. An obligation of the authority, statutory, contractual, or otherwise, shall not be the obligation of the state.
(h)The authority shall not be a person subject to suit under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code).
(i) The authority is not subject to the jurisdiction of a local agency formation commission pursuant to the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code), or any successor statute.
(j)The authority is a district within the meaning set forth in the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code). Employees of the authority are eligible to become members or maintain membership, as applicable, in the Kern County Employees Retirement Association, to the extent described in subdivision (g) of Section 101853.1.
(k)Any determination with respect to the manner in which the authority qualifies as a governmental plan sponsor under Section 414(d) of the Internal Revenue Code shall be limited to relevant employee benefits purposes of that code only, and shall not change or otherwise modify the authoritys status as a public agency that is a local unit of government for other purposes specified in this chapter.
SEC. 4.Section 101853.1 of the Health and Safety Code is amended to read:101853.1.(a)In exercising its powers to employ personnel, the authority shall implement, and the board of supervisors shall adopt, a personnel transition plan. The personnel transition plan shall require all of the following:
(1)Ongoing communication to employees and recognized employee organizations regarding the impact of the transition on existing medical center, county, and other health care facility employees and employee classifications.
(2)Meeting and conferring with representatives of affected bargaining unit employees on both of the following issues:
(A)A timeframe for which the transfer of personnel shall occur.
(B)Specified periods of time during which county or medical center employees affected by the establishment of the authority may elect to be considered for appointment and exercise reinstatement rights, if applicable, to funded, equivalent, vacant county positions for which they are qualified and eligible. An employee who first elects to remain with the county may subsequently seek reinstatement with the authority within 30 days of the election to remain with the county and shall be subject to the requirements of this article.
(3)Acknowledgment that the authority, to the extent permitted by federal and state law, and consistent with paragraph (3) of subdivision (d), shall be bound by the terms of those memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date of the transfer of control of the medical center to the authority. Subsequent memoranda of understanding with exclusive employee representatives shall be subject to approval only by the board of governors.
(4)Communication to the Board of Retirement of the Kern County Employees Retirement Association or other retirement plan of any personnel transition plan, memoranda of understanding, or other arrangements that are related to the participation of the authoritys employees or the addition of new employees in the retirement plan.
(b)Implementation of this chapter shall not be a cause for the modification of the medical center or county employment benefits. Employees of the medical center or county on the date of transfer, who become authority employees, shall retain their existing or equivalent classifications and job descriptions upon transfer to the authority, comparable pension benefits (if permissible pursuant to relevant plan terms), and their existing salaries and other benefits that include, but are not limited to, accrued and unused vacation, sick leave, personal leave, health care, retiree health benefits, and deferred compensation plans. The transfer of an employee from the medical center or county shall not constitute a termination of employment for purposes of Section 227.3 of the Labor Code, or employee benefit plans and arrangements maintained by the medical center or county, except as otherwise provided in the enabling ordinance or personnel transition plan, nor shall it be counted as a break in uninterrupted employment for purposes of Section 31641 of the Government Code with respect to the Kern County Employees Retirement Association, or state service for purposes of the Public Employees Retirement System (Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code).
(c)Subject to applicable state law, the authority shall recognize the exclusive employee representatives of those authority employees who are transferred from the county or medical center to the authority pursuant to this chapter.
(d)In order to stabilize labor and employment relations and provide continuity of care and services to the people of the county, and notwithstanding any other law, the authority shall do all of the following for a period of 24 months after the effective date of the transfer of control of the medical center to the authority:
(1)Continue to recognize each exclusive employee representative of each bargaining unit.
(2)Continue to provide the same level of employee benefits to authority employees, whether the obligation to provide those benefits arise out of a memorandum of understanding, or other agreements or law.
(3)Extend and continue to be bound by any existing memoranda of understanding covering the terms and conditions of employment for employees of the authority, including the level of wages and benefits, and any county rules, ordinances, or policies specifically identified and incorporated by reference in a memoranda of understanding for 24 months or through the term of the memorandum of understanding, whichever shall be the longer, unless modified by mutual agreement with each of the exclusive employee representatives. The authority shall continue to provide those pension benefits specified in any memoranda of agreement as long as doing so does not conflict with any Kern County Employee Retirement Association plan provisions, or federal or state law including the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code and the federal Internal Revenue Code). If a memoranda of understanding is expired on the date of the transfer of control of the medical center, then the authority shall continue to be bound by the terms and conditions of the most recent memoranda of understanding, unless modified by a mutual agreement with each of the exclusive employee representatives, and the benefits and wages of transferred employees shall be retained consistent with subdivision (b).
(4)Meet and confer with the exclusive employee representatives to develop processes and procedures to address employee disciplinary action taken against permanent employees. If the authority terminates, suspends, demotes, or reduces the pay of a permanent employee for disciplinary reasons, those actions shall only be for cause consistent with state law, and an employee shall be afforded applicable due process protections granted to public employees under state law. Permanent employees laid off by the authority within six months of the date of the transfer of control of the medical center shall remain on the county reemployment list for two years. Inclusion on the county reemployment list is not a guarantee of reemployment. For the purposes of this paragraph, the term permanent employees excludes probationary employees, temporary employees, seasonal employees, provisional employees, extra help employees, and per diem employees.
(5)To the extent layoffs occur, and provided that all other previously agreed upon factors are equal, ensure that seniority shall prevail. The authority shall meet and confer with the exclusive employee representatives to address layoff procedures and the manner in which, and the extent to which, seniority shall be measured for employees who transfer from the medical center or county.
(e)Permanent employees of the medical center or county on the effective date of the transfer of control of the medical center to the authority, shall be deemed qualified for employment in equivalent positions at the authority, and no other qualifications shall be required except as otherwise required by state or federal law. Probationary employees on the effective date of the transfer, as set forth in this paragraph, shall retain their probationary status and rights and shall not be required to serve a new probationary period or extend their probationary period by reason of the transfer. To the extent possible, employees who transfer to equivalent positions at the authority shall retain their existing classifications and job descriptions, but if there is a dispute over this issue, the authority agrees to meet and confer with the exclusive employee representatives of the transferred employees.
(f)Employees who transfer from the medical center or county to the authority shall retain the seniority they earned at the medical center or county and any benefits or privileges based on the seniority.
(g)Notwithstanding any other law, employees of the authority may participate in the Kern County Employees Retirement Association, operated pursuant to the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code) as set forth below. However, the authority and employees of the authority, or certain designated parts thereof, shall not participate in the Kern County Employees Retirement Association if the board of retirement, in its sole discretion, determines that their participation could jeopardize the Kern County Employees Retirement Associations tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Chapters 3 (commencing with Section 31450) and 3.9 (commencing with Section 31899) of Part 3 of Division 4 of Title 3 of the Government Code or Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code, and that the board determines would adversely affect the administration of the system. There shall not be any individual employee elections regarding participation in the Kern County Employees Retirement Association or other retirement plans except to the extent such retirement plans provide for elective employee salary deferral contributions in accordance with federal Internal Revenue Code rules.
(1)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, to the extent provided for in the applicable memorandum of understanding.
(2)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided for in the applicable memorandum of understanding.
(3)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, as provided in the enabling ordinance or the personnel transition plan.
(4)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or the personnel transition plan.
(5)Employees hired by the authority on or after the effective date of the transfer of control of the medical center shall become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or personnel transition plan described in subdivision (a), or, if subject to a memorandum of understanding between the authority and an exclusive employee representative as described in paragraphs (2) and (3) of subdivision (d), to the extent provided for in the applicable memorandum of understanding.
(6)(A)Notwithstanding any other law, for purposes of California Public Employees Pension Reform Act of 2013 (Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code), an individual who was employed by the county or the medical center when it was a constituent department of the county, and is a member of the Kern County Employees Retirement Association or the Public Employees Retirement System, as set forth in Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code or a member prior to January 1, 2013, and who transfers, directly or after a break in service of less than six months, to the authority, in which the individual continues to be a member of either the Kern County Employees Retirement Association or the Public Employees Retirement System, as applicable, shall not be deemed to be a new employee or a new member within the meaning of Section 7522.04 of the Government Code, and shall continue to be subject, immediately after the transfer, to the same defined benefit formula, as defined in Section 7522.04 of the Government Code, and plan of replacement benefits offered by the county pursuant to Section 31899.4 of the Government Code and the Kern County Replacement Benefits Plan for retirement benefits limited by Section 415 of Title 26 of the United States Code.
(B)For purposes of subdivision (c) of Section 7522.43 of the Government Code, the authority shall be treated as a public employer that offered a plan of replacement benefits prior to January 1, 2013. The countys plan of replacement benefits that was in effect prior to January 1, 2013, is deemed to also be the authoritys replacement plan for the sole purpose of allowing the authority to continue to offer the plan of replacement benefits, immediately after the transfer, for Kern County Employees Retirement Association members who meet both of the following requirements, and the qualifying survivors or beneficiaries of those members:
(i)The employee was employed as of January 1, 2013, by the county or the medical center when it was a constituent department of the county.
(ii)The employee is part of a member group to which the county offered a plan of replacement benefits prior to January 1, 2013.
(7)(i)Notwithstanding any other law, legacy employees shall be deemed to be county employees for purposes of participation in a benefit plan administered by the Kern County Employees Retirement Association, but only for that purpose, and shall not be employees of the county for any other purpose. Upon the transfer of control of the medical center and thereafter, the county shall include legacy employees in a special county employee group for which the county has primary financial responsibility to fund all employer contributions that, together with contributions by employees and earnings thereon, are necessary to fund all benefits for legacy employees administered by the Kern County Employees Retirement Association, notwithstanding the fact that, following the transfer of control of the medical center, the authority shall commence making periodic employer contributions for legacy employees. In the event the authority fails to make required employer contributions for legacy employees when due and after demand from the Kern County Employees Retirement Association, the county, after receipt of notice and demand from the Kern County Employees Retirement Association, shall be obligated to make those contributions in place of the authority.
(ii)The authority shall be primarily responsible for any employer contributions that, together with contributions by employees and earnings thereon, are necessary to fund all benefits for new employees. In the event the authority fails to make required contributions for new employees, the county shall be obligated to make the required contributions after receipt of notice and demand from the Kern County Employees Retirement Association. The county shall maintain this obligation for new employees until the authority demonstrates, and the Kern County Employees Retirement Associations Board of Retirement determines, that the authority is sufficiently capable financially to fully assume the obligation to make all employer contributions for new employees, based upon the standard of financial capability approved by the Kern County Employees Retirement Association and the county in a plan of participation, and incorporated within a written agreement between the county and the authority. In the event the authority fails to make required contributions for any new employees due to the authoritys dissolution or bankruptcy, the county shall be obligated to make the required contributions after receipt of notice and demand from the Kern County Employees Retirement Association.
(h)This chapter shall not prohibit the authority from contracting with the Public Employees Retirement System, in accordance with the requirements of Section 20508 and any other applicable provisions of Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, for the purpose of providing employee participation in that system, or from establishing an alternative or supplemental retirement system or arrangement, including, but not limited to, deferred compensation arrangements, to the extent permitted by law and subject to any applicable agreement between the authority and the exclusive employee representatives, and as provided in the enabling ordinance or the personnel transition plan. Notwithstanding any other law, the authority and employees of the authority shall not participate in the Public Employees Retirement System if the Board of Administration of the Public Employees Retirement System, in its sole discretion, determines that their participation could jeopardize the Public Employees Retirement Systems tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, and that the board determines would adversely affect the administration of the system.
(i)Provided that this is not inconsistent with anything in this chapter, this chapter does not prohibit the authority from determining the number of employees, the number of full-time equivalent positions, job descriptions, the nature and extent of classified employment positions, and salaries of employees.
SEC. 5.Section 101855 of the Health and Safety Code is amended to read:101855.(a)Subject to any terms, conditions, and limitations as may be imposed by the enabling ordinance, the authority, in addition to any other powers granted pursuant to this chapter, shall have the following powers:
(1)To have the duties, privileges, immunities, rights, liabilities, and limitations of a local unit of government within the state.
(2)To have perpetual existence, subject to Article 5 (commencing with Section 101856).
(3)To adopt, have, and use a seal, and to alter it at its pleasure.
(4)To sue and be sued in the name of the authority in all actions and proceedings in all courts and tribunals of competent jurisdiction.
(5)To purchase, lease, trade, exchange, or otherwise acquire, maintain, hold, improve, mortgage, lease, sell, and dispose of real and personal property of any kind necessary or convenient to perform its functions and fully exercise its powers.
(6)To appoint and employ or otherwise engage a chief executive officer and other officers and employees that may be necessary or appropriate, including legal counsel, to establish their compensation, provide for their health, retirement, and other employment benefits, and to define the power and duties of officers and employees.
(7)(A)To incur indebtedness and to borrow money and issue bonds evidencing the same, including the authority to issue, from time to time, notes and revenue bonds in principal amounts that the authority determines to be necessary to provide sufficient funds for achieving any of its purposes, including, but not limited to, assumption or refinancing of debt service for capital projects eligible for Medi-Cal supplemental payments pursuant to Section 14085.5 of the Welfare and Institutions Code, or any successor or modified Medi-Cal debt service reimbursement program, the payment of principal and interest on notes and bonds of the authority, the establishment of reserves to secure those notes and bonds, and all other expenditures of the authority incident to and necessary or convenient to carry out its purposes and powers.
(B)Any notes, bonds, or other securities issued, and the income from them, including any profit from the sale thereof, shall at all times be free from taxation by the state or any agency, political subdivision, or instrumentality of the state.
(C)Notwithstanding the provisions of subparagraph (A), for any indebtedness, notes, bonds, or other securities that require voter approval pursuant to state law, the prior approval of the board of supervisors shall be required. Notwithstanding the required prior approval of the board of supervisors, supervisors and except as otherwise provided in this chapter, any indebtedness incurred, or notes, bonds, or other securities issued pursuant to this subparagraph shall be the indebtedness, notes, bonds, or securities of the authority and not of the county, and the credit of the county shall not be pledged or relied upon in any manner in order to incur the indebtedness, or issue the notes, bonds, or other securities, unless the board of supervisors explicitly authorizes the use of the countys credit. The authority shall reimburse the county for all costs associated with the countys consideration of the indebtedness, notes, bonds, or securities, and the authority shall defend, indemnify, and hold harmless the county from any and all liability, costs, or expenses arising from or related to the indebtedness, notes, bonds, or securities.
(D)Nothing in this section shall preclude the authority from repayment of its debts or other liabilities, using funds that are not otherwise encumbered.
(8)To pursue its own credit rating.
(9)To enter into one or more contracts or agreements consistent with this chapter and other applicable laws of this state, including, but not limited to, contracting with any public or private entity or person for management or other services and personnel, and to authorize the chief executive officer to enter into contracts, execute all instruments, and do all things necessary or convenient in the exercise of the powers granted in this chapter.
(10)To purchase supplies, equipment, materials, property, and services.
(11)To establish policies relating to its purposes.
(12)To acquire or contract to acquire, rights-of-way, easements, privileges, and property, and to construct, equip, maintain, and operate any and all works or improvements wherever located that are necessary, convenient, or proper to carry out any of the provisions, objects, or purposes of this chapter, and to complete, extend, add to, repair, or otherwise improve any works or improvements acquired by it.
(13)To participate in, contract for, and to accept, gifts, grants, and loans of funds, property, or other aid or finance opportunity in any form from the federal government, the state, a state agency, or other source, or combination thereof, as otherwise would be available to a public, government, or private entity, and to comply, subject to this chapter, with the terms and conditions thereof.
(14)If not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, the authority may establish its own treasury, invest surplus money in its own treasury, manage investments, and engage third-party investment managers, in accordance with state law.
(15)To arrange for guarantees or insurance of its bonds, notes, or other obligations by the federal or state government or by a private insurer, and to pay the premiums thereof.
(16)To engage in managed care contracting, joint ventures, affiliations with other health care facilities, other health care providers and payers, management agreements, or to participate in alliances, purchasing consortia, health insurance pools, accountable care organizations, alternative delivery systems, or other cooperative arrangements, with any public or private entity.
(17)To enter into joint powers agreements pursuant to Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code. Notwithstanding any other law, the authority may enter into a joint powers agreement as described in Section 6523.5 of the Government Code as though that section applied to hospitals and other health care facilities in the County of Kern.
(18)To establish nonprofit, for-profit, or other entities necessary to carry out the duties of the authority.
(19)To elect to transfer funds to the state and incur certified public expenditures in support of the Medi-Cal program and other programs for which federal financial participation is available.
(20)To use a computerized management information system, including an electronic health records system, in connection with its operations, including, without limitation the administration of its facilities.
(21)To request that the board of supervisors levy a tax on behalf of the authority. If the board of supervisors approves the proposal to levy the tax, it shall call the election to seek voter approval and place the appropriate measure on the ballot for that election. The proceeds of these taxes shall be tax proceeds of the authority and not of the county. The authority shall reimburse the county for all costs associated with the countys consideration of those taxes, and shall defend, indemnify, and hold harmless the county from any liability, costs, or expenses arising from or related to the imposition of these taxes.
(22)Notwithstanding the provisions of this chapter relating to the obligations and liabilities of the authority, or any other law, the authority shall have the same rights, privileges, exemptions, preferences, and authority of a county with respect to owning, operating, and providing coverage and services through hospitals, clinics and other health facilities, health programs, care organizations, physicians and physician practice plans, delivery systems, health care service plans, and other provider types and coverage mechanisms.
(23)To engage in other activities that may be in the best interests of the authority and the persons served by the authority, as determined by the board of governors, in order to respond to changes in the health care industry.
(b)The authority shall conform to the following requirements:
(1)(A)Be a government agency that is a local unit of government separate and apart for all purposes from the county and any other public entity, and shall not be considered to be an agency, division, or department of the county or any other public entity. The authority shall not be governed by or subject to the civil service requirements of the county. Notwithstanding any other law, except as otherwise provided for in the enabling ordinance enacted pursuant to this chapter, and as set forth in Section 101853.1 relating to the personnel transition plan, the authority shall not be governed by, or subject to, other policies or operational rules applicable to the county, the medical center prior to its transfer, or any other public entity, including, but not limited to, those relating to personnel and procurement.
(B)The board of governors shall adopt written rules, regulations, and procedures with regard to basic human resource functions not inconsistent with memoranda of understanding covering employees represented by employee organizations or the provisions of this chapter. Until the time that the board of governors adopts its own rules, regulations, or procedures with regard to these functions, the existing rules, regulations, and procedures set forth in any memoranda of understanding described in Section 101853.1, and the rules and regulations adopted by the county and described in paragraph (4), shall continue to apply.
(2)Be subject to state and federal taxation laws that are applicable to public entities generally.
(3)Except as otherwise specifically provided in this chapter, comply with the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code), the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).
(4)Be subject to the jurisdiction of the Public Employment Relations Board. Until the authority adopts rules and regulations pursuant to subdivision (a) of Section 3507 of the Government Code, the existing rules adopted by the county and contained in the countys employer-employee relations resolution, as amended, shall apply, modified to account for the creation of the authority, and provided further that the resolution shall not contain any incorporation of the countys civil service rules or county ordinances unless specifically addressed in this chapter.
(5)Carry professional and general liability insurance or programs to the extent sufficient to cover its activities.
(6)Comply with the requirements of Sections 53260 and 53261 of the Government Code.
(7)Maintain financial and accounting records.
(8)Meet all local, state, and federal data reporting requirements.
(c)(1)Subject to any restrictions applicable to public agencies, and subject to any limitations or conditions set forth in the enabling ordinance adopted by the board of supervisors, the authority may borrow money from the county, repay debt it owes to the county, and use the borrowed funds to provide for its operating and capital needs. The county may lend the authority funds and may issue debt instruments, including, without limitation, revenue anticipation notes to obtain funds to provide, by loan or otherwise, amounts necessary for the authority to meet its operating and capital needs.
(2)Notwithstanding paragraph (1), nothing in this chapter shall be construed to limit the borrowing powers the county otherwise has under law for the purposes specified in paragraph (1) or any other purposes.
(d)Open sessions of the authority shall constitute official proceedings authorized by law within the meaning of Section 47 of the Civil Code. The privileges set forth in that section with respect to official proceedings shall apply to open sessions of the authority.
(e)(1)Notwithstanding any other law, the board of governors or board of supervisors, as applicable, may order that a meeting held solely for the purpose of discussion or taking action on authority trade secrets, as defined in subdivision (d) of Section 3426.1 of the Civil Code, or to consider and take action on matters pertaining to contracts and contract negotiations concerning all matters related to rates of payment for health care services arranged or provided by the authority, shall be held in closed session. Trade secrets for purposes of this chapter shall also include information for which the secrecy of the information is necessary for the authority to initiate a new service, program, marketing strategy, business plan, or technology, or to add a benefit or product, and premature disclosure of the trade secret would create a substantial probability of depriving the authority of a substantial economic benefit or opportunity.
(2)The requirements of making a public report of actions taken in closed session and the vote or abstention of every member present may be limited to a brief general description devoid of the information constituting the trade secret or concerning the matters related to rates of payment.
(3)Those records of the authority or board of supervisors, as applicable, that reveal the authoritys trade secrets are exempt from disclosure pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. This exemption shall apply for a period of two years after the service, program, marketing strategy, business plan, technology, benefit, or product that is the subject of the trade secret is formally adopted by the governing body of the authority, provided that the service, program, marketing strategy, business plan, technology, benefit, or product continues to be a trade secret. The board of governors or board of supervisors, as applicable, may delete the portion or portions containing trade secrets from any documents that were finally approved in the closed session that are provided to persons who have made the timely or standing request.
(4)This chapter shall not prevent the board of governors or board of supervisors, as applicable, from meeting in closed session as otherwise provided by law.
(f)Notwithstanding any other law, those records of the authority and of the county that reveal the authoritys rates of payment for health care services arranged or provided by the authority or its deliberative processes, strategies, discussions, communications, or any other portion of the negotiations with providers of health care services or Medi-Cal, health care plans, or other payers for rates of payment, shall not be required to be disclosed pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. However, three years after a contract or amendment to a contract is fully executed, the portion of the contract or amendment containing the rates of payment shall be open to inspection.
(g)The authority shall be a public agency that is a local unit of government for purposes of eligibility with respect to grants and other funding and loan guarantee programs. Contributions to the authority shall be tax deductible to the extent permitted by state and federal law. Nonproprietary income of the authority shall be exempt from state income taxation.
(h)Unless otherwise provided by the board of supervisors by way of resolution, the authority is empowered, or the board of supervisors is empowered on behalf of the authority, to apply as a public agency for one or more licenses for the provision of health care or the operation of a health care service plan pursuant to statutes and regulations governing licensing as currently written or subsequently amended.
(i)The statutory authority of a board of supervisors to prescribe rules that authorize a county hospital to integrate its services with those of other providers into a system of community service that offers free choice of hospitals to those requiring hospital care, as set forth in Section 14000.2 of the Welfare and Institutions Code, shall apply to the authority and the board of governors.
(j)(1)Except as otherwise provided in this chapter, provisions of the Evidence Code, the Government Code, including the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), the Civil Code, the Business and Professions Code, and other applicable law pertaining to the confidentiality of peer review activities of peer review bodies shall apply to the peer review activities of the authority, or any peer review body, as defined in paragraph (1) of subdivision (a) of Section 805 of the Business and Professions Code, formed pursuant to the powers granted to the authority. The laws pertaining to the confidentiality of peer review activities shall be together construed as extending, to the extent permitted by law, the maximum degree of protection of confidentiality.
(2)Notwithstanding Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of law, any peer review body formed pursuant to the powers granted to the authority, may, at its discretion and without notice to the public, meet in closed session, so long as the purpose of the meeting is the peer review bodys discharge of its responsibility to evaluate and improve the quality of care rendered by health facilities and health practitioners. The peer review body and its members shall receive, to the fullest extent, all immunities, privileges, and protections available to those peer review bodies, their individual members, and persons or entities assisting in the peer review process, including those afforded by Section 1157 of the Evidence Code and Section 1370. Peer review proceedings shall constitute an official proceeding authorized by law within the meaning of Section 47 of the Civil Code and those privileges set forth in that section with respect to official proceedings shall apply to peer review proceedings of the authority.
(3)Notwithstanding the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of state or local law requiring disclosure of public records, those records of a peer review body formed pursuant to the powers granted to the authority, shall not be required to be disclosed. The records and proceedings of the peer review body and its individual members shall receive, to the fullest extent, all immunities, privileges, and protections available to those records and proceedings, including those afforded by Section 1157 of the Evidence Code and Section 1370 of the Health and Safety Code.
(4)If the authority is required by law or contractual obligation to submit to the state or federal government peer review information or information relevant to the credentialing of a participating provider, that submission shall not constitute a waiver of confidentiality.
(5)Notwithstanding any other law, Section 1461 shall apply to hearings on reports of hospital medical audit or quality assurance committees.
(k)Except as expressly provided by other provisions of this section, all exemptions and exclusions from disclosure as public records pursuant to this chapter and the California Public Records Act, including, but not limited to, those pertaining to trade secrets and information withheld in the public interest, shall be fully applicable to the authority, and for the board of supervisors, and all state and local agencies with respect to all writings that the authority is required to prepare, produce, or submit, and which shall not constitute a waiver of exemption from disclosure.
(l)The authority and the county, or any combination thereof, may engage in marketing, advertising, and promotion of the medical and health care services made available to the community by the authority.
(m)(1)The board of supervisors may contract for services or purchase items on behalf of the authority.
(2)Unless otherwise provided for, and subject to the limitations and conditions set forth in the enabling ordinance, the board of governors shall have authority over procurement and contracts for the authority and shall adopt written rules, regulations, and procedures with regard to these functions. The authoritys ability to contract for personnel or other services and items it deems necessary, appropriate, or convenient for the conduct of its activities consistent with its purposes shall only be limited by the provisions in this chapter and obligations under the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code).
(3)Contracts by and between the authority and a public agency, and contracts by and between the authority and providers of health care, goods, or services, may be let on a nonbid basis and shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.
(n)The authority may contract with the county for services and personnel upon mutually agreeable terms.
(o)Notwithstanding Article 4.7 (commencing with Section 1125) of Chapter 1 of Division 4 of Title 1 of the Government Code, related to incompatible activities, Section 1099 of the Government Code, related to incompatible offices, or any other law, a member of the authoritys administrative staff shall not be considered to hold an incompatible office or to be engaged in activities inconsistent and incompatible with his or her duties as a result of his or her employment or affiliation with the county or an agency of the county.
(p)The board of governors and the officers and employees of the authority are public employees for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code, relating to claims and actions against public entities and public employees, and shall be protected by the immunities applicable to public entities and public employees governed by Part 2 (commencing with Section 814) of Division 3.6 of Title 1 of the Government Code, except as provided by other statutes or regulations that apply expressly to the authority.
SEC. 6.Section 101855.1 of the Health and Safety Code is amended to read:101855.1.(a)Transfer of control of the medical center, whether or not the transfer includes the surrendering by the county of the existing general acute care hospital license and corresponding application for a change of ownership of the license, shall not affect the eligibility of the county to undertake, and shall authorize the authority, subject to applicable requirements, to do any of the following:
(1)With the written consent of the county, participate in and receive allocations pursuant to the California Health Care for Indigents Program pursuant to Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9 of the Welfare and Institutions Code, or similar programs, as may be identified or earmarked by the county in support of uncompensated services of the type provided by the medical center.
(2)With the written consent of the county, participate in and receive allocations of local revenue fund amounts provided pursuant to Chapter 6 (commencing with Section 17600) of Part 5 of Division 9 of the Welfare and Institutions Code as may be identified or earmarked by the county in support of health care services of the type provided by the medical center to low-income individuals.
(3)Participate in the financing of, as applicable, and receive, Medicaid disproportionate share hospital payments available to a county hospital or designated public hospital, or any other successor or modified payment or funding that is intended to assist hospitals that serve a disproportionate share of low-income patients with special needs. The allocation of Medicaid disproportionate share hospital payments shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(4)Participate in the financing of, as applicable, and receive, Medi-Cal payments and supplemental reimbursements, including, but not limited to, payments made pursuant to Sections 14105.96, 14105.965, 14166.4, 14182.15, and 14199.2 of the Welfare and Institutions Code, payments described in paragraph (4) of subdivision (b) of Section 14301.4 of, and Section 14301.5 of, the Welfare and Institutions Code, and payments made available to a county provider or designated public hospital, or governmental entity with which it is affiliated, under any other successor or modified Medicaid payment system.
(5)Participate in the financing of, as applicable, and receive, safety net care pool funding, stabilization funding, delivery system reform incentive pool payments, and any other funding available to a county provider or designated public hospital, or governmental entities with which it is affiliated under the Medicaid demonstration project authorized pursuant to Article 5.2 (commencing with Section 14166) and Article 5.4 (commencing with Section 14180) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system. The allocation of safety net care pool funds shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(6)Participate in the financing, administration, and provision of services under the Low Income Health Program authorized pursuant to Part 3.6 (commencing with Section 15909) of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system if the authority enters into an agreement with the county concerning the provision of services by, and payment for these services to, the county.
(7)Participate in and receive direct grant and payment allocations pursuant to Article 5.230 (commencing with Section 14169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified direct grant and payment systems funded by hospital or other provider fee assessments.
(8)Receive Medi-Cal capital supplements pursuant to Section 14085.5 of the Welfare and Institutions Code, or any other successor or modified Medi-Cal debt service reimbursement program. Notwithstanding any other law, supplemental payments shall be made to the medical center under those programs for the debt service costs incurred by the county, and, if applicable, by the authority to the extent that debt service responsibility is refinanced, transferred to, or otherwise assumed by, directly or indirectly, the authority.
(9)Receive any other funds, or preference in the assignment of health care plan enrollees, that would otherwise be available to a county health plan, provider, or designated public hospital, or governmental entity with which it is affiliated.
(b)The transfer of control of the medical center to the authority pursuant to this chapter shall not otherwise disqualify the county or the authority from participating in any of the following:
(1)Local, state, and federal funding sources either specific to county or other publicly owned or operated health care service plans, hospitals, or other health care providers, including, but not limited to, ambulatory care clinics, health systems, practices, designated public hospitals, or governmental entities with which they are affiliated, for which there are special provisions specific to those plans, hospitals, ambulatory care clinics, health systems, practices, other health care providers or governmental entities with which they are affiliated.
(2)All funding programs in which the county, by itself or on behalf of the medical center had participated prior to the creation of the authority, or would otherwise be qualified to participate in had the authority not been created, and the maintenance, operation, management, control, ownership, or lease of the medical center not been transferred to the authority pursuant to this chapter.
SEC. 7.Section 101856 of the Health and Safety Code is amended to read:101856.(a)The board of supervisors may find and declare that the authority shall cease to exist. In that event, the board of supervisors shall provide for the disposition of the authoritys assets, obligations, and liabilities, which may include the transfer to the county of the medical center and other operations, or specified components of the medical center and other operations, through ordinance, resolution, or other action. Alternatively, the board of supervisors may order the board of governors to develop a plan of dissolution providing for the disposition of all of the assets and liabilities of the authority, which shall be subject to approval by the board of supervisors. Absent written agreement, or as otherwise provided in this chapter, the county shall not be obligated under any law to assume the authoritys obligations or liabilities, or take title to, or custody or control of, the authoritys assets.
(b)Upon the disposition of the liabilities of the authority and distribution of any remaining assets, as applicable, the board of supervisors shall rescind the ordinance that established the authority, and the authority shall cease to exist. The board of supervisors shall notify the State Department of Health Care Services 30 days prior to the effective date of the dissolution, and include in the notice whether the county intends for either or both, or specified components of, the medical center or other operations to be transferred to the county upon the effective date of dissolution of the authority.
(a)This chapter shall be known, and may be cited, as the Kern County Hospital Authority Act.
(b)The Legislature finds and declares all of the following:
(1)Kern Medical Center, an acute care hospital currently operated as a constituent department of the County of Kern, is a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and a critical component of the states health care safety net.
(2) A county is authorized under existing law to integrate its county hospital services with those of other hospitals into a system of community service that offers free choice of hospitals to those requiring hospital care, with the objective of eliminating discrimination or segregation based on economic disability, so that the county hospital and other hospitals in the community share in providing services to paying patients and to those who qualify for care in public medical care programs. However, in a new era of health care delivery, it is necessary to pursue approaches that transition beyond acute care-centric orientations.
(3)The ongoing evolution of the health care environment requires public entities providing or arranging health care services to pursue innovative health care delivery models that proactively improve the quality of patient care services and patient experience, efficiently and effectively increase access to needed health care services across the care continuum, provide services in a patient-centered manner, and moderate the rate of growth of health care expenditures.
(4)The board of supervisors of the County of Kern has determined that providing access to affordable, high-quality health care services, and ensuring the full engagement and viability of the health care safety net in the county are essential for improving the health status of the people of the County of Kern. To further this imperative, it is necessary that the Kern Medical Center, while continuing as a designated public hospital and maintaining its mission, is provided with an organizational and operational structure that facilitates and improves its ability to function with flexibility, responsiveness, and innovation to promote a patient-centric system of care delivery featuring community-based care. This can best be accomplished by allowing the operation of the Kern Medical Center, along with other health-related resources, under a new hospital authority that is able to pursue efforts towards a delivery system that embraces population health management strategies, is effectively positioned for health plan-provider alignment, and maximizes opportunities for employees and enhancement of staff morale.
(5)This chapter is necessary to allow the formation of a new political subdivision, a public hospital authority, for the purposes described above.
SEC. 2.Section 101852.1 of the Health and Safety Code is amended to read:101852.1.For purposes of this chapter, the following definitions shall apply:
(a)Authority means the Kern Hospital System Authority established pursuant to this chapter.
(b)Board of supervisors means the board of supervisors of the County of Kern.
(c)Board of governors means the governing body of the authority.
(d)County means the County of Kern.
(e)Enabling ordinance means the county ordinance enacted by the board of supervisors pursuant to this chapter to establish the authority, as it may be amended from time to time.
(f)Medical center means the assets and liabilities comprising the Kern Medical Center, including, without limitation, a licensed acute care hospital and related public health care programs, facilities, care organizations, physician practice plans and delivery systems, which may be hospital-based or nonhospital-based, as specified by the board of supervisors or the authority now or in the future, as the case may be, depending on which entity controls the medical center.
(g)Transfer of control of the medical center means the transfer by the county to the authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
SEC. 3.Section 101853 of the Health and Safety Code is amended to read:101853.(a)Pursuant to this chapter, the board of supervisors may establish by ordinance the Kern County Hospital Authority, which shall be a public agency that is a local unit of government separate and apart from the county and any other public entity for all purposes. The authority established pursuant to this chapter shall file the statement required by Section 53051 of the Government Code, and is a public entity for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code.
(b)The purpose of the authority shall be to do all of the following:
(1)Provide management, administration, and other controls consistent with this chapter as needed to operate the medical center and maintain its status as a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and for the operation of additional programs, clinics and other facilities, care organizations, health care service and physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center, to ensure the viability of the health care safety net in the county in a manner consistent with the countys requirements under Section 17000 of the Welfare and Institutions Code.
(2)Provide management, administration, and other controls consistent with this chapter to negotiate and enter into contracts to provide or arrange, or provide directly, on a fee-for-service, capitated, or other basis, health care services to individuals including, but not limited to, those covered under Subchapters XVIII (commencing with Section 1395), XIX (commencing with Section 1396), and XXI (commencing with Section 1397aa) of Chapter 7 of Title 42 of the United States Code, those entitled to coverage under private group coverage, private individual coverage, including without limitation, coverage through Covered California, other publicly supported programs, those employed by public agencies or private businesses, and uninsured or indigent individuals.
(c)Subject to the requirements of this chapter, the authority shall have, and be charged with, authority for the maintenance, operation, management, control, ownership, or lease of the medical center and other health-related resources, as provided by the enabling ordinance. The State Department of Health Care Services shall take all necessary steps to ensure all of the following:
(1)The authority has all of the licenses, permits, and approvals needed to operate the medical center.
(2)The medical center continues its status as a designated public hospital to at least the same extent as it would be designated in the absence of its transfer to the authority pursuant to this chapter.
(3)The authority may participate as a contributing public agency for all of the purposes specified in Section 433.51 of Title 42 of the Code of Federal Regulations, to the extent permitted by federal law.
(d)The board of supervisors, in the enabling ordinance, shall establish the terms and conditions of the transfer to the authority from the county, including, but not limited to, all of the following:
(1)Any transfer of real and personal property, assets, and liabilities, including, but not limited to, liabilities of the medical center determined and assigned by the county for county funds previously advanced, but not repaid or otherwise recovered, to fund the operations of the medical center.
(2)Transfer of employees, including any necessary personnel transition plan, as specified in Section 101853.1, allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities under the Kern County Employees Retirement Association or other retirement plans, and funding of the accrued benefits of employees of the authority in the event of withdrawal from the plan or dissolution of the authority. Any allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities with respect to the Kern County Employees Retirement Association must be approved by its governing board of retirement after consideration of legal and actuarial analysis, and no such allocation may be made that would jeopardize the qualified status of the Kern County Employees Retirement Association under the federal Internal Revenue Code.
(3)Maintenance, operation, management, control, ownership, or lease of the medical center.
(4)Transfer of licenses.
(5)Whether funds of the authority shall be deposited in the custody of, and paid out solely through, the county treasurers office.
(6)Any other matters as the board of supervisors deems necessary, appropriate, or convenient for the conduct of the authoritys activities.
(e)(1)Notwithstanding any other law, a transfer of control of the medical center to the authority may be made, with or without the payment of a purchase price by the authority, and otherwise upon the terms and conditions as found necessary by the board of supervisors and specified in the enabling ordinance to ensure that the transfer will constitute an ongoing material benefit to the county and its residents.
(2)A transfer of control of the medical center to the authority shall not be construed as empowering the authority to transfer any ownership interest of the county in any portion of the medical center except as otherwise approved by the board of supervisors.
(3)The authority shall not transfer the maintenance, operation, management, control, ownership, or lease of the medical center to any other person or entity without the prior written approval of the board of supervisors. This paragraph shall not prevent the county, by ordinance, from allowing the disposal of obsolete or surplus equipment, supplies, or furnishings of the medical center by the authority.
(4)With respect to its maintenance, operation, management, control, ownership, or lease of the medical center, the authority shall conform to both of the following requirements:
(A)Comply with any applicable requirements of Section 14000.2 of the Welfare and Institutions Code.
(B)Comply with any applicable requirements of Section 1442.5.
(5)The board of supervisors may retain control of the medical center physical plant and facilities, as specifically provided for in the enabling ordinance or other lawful agreements entered into by the board of supervisors. Any lease agreement between the county and the authority shall provide that county premises shall not be sublet without the approval of the board of supervisors.
(6)Notwithstanding any other provision of this chapter, and whether or not accompanied by a change in licensing, the authoritys responsibility for the maintenance, operation, management, or control of the medical center, or any ownership or leasehold interest of the authority in the medical center, does not relieve the county of the ultimate responsibility for indigent care pursuant to Section 17000 of the Welfare and Institutions Code.
(7)For purposes of Article 12 (commencing with Section 17612.1) of Chapter 6 of Part 5 of Division 9 of the Welfare and Institutions Code, and the definition set forth in subdivision (f) of Section 17612.2 of the Welfare and Institutions Code, the medical center, excluding components that provide predominately public health services, and the county are affiliated governmental entities.
(f)The board of supervisors may contract with the authority for the provision of indigent care services on behalf of the county. The contract shall specify that county policies, as may be modified from time to time and consistent with the countys obligations under Section 17000 of the Welfare and Institutions Code, shall be applicable. Notwithstanding any other provision of this chapter, the authority shall not undertake any of the countys obligations under Section 17000 of the Welfare and Institutions Code, nor shall the authority have an entitlement to receive any revenue for the discharge of the countys obligations, without a written agreement with the county. Any contract executed by and between the county and the authority shall provide for the indemnification of the county by the authority for liabilities as specifically set forth in the contract, except that the contract shall include a provision that the county shall remain liable for its own negligent acts. Indemnification by the authority shall not divest the county from its ultimate responsibility for compliance with Section 17000 of the Welfare and Institutions Code.
(g)Unless otherwise agreed to by the authority and the board of supervisors, an obligation of the authority, statutory, contractual, or otherwise, shall be the obligation solely of the authority and shall not be the obligation of the county or any other entity, and any contract executed by and between the county and the authority, or any other entity and the authority, shall contain a provision that liabilities or obligations of the authority with respect to its activities pursuant to the contract shall be the liabilities or obligations of the authority and shall not be or become the liabilities or obligations of the county or the other entity, respectively. An obligation of the authority, statutory, contractual, or otherwise, shall not be the obligation of the state.
(h)The authority shall not be a person subject to suit under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code).
(i) The authority is not subject to the jurisdiction of a local agency formation commission pursuant to the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code), or any successor statute.
(j)The authority is a district within the meaning set forth in the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code). Employees of the authority are eligible to become members or maintain membership, as applicable, in the Kern County Employees Retirement Association, to the extent described in subdivision (g) of Section 101853.1.
(k)Any determination with respect to the manner in which the authority qualifies as a governmental plan sponsor under Section 414(d) of the Internal Revenue Code shall be limited to relevant employee benefits purposes of that code only, and shall not change or otherwise modify the authoritys status as a public agency that is a local unit of government for other purposes specified in this chapter.
SEC. 4.Section 101853.1 of the Health and Safety Code is amended to read:101853.1.(a)In exercising its powers to employ personnel, the authority shall implement, and the board of supervisors shall adopt, a personnel transition plan. The personnel transition plan shall require all of the following:
(1)Ongoing communication to employees and recognized employee organizations regarding the impact of the transition on existing medical center, county, and other health care facility employees and employee classifications.
(2)Meeting and conferring with representatives of affected bargaining unit employees on both of the following issues:
(A)A timeframe for which the transfer of personnel shall occur.
(B)Specified periods of time during which county or medical center employees affected by the establishment of the authority may elect to be considered for appointment and exercise reinstatement rights, if applicable, to funded, equivalent, vacant county positions for which they are qualified and eligible. An employee who first elects to remain with the county may subsequently seek reinstatement with the authority within 30 days of the election to remain with the county and shall be subject to the requirements of this article.
(3)Acknowledgment that the authority, to the extent permitted by federal and state law, and consistent with paragraph (3) of subdivision (d), shall be bound by the terms of those memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date of the transfer of control of the medical center to the authority. Subsequent memoranda of understanding with exclusive employee representatives shall be subject to approval only by the board of governors.
(4)Communication to the Board of Retirement of the Kern County Employees Retirement Association or other retirement plan of any personnel transition plan, memoranda of understanding, or other arrangements that are related to the participation of the authoritys employees or the addition of new employees in the retirement plan.
(b)Implementation of this chapter shall not be a cause for the modification of the medical center or county employment benefits. Employees of the medical center or county on the date of transfer, who become authority employees, shall retain their existing or equivalent classifications and job descriptions upon transfer to the authority, comparable pension benefits (if permissible pursuant to relevant plan terms), and their existing salaries and other benefits that include, but are not limited to, accrued and unused vacation, sick leave, personal leave, health care, retiree health benefits, and deferred compensation plans. The transfer of an employee from the medical center or county shall not constitute a termination of employment for purposes of Section 227.3 of the Labor Code, or employee benefit plans and arrangements maintained by the medical center or county, except as otherwise provided in the enabling ordinance or personnel transition plan, nor shall it be counted as a break in uninterrupted employment for purposes of Section 31641 of the Government Code with respect to the Kern County Employees Retirement Association, or state service for purposes of the Public Employees Retirement System (Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code).
(c)Subject to applicable state law, the authority shall recognize the exclusive employee representatives of those authority employees who are transferred from the county or medical center to the authority pursuant to this chapter.
(d)In order to stabilize labor and employment relations and provide continuity of care and services to the people of the county, and notwithstanding any other law, the authority shall do all of the following for a period of 24 months after the effective date of the transfer of control of the medical center to the authority:
(1)Continue to recognize each exclusive employee representative of each bargaining unit.
(2)Continue to provide the same level of employee benefits to authority employees, whether the obligation to provide those benefits arise out of a memorandum of understanding, or other agreements or law.
(3)Extend and continue to be bound by any existing memoranda of understanding covering the terms and conditions of employment for employees of the authority, including the level of wages and benefits, and any county rules, ordinances, or policies specifically identified and incorporated by reference in a memoranda of understanding for 24 months or through the term of the memorandum of understanding, whichever shall be the longer, unless modified by mutual agreement with each of the exclusive employee representatives. The authority shall continue to provide those pension benefits specified in any memoranda of agreement as long as doing so does not conflict with any Kern County Employee Retirement Association plan provisions, or federal or state law including the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code and the federal Internal Revenue Code). If a memoranda of understanding is expired on the date of the transfer of control of the medical center, then the authority shall continue to be bound by the terms and conditions of the most recent memoranda of understanding, unless modified by a mutual agreement with each of the exclusive employee representatives, and the benefits and wages of transferred employees shall be retained consistent with subdivision (b).
(4)Meet and confer with the exclusive employee representatives to develop processes and procedures to address employee disciplinary action taken against permanent employees. If the authority terminates, suspends, demotes, or reduces the pay of a permanent employee for disciplinary reasons, those actions shall only be for cause consistent with state law, and an employee shall be afforded applicable due process protections granted to public employees under state law. Permanent employees laid off by the authority within six months of the date of the transfer of control of the medical center shall remain on the county reemployment list for two years. Inclusion on the county reemployment list is not a guarantee of reemployment. For the purposes of this paragraph, the term permanent employees excludes probationary employees, temporary employees, seasonal employees, provisional employees, extra help employees, and per diem employees.
(5)To the extent layoffs occur, and provided that all other previously agreed upon factors are equal, ensure that seniority shall prevail. The authority shall meet and confer with the exclusive employee representatives to address layoff procedures and the manner in which, and the extent to which, seniority shall be measured for employees who transfer from the medical center or county.
(e)Permanent employees of the medical center or county on the effective date of the transfer of control of the medical center to the authority, shall be deemed qualified for employment in equivalent positions at the authority, and no other qualifications shall be required except as otherwise required by state or federal law. Probationary employees on the effective date of the transfer, as set forth in this paragraph, shall retain their probationary status and rights and shall not be required to serve a new probationary or extend their probationary period by reason of the transfer. To the extent possible, employees who transfer to equivalent positions at the authority shall retain their existing classifications and job descriptions, but if there is a dispute over this issue, the authority agrees to meet and confer with the exclusive employee representatives of the transferred employees.
(f)Employees who transfer from the medical center or county to the authority shall retain the seniority they earned at the medical center or county and any benefits or privileges based on the seniority.
(g)Notwithstanding any other law, employees of the authority may participate in the Kern County Employees Retirement Association, operated pursuant to the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code) as set forth below. However, the authority and employees of the authority, or certain designated parts thereof, shall not participate in the Kern County Employees Retirement Association if the board of retirement, in its sole discretion, determines that their participation could jeopardize the Kern County Employees Retirement Associations tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Chapters 3 (commencing with Section 31450) and 3.9 (commencing with Section 31899) of Part 3 of Division 4 of Title 3 of the Government Code or Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code, and that the board determines would adversely affect the administration of the system. There shall not be any individual employee elections regarding participation in the Kern County Employees Retirement Association or other retirement plans except to the extent such retirement plans provide for elective employee salary deferral contributions in accordance with federal Internal Revenue Code rules.
(1)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, to the extent provided for in the applicable memorandum of understanding.
(2)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided for in the applicable memorandum of understanding.
(3)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, as provided in the enabling ordinance or the personnel transition plan.
(4)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or the personnel transition plan.
(5)Employees hired by the authority on or after the effective date of the transfer of control of the medical center shall become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or personnel transition plan described in subdivision (a), or, if subject to a memorandum of understanding between the authority and an exclusive employee representative as described in paragraphs (2) and (3) of subdivision (d), to the extent provided for in the applicable memorandum of understanding.
(6)(A)Notwithstanding any other law, for purposes of California Public Employees Pension Reform Act of 2013 (Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code), an individual who was employed by the county or the medical center when it was a constituent department of the county, and is a member of the Kern County Employees Retirement Association or the Public Employees Retirement System, as set forth in Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, or current or contingent member of a plan of replacement for members whose retirement benefits are limited by Section 415 of Title 26 of the United States Code as provided in Section 7522.43 of the Government Code, Code or a member prior to January 1, 2013, and who transfers, directly or after a break in service of less than six months, to the authority, in which the individual continues to be a member of either the Kern County Employees Retirement Association or the Public Employees Retirement System, as applicable, shall not be deemed to be a new employee or a new member within the meaning of Section 7522.04 or 7522.43 of the Government Code, and shall continue to be subject subject, immediately after the transfer, to the same defined benefit formula, as defined in Section 7522.04 of the Government Code, or and plan of replacement benefits for members whose retirement benefits are limited by Section 415 of Title 26 of the United States Code, as provided in Section 7522.43 of the Government Code, to which the member was subject immediately prior to the transfer. offered by the county pursuant to Section 31899.4 of the Government Code and the Kern County Replacement Benefits Plan for retirement benefits limited by Section 415 of Title 26 of the United States Code.
(B)For purposes of subdivision (c) of Section 7522.43 of the Government Code, the authority shall be treated as a public employer that offered a plan of replacement benefits for members whose retirement benefits are limited by Section 415 of Title 26 of the United States Code prior to January 1, 2013, with respect to current or contingent members of that plan who were employed by the county or the medical center when it was a constituent department of the county prior to January 1, 2013, and who transfer, directly or after a break in service of less than six months, to the authority and continue to be a member of either the Kern County Employees Retirement Association or the Public Employees Retirement System, as applicable. prior to January 1, 2013. The countys plan of replacement benefits that was in effect prior to January 1, 2013, is deemed to also be the authoritys replacement plan for the sole purpose of allowing the authority to continue to offer the plan of replacement benefits, immediately after the transfer, for Kern County Employees Retirement Association members who meet both of the following requirements, and the qualifying survivors or beneficiaries of those members:
(i)The employee was employed as of January 1, 2013, by the county or the medical center when it was a constituent department of the county.
(ii)The employee is part of a member group to which the county offered a plan of replacement benefits prior to January 1, 2013.
(h)This chapter shall not prohibit the authority from contracting with the Public Employees Retirement System, in accordance with the requirements of Section 20508 and any other applicable provisions of Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, for the purpose of providing employee participation in that system, or from establishing an alternative or supplemental retirement system or arrangement, including, but not limited to, deferred compensation arrangements, to the extent permitted by law and subject to any applicable agreement between the authority and the exclusive employee representatives, and as provided in the enabling ordinance or the personnel transition plan. Notwithstanding any other law, the authority and employees of the authority shall not participate in the Public Employees Retirement System if the Board of Administration of the Public Employees Retirement System, in its sole discretion, determines that their participation could jeopardize the Public Employees Retirement Systems tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, and that the board determines would adversely affect the administration of the system.
(i)Provided that this is not inconsistent with anything in this chapter, this chapter does not prohibit the authority from determining the number of employees, the number of full-time equivalent positions, job descriptions, the nature and extent of classified employment positions, and salaries of employees.
SEC. 5.Section 101855 of the Health and Safety Code is amended to read:101855.(a)Subject to any terms, conditions, and limitations as may be imposed by the enabling ordinance, the authority, in addition to any other powers granted pursuant to this chapter, shall have the following powers:
(1)To have the duties, privileges, immunities, rights, liabilities, and limitations of a local unit of government within the state.
(2)To have perpetual existence, subject to Article 5 (commencing with Section 101856).
(3)To adopt, have, and use a seal, and to alter it at its pleasure.
(4)To sue and be sued in the name of the authority in all actions and proceedings in all courts and tribunals of competent jurisdiction.
(5)To purchase, lease, trade, exchange, or otherwise acquire, maintain, hold, improve, mortgage, lease, sell, and dispose of real and personal property of any kind necessary or convenient to perform its functions and fully exercise its powers.
(6)To appoint and employ or otherwise engage a chief executive officer and other officers and employees that may be necessary or appropriate, including legal counsel, to establish their compensation, provide for their health, retirement, and other employment benefits, and to define the power and duties of officers and employees.
(7)(A)To incur indebtedness and to borrow money and issue bonds evidencing the same, including the authority to issue, from time to time, notes and revenue bonds in principal amounts that the authority determines to be necessary to provide sufficient funds for achieving any of its purposes, including, but not limited to, assumption or refinancing of debt service for capital projects eligible for Medi-Cal supplemental payments pursuant to Section 14085.5 of the Welfare and Institutions Code, or any successor or modified Medi-Cal debt service reimbursement program, the payment of principal and interest on notes and bonds of the authority, the establishment of reserves to secure those notes and bonds, and all other expenditures of the authority incident to and necessary or convenient to carry out its purposes and powers.
(B)Any notes, bonds, or other securities issued, and the income from them, including any profit from the sale thereof, shall at all times be free from taxation by the state or any agency, political subdivision, or instrumentality of the state.
(C)Notwithstanding the provisions of subparagraph (A), for any indebtedness, notes, bonds, or other securities that require voter approval pursuant to state law, the prior approval of the board of supervisors shall be required. Notwithstanding the required prior approval of the board of supervisors, any indebtedness incurred, or notes, bonds, or other securities issued pursuant to this subparagraph shall be the indebtedness, notes, bonds, or securities of the authority and not of the county, and the credit of the county shall not be pledged or relied upon in any manner in order to incur the indebtedness, or issue the notes, bonds, or other securities, unless the board of supervisors explicitly authorizes the use of the countys credit. The authority shall reimburse the county for all costs associated with the countys consideration of the indebtedness, notes, bonds, or securities, and the authority shall defend, indemnify, and hold harmless the county from any and all liability, costs, or expenses arising from or related to the indebtedness, notes, bonds, or securities.
(D)Nothing in this section shall preclude the authority from repayment of its debts or other liabilities, using funds that are not otherwise encumbered.
(8)To pursue its own credit rating.
(9)To enter into one or more contracts or agreements consistent with this chapter and other applicable laws of this state, including, but not limited to, contracting with any public or private entity or person for management or other services and personnel, and to authorize the chief executive officer to enter into contracts, execute all instruments, and do all things necessary or convenient in the exercise of the powers granted in this chapter.
(10)To purchase supplies, equipment, materials, property, and services.
(11)To establish policies relating to its purposes.
(12)To acquire or contract to acquire, rights-of-way, easements, privileges, and property, and to construct, equip, maintain, and operate any and all works or improvements wherever located that are necessary, convenient, or proper to carry out any of the provisions, objects, or purposes of this chapter, and to complete, extend, add to, repair, or otherwise improve any works or improvements acquired by it.
(13)To participate in, contract for, and to accept, gifts, grants, and loans of funds, property, or other aid or finance opportunity in any form from the federal government, the state, a state agency, or other source, or combination thereof, as otherwise would be available to a public, government, or private entity, and to comply, subject to this chapter, with the terms and conditions thereof.
(14)If not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, the authority may establish its own treasury, invest surplus money in its own treasury, manage investments, and engage third-party investment managers, in accordance with state law.
(15)To arrange for guarantees or insurance of its bonds, notes, or other obligations by the federal or state government or by a private insurer, and to pay the premiums thereof.
(16)To engage in managed care contracting, joint ventures, affiliations with other health care facilities, other health care providers and payers, management agreements, or to participate in alliances, purchasing consortia, health insurance pools, accountable care organizations, alternative delivery systems, or other cooperative arrangements, with any public or private entity.
(17)To enter into joint powers agreements pursuant to Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code. Notwithstanding any other law, the authority may enter into a joint powers agreement as described in Section 6523.5 of the Government Code as though that section applied to hospitals and other health care facilities in the County of Kern.
(18)To establish nonprofit, for-profit, or other entities necessary to carry out the duties of the authority.
(19)To elect to transfer funds to the state and incur certified public expenditures in support of the Medi-Cal program and other programs for which federal financial participation is available.
(20)To use a computerized management information system, including an electronic health records system, in connection with its operations, including, without limitation the administration of its facilities.
(21)To request that the board of supervisors levy a tax on behalf of the authority. If the board of supervisors approves the proposal to levy the tax, it shall call the election to seek voter approval and place the appropriate measure on the ballot for that election. The proceeds of these taxes shall be tax proceeds of the authority and not of the county. The authority shall reimburse the county for all costs associated with the countys consideration of those taxes, and shall defend, indemnify, and hold harmless the county from any liability, costs, or expenses arising from or related to the imposition of these taxes.
(22)Notwithstanding the provisions of this chapter relating to the obligations and liabilities of the authority, or any other law, a transfer of control of the medical center to the authority pursuant to this chapter shall confer onto the authority all shall have the same rights, privileges, exemptions, preferences, and authority set forth in state law to own, operate, and provide of a county with respect to owning, operating, and providing coverage and services through hospitals, clinics and other health facilities, health programs, care organizations, physicians and physician practice plans, delivery systems, health care service plans, and other provider types and coverage mechanisms that may be owned or operated by a county. mechanisms.
(23)To engage in other activities that may be in the best interests of the authority and the persons served by the authority, as determined by the board of governors, in order to respond to changes in the health care industry.
(b)The authority shall conform to the following requirements:
(1)(A)Be a government agency that is a local unit of government separate and apart for all purposes from the county and any other public entity, and shall not be considered to be an agency, division, or department of the county or any other public entity. The authority shall not be governed by or subject to the civil service requirements of the county. Notwithstanding any other law, except as otherwise provided for in the enabling ordinance enacted pursuant to this chapter, and as set forth in Section 101853.1 relating to the personnel transition plan, the authority shall not be governed by, or subject to, other policies or operational rules applicable to the county, the medical center prior to its transfer, or any other public entity, including, but not limited to, those relating to personnel and procurement.
(B)The board of governors shall adopt written rules, regulations, and procedures with regard to basic human resource functions not inconsistent with memoranda of understanding covering employees represented by employee organizations or the provisions of this chapter. Until the time that the board of governors adopts its own rules, regulations, or procedures with regard to these functions, the existing rules, regulations, and procedures set forth in any memoranda of understanding described in Section 101853.1, and the rules and regulations adopted by the county and described in paragraph (4), shall continue to apply.
(2)Be subject to state and federal taxation laws that are applicable to public entities generally.
(3)Except as otherwise specifically provided in this chapter, comply with the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code), the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).
(4)Be subject to the jurisdiction of the Public Employment Relations Board. Until the authority adopts rules and regulations pursuant to subdivision (a) of Section 3507 of the Government Code, the existing rules adopted by the county and contained in the countys employer-employee relations resolution, as amended, shall apply, modified to account for the creation of the authority, and provided further that the resolution shall not contain any incorporation of the countys civil service rules or county ordinances unless specifically addressed in this chapter.
(5)Carry professional and general liability insurance or programs to the extent sufficient to cover its activities.
(6)Comply with the requirements of Sections 53260 and 53261 of the Government Code.
(7)Maintain financial and accounting records.
(8)Meet all local, state, and federal data reporting requirements.
(c)(1)Subject to any restrictions applicable to public agencies, and subject to any limitations or conditions set forth in the enabling ordinance adopted by the board of supervisors, the authority may borrow money from the county, repay debt it owes to the county, and use the borrowed funds to provide for its operating and capital needs. The county may lend the authority funds and may issue debt instruments, including, without limitation, revenue anticipation notes to obtain funds to provide, by loan or otherwise, amounts necessary for the authority to meet its operating and capital needs.
(2)Notwithstanding paragraph (1), nothing in this chapter shall be construed to limit the borrowing powers the county otherwise has under law for the purposes specified in paragraph (1) or any other purposes.
(d)Open sessions of the authority shall constitute official proceedings authorized by law within the meaning of Section 47 of the Civil Code. The privileges set forth in that section with respect to official proceedings shall apply to open sessions of the authority.
(e)(1)Notwithstanding any other law, the board of governors or board of supervisors, as applicable, may order that a meeting held solely for the purpose of discussion or taking action on authority trade secrets, as defined in subdivision (d) of Section 3426.1 of the Civil Code, or to consider and take action on matters pertaining to contracts and contract negotiations concerning all matters related to rates of payment for health care services arranged or provided by the authority, shall be held in closed session. Trade secrets for purposes of this chapter shall also include information for which the secrecy of the information is necessary for the authority to initiate a new service, program, marketing strategy, business plan, or technology, or to add a benefit or product, and premature disclosure of the trade secret would create a substantial probability of depriving the authority of a substantial economic benefit or opportunity.
(2)The requirements of making a public report of actions taken in closed session and the vote or abstention of every member present may be limited to a brief general description devoid of the information constituting the trade secret or concerning the matters related to rates of payment.
(3)Those records of the authority or board of supervisors, as applicable, that reveal the authoritys trade secrets are exempt from disclosure pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. This exemption shall apply for a period of two years after the service, program, marketing strategy, business plan, technology, benefit, or product that is the subject of the trade secret is formally adopted by the governing body of the authority, provided that the service, program, marketing strategy, business plan, technology, benefit, or product continues to be a trade secret. The board of governors or board of supervisors, as applicable, may delete the portion or portions containing trade secrets from any documents that were finally approved in the closed session that are provided to persons who have made the timely or standing request.
(4)This chapter shall not prevent the board of governors or board of supervisors, as applicable, from meeting in closed session as otherwise provided by law.
(f)Notwithstanding any other law, those records of the authority and of the county that reveal the authoritys rates of payment for health care services arranged or provided by the authority or its deliberative processes, strategies, discussions, communications, or any other portion of the negotiations with providers of health care services or Medi-Cal, health care plans, or other payers for rates of payment, shall not be required to be disclosed pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. However, three years after a contract or amendment to a contract is fully executed, the portion of the contract or amendment containing the rates of payment shall be open to inspection.
(g)The authority shall be a public agency that is a local unit of government for purposes of eligibility with respect to grants and other funding and loan guarantee programs. Contributions to the authority shall be tax deductible to the extent permitted by state and federal law. Nonproprietary income of the authority shall be exempt from state income taxation.
(h)Unless otherwise provided by the board of supervisors by way of resolution, the authority is empowered, or the board of supervisors is empowered on behalf of the authority, to apply as a public agency for one or more licenses for the provision of health care or the operation of a health care service plan pursuant to statutes and regulations governing licensing as currently written or subsequently amended.
(i)The statutory authority of a board of supervisors to prescribe rules that authorize a county hospital to integrate its services with those of other providers into a system of community service that offers free choice of hospitals to those requiring hospital care, as set forth in Section 14000.2 of the Welfare and Institutions Code, shall apply to the authority and the board of governors.
(j)(1)Except as otherwise provided in this chapter, provisions of the Evidence Code, the Government Code, including the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), the Civil Code, the Business and Professions Code, and other applicable law pertaining to the confidentiality of peer review activities of peer review bodies shall apply to the peer review activities of the authority, or any peer review body, as defined in paragraph (1) of subdivision (a) of Section 805 of the Business and Professions Code, formed pursuant to the powers granted to the authority. The laws pertaining to the confidentiality of peer review activities shall be together construed as extending, to the extent permitted by law, the maximum degree of protection of confidentiality.
(2)Notwithstanding Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of law, any peer review body formed pursuant to the powers granted to the authority, may, at its discretion and without notice to the public, meet in closed session, so long as the purpose of the meeting is the peer review bodys discharge of its responsibility to evaluate and improve the quality of care rendered by health facilities and health practitioners. The peer review body and its members shall receive, to the fullest extent, all immunities, privileges, and protections available to those peer review bodies, their individual members, and persons or entities assisting in the peer review process, including those afforded by Section 1157 of the Evidence Code and Section 1370. Peer review proceedings shall constitute an official proceeding authorized by law within the meaning of Section 47 of the Civil Code and those privileges set forth in that section with respect to official proceedings shall apply to peer review proceedings of the authority.
(3)Notwithstanding the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of state or local law requiring disclosure of public records, those records of a peer review body formed pursuant to the powers granted to the authority, shall not be required to be disclosed. The records and proceedings of the peer review body and its individual members shall receive, to the fullest extent, all immunities, privileges, and protections available to those records and proceedings, including those afforded by Section 1157 of the Evidence Code and Section 1370 of the Health and Safety Code.
(4)If the authority is required by law or contractual obligation to submit to the state or federal government peer review information or information relevant to the credentialing of a participating provider, that submission shall not constitute a waiver of confidentiality.
(5)Notwithstanding any other law, Section 1461 shall apply to hearings on reports of hospital medical audit or quality assurance committees.
(k)Except as expressly provided by other provisions of this section, all exemptions and exclusions from disclosure as public records pursuant to this chapter and the California Public Records Act, including, but not limited to, those pertaining to trade secrets and information withheld in the public interest, shall be fully applicable to the authority, and for the board of supervisors, and all state and local agencies with respect to all writings that the authority is required to prepare, produce, or submit, and which shall not constitute a waiver of exemption from disclosure.
(l)The authority and the county, or any combination thereof, may engage in marketing, advertising, and promotion of the medical and health care services made available to the community by the authority.
(m)(1)The board of supervisors may contract for services or purchase items on behalf of the authority.
(2)Unless otherwise provided for, and subject to the limitations and conditions set forth in the enabling ordinance, the board of governors shall have authority over procurement and contracts for the authority and shall adopt written rules, regulations, and procedures with regard to these functions. The authoritys ability to contract for personnel or other services and items it deems necessary, appropriate, or convenient for the conduct of its activities consistent with its purposes shall only be limited by the provisions in this chapter and obligations under the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code).
(3)Contracts by and between the authority and a public agency, and contracts by and between the authority and providers of health care, goods, or services, may be let on a nonbid basis and shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.
(n)The authority may contract with the county for services and personnel upon mutually agreeable terms.
(o)Notwithstanding Article 4.7 (commencing with Section 1125) of Chapter 1 of Division 4 of Title 1 of the Government Code, related to incompatible activities, Section 1099 of the Government Code, related to incompatible offices, or any other law, a member of the authoritys administrative staff shall not be considered to hold an incompatible office or to be engaged in activities inconsistent and incompatible with his or her duties as a result of his or her employment or affiliation with the county or an agency of the county.
(p)The board of governors and the officers and employees of the authority are public employees for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code, relating to claims and actions against public entities and public employees, and shall be protected by the immunities applicable to public entities and public employees governed by Part 2 (commencing with Section 814) of Division 3.6 of Title 1 of the Government Code, except as provided by other statutes or regulations that apply expressly to the authority.
SEC. 6.Section 101855.1 of the Health and Safety Code is amended to read:101855.1.(a)Transfer of control of the medical center, whether or not the transfer includes the surrendering by the county of the existing general acute care hospital license and corresponding application for a change of ownership of the license, shall not affect the eligibility of the county to undertake, and shall authorize the authority, subject to applicable requirements, to do any of the following:
(1)With the written consent of the county, participate in and receive allocations pursuant to the California Health Care for Indigents Program pursuant to Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9 of the Welfare and Institutions Code, or similar programs, as may be identified or earmarked by the county for indigent health care in support of uncompensated services of the type provided by the medical center.
(2)With the written consent of the county, participate in and receive allocations of local revenue fund amounts provided pursuant to Chapter 6 (commencing with Section 17600) of Part 5 of Division 9 of the Welfare and Institutions Code as may be identified or earmarked by the county for indigent in support of health care services of the type provided by the medical center. center to low-income individuals.
(3)Participate in the financing of, as applicable, and receive, Medicaid disproportionate share hospital payments available to a county hospital or designated public hospital, or any other successor or modified payment or funding that is intended to assist hospitals that serve a disproportionate share of low-income patients with special needs. The allocation of Medicaid disproportionate share hospital payments shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(4)Participate in the financing of, as applicable, and receive, Medi-Cal payments and supplemental reimbursements, including, but not limited to, payments made pursuant to Sections 14105.96, 14105.965, 14166.4, 14182.15, and 14199.2 of the Welfare and Institutions Code, payments described in paragraph (4) of subdivision (b) of Section 14301.4 of, and Section 14301.5 of, the Welfare and Institutions Code, and payments made available to a county provider or designated public hospital, or governmental entity with which it is affiliated, under any other successor or modified Medicaid payment system.
(5)Participate in the financing of, as applicable, and receive, safety net care pool funding, stabilization funding, delivery system reform incentive pool payments, and any other funding available to a county provider or designated public hospital, or governmental entities with which it is affiliated under the Medicaid demonstration project authorized pursuant to Article 5.2 (commencing with Section 14166) and Article 5.4 (commencing with Section 14180) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system. The allocation of safety net care pool funds shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(6)Participate in the financing, administration, and provision of services under the Low Income Health Program authorized pursuant to Part 3.6 (commencing with Section 15909) of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system if the authority enters into an agreement with the county concerning the provision of services by, and payment for these services to, the county.
(7)Participate in and receive direct grant and payment allocations pursuant to Article 5.230 (commencing with Section 14169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified direct grant and payment systems funded by hospital or other provider fee assessments.
(8)Receive Medi-Cal capital supplements pursuant to Section 14085.5 of the Welfare and Institutions Code, or any other successor or modified Medi-Cal debt service reimbursement program. Notwithstanding any other law, supplemental payments shall be made to the medical center under those programs for the debt service costs incurred by the county, and, if applicable, by the authority to the extent that debt service responsibility is refinanced, transferred to, or otherwise assumed by, directly or indirectly, the authority.
(9)Receive any other funds, or preference in the assignment of health care plan enrollees, that would otherwise be available to a county health plan, provider, or designated public hospital, or governmental entity with which it is affiliated.
(b)The transfer of control of the medical center to the authority pursuant to this chapter shall not otherwise disqualify the county or the authority from participating in any of the following:
(1)Local, state, and federal funding sources either specific to county or other publicly owned or operated health care service plans, hospitals, or other health care providers, including, but not limited to, ambulatory care clinics, health systems, practices, designated public hospitals, or governmental entities with which they are affiliated, for which there are special provisions specific to those plans, hospitals, ambulatory care clinics, health systems, practices, other health care providers or governmental entities with which they are affiliated.
(2)All funding programs in which the county, by itself or on behalf of the medical center had participated prior to the creation of the authority, or would otherwise be qualified to participate in had the authority not been created, and the maintenance, operation, management, control, ownership, or lease of the medical center not been transferred to the authority pursuant to this chapter.
(a)This chapter shall be known, and may be cited, as the Kern County Hospital Authority Act.
(b)The Legislature finds and declares all of the following:
(1)Kern Medical Center, an acute care hospital currently operated as a constituent department of the County of Kern, is a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and a critical component of the states health care safety net.
(2) A county is authorized under existing law to integrate its county hospital services with those of other hospitals into a system of community service that offers free choice of hospitals to those requiring hospital care, with the objective of eliminating discrimination or segregation based on economic disability, so that the county hospital and other hospitals in the community share in providing services to paying patients and to those who qualify for care in public medical care programs. However, in a new era of health care delivery, it is necessary to pursue approaches that transition beyond acute care-centric orientations.
(3)The ongoing evolution of the health care environment requires public entities providing or arranging health care services to pursue innovative health care delivery models that proactively improve the quality of patient care services and patient experience, efficiently and effectively increase access to needed health care services across the care continuum, provide services in a patient-centered manner, and moderate the rate of growth of health care expenditures.
(4)The board of supervisors of the County of Kern has determined that providing access to affordable, high-quality health care services, and ensuring the full engagement and viability of the health care safety net in the county are essential for improving the health status of the people of the County of Kern. To further this imperative, it is necessary that the Kern Medical Center, while continuing as a designated public hospital and maintaining its mission, is provided with an organizational and operational structure that facilitates and improves its ability to function with flexibility, responsiveness, and innovation to promote a patient-centric system of care delivery featuring community-based care. This can best be accomplished by allowing the operation of the Kern Medical Center, along with other health-related resources, under a new hospital authority that is able to pursue efforts towards a delivery system that embraces population health management strategies, is effectively positioned for health plan-provider alignment, and maximizes opportunities for employees and enhancement of staff morale.
(5)This chapter is necessary to allow the formation of a new political subdivision, a public hospital authority authority, for the purposes described above.
SEC. 2.Section 101852.1 of the Health and Safety Code is amended to read:101852.1.For purposes of this chapter, the following definitions shall apply:
(a)Authority means the Kern Hospital System Authority established pursuant to this chapter.
(b)Board of supervisors means the board of supervisors of the County of Kern.
(c)Board of governors means the governing body of the authority.
(d)County means the County of Kern.
(e)Enabling ordinance means the county ordinance enacted by the board of supervisors pursuant to this chapter to establish the authority, as it may be amended from time to time.
(f)Medical center means the assets and liabilities comprising the Kern Medical Center, including, without limitation, a licensed acute care hospital and related public health care programs, facilities, care organizations, physician practice plans and delivery systems, which may be hospital-based or nonhospital-based, as specified by the board of supervisors or the authority now or in the future, as the case may be, depending on which entity controls the medical center.
(g)Transfer of control of the medical center means the transfer by the county to the authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
SEC. 3.Section 101853 of the Health and Safety Code is amended to read:101853.(a)Pursuant to this chapter, the board of supervisors may establish by ordinance the Kern County Hospital Authority, which shall be a public agency that is a local unit of government separate and apart from the county and any other public entity for all purposes. The authority established pursuant to this chapter shall file the statement required by Section 53051 of the Government Code, and is a public entity for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code.
(b)The purpose of the authority shall be to do all of the following:
(1)Provide management, administration, and other controls consistent with this chapter as needed to operate the medical center and maintain its status as a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and for the operation of additional programs, clinics and other facilities, care organizations, health care service and physician practice plans, and delivery systems that may be affiliated or consolidated with the medical center, to ensure the viability of the health care safety net in the county in a manner consistent with the countys requirements under Section 17000 of the Welfare and Institutions Code.
(2)Provide management, administration, and other controls consistent with this chapter to negotiate and enter into contracts to provide or arrange, or provide directly, on a fee-for-service, capitated, or other basis, health care services to individuals including, but not limited to, those covered under Subchapters XVIII (commencing with Section 1395), XIX (commencing with Section 1396), and XXI (commencing with Section 1397aa) of Chapter 7 of Title 42 of the United States Code, those entitled to coverage under private group coverage, private individual coverage, including without limitation, coverage through Covered California, other publicly supported programs, those employed by public agencies or private businesses, and uninsured or indigent individuals.
(c)Subject to the requirements of this chapter, the authority shall have, and be charged with, authority for the management, administration, and control maintenance, operation, management, control, ownership, or lease of the medical center and other health-related resources, as provided by the enabling ordinance. The State Department of Health Care Services shall take all necessary steps to ensure all of the following:
(1)The authority is permitted has all of the licenses, permits, and approvals needed to operate the medical center.
(2)The medical center continues its status as a designated public hospital to at least the same extent as it would be designated in the absence of its transfer to the authority pursuant to this chapter.
(3)The authority may participate as a contributing public agency for all of the purposes specified in Section 433.51 of Title 42 of the Code of Federal Regulations, to the extent permitted by federal law.
(d)The board of supervisors, in the enabling ordinance, shall establish the terms and conditions of the transfer to the authority from the county, including, but not limited to, all of the following:
(1)Any transfer of real and personal property, assets, and liabilities, including, but not limited to, liabilities of the medical center determined and assigned by the county for county funds previously advanced, but not repaid or otherwise recovered, to fund the operations of the medical center.
(2)Transfer of employees, including any necessary personnel transition plan, as specified in Section 101853.1, allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities under the Kern County Employees Retirement Association or other retirement plans, and funding of the accrued benefits of employees of the authority in the event of withdrawal from the plan or dissolution of the authority. Any allocation of credit for funded pension assets and responsibility for any unfunded pension liabilities with respect to the Kern County Employees Retirement Association must be approved by its governing board of retirement after consideration of legal and actuarial analysis, and no such allocation may be made that would jeopardize the qualified status of the Kern County Employees Retirement Association under the federal Internal Revenue Code.
(3)Maintenance, operation, and management or ownership management, control, ownership, or lease of the medical center.
(4)Transfer of licenses.
(5)Whether funds of the authority shall be deposited in the custody of, and paid out solely through, the county treasurers office.
(5)
(6)Any other matters as the board of supervisors deems necessary, appropriate, or convenient for the conduct of the authoritys activities.
(e)(1)Notwithstanding any other law, a transfer of maintenance, operation, and management or ownership or lease control of the medical center to the authority may be made, with or without the payment of a purchase price by the authority, and otherwise upon the terms and conditions as found necessary by the board of supervisors and specified in the enabling ordinance to ensure that the transfer will constitute an ongoing material benefit to the county and its residents.
(2)A transfer of the maintenance, operation, and management, or ownership or lease control of the medical center to the authority shall not be construed as empowering the authority to transfer any ownership interest of the county in any portion of the medical center except as otherwise approved by the board of supervisors.
(3)The authority shall not transfer the maintenance, operation, and management or ownership management, control, ownership, or lease of the medical center to any other person or entity without the prior written approval of the board of supervisors. This paragraph shall not prevent the county, by ordinance, from allowing the disposal of obsolete or surplus equipment, supplies, or furnishings of the medical center by the authority.
(4)With respect to the its maintenance, operation, and management or ownership management, control, ownership, or lease of the medical center, the authority shall conform to both of the following requirements:
(A)Comply with any applicable requirements of Section 14000.2 of the Welfare and Institutions Code.
(B)Comply with any applicable requirements of Section 1442.5.
(5)The board of supervisors may retain control of the medical center physical plant and facilities, as specifically provided for in the enabling ordinance or other lawful agreements entered into by the board of supervisors. Any lease agreement between the county and the authority shall provide that county premises shall not be sublet without the approval of the board of supervisors.
(6)Notwithstanding any other provision of this chapter, and whether or not accompanied by a change in licensing, the authoritys responsibility for the maintenance, operation, and management management, or control of the medical center, or any ownership or leasehold interest of the authority in the medical center, does not relieve the county of the ultimate responsibility for indigent care pursuant to Section 17000 of the Welfare and Institutions Code.
(7)For purposes of Article 12 (commencing with Section 17612.1) of Chapter 6 of Part 5 of Division 9 of the Welfare and Institutions Code, and the definition set forth in subdivision (f) of Section 17612.2 of the Welfare and Institutions Code, the medical center, excluding components that provide predominately public health services, and the county are affiliated governmental entities.
(f)The board of supervisors may contract with the authority for the provision of indigent care services on behalf of the county. The contract shall specify that county policies, as may be modified from time to time and consistent with the countys obligations under Section 17000 of the Welfare and Institutions Code, shall be applicable. Notwithstanding any other provision of this chapter, the authority shall not undertake any of the countys obligations under Section 17000 of the Welfare and Institutions Code, nor shall the authority have an entitlement to receive any revenue for the discharge of the countys obligations, without a written agreement with the county. Any contract executed by and between the county and the authority shall provide for the indemnification of the county by the authority for liabilities as specifically set forth in the contract, except that the contract shall include a provision that the county shall remain liable for its own negligent acts. Indemnification by the authority shall not divest the county from its ultimate responsibility for compliance with Section 17000 of the Welfare and Institutions Code.
(g)Unless otherwise agreed to by the authority and the board of supervisors, an obligation of the authority, statutory, contractual, or otherwise, shall be the obligation solely of the authority and shall not be the obligation of the county or any other entity, and any contract executed by and between the county and the authority, or any other entity and the authority, shall contain a provision that liabilities or obligations of the authority with respect to its activities pursuant to the contract shall be the liabilities or obligations of the authority and shall not be or become the liabilities or obligations of the county or the other entity, respectively. An obligation of the authority, statutory, contractual, or otherwise, shall not be the obligation of the state.
(h)The authority shall not be a person subject to suit under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code).
(i) The authority is not subject to the jurisdiction of a local agency formation commission pursuant to the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code), or any successor statute.
(j)The authority is a district within the meaning set forth in the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code). Employees of the authority are eligible to become members or maintain membership, as applicable, in the Kern County Employees Retirement Association, to the extent described in subdivision (g) of Section 101853.1.
(k)Any determination with respect to the manner in which the authority qualifies as a governmental plan sponsor under Section 414(d) of the Internal Revenue Code shall be limited to relevant employee benefits purposes of that code only, and shall not change or otherwise modify the authoritys status as a public agency that is a unit of local local unit of government for other purposes specified in this chapter.
SEC. 4.Section 101853.1 of the Health and Safety Code is amended to read:101853.1.(a)In exercising its powers to employ personnel, the authority shall implement, and the board of supervisors shall adopt, a personnel transition plan. The personnel transition plan shall require all of the following:
(1)Ongoing communication to employees and recognized employee organizations regarding the impact of the transition on existing medical center, county, and other health care facility employees and employee classifications.
(2)Meeting and conferring with representatives of affected bargaining unit employees on both of the following issues:
(A)A timeframe for which the transfer of personnel shall occur.
(B)Specified periods of time during which county or medical center employees affected by the establishment of the authority may elect to be considered for appointment and exercise reinstatement rights, if applicable, to funded, equivalent, vacant county positions for which they are qualified and eligible. An employee who first elects to remain with the county may subsequently seek reinstatement with the authority within 30 days of the election to remain with the county and shall be subject to the requirements of this article.
(3)Acknowledgment that the authority, to the extent permitted by federal and state law, and consistent with paragraph (3) of subdivision (d), shall be bound by the terms of the those memoranda of understanding executed between the county and its exclusive employee representatives that are in effect on the date the county adopts the enabling ordinance pursuant to this chapter. of the transfer of control of the medical center to the authority. Subsequent memoranda of understanding with exclusive employee representatives shall be subject to approval only by the board of governors.
(4)Communication to the Board of Retirement of the Kern County Employees Retirement Association or other retirement plan of any personnel transition plan, memoranda of understanding, or other arrangements that are related to the participation of the authoritys employees or the addition of new employees in the retirement plan.
(b)Implementation of this chapter shall not be a cause for the modification of the medical center or county employment benefits. Upon the execution of the enabling ordinance, employees Employees of the medical center or county on the date of execution, transfer, who become authority employees, shall retain their existing or equivalent classifications and job descriptions upon transfer to the authority, comparable pension benefits (if permissible pursuant to relevant plan terms), and their existing salaries and other benefits that include, but are not limited to, accrued and unused vacation, sick leave, personal leave, health care, retiree health benefits, and deferred compensation plans. The transfer of an employee from the medical center or county shall not constitute a termination of employment for purposes of Section 227.3 of the Labor Code, or employee benefit plans and arrangements maintained by the medical center or county, except as otherwise provided in the enabling ordinance or personnel transition plan, nor shall it be counted as a break in uninterrupted employment for purposes of Section 31641 of the Government Code with respect to the Kern County Employees Retirement Association, or state service for purposes of the Public Employees Retirement System (Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code).
(c)Subject to applicable state law, the authority shall recognize the exclusive employee representatives of those authority employees who are transferred from the county or medical center to the authority pursuant to this chapter.
(d)In order to stabilize labor and employment relations and provide continuity of care and services to the people of the county, and notwithstanding any other law, the authority shall do all of the following for a period of 24 months after the effective date of the transfer of control of the medical center to the authority:
(1)Continue to recognize each exclusive employee representative of each bargaining unit.
(2)Continue to provide the same level of employee benefits to authority employees, whether the obligation to provide those benefits arise out of a memorandum of understanding, or other agreements or law.
(3)Extend and continue to be bound by any existing memoranda of understanding covering the terms and conditions of employment for employees of the authority, including the level of wages and benefits, and any county rules, ordinances, or policies specifically identified and incorporated by reference in a memoranda of understanding for 24 months or through the term of the memorandum of understanding, whichever shall be the longer, unless modified by mutual agreement with each of the exclusive employee representatives. The authority shall continue to provide those pension benefits specified in any memoranda of agreement as long as doing so does not conflict with any Kern County Employee Retirement Association plan provisions, or federal or state law including the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code and the federal Internal Revenue Code).
(4)Meet and confer with the exclusive employee representatives to develop processes and procedures to address employee disciplinary action taken against permanent employees. If the authority terminates, suspends, demotes, or reduces the pay of a permanent employee for disciplinary reasons, those actions shall only be for cause consistent with state law, and an employee shall be afforded applicable due process protections granted to public employees under state law. Permanent employees laid off by the authority within six months of the date the ordinance is adopted of the transfer of control of the medical center shall remain on the county reemployment list for two years. Inclusion on the county reemployment list is not a guarantee of reemployment. For the purposes of this paragraph, the term permanent employees excludes probationary employees, temporary employees, seasonal employees, provisional employees, extra help employees, and per diem employees.
(5)To the extent layoffs occur, and provided that all other previously agreed upon factors are equal, ensure that seniority shall prevail. The authority shall meet and confer with the exclusive employee representatives to address layoff procedures and the manner in which, and the extent to which, seniority shall be measured for employees who transfer from the medical center or county.
(e)Permanent employees of the medical center or county on the effective date of the transfer of control of the medical center to the authority, shall be deemed qualified for employment in equivalent positions at the authority, and no other qualifications shall be required except as otherwise required by state or federal law. Probationary employees on the effective date of the transfer, as set forth in this paragraph, shall retain their probationary status and rights and shall not be required to serve a new probationary or extend their probationary period by reason of the transfer. To the extent possible, employees who transfer to equivalent positions at the authority shall retain their existing classifications and job descriptions, but if there is a dispute over this issue, the authority agrees to meet and confer with the exclusive employee representatives of the transferred employees.
(f)Employees who transfer from the medical center or county to the authority shall retain the seniority they earned at the medical center or county and any benefits or privileges based on the seniority.
(g)Notwithstanding any other law, employees of the authority may participate in the Kern County Employees Retirement Association, operated pursuant to the County Employees Retirement Law of 1937 (Chapter 3 (commencing with Section 31450) of Part 3 of Division 4 of Title 3 of the Government Code) as set forth below. However, the authority and employees of the authority, or certain designated parts thereof, shall not participate in the Kern County Employees Retirement Association if the board of retirement, in its sole discretion, determines that their participation could jeopardize the Kern County Employees Retirement Associations tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Chapters 3 (commencing with Section 31450) and 3.9 (commencing with Section 31899) of Part 3 of Division 4 of Title 3 of the Government Code or Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code, and that the board determines would adversely affect the administration of the system. There shall not be any individual employee elections regarding participation in the Kern County Employees Retirement Association or other retirement plans except to the extent such retirement plans provide for elective employee salary deferral contributions in accordance with federal Internal Revenue Code rules.
(1)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, to the extent provided for in the applicable memorandum of understanding.
(2)Employees transferred from the county or medical center to the authority who are subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided for in the applicable memorandum of understanding.
(3)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall continue to be a member of the Kern County Employees Retirement Association, retaining service credit earned to the date of transfer, as provided in the enabling ordinance or the personnel transition plan.
(4)Employees transferred from the county or medical center to the authority who are not subject to a memorandum of understanding between the authority and an exclusive employee representative, as described in paragraphs (2) and (3) of subdivision (d), and who were not members of the Kern County Employees Retirement Association at the time of their transfer of employment, shall subsequently become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or the personnel transition plan.
(5)Employees hired by the authority on or after the effective date of the enabling ordinance transfer of control of the medical center shall become a member of the Kern County Employees Retirement Association only to the extent provided in the enabling ordinance or personnel transition plan described in subdivision (a), or, if subject to a memorandum of understanding between the authority and an exclusive employee representative as described in paragraphs (2) and (3) of subdivision (d), to the extent provided for in the applicable memorandum of understanding.
(6)(A)Notwithstanding any other law, for purposes of California Public Employees Pension Reform Act of 2013 (Article 4 (commencing with Section 7522) of Chapter 21 of Division 7 of Title 1 of the Government Code), an individual who was employed by the county or the medical center when it was a constituent department of the county, and is a member of the Kern County Employees Retirement Association or the Public Employees Retirement System, as set forth in Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, or current or contingent member of a plan of replacement for members whose retirement benefits are limited by Section 415 of Title 26 of the United States Code as provided in Section 7522.43 of the Government Code, prior to January 1, 2013, and who transfers, directly or after a break in service of less than six months, to the authority, in which the individual continues to be a member of either the Kern County Employees Retirement Association or the Public Employees Retirement System, as applicable, shall not be deemed to be a new employee or a new member within the meaning of Section 7522.04 or 7522.43 of the Government Code, and shall continue to be subject to the same defined benefit formula, as defined in Section 7522.04 of the Government Code, or plan of replacement benefits for members whose retirement benefits are limited by Section 415 of Title 26 of the United States Code, as provided in Section 7522.43 of the Government Code, to which the member was subject immediately prior to the transfer.
(B)For purposes of Section 7522.43 of the Government Code, the authority shall be treated as a public employer that offered a plan of replacement benefits for members whose retirement benefits are limited by Section 415 of Title 26 of the United States Code prior to January 1, 2013, with respect to current or contingent members of that plan who were employed by the county or the medical center when it was a constituent department of the county prior to January 1, 2013, and who transfer, directly or after a break in service of less than six months, to the authority and continue to be a member of either the Kern County Employees Retirement Association or the Public Employees Retirement System, as applicable.
(h)This chapter shall not prohibit the authority from contracting with the Public Employees Retirement System, in accordance with the requirements of Section 20508 and any other applicable provisions of Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, for the purpose of providing employee participation in that system, or from establishing an alternative or supplemental retirement system or arrangement, including, but not limited to, deferred compensation arrangements, to the extent permitted by law and subject to any applicable agreement between the authority and the exclusive employee representatives, and as provided in the enabling ordinance or the personnel transition plan. Notwithstanding any other law, the authority and employees of the authority shall not participate in the Public Employees Retirement System if the Board of Administration of the Public Employees Retirement System, in its sole discretion, determines that their participation could jeopardize the Public Employees Retirement Systems tax-qualified or governmental plan status under federal law, or if a contract or related contract amendment proposed by the authority contains any benefit provisions that are not specifically authorized by Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government Code, and that the board determines would adversely affect the administration of the system.
(i)Provided that this is not inconsistent with anything in this chapter, this chapter does not prohibit the authority from determining the number of employees, the number of full-time equivalent positions, job descriptions, the nature and extent of classified employment positions, and salaries of employees.
SEC. 5.Section 101855 of the Health and Safety Code is amended to read:101855.(a)The Subject to any terms, conditions, and limitations as may be imposed by the enabling ordinance, the authority, in addition to any other powers granted pursuant to this chapter, shall have the following powers:
(1)To have the duties, privileges, immunities, rights, liabilities, and limitations of a local unit of government within the state.
(2)To have perpetual existence, subject to Article 5 (commencing with Section 101856).
(3)To adopt, have, and use a seal, and to alter it at its pleasure.
(4)To sue and be sued in the name of the authority in all actions and proceedings in all courts and tribunals of competent jurisdiction.
(5)To purchase, lease, trade, exchange, or otherwise acquire, maintain, hold, improve, mortgage, lease, sell, and dispose of real and personal property of any kind necessary or convenient to perform its functions and fully exercise its powers.
(6)To appoint and employ or otherwise engage a chief executive officer and other officers and employees that may be necessary or appropriate, including legal counsel, to establish their compensation, provide for their health, retirement, and other employment benefits, and to define the power and duties of officers and employees.
(7)(A)To incur indebtedness and to borrow money and issue bonds evidencing the same, including the authority to issue, from time to time, notes and revenue bonds in principal amounts that the authority determines to be necessary to provide sufficient funds for achieving any of its purposes, including, but not limited to, assumption or refinancing of debt service for capital projects eligible for Medi-Cal supplemental payments pursuant to Section 14085.5 of the Welfare and Institutions Code, or any successor or modified Medi-Cal debt service reimbursement program, the payment of principal and interest on notes and bonds of the authority, the establishment of reserves to secure those notes and bonds, and all other expenditures of the authority incident to and necessary or convenient to carry out its purposes and powers.
(B)Any notes, bonds, or other securities issued, and the income from them, including any profit from the sale thereof, shall at all times be free from taxation by the state or any agency, political subdivision, or instrumentality of the state.
(C)Notwithstanding the provisions of subparagraph (A), for any indebtedness, notes, bonds, or other securities that require voter approval pursuant to state law, the prior approval of the board of supervisors shall be required. Notwithstanding the required prior approval of the board of supervisors, any indebtedness incurred, or notes, bonds, or other securities issued pursuant to this subparagraph shall be the indebtedness, notes, bonds, or securities of the authority and not of the county, and the credit of the county shall not be pledged or relied upon in any manner in order to incur the indebtedness, or issue the notes, bonds, or other securities, unless the board of supervisors explicitly authorizes the use of the countys credit. The authority shall reimburse the county for all costs associated with the countys consideration of the indebtedness, notes, bonds, or securities, and the authority shall defend, indemnify, and hold harmless the county from any and all liability, costs, or expenses arising from or related to the indebtedness, notes, bonds, or securities.
(D)Nothing in this section shall preclude the authority from repayment of its debts or other liabilities, using funds that are not otherwise encumbered.
(8)To pursue its own credit rating.
(9)To enter into a contract or agreement one or more contracts or agreements consistent with this chapter or the and other applicable laws of this state, including, but not limited to, contracting with any public or private entity or person for management or other services and personnel, and to authorize the chief executive officer to enter into contracts, execute all instruments, and do all things necessary or convenient in the exercise of the powers granted in this chapter.
(10)To purchase supplies, equipment, materials, property, and services.
(11)To establish policies relating to its purposes.
(12)To acquire or contract to acquire, rights-of-way, easements, privileges, and property, and to construct, equip, maintain, and operate any and all works or improvements wherever located that are necessary, convenient, or proper to carry out any of the provisions, objects, or purposes of this chapter, and to complete, extend, add to, repair, or otherwise improve any works or improvements acquired by it.
(13)To participate in, contract for, and to accept, gifts, grants, and loans of funds, property, or other aid or finance opportunity in any form from the federal government, the state, a state agency, or other source, or combination thereof, as otherwise would be available to a public, government, or private entity, and to comply, subject to this chapter, with the terms and conditions thereof.
(14)To If not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, the authority may establish its own treasury, invest surplus money in its own treasury, manage investments, and engage third-party investment managers, in accordance with state law.
(15)To arrange for guarantees or insurance of its bonds, notes, or other obligations by the federal or state government or by a private insurer, and to pay the premiums thereof.
(16)To engage in managed care contracting, joint ventures, affiliations with other health care facilities, other health care providers and payers, management agreements, or to participate in alliances, purchasing consortia, health insurance pools, accountable care organizations, alternative delivery systems, or other cooperative arrangements, with any public or private entity.
(17)To enter into joint powers agreements pursuant to Chapter 5 (commencing with Section 6500) of Division 7 of Title 1 of the Government Code. Notwithstanding any other law, the authority may enter into a joint powers agreement as described in Section 6523.5 of the Government Code as though that section applied to hospitals and other health care facilities in the County of Kern.
(18)To establish nonprofit, for-profit, or other entities necessary to carry out the duties of the authority.
(19)To elect to transfer funds to the state and incur certified public expenditures in support of the Medi-Cal program and other programs for which federal financial participation is available.
(20)To use a computerized management information system, including an electronic health records system, in connection with its operations, including, without limitation the administration of its facilities.
(21)To request that the board of supervisors levy a tax on behalf of the authority. If the board of supervisors approves the proposal to levy the tax, it shall call the election to seek voter approval and place the appropriate measure on the ballot for that election. The proceeds of these taxes shall be tax proceeds of the authority and not of the county. The authority shall reimburse the county for all costs associated with the countys consideration of those taxes, and shall defend, indemnify, and hold harmless the county from any liability, costs, or expenses arising from or related to the imposition of these taxes.
(22)Notwithstanding the provisions of this chapter relating to the obligations and liabilities of the authority, or any other law, a transfer of control or ownership of the medical center to the authority pursuant to this chapter shall confer onto the authority all the rights, privileges, and authority set forth in state law to own, operate, and provide coverage and services through hospitals, clinics and other health facilities, health programs, care organizations, physician practice plans, delivery systems, health care service plans, and other coverage mechanisms that may be owned or operated by a county.
(23)To engage in other activities that may be in the best interests of the authority and the persons served by the authority, as determined by the board of governors, in order to respond to changes in the health care industry.
(b)The authority shall conform to the following requirements:
(1)(A)Be a government agency that is a local unit of government separate and apart for all purposes from the county and any other public entity, and shall not be considered to be an agency, division, or department of the county or any other public entity. The authority shall not be governed by or subject to the civil service requirements of the county. Except Notwithstanding any other law, except as otherwise provided for in the enabling ordinance consistent with enacted pursuant to this chapter, and as set forth in Section 101853.1 relating to the personnel transition plan, the authority shall not be governed by, or subject to, other policies or operational rules of applicable to the county, the medical center prior to its transfer, or any other public entity, including, but not limited to, those relating to personnel and procurement.
(B)The board of governors shall adopt written rules, regulations, and procedures with regard to basic human resource functions not inconsistent with memoranda of understanding covering employees represented by employee organizations or the provisions of this chapter. Until the time that the board of governors adopts its own rules, regulations, or procedures with regard to these functions, the existing rules, regulations, and procedures set forth in any memoranda of understanding described in Section 101853.1, and the rules and regulations adopted by the county and described in paragraph (4), shall continue to apply.
(2)Be subject to state and federal taxation laws that are applicable to public entities generally.
(3)Except as otherwise specifically provided in this chapter, comply with the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code), the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), and the Ralph M. Brown Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of the Government Code).
(4)Be subject to the jurisdiction of the Public Employment Relations Board. Until the authority adopts rules and regulations pursuant to subdivision (a) of Section 3507 of the Government Code, the existing rules adopted by the county and contained in the countys employer-employee relations resolution, as amended, shall apply, modified to account for the creation of the authority, and provided further that the resolution shall not contain any incorporation of the countys civil service rules or county ordinances unless specifically addressed in this chapter.
(5)Carry professional and general liability insurance or programs to the extent sufficient to cover its activities.
(6)Comply with the requirements of Sections 53260 and 53261 of the Government Code.
(7)Maintain financial and accounting records.
(8)Meet all local, state, and federal data reporting requirements.
(c)(1)Subject to any restrictions applicable to public agencies, and subject to any limitations or conditions set forth in the enabling ordinance adopted by the board of supervisors, the authority may borrow money from the county, repay debt it owes to the county, and use the borrowed funds to provide for its operating and capital needs. The county may lend the authority funds or issue and may issue debt instruments, including, without limitation, revenue anticipation notes to obtain those funds to provide, by loan or otherwise, amounts necessary for the authority to meet its operating or and capital needs.
(2)Notwithstanding paragraph (1), nothing in this chapter shall be construed to limit the borrowing powers the county otherwise has under law for the purposes specified in paragraph (1) or any other purposes.
(d)Open sessions of the authority shall constitute official proceedings authorized by law within the meaning of Section 47 of the Civil Code. The privileges set forth in that section with respect to official proceedings shall apply to open sessions of the authority.
(e)(1)Notwithstanding any other law, the board of governors may order that a meeting held solely for the purpose of discussion or taking action on authority trade secrets, as defined in subdivision (d) of Section 3426.1 of the Civil Code, or to consider and take action on matters pertaining to contracts and contract negotiations concerning all matters related to rates of payment for health care services arranged or provided by the authority, shall be held in closed session. Trade secrets for purposes of this chapter shall also include information for which the secrecy of the information is necessary for the authority to initiate a new service, program, marketing strategy, business plan, or technology, or to add a benefit or product, and premature disclosure of the trade secret would create a substantial probability of depriving the authority of a substantial economic benefit or opportunity.
(2)The requirements of making a public report of actions taken in closed session and the vote or abstention of every member present may be limited to a brief general description devoid of the information constituting the trade secret or concerning the matters related to rates of payment.
(3)Those records of the authority that reveal the authoritys trade secrets are exempt from disclosure pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. This exemption shall apply for a period of two years after the service, program, marketing strategy, business plan, technology, benefit, or product that is the subject of the trade secret is formally adopted by the governing body of the authority, provided that the service, program, marketing strategy, business plan, technology, benefit, or product continues to be a trade secret. The board of governors may delete the portion or portions containing trade secrets from any documents that were finally approved in the closed session that are provided to persons who have made the timely or standing request.
(4)This chapter shall not prevent the board of governors from meeting in closed session as otherwise provided by law.
(f)Notwithstanding any other law, those records of the authority and of the county that reveal the authoritys rates of payment for health care services arranged or provided by the authority or its deliberative processes, strategies, discussions, communications, or any other portion of the negotiations with providers of health care services or Medi-Cal, health care plans, or other payers for rates of payment, shall not be required to be disclosed pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records. However, three years after a contract or amendment to a contract is fully executed, the portion of the contract or amendment containing the rates of payment shall be open to inspection.
(g)The authority shall be a public agency that is a local unit of government for purposes of eligibility with respect to grants and other funding and loan guarantee programs. Contributions to the authority shall be tax deductible to the extent permitted by state and federal law. Nonproprietary income of the authority shall be exempt from state income taxation.
(h)Unless otherwise provided by the board of supervisors by way of resolution, the authority is empowered, or the board of supervisors is empowered on behalf of the authority, to apply as a public agency for one or more licenses for the provision of health care or the operation of a health care service plan pursuant to statutes and regulations governing licensing as currently written or subsequently amended.
(i)The statutory authority of a board of supervisors to prescribe rules that authorize a county hospital to integrate its services with those of other providers into a system of community service that offers free choice of hospitals to those requiring hospital care, as set forth in Section 14000.2 of the Welfare and Institutions Code, shall apply to the authority and the board of governors.
(j)(1)Except as otherwise provided in this chapter, provisions of the Evidence Code, the Government Code, including the Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), the Civil Code, the Business and Professions Code, and other applicable law pertaining to the confidentiality of peer review activities of peer review bodies shall apply to the peer review activities of the authority, or any peer review body, as defined in paragraph (1) of subdivision (a) of Section 805 of the Business and Professions Code, formed pursuant to the powers granted to the authority. The laws pertaining to the confidentiality of peer review activities shall be together construed as extending, to the extent permitted by law, the maximum degree of protection of confidentiality.
(2)Notwithstanding Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of law, any peer review body formed pursuant to the powers granted to the authority, may, at its discretion and without notice to the public, meet in closed session, so long as the purpose of the meeting is the peer review bodys discharge of its responsibility to evaluate and improve the quality of care rendered by health facilities and health practitioners. The peer review body and its members shall receive, to the fullest extent, all immunities, privileges, and protections available to those peer review bodies, their individual members, and persons or entities assisting in the peer review process, including those afforded by Section 1157 of the Evidence Code and Section 1370. Peer review proceedings shall constitute an official proceeding authorized by law within the meaning of Section 47 of the Civil Code and those privileges set forth in that section with respect to official proceedings shall apply to peer review proceedings of the authority.
(3)Notwithstanding the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), or Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9 (commencing with Section 54950) of Part 1 of Division 2 of Title 5 of, the Government Code, or any other provision of state or local law requiring disclosure of public records, those records of a peer review body formed pursuant to the powers granted to the authority, shall not be required to be disclosed. The records and proceedings of the peer review body and its individual members shall receive, to the fullest extent, all immunities, privileges, and protections available to those records and proceedings, including those afforded by Section 1157 of the Evidence Code and Section 1370 of the Health and Safety Code.
(4)If the authority is required by law or contractual obligation to submit to the state or federal government peer review information or information relevant to the credentialing of a participating provider, that submission shall not constitute a waiver of confidentiality.
(5)Notwithstanding any other law, Section 1461 shall apply to hearings on reports of hospital medical audit or quality assurance committees.
(k)Except as expressly provided by other provisions of this section, all exemptions and exclusions from disclosure as public records pursuant to this chapter and the California Public Records Act, including, but not limited to, those pertaining to trade secrets and information withheld in the public interest, shall be fully applicable to the authority, and for the board of supervisors, and all state and local agencies with respect to all writings that the authority is required to prepare, produce, or submit, and which shall not constitute a waiver of exemption from disclosure.
(l)The authority and the county, or any combination thereof, may engage in marketing, advertising, and promotion of the medical and health care services made available to the community by the authority.
(m)The
(m)(1)The board of supervisors may contract for services or purchase items on behalf of the authority.
(2)Unless otherwise provided for, and subject to the limitations and conditions set forth in the enabling ordinance, the board of governors shall have authority over procurement and contracts for the authority. The board of governors authority and shall adopt written rules, regulations, and procedures with regard to these functions. Contracts The authoritys ability to contract for personnel or other services and items it deems necessary, appropriate, or convenient for the conduct of its activities consistent with its purposes shall only be limited by the provisions in this chapter and obligations under the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section 3500) of Division 4 of Title 1 of the Government Code).
(3)Contracts by and between the authority and a public agency, and contracts by and between the authority and providers of health care, goods, or services, may be let on a nonbid basis and shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.
(n)The authority may contract with the county for services and personnel upon mutually agreeable terms.
(o)Notwithstanding Article 4.7 (commencing with Section 1125) of Chapter 1 of Division 4 of Title 1 of the Government Code, related to incompatible activities, Section 1099 of the Government Code, related to incompatible offices, or any other law, a member of the authoritys administrative staff shall not be considered to hold an incompatible office or to be engaged in activities inconsistent and incompatible with his or her duties as a result of his or her employment or affiliation with the county or an agency of the county.
(p)The board of governors and the officers and employees of the authority are public employees for purposes of Division 3.6 (commencing with Section 810) of Title 1 of the Government Code, relating to claims and actions against public entities and public employees, and shall be protected by the immunities applicable to public entities and public employees governed by Part 2 (commencing with Section 814) of Division 3.6 of Title 1 of the Government Code, except as provided by other statutes or regulations that apply expressly to the authority.
SEC. 6.Section 101855.1 of the Health and Safety Code is amended to read:101855.1.(a)Transfer by the county to the authority of the maintenance, operation, and management or ownership of control of the medical center, whether or not the transfer includes the surrendering by the county of the existing general acute care hospital license and corresponding application for a change of ownership of the license, shall not affect the eligibility of the county to undertake, and shall authorize the authority, subject to applicable requirements, to do any of the following:
(1)With the written consent of the county, participate in and receive allocations pursuant to the California Health Care for Indigents Program pursuant to Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9 of the Welfare and Institutions Code, or similar programs, as may be identified or earmarked by the county for indigent health care services of the type provided by the medical center.
(2)With the written consent of the county, participate in and receive allocations of local revenue fund amounts provided pursuant to Chapter 6 (commencing with Section 17600) of Part 5 of Division 9 of the Welfare and Institutions Code as may be identified or earmarked by the county for indigent health care services of the type provided by the medical center.
(3)Participate in the financing of, as applicable, and receive, Medicaid disproportionate share hospital payments available to a county hospital or designated public hospital, or any other successor or modified payment or funding that is intended to assist hospitals that serve a disproportionate share of low-income patients with special needs. The allocation of Medicaid disproportionate share hospital payments shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(4)Participate in the financing of, as applicable, and receive, Medi-Cal payments and supplemental reimbursements, including, but not limited to, payments made pursuant to Sections 14105.96, 14105.965, 14166.4, 14182.15, and 14199.2 of the Welfare and Institutions Code, payments described in paragraph (4) of subdivision (b) of Section 14301.4 of, and Section 14301.5 of, the Welfare and Institutions Code, and payments made available to a county provider or designated public hospital, or governmental entity with which it is affiliated, under any other successor or modified Medicaid payment system.
(5)Participate in the financing of, as applicable, and receive, safety net care pool funding, stabilization funding, delivery system reform incentive pool payments, and any other funding available to a county provider or designated public hospital, or governmental entities with which it is affiliated under the Medicaid demonstration project authorized pursuant to Article 5.2 (commencing with Section 14166) and Article 5.4 (commencing with Section 14180) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system. The allocation of safety net care pool funds shall be made in consultation with the State Department of Health Care Services and other designated safety net hospitals.
(6)Participate in the financing, administration, and provision of services under the Low Income Health Program authorized pursuant to Part 3.6 (commencing with Section 15909) of Division 9 of the Welfare and Institutions Code, or under any other successor or modified Medicaid demonstration project or Medicaid payment system if the authority enters into an agreement with the county concerning the provision of services by, and payment for these services to, the county.
(7)Participate in and receive direct grant and payment allocations pursuant to Article 5.230 (commencing with Section 14169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, or under any other successor or modified direct grant and payment systems funded by hospital or other provider fee assessments.
(8)Receive Medi-Cal capital supplements pursuant to Section 14085.5 of the Welfare and Institutions Code, or any other successor or modified Medi-Cal debt service reimbursement program. Notwithstanding any other law, supplemental payments shall be made to the medical center under those programs for the debt service costs incurred by the county, and, if applicable, by the authority to the extent that debt service responsibility is refinanced, transferred to, or otherwise assumed by, directly or indirectly, the authority.
(9)Receive any other funds, or preference in the assignment of health care plan enrollees, that would otherwise be available to a county health plan, provider, or designated public hospital, or governmental entity with which it is affiliated.
(b)The transfer of control of the medical center to the authority pursuant to this chapter shall not otherwise disqualify the county or the authority from participating in any of the following:
(1)Local, state, and federal funding sources either specific to county or other publicly owned or operated health care service plans, hospitals, or other health care providers, including, but not limited to, ambulatory care clinics, health systems, practices, designated public hospitals, or governmental entities with which they are affiliated, for which there are special provisions specific to those plans, hospitals, ambulatory care clinics, health systems, practices, other health care providers or governmental entities with which they are affiliated.
(2)All funding programs in which the county, by itself or on behalf of the medical center had participated prior to the creation of the authority, or would otherwise be qualified to participate in had the authority not been created, and the maintenance, operation, and management or ownership management, control, ownership, or lease of the medical center not been transferred to the authority pursuant to this chapter.
(a)This chapter shall be known known, and may be cited cited, as the Kern County Hospital Authority Act.
(b)The Legislature finds and declares all of the following:
(1)Kern Medical Center, an acute care hospital currently operated as a constituent department of the County of Kern, is a designated public hospital, as defined in subdivision (d) of Section 14166.1 of the Welfare and Institutions Code, and a critical component of the states health care safety net.
(2)Counties are A county is authorized under current existing law to integrate their its county hospital services with those of other hospitals into a system of community service that offers free choice of hospitals to those requiring hospital care, with the objective of eliminating discrimination or segregation based on economic disability, so that the county hospital and other hospitals in the community share in providing services to paying patients and to those who qualify for care in public medical care programs. However, in a new era of health care delivery, it is necessary to pursue approaches that transition beyond acute care-centric orientations.
(3)The ongoing evolution of the health care environment requires public entities providing or arranging health care services to pursue innovative health care delivery models that proactively improve the quality of patient care services and patient experience, efficiently and effectively increase access to needed health care services across the care continuum, provide services in a patient-centered manner, and moderate the rate of growth of health care expenditures.
(4)The board of supervisors of the County of Kern has determined that providing access to affordable, high-quality health care services, and ensuring the full engagement and viability of the health care safety net in the county are essential for improving the health status of the people of the County of Kern. To further this imperative, it is necessary that the Kern Medical Center, while continuing as a designated public hospital and maintaining its mission, is provided with an organizational and operational structure that facilitates and improves its ability to function with flexibility, responsiveness, and innovation to promote a patient-centric system of care delivery featuring community-based care. This can best be accomplished by allowing the operation of the Kern Medical Center, along with other health-related resources, under a new hospital authority that is able to pursue efforts towards a delivery system that embraces population health management strategies, is effectively positioned for health plan-provider alignment, and maximizes opportunities for employees and enhancement of staff morale.
(5)This chapter is necessary to allow the formation of a public hospital authority for the purposes described above.
|
Date
|
Status
|
|---|---|
| May 28, 2015 | Referred to Coms. on HEALTH and GOV. & F. |
| Oct 11, 2015 | Chaptered by Secretary of State - Chapter 790, Statutes of 2015. |
| Oct 11, 2015 | Approved by the Governor. |
| Sep 1, 2015 | Enrolled and presented to the Governor at 4 p.m. |
| Aug 24, 2015 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 80. Noes 0. Page 2562.). |
| Aug 24, 2015 | Senate amendments concurred in. To Engrossing and Enrolling. |
| Aug 20, 2015 | Read third time. Passed. Ordered to the Assembly. (Ayes 38. Noes 0. Page 2117.). |
| Aug 20, 2015 | Read third time. Passed. Ordered to the Assembly. |
| Aug 20, 2015 | In Assembly. Concurrence in Senate amendments pending. May be considered on or after August 22 pursuant to Assembly Rule 77. |
| Jul 16, 2015 | Read second time. Ordered to Consent Calendar. |
| Jul 15, 2015 | From committee: Do pass. To Consent Calendar. (Ayes 6. Noes 0.) (July 15). |
| Jun 25, 2015 | From committee: Do pass and re-refer to Com. on GOV. & F. with recommendation: To Consent Calendar. (Ayes 8. Noes 0.) (June 24). Re-referred to Com. on GOV. & F. |
| Jun 16, 2015 | From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH. |
| Jun 9, 2015 | In committee: Set, first hearing. Hearing canceled at the request of author. |
| Feb 27, 2015 | Introduced. To print. |
| May 14, 2015 | Read third time. Passed. Ordered to the Senate. (Ayes 80. Noes 0. Page 1442.) |
| May 14, 2015 | Read third time. Passed. Ordered to the Senate. |
| May 14, 2015 | In Senate. Read first time. To Com. on RLS. for assignment. |
| May 11, 2015 | Read second time. Ordered to third reading. |
| May 7, 2015 | From committee: Do pass. (Ayes 9. Noes 0.) (May 6). |
| Apr 29, 2015 | Re-referred to Com. on L. GOV. |
| Apr 28, 2015 | From committee chair, with author's amendments: Amend, and re-refer to Com. on L. GOV. Read second time and amended. |
| Apr 6, 2015 | Re-referred to Com. on L. GOV. |
| Mar 26, 2015 | Referred to Com. on L. GOV. |
| Mar 26, 2015 | From committee chair, with author's amendments: Amend, and re-refer to Com. on L. GOV. Read second time and amended. |
| Mar 2, 2015 | Read first time. |
| Mar 1, 2015 | From printer. May be heard in committee March 31. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Aug 24, 2015 | AB 1350 SALAS Concurrence in Senate Amendments | Assembly Floor |
Passed |
|
| Aug 20, 2015 | Consent Calendar 2nd AB1350 Salas | Senate Floor |
Passed |
|
| Jul 15, 2015 | Do pass and be ordered to the Consent Calendar | Senate Standing Committee on Governance and Finance |
Passed |
|
| Jun 24, 2015 | Do pass, but first be re-referred to the Committee on [Governance and Finance] with the recommendation: To Consent Calendar | Senate Standing Committee on Health |
Passed |
|
| May 14, 2015 | AB 1350 SALAS Assembly Third Reading | Assembly Floor |
Passed |
|
| May 6, 2015 | Do pass. | Assembly Standing Committee on Local Government |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| Kern County Board of Supervisors | ** Support | Aug 24, 2015 |
| Kern County Board of Supervisors Kern Health Systems | ** Support | May 6, 2015 |
| Kern Health Systems | ** Support | Aug 24, 2015 |
| Kern Medical Center | * Support | May 6, 2015 |
| Service Employees International Union, California State Council | ** Support | Aug 24, 2015 |
AB 1350
Page 4
CONCURRENCE IN SENATE AMENDMENTS
AB 1350
(Salas)
As Amended June 16, 2015
Majority vote
ASSEMBLY: |
80-0 |
(May 14, 2015) |
SENATE: |
38-0 |
(August 20, 2015) |
Original Committee Reference: L. GOV.
SUMMARY: Makes changes to existing law which authorizes the Kern County Board of Supervisors (Board of Supervisors) to establish the Kern County Hospital Authority (Authority).
The Senate amendments:
Define "legacy employee" to mean "employees of the county who retired from the medical center prior to the date of transfer of control of the medical center, employees of the county who are initially transferred to the authority on the date of transfer of control of the medical center, and employees first hired by or retired from the authority during the 24-month period following the date of transfer of control of the medical center."
Define "new employee" to mean "employees first hired by the authority after the 24-month period following the date of transfer of control of the medical center."
Require the Authority, if a memoranda of understanding (MOU) is expired on the date of the transfer of control of Kern Medical Center (KMC), to continue to be bound by the terms and conditions of the most recent MOU, unless modified by a mutual agreement with each of the exclusive employee representatives, and the benefits and wages of transferred employees, as specified.
Require legacy employees to be deemed to be Kern County (County) employees for purposes of participation in a benefit plan administered by the Kern County Employees Retirement Association, but only for that purpose, and not to be employees of the County for any other purpose.
Require the County, upon the transfer of control of KMC and thereafter, to include legacy employees in a special county employee group for which the County has primary financial responsibility to fund all employer contributions, as specified, that are necessary to fund all benefits for legacy employees administered by the Kern County Employees Retirement Association, as specified.
Require the County, if the Authority fails to make required employer contributions for legacy employees and new employees and after demand and notice from the Kern County Employees Retirement Association, to be obligated to make employer contributions in the place of the Authority.
Require the Authority to be primarily responsible for any employer contributions, as specified, that are necessary to fund all benefits for new employees.
Require the County to maintain the obligation of employer contributions for new employees, as specified, until the Authority demonstrates and the Kern County Employees Retirement Association's Board of Retirement determines that the Authority is sufficiently capable financially to fully assume the obligation to make all employer contributions for new employees based on a plan of participation incorporated within a written agreement between the County and the Authority. Require the County, if the Authority fails to make contributions due to dissolution or bankruptcy of the Authority, to be obligated to make required contributions after receipt of notice and demand from the Kern County Employee's Retirement Association.
Make technical and conforming changes.
EXISTING LAW authorizes the Board of Supervisors to establish the Authority, and specifies the Authority's governance, powers, and procedures.
AS PASSED BY THE ASSEMBLY, this bill:
Made a number of changes to existing law which authorizes the Board of Supervisors to establish by ordinance the Authority and to allow for the transfer of the county-run KMC to the Authority.
Defined "transfer of control of the medical center" to mean "the transfer by the County to the Authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the Board of Supervisors in the enabling ordinance."
Added to the list of terms and conditions the Board of Supervisors may include in the enabling ordinance to transfer control to the Authority from the County, whether funds of the Authority shall be deposited in the custody of, and paid out solely through, the County's treasurer's office.
Changed the effective date from the date the County adopts the enabling ordinance to transfer control to the Authority instead to the actual date of the transfer of control to the Authority in a number of provisions in existing law which require the Authority to be bound by the terms of MOU between the County and its employee representatives and in several other provisions that provide protections for employee benefits.
Required the Authority to be treated as a public employer that offered a plan of replacement benefits prior to January 1, 2013. Provides that the County's plan of replacement benefits that was in effect prior to January 1, 2013, is deemed to be the Authority's replacement plan for the sole purpose of allowing the Authority to continue to offer the plan of replacement benefits, immediately after the transfer for Kern County Employees' Retirement Association members who meet specified requirements.
Authorized the Authority, if not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, to establish its own treasury.
Provided that the powers granted to the Authority, pursuant to existing law, may be subject to any terms, conditions, and limitations imposed by the County's enabling ordinance.
Added physicians and other provider types and coverage mechanisms to the list of services, coverage, and programs that the Authority has the same rights as the county with respect to owning, operating, and providing.
Expanded the County's authority to issue debt instruments, beyond revenue anticipation notes, to provide by loan or otherwise amounts necessary to the Authority to meets its operating and capital needs.
Provided that existing law, which governs the Authority, shall not be construed to limit the borrowing authority of the County.
Authorized the Board of Supervisors, as applicable, to hold meetings relating to the Authority's trade secrets, as specified.
Authorized the Board of Supervisors to contract for services or purchase items on behalf of the Authority.
Provided that the Authority's governing body as authority over procurement and contracts, unless otherwise provided for and subject to the limitations and conditions established in the enabling ordinance. Requires the Authority to adopt written rules, regulations and procedures with regard to procurement and contract functions.
Required the Authority's ability to contract for personnel or other services and items, as specified, to only be limited by the provisions in this chapter and the Meyers-Milias-Brown Act.
FISCAL EFFECT: None
COMMENTS:
Prior Legislation. Facing escalating costs, some county hospitals have sought to restructure their governance or affiliate with other hospitals in their areas. In these instances, the Legislature has granted several counties the ability to create health authorities, including Alameda [AB 2374 (Bates), Chapter 816, Statutes of 1996], Monterey [AB 276 (Alejo), Chapter 686, Statutes of 2012], San Luis Obispo [SB 538 (O'Connell), Chapter 899, Statutes of 1999], Santa Barbara, and Sonoma (for dental).
Most recently, the Legislature passed AB 2546 (Salas), Chapter 613, Statutes of 2014, which authorized the Board of Supervisors to establish a separate Authority to govern the KMC. AB 2546 contains several provisions to ensure that healthcare services remain accessible to patients regardless of their ability to pay and that the Authority, as a separate entity from the County, will still continue to serve as a hospital. AB 2546 also established requirements for the Authority upon the transfer of KMC employees.
Bill Summary. This bill builds upon the authority granted to the Kern County Board of Supervisors by AB 2546 to establish the Authority and to transfer the medical center to the separate Authority. This bill makes a number of changes to the laws governing the transfer of KMC.
Senate amendments define "legacy employees" and "new employees" and specify the County's obligations to make required employer contributions in the event that the Authority fails to do so.
This bill is author-sponsored.
Author's Statement. According to the author, "KMC serves a community of over 650,000 residents, including indigent individuals with no other means of obtaining medical care. KMC provides the only trauma care between Los Angeles and Fresno, and is vital to training physicians through academic residency and education programs.
"A hospital authority allows Kern County to benefit from the cost savings that can be generated by operating under a separate governance structure and provide opportunities for increased flexibility, responsiveness, and innovation. The law established extensive provisions intended to ensure the medical center will continue to provide affordable, high-quality health care services and that medical center employees will have a seamless transition of wages, benefits, and contracts without loss of rights or status. This bill contains technical and clarifying changes to ensure the successful transfer of KMC to an Authority."
Arguments in Support. Supporters argue that this bill makes a number of changes to provide for a smooth and equitable transition of KMC to a hospital authority.
Arguments in Opposition. None on file.
Analysis Prepared by: Misa Lennox / L. GOV. / (916) 319-3958 FN: 0001296
AB 1350
Page 8
|
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 |
CONSENT
Bill No: AB 1350
Amended: 6/16/15 in Senate
SENATE HEALTH COMMITTEE: 8-0, 6/24/15
AYES: Hernandez, Nguyen, Mitchell, Monning, Nielsen, Pan, Roth, Wolk
NO VOTE RECORDED: Hall
SENATE GOVERNANCE & FIN. COMMITTEE: 6-0, 7/15/15
AYES: Hertzberg, Nguyen, Beall, Hernandez, Moorlach, Pavley
NO VOTE RECORDED: Lara
ASSEMBLY FLOOR: 80-0, 5/14/15 - See last page for vote
SUBJECT: Kern County Hospital Authority
DIGEST: This bill makes a number of changes to provisions of law governing the ability of Kern County (County) to establish a separate authority, and to transfer control of the county hospital, Kern Medical Center, to this authority. These changes include requiring the County to be obligated to ensure that required employer contributions to fund retirement benefits for employees are paid, requiring an expired memorandum of understanding to be adhered to in the same manner as a memorandum of understanding that has not expired, as well as other technical, clarifying, and conforming changes.
Existing law:
Requires every county to be a "provider of last resort," by supporting all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, who reside in the county, when such persons are not supported and relieved by their relatives or friends, by their own means, or by state hospitals or other state or private institutions.
Authorizes the County to establish, by ordinance, the Kern County Hospital Authority (Authority) as a separate public entity, in order to transfer the management, administration, and control of Kern Medical Center (KMC) and other health-related resources.
Requires the enabling ordinance adopted by the County to establish the terms and conditions of the transfer to the Authority from the County, including any transfer of real and personal property, assets and liabilities, and transfer of employees.
Contains extensive provisions relating to the Authority’s effects on current KMC and County employees, including requirements related to the maintenance of current employees’ seniority and benefits, employees’ eligibility for membership in the Kern County Employee’s Retirement Association, recognition of exclusive representatives of employee’s bargaining units, and the continuation of an existing memorandum of understanding (MOU) covering the terms and conditions, including the level of wages and benefits, of current employees for 24 months or through the term of the MOU, whichever is longer.
Requires the Authority to be a government entity separate and apart from the County, and exempts the Authority from the County’s civil service requirements, and from the policies or operational rules of the County or any other public entity, including policies or rules relating to personnel and procurement.
Requires the Authority to be subject to the jurisdiction of the Public Employment Relations Board, to comply with specified statutes relating to the termination of employee contracts, to maintain financial and accounting records, and to meet all local, state, and federal data reporting requirements.
Specifies how the Board may dissolve the Authority and provide for the disposition of its assets, obligations, and liabilities.
This bill:
Requires the enabling ordinance establishing the Authority to specify whether funds of the Authority are to be deposited in the custody of, and paid out solely through, the County treasurer’s office. Clarifies that if the enabling ordinance does not require funds to be deposited in the County treasury, the Authority is permitted to establish its own treasury.
Requires the Authority, if a memoranda of understanding (MOU) is expired on the date of the transfer of control of KMC, to continue to be bound by the terms and conditions of the most recent MOU for 24 months, unless modified by a mutual agreement with each of the exclusive employee representatives, and requires the benefits and wages of transferred employees to be retained, as specified.
Requires the Authority to be considered a public employer that offered a plan of replacement benefits prior to January 1, 2013, for purposes of a provision of law prohibiting a public employer from offering a replacement benefits plan for employees after January 1, 2013 if they had not already been offering such a plan prior to January 1, 2013. Deems the County’s plan of replacement benefits in effect prior to January 1, 2013 to also be the Authority’s replacement plan for the sole purpose of allowing the Authority to continue to offer the replacement benefit plan to an employee who was employed as of January 1, 2013, or to employees who are part of a member group to which the County offered a replacement benefit plan prior to January 1, 2013.
Requires legacy employees, as defined, to be deemed County employees for purposes of participation in a benefit plan administered by the Kern County Employees’ Retirement Association, but only for that purpose, and not be employees of the County for any other purpose.
Requires Kern County, upon the transfer of control of KMC, to include legacy employees in a special County employee group for which the County has primary financial responsibility to fund all employer contributions that, together with contributions by employees and earnings, are necessary to fund all benefits for legacy employees administered by the Kern County Employees’ Retirement Association, notwithstanding the fact that the Authority is required to commence making periodic employer contributions for legacy employees folowing the transfer of control of KMC. Requires the County to be obligated to make employer contributions in the event the Authority fails to make the required contributions.
Defines “legacy employees,” for purposes of the Authority, as the employees of the County who retired from KMC prior to the date of transfer of control of KMC, employees of the County who are initially transferred to the Authority on the date of transfer of control of KMC, and employees first hired by or retired from the Authority during the 24-month period following the date of transfer of control of KMC.
Requires the Authority to be primarily responsible for any employer contributions necessary to fund benefits for new employees, but requires the County to be obligated to make the required contributions in the event the Authority fails to make the required contributions for new employees. Requires the County to maintain this obligation until the Authority demonstrates, and the Kern County Employees’ Retirement Association’s Board of Retirement determines, that the Authority is sufficiently capable financially to fully assume the obligation to make all employer contributions, as specified. However, in the event the Authority fails to make contributions due to the Authority’s dissolution or bankruptcy, the County is again obligated to make the required contributions.
Defines “new employees,” for purposes of the Authority, as employees first hired by the Authority after the 24-month period following the date of transfer of control of KMC.
Clarifies that the County, in the enabling ordinance transferring control of KMC to the Authority, has the option to require the Authority to lease KMC, in addition to the option of transferring ownership of KMC to the Authority.
Clarifies that the current requirement that the Department of Health Care Services take all necessary steps to ensure that the Authority is permitted to operate KMC includes ensuring that the Authority has all of the licenses, permits, and approvals needed.
Clarifies the ability of the County to lend the Authority funds to meet its operating and capital needs by permitting the County to use any borrowing power the County otherwise has under law, and not just issue revenue anticipation notes.
Permits the County to contract for services or purchase items on behalf of the Authority, and unless otherwise provided for, requires the Authority’s board of governors to have authority over procurement and contracts for the Authority.
Specifies that the Authority’s ability to contract for personnel or other services and items it deems necessary is only limited by the obligations under specified provisions of law which govern the relationship between employee groups and local governments.
Defines “transfer of control” of KMC as the transfer by the County to the Authority of the maintenance, operation, management, and personnel of KMC, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
Makes other technical, clarifying and conforming changes.
Comments
Author’s statement. According to the author, KMC is owned and operated by the County. KMC serves a community of over 650,000 residents, including indigent individuals with no other means of obtaining medical care. KMC provides the only trauma care between Los Angeles and Fresno, and is vital to training physicians through academic residency and education programs. Last year, AB 2546 (Salas, Chapter 613, Statutes of 2014), was enacted to give the Kern County Board of Supervisors the option to establish a hospital authority to manage and administer KMC. A hospital authority allows the County to benefit from the cost savings that can be generated by operating under a separate governance structure and provide opportunities for increased flexibility, responsiveness, and innovation. The law established extensive provisions intended to ensure the medical center will continue to provide affordable, high-quality health care services and that medical center employees will have a seamless transition of wages, benefits, and contracts without loss of rights or status. This bill makes technical and clarifying changes to ensure that employees transferred from KMC to the Authority are covered under most current MOU and receive the same retirement benefits. This bill also allows the Authority to deposit and borrow funds from the County Treasury, and gives the Authority the option of establishing its own treasury. In addition, this bill clarifies the scope of the transfer of control of KMC operations to the Authority, the Authority’s responsibilities as hospital operator, and the conditions under which the transfer shall occur.
Background on KMC. KMC is a 222-bed acute care teaching hospital owned and operated by the County, and the County reports that it has historically faced significant operational issues and financial losses. Prior to the County appointing a new Chief Executive Officer (CEO) in December 2013, the hospital had been losing $3 million per month. Since that time under new leadership, considerable improvements have been achieved. Within five months of the new leadership team being in place, the losses were reduced to $400,000 per month, and within eight months the medical center began generating a profit. Through the 10 months ended April 30, 2015, the net income for KMC is $7,272,956. During the same period last year the hospital reported a net loss of $12,083,046. The $19,356,003 improvement has been achieved through a number of initiatives including replacing management staff, improvements in how the hospital bills and collects, labor productivity management, and renegotiated managed care contracts. The County reports that it has begun pursuing growth opportunities, including physician recruitment in needed specialties, adding new clinics and services, including a medical home model, and enhancing access to care in outpatient clinics, with monthly visits increasing by 40 % over the past year.
Background on plan to transfer KMC to the Authority. Last year, AB 2546 was introduced with the initial plan to form an authority that would combine under a single governance structure both KMC and Kern Health Systems, which is the Local Initiative Medi-Cal managed care plan. In response to concerns regarding the financial implications of a merger of Kern Health Systems with the hospital, AB 2546 was scaled back to follow the precedent that the Legislature had established in previous legislation for Alameda and Monterey counties by allowing the County to establish an authority to govern the county’s medical center. The author and sponsor state that by separating KMC from the County’s governance structure, there will be opportunities for increased flexibility, responsiveness, and innovation that will enable KMC to stabilize financially and continue to meet the needs of the community.
Following the enactment of AB 2546 last year, the County reports that an implementation plan was approved in January 2015. The implementation plan detailed the guiding principles of the transition, a transition plan, a transition budget, and a list of agreements and steps necessary to transition the medical center. The County and KMC formed a Hospital Authority Steering Committee, which is responsible for the overall coordination and implementation of the transfer. The County states that in order to successfully transition KMC from a County department to a hospital authority, KMC has begun to engage with legal and financial consultants to gain an understanding of the mechanics of the transfer of control, assets, liabilities, and personnel of the medical center to the hospital authority. The draft ordinance to enact the hospital authority has been drafted and is in circulation for public review and feedback. The County states it plans on taking the ordinance to the Board of Supervisors for a vote in the fall of 2015 and transferring the medical center, personnel, assets and liabilities from the county to the hospital authority in July 2016.
Prior Legislation
AB 2546 authorized the County to establish the Authority to manage, administer, and control KMC, and provided for the Authority’s governance, powers, and procedures.
AB
276 (Alejo, Chapter 686, Statutes of 2012), authorized the Monterey
County Board of Supervisors to establish the Central Coast Hospital
Authority (CCHA), as specified, and prohibited the board of
supervisors from establishing the CCHA until an agreement to
affiliate with at least one other health care facility is
reached.
AB 2374 (Bates, Chapter 816, Statutes of 1996),
authorized the County of Alameda to establish a hospital authority to
manage the respective county hospitals and county programs of the
Alameda County Medical Center.
FISCAL EFFECT: Appropriation: No Fiscal Com.: No Local: No
Kern County Board of Supervisors
Kern Health Systems
Service Employees International Union, California State Council
None received
ARGUMENTS IN SUPPORT: This bill is supported by the Kern County Board of Supervisors, which states that among other provisions, this bill will ensure that the most current MOU existing at the time that KMC is transferred to the Authority will apply to any County employees who are transferred to the Authority. The County states that other provisions clarify the ability of the Authority to deposit funds in, and borrow funds from, the County treasury, which will allow the Authority to receive temporary cash transfer from the County treasury pool. The County states that this bill also makes needed amendments to treat the Authority as a public employer for purposes of making County employees whose retirement benefits are limited by federal law eligible for the same replacement benefits after transferring to the Authority that would be due to them as County employees. This bill is also supported by the California State Council of the Service Employees International Union (SEIU California), which states that the purpose of last year’s AB 2546 was to ensure a smooth transition of KMC to an authority while preserving key protections for the hospital employees who would be transitioning to a different model of administration within the County. After AB 2546’s enactment, SEIU California states that the need for clarification and clean-up has emerged on several issues related to the transition of KMC into the Authority. Kern Health Systems states in support that it is a partner with KMC in preserving and improving the delivery system that serves California’s uninsured and indigent population, and therefore supports this bill so that these technical changes can be enacted as swiftly as possible, clearing the way for KMC’s transition to a hospital authority.
ASSEMBLY FLOOR: 80-0, 5/14/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins
Prepared by: Vince Marchand / HEALTH /
8/13/15 13:24:41
**** END ****
AB 1350 (Salas) 6/16/15 Page 4 of 4
SENATE COMMITTEE ON GOVERNANCE AND FINANCE
Senator Robert M. Hertzberg, Chair
2015 - 2016 Regular
Bill No: |
AB 1350 |
Hearing Date: |
7/15/15 |
Author: |
Salas |
Tax Levy: |
No |
Version: |
6/16/15 |
Fiscal: |
No |
Consultant: |
Weinberger |
||
KERN COUNTY HOSPITAL AUTHORITY
Makes numerous changes to state laws allowing the Kern County Board of Supervisors to create the Kern County Hospital Authority.
Background and Existing Law
State law requires counties to provide or secure public health care services and authorizes the formation of hospital districts to provide such services. Facing escalating costs, however, some county hospitals have sought to restructure their governance, merge, or affiliate with other hospitals in their areas.
Kern Medical Center is a 222-bed acute care teaching hospital owned and operated by Kern County. The Medical Center serves a community of approximately 650,000 and employs approximately 1,800 staff members. Kern Medical Center provides care for over 16,000 inpatients annually, while the clinics provide care and services for over 100,000 patients. The emergency room experiences 43,000 visits per year. As one of California’s public safety-net hospitals, Kern Medical Center serves a high proportion of underinsured and uninsured patients, providing healthcare access to all patients regardless of their ability to pay.
As a public safety-net hospital, Kern Medical Center faces significant challenges. The recent economic slowdown has increased the population of patients, who rely on the hospital’s safety-net services while, at the same time, decreasing the reimbursements that the hospital receives from the federal and state governments. The Medical Center is confronting significant fiscal challenges. The medical center’s management team has taken steps to reduce costs and has succeeded in significantly reducing operating deficits in recent months.
Public hospitals also face the challenge of competing with private health care providers while complying with statutes governing procurement, hiring, public records, and other restrictions imposed by state law. In response to similar concerns, the Legislature granted the Alameda County Board of Supervisors the power to establish a separate hospital authority to govern the county’s medical center (AB 2374, Bates, 1996). Recently, the Legislature granted similar authority to the Monterey County Board of Supervisors (AB 276, Alejo, 2012).
Last year, the Legislature passed AB 2546 (Salas, 2014), which allowed the Kern County Board of Supervisors to create a hospital authority to govern the Kern Medical Center (KMC). Now that the county has started the process of forming a hospital authority, stakeholders have identified more changes to state law that will help facilitate KMC’s transfer to the new authority.
Proposed Law
State law authorizes the Kern County Board of Supervisors to establish, by ordinance, the Kern County Hospital Authority (KCHA) as a separate public entity, specifies KCHA’s purpose, and charges it with the management, administration, and control of Kern Medical Center (KMC) and other health related resources. Assembly Bill 1350 requires the enabling ordinance establishing the KCHA to specify whether KCHA’s funds are to be deposited in the custody of, and paid out solely through, the county treasurer’s office. The bill clarifies that if the enabling ordinance does not require funds to be deposited in the county treasury, KCHA can establish its own treasury.
State law requires the Department of Health Care Services take all necessary steps to ensure that KCHA is permitted to operate KMC. Assembly Bill 1350 clarifies that this requirement includes ensuring that KCHA has all of the licenses, permits, and approvals needed.
Assembly Bill 1350 defines “transfer of control” of KMC as the transfer by the county to KCHA of the maintenance, operation, management, and personnel of KMC, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
State law requires the enabling ordinance adopted by the board of supervisors, to establish the terms and conditions of the transfer to KCHA from the county, including the maintenance, operation, and management or ownership of the KMC. Assembly Bill 1350 clarifies that the county, has the option to require KCHA to lease KMC, in addition to the option of transferring ownership of KMC.
State law contains extensive provisions relating to KCHA’s effects on current medical center and county employees, including requirements related to the continuation of an existing memorandum, of understanding or agreement covering the terms and conditions, including the level of wages and benefits, of current employees. Assembly Bill 1350 requires KCHA, if a memoranda of understanding (MOU) is expired on the date of the transfer of control of KMC, to continue to be bound by the terms and conditions of the most recent MOU for 24 months, unless modified by a mutual agreement with each of the exclusive employee representatives, and requires the benefits and wages of transferred employees to be retained, as specified.
State law specifies the manner in which current KMC employees would retain membership in specified retirement systems after a transfer to KCHA. Assembly Bill 1350 requires KCHA to be considered a public employer that offered a plan of replacement benefits prior to January 1, 2013, for purposes of a statute prohibiting a public employer from offering a replacement benefits plan for employees after January 1, 2013, if it had not already been offering such a plan prior to January 1, 2013. Assembly Bill 1350 deems the County’s plan of replacement benefits in effect prior to January 1, 2013 to also be the KCHA’s replacement plan for the sole purpose of allowing KCHA to continue to offer the replacement benefit plan, to an employee who was employed as of January 1, 2013, or to employees who are part of a member group to which the County offered a replacement benefit plan prior to January 1, 2013.
Assembly Bill 1350 defines “legacy employees,” for purposes of KCHA, as county employees who retired from KMC before the date of transfer of control of KMC, county employees who are initially transferred to KCHA on the date of transfer of control of KMC, and employees first hired by or retired from KCHA during the 24-month period following the date of transfer of control of KMC. Assembly Bill 1350 requires legacy employees, as defined, to be deemed county employees for purposes of participation in a benefit plan administered by the Kern County Employees’ Retirement Association, but only for that purpose, and not be employees of the County for any other purpose. The bill requires Kern County, upon the transfer of control of KMC, to include legacy employees in a special county employee group for which the county has primary financial responsibility to fund all employer contributions that, together with contributions by employees and earnings, are necessary to fund all benefits for legacy employees administered by the Kern County Employees’ Retirement Association, notwithstanding the fact that KCHA must make periodic employer contributions for legacy employees following the transfer of control of KMC. The bill requires the county to be obligated to make employer contributions in the event the KCHA fails to make the required contributions.
Assembly Bill 1350 defines “new employees,” for purposes of KCHA, as employees first hired by KCHA after the 24-month period following the date of transfer of control of KMC. Assembly Bill 1350 requires KCHA to be primarily responsible for any employer contributions necessary to fund benefits for new employees, but requires the county to be obligated to make the required contributions in the event KCHA fails to make the required contributions for new employees. The bill requires the county to maintain this obligation until KCHA demonstrates, and the Kern County Employees’ Retirement Association’s Board of Retirement determines, that KCHA is sufficiently capable financially to fully assume the obligation to make all employer contributions, as specified. However, in the event that KCHA fails to make contributions due to dissolution or bankruptcy, the County is again obligated to make the required contributions.
State law allows the county to lend KCHA funds or issue revenue anticipation notes to obtain funds necessary to meet KCHA’s operational or capital needs. Assembly Bill 1350 clarifies the county’s ability to lend KCHA funds to meet its operating and capital needs by permitting the County to use any borrowing power the County otherwise has under law, and not just issue revenue anticipation notes.
State law requires KCHA’s board of governors to have authority over procurement and contracts for KCHA, subject to written rules, regulations, and procedures adopted by the board. Assembly Bill 1350 allows the county to contract for services or purchase items on behalf of KCHA. The bill specifies that KCHA’s ability to contract for personnel or other services and items it deems necessary is only limited by the obligations under specified provisions of law which govern the relationship between employee groups and local governments.
Assembly Bill 1350 makes other technical, clarifying and conforming changes to the statutes governing KCHA.
State Revenue Impact
No estimate.
Comments
1. Purpose of the bill. The Kern Medical Center (KMC), which is owned and operated by the Kern County Board of Supervisors, serves a community of over 650,000 residents, including indigent individuals with no other means of obtaining medical care. KMC provides the only trauma care between Los Angeles and Fresno, and is vital to training physicians through academic residency and education programs. Last year, AB 2546 gave Kern County the option to establish the KCHA to manage and administer KMC. AB 1350’s provisions will ensure that employees transferred from KMC to KCHA are covered under the most current MOU and receive the same health and retirement benefits. The bill also protects retiree benefits should KCHA dissolve, allows KCHA to deposit and borrow funds from the county treasury, and gives KCHA the option of establishing its own treasury. In addition, AB 1350 clarifies the scope of the transfer of control of KMC operations, KCHA’s responsibilities as hospital operator, and the conditions under which the transfer must occur. By facilitating the establishment of KCHA, AB 1350 will allow Kern County to benefit from the cost savings, that can be generated by operating KMC under a separate governance structure and provide opportunities for increased flexibility, responsiveness, and innovation.
2. Double-referred. Because AB 1350 relates to the creation of a new local hospital authority, Senate Rules Committee double-referred the bill, first to the Senate Health Committee, which hears bills related to health care policy, and then to the Senate Governance & Finance Committee, which hears bills related to local governments’ powers. At its June 24 hearing, the Senate Health Committee passed AB 1350 on an 8-0 vote.
Assembly Actions
Assembly Local Government Committee: 9-0
Assembly Floor: 80-0
Support and Opposition
(7/9/15)
Support: Kern County Board of Supervisors; Kern Health Systems; Service Employees International Union, California State Council
Opposition: Unknown.
-- END --
AB 1350 (Salas) Page 6 of 6
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1350
AUTHOR: |
Salas |
||
VERSION: |
June 16, 2015 |
||
HEARING DATE: |
June 24, 2015 |
|
|
CONSULTANT: |
Vince Marchand |
||
SUBJECT: Kern County Hospital Authority
SUMMARY:
Makes a number of changes to provisions of law governing the ability of Kern County (County) to establish a separate authority, and to transfer control of the county hospital, Kern Medical Center, to this authority. These changes include requiring the County to be obligated to ensure that required employer contributions to fund retirement benefits for employees are paid, requiring an expired memorandum of understanding to be adhered to in the same manner as a memorandum of understanding that has not expired, as well as other technical, clarifying, and conforming changes.
Existing law:
Requires every county to be a "provider of last resort," by supporting all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, who reside in the county, when such persons are not supported and relieved by their relatives or friends, by their own means, or by state hospitals or other state or private institutions.
Authorizes the County to establish, by ordinance, the Kern County Hospital Authority (Authority) as a separate public entity, in order to transfer the management, administration, and control of Kern Medical Center (KMC) and other health-related resources.
Requires the enabling ordinance adopted by the County to establish the terms and conditions of the transfer to the Authority from the County, including any transfer of real and personal property, assets and liabilities, and transfer of employees.
Contains extensive provisions relating to the Authority’s effects on current KMC and County employees, including requirements related to the maintenance of current employees’ seniority and benefits, employees’ eligibility for membership in the Kern County Employee’s Retirement Association, recognition of exclusive representatives of employee’s bargaining units, and the continuation of an existing memorandum of understanding (MOU) covering the terms and conditions, including the level of wages and benefits, of current employees for 24 months or through the term of the MOU, whichever is longer.
Requires the Authority to be a government entity separate and apart from the County, and exempts the Authority from the County’s civil service requirements, and from the policies or operational rules of the County or any other public entity, including policies or rules relating to personnel and procurement.
Requires the Authority to be subject to the jurisdiction of the Public Employment Relations Board, to comply with specified statutes relating to the termination of employee contracts, to maintain financial and accounting records, and to meet all local, state, and federal data reporting requirements.
Specifies how the Board may dissolve the Authority and provide for the disposition of its assets, obligations, and liabilities.
This bill:
Requires the enabling ordinance establishing the Authority to specify whether funds of the Authority are to be deposited in the custody of, and paid out solely through, the County treasurer’s office. Clarifies that if the enabling ordinance does not require funds to be deposited in the County treasury, the Authority is permitted to establish its own treasury.
Requires the Authority, if a memoranda of understanding (MOU) is expired on the date of the transfer of control of KMC, to continue to be bound by the terms and conditions of the most recent MOU for 24 months, unless modified by a mutual agreement with each of the exclusive employee representatives, and requires the benefits and wages of transferred employees to be retained, as specified.
Requires the Authority to be considered a public employer that offered a plan of replacement benefits prior to January 1, 2013, for purposes of a provision of law prohibiting a public employer from offering a replacement benefits plan for employees after January 1, 2013 if they had not already been offering such a plan prior to January 1, 2013. Deems the County’s plan of replacement benefits in effect prior to January 1, 2013 to also be the Authority’s replacement plan for the sole purpose of allowing the Authority to continue to offer the replacement benefit plan to an employee who was employed as of January 1, 2013, or to employees who are part of a member group to which the County offered a replacement benefit plan prior to January 1, 2013.
Requires legacy employees, as defined, to be deemed County employees for purposes of participation in a benefit plan administered by the Kern County Employees’ Retirement Association, but only for that purpose, and not be employees of the County for any other purpose.
Requires Kern County, upon the transfer of control of KMC, to include legacy employees in a special County employee group for which the County has primary financial responsibility to fund all employer contributions that, together with contributions by employees and earnings, are necessary to fund all benefits for legacy employees administered by the Kern County Employees’ Retirement Association, notwithstanding the fact that the Authority is required to commence making periodic employer contributions for legacy employees following the transfer of control of KMC. Requires the County to be obligated to make employer contributions in the event the Authority fails to make the required contributions.
Defines “legacy employees,” for purposes of the Authority, as the employees of the County who retired from KMC prior to the date of transfer of control of KMC, employees of the County who are initially transferred to the Authority on the date of transfer of control of KMC, and employees first hired by or retired from the Authority during the 24-month period following the date of transfer of control of KMC.
Requires the Authority to be primarily responsible for any employer contributions necessary to fund benefits for new employees, but requires the County to be obligated to make the required contributions in the event the Authority fails to make the required contributions for new employees. Requires the County to maintain this obligation until the Authority demonstrates, and the Kern County Employees’ Retirement Association’s Board of Retirement determines, that the Authority is sufficiently capable financially to fully assume the obligation to make all employer contributions, as specified. However, in the event the Authority fails to make contributions due to the Authority’s dissolution or bankruptcy, the County is again obligated to make the required contributions.
Defines “new employees,” for purposes of the Authority, as employees first hired by the Authority after the 24-month period following the date of transfer of control of KMC.
Clarifies that the County, in the enabling ordinance transferring control of KMC to the Authority, has the option to require the Authority to lease KMC, in addition to the option of transferring ownership of KMC to the Authority.
Clarifies that the current requirement that the Department of Health Care Services take all necessary steps to ensure that the Authority is permitted to operate KMC includes ensuring that the Authority has all of the licenses, permits, and approvals needed.
Clarifies the ability of the County to lend the Authority funds to meet its operating and capital needs by permitting the County to use any borrowing power the County otherwise has under law, and not just issue revenue anticipation notes.
Permits the County to contract for services or purchase items on behalf of the Authority, and unless otherwise provided for, requires the Authority’s board of governors to have authority over procurement and contracts for the Authority.
Specifies that the Authority’s ability to contract for personnel or other services and items it deems necessary is only limited by the obligations under specified provisions of law which govern the relationship between employee groups and local governments.
Defines “transfer of control” of KMC as the transfer by the County to the Authority of the maintenance, operation, management, and personnel of KMC, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the board of supervisors in the enabling ordinance.
Makes other technical, clarifying and conforming changes.
FISCAL EFFECT:
This bill is keyed non-fiscal.
PRIOR VOTES:
Assembly Floor: |
80 - 0 |
Assembly Local Government Committee: |
9 - 0 |
COMMENTS:
Author’s statement. According to the author, KMC is owned and operated by the County. KMC serves a community of over 650,000 residents, including indigent individuals with no other means of obtaining medical care. KMC provides the only trauma care between Los Angeles and Fresno, and is vital to training physicians through academic residency and education programs. Last year, AB 2546 (Salas, Chapter 613, Statutes of 2014), was enacted to give the Kern County Board of Supervisors the option to establish a hospital authority to manage and administer KMC. A hospital authority allows the County to benefit from the cost savings that can be generated by operating under a separate governance structure and provide opportunities for increased flexibility, responsiveness, and innovation. The law established extensive provisions intended to ensure the medical center will continue to provide affordable, high-quality health care services and that medical center employees will have a seamless transition of wages, benefits, and contracts without loss of rights or status. This bill makes technical and clarifying changes to ensure that employees transferred from KMC to the Authority are covered under most current MOU and receive the same retirement benefits. This bill also allows the Authority to deposit and borrow funds from the County Treasury, and gives the Authority the option of establishing its own treasury. In addition, this bill clarifies the scope of the transfer of control of KMC operations to the Authority, the Authority’s responsibilities as hospital operator, and the conditions under which the transfer shall occur.
Background on KMC. KMC is a 222-bed acute care teaching hospital owned and operated by the County, and the County reports that it has historically faced significant operational issues and financial losses. Prior to the County appointing a new Chief Executive Officer (CEO) in December 2013, the hospital had been losing $3 million per month. Since that time under new leadership, considerable improvements have been achieved. Within five months of the new leadership team being in place, the losses were reduced to $400,000 per month, and within eight months the medical center began generating a profit. Through the 10 months ended April 30, 2015, the net income for KMC is $7,272,956. During the same period last year the hospital reported a net loss of $12,083,046. The $19,356,003 improvement has been achieved through a number of initiatives including replacing management staff, improvements in how the hospital bills and collects, labor productivity management, and renegotiated managed care contracts. The County reports that it has begun pursuing growth opportunities, including physician recruitment in needed specialties, adding new clinics and services, including a medical home model, and enhancing access to care in outpatient clinics, with monthly visits increasing by 40 % over the past year.
Background on plan to transfer KMC to the Authority. Last year, AB 2546 was introduced with the initial plan to form an authority that would combine under a single governance structure both KMC and Kern Health Systems, which is the Local Initiative Medi-Cal managed care plan. In response to concerns regarding the financial implications of a merger of Kern Health Systems with the hospital, AB 2546 was scaled back to follow the precedent that the Legislature had established in previous legislation for Alameda and Monterey counties by allowing the County to establish an authority to govern the county’s medical center. The author and sponsor state that by separating KMC from the County’s governance structure, there will be opportunities for increased flexibility, responsiveness, and innovation that will enable KMC to stabilize financially and continue to meet the needs of the community.
Following the enactment of AB 2546 last year, the County reports that an implementation plan was approved in January 2015. The implementation plan detailed the guiding principles of the transition, a transition plan, a transition budget, and a list of agreements and steps necessary to transition the medical center. The County and KMC formed a Hospital Authority Steering Committee, which is responsible for the overall coordination and implementation of the transfer. The County states that in order to successfully transition KMC from a County department to a hospital authority, KMC has begun to engage with legal and financial consultants to gain an understanding of the mechanics of the transfer of control, assets, liabilities, and personnel of the medical center to the hospital authority. The draft ordinance to enact the hospital authority has been drafted and is in circulation for public review and feedback. The County states it plans on taking the ordinance to the Board of Supervisors for a vote in the fall of 2015 and transferring the medical center, personnel, assets and liabilities from the county to the hospital authority in July 2016.
Double referral. This bill is double referred. Should this bill pass out of this committee, it will be referred to Senate Committee on Governance and Finance.
Prior legislation. AB 2546 authorized the County to establish the Authority to manage, administer, and control KMC, and provided for the Authority’s governance, powers, and procedures.
AB 276 (Alejo, Chapter 686,
Statutes of 2012), authorized the Monterey County Board of
Supervisors to establish the Central Coast Hospital Authority (CCHA),
as specified, and prohibited the board of supervisors from
establishing the CCHA until an agreement to affiliate with at least
one other health care facility is reached.
AB 2374 (Bates,
Chapter 816, Statutes of 1996), authorized the County of Alameda to
establish a hospital authority to manage the respective county
hospitals and county programs of the Alameda County Medical Center.
Support. This bill is supported by the Kern County Board of Supervisors, which states that among other provisions, this bill will ensure that the most current MOU existing at the time that KMC is transferred to the Authority will apply to any County employees who are transferred to the Authority. The County states that other provisions clarify the ability of the Authority to deposit funds in, and borrow funds from, the County treasury, which will allow the Authority to receive temporary cash transfer from the County treasury pool. The County states that this bill also makes needed amendments to treat the Authority as a public employer for purposes of making County employees whose retirement benefits are limited by federal law eligible for the same replacement benefits after transferring to the Authority that would be due to them as County employees. This bill is also supported by the California State Council of the Service Employees International Union (SEIU California), which states that the purpose of last year’s AB 2546 was to ensure a smooth transition of KMC to an authority while preserving key protections for the hospital employees who would be transitioning to a different model of administration within the County. After AB 2546’s enactment, SEIU California states that the need for clarification and clean-up has emerged on several issues related to the transition of KMC into the Authority. Kern Health Systems states in support that it is a partner with KMC in preserving and improving the delivery system that serves California’s uninsured and indigent population, and therefore supports this bill so that these technical changes can be enacted as swiftly as possible, clearing the way for KMC’s transition to a hospital authority.
SUPPORT AND OPPOSITION:
Support: Kern
County Board of Supervisors
Kern Health Systems
Service Employees International
Union, California State Council
Oppose: None received
-- END --
AB 1350
Page 3
ASSEMBLY THIRD READING
AB 1350
(Salas)
As Amended April 28, 2015
Majority vote
Committee |
Votes |
Ayes |
|
Local Government |
9-0 |
Maienschein, Gonzalez, Alejo, Chiu, Cooley, Gordon, Holden, Linder, Waldron |
|
SUMMARY: Makes changes to existing law which authorizes the Kern County Board of Supervisors (Board of Supervisors) to establish the Kern County Hospital Authority (Authority). Specifically, this bill:
Makes a number of changes to existing law which authorizes the Board of Supervisors to establish by ordinance the Authority and to allow for the transfer of the county-run Kern Medical Center (KMC) to the Authority.
Defines "transfer of control of the medical center" to mean "the transfer by Kern County (County) to the Authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the Board of Supervisors in the enabling ordinance."
Adds to the list of terms and conditions the Board of Supervisors may include in the enabling ordinance to transfer control to the Authority from the County, whether funds of the Authority shall be deposited in the custody of, and paid out solely through, the County's treasurer's office.
Changes the effective date from the date the County adopts the enabling ordinance to transfer control to the Authority instead to the actual date of the transfer of control to the Authority in a number of provisions in existing law which require the Authority to be bound by the terms of memoranda of understanding between the County and its employee representatives and in several other provisions that provide protections for employee benefits.
Requires the Authority to be treated as a public employer that offered a plan of replacement benefits prior to January 1, 2013. Provides that the County's plan of replacement benefits that was in effect prior to January 1, 2013, is deemed to be the Authority's replacement plan for the sole purpose of allowing the Authority to continue to offer the plan of replacement benefits, immediately after the transfer for Kern County Employees' Retirement Association members who meet specified requirements.
Authorizes the Authority, if not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, to establish its own treasury.
Provides that the powers granted to the Authority, pursuant to existing law, may be subject to any terms, conditions, and limitations imposed by the County's enabling ordinance.
Adds physicians and other provider types and coverage mechanisms to the list of services, coverage, and programs that the Authority has the same rights as the county with respect to owning, operating, and providing.
Expands the County's authority to issue debt instruments, beyond revenue anticipation notes, to provide by loan or otherwise amounts necessary to the Authority to meets its operating and capital needs.
Provides that existing law, which governs the Authority, shall not be construed to limit the borrowing authority of the County.
Authorizes the Board of Supervisors, as applicable, to hold meetings relating to the Authority's trade secrets, as specified.
Authorizes the Board of Supervisors to contract for services or purchase items on behalf
of the Authority.Provides that the Authority's governing body as authority over procurement and contracts, unless otherwise provided for and subject to the limitations and conditions established in the enabling ordinance. Requires the Authority to adopt written rules, regulations and procedures with regard to procurement and contract functions.
Requires the Authority's ability to contract for personnel or other services and items, as specified, to only be limited by the provisions in this chapter and the Meyers-Milias-Brown Act.
Makes other technical and conforming changes.
Makes minor changes to the findings and declarations.
EXISTING LAW authorizes the Board of Supervisors to establish the Authority, and specifies the Authority's governance, powers, and procedures.
FISCAL EFFECT: None
COMMENTS:
Prior Legislation. Facing escalating costs, some county hospitals have sought to restructure their governance or affiliate with other hospitals in their areas. In these instances, the Legislature has granted several counties the ability to create health authorities, including Alameda [AB 2374 (Bates), Chapter 816, Statues of 1996], Monterey [AB 276 (Alejo), Chapter 686, Statutes of 2012], San Luis Obispo [SB 538 (O'Connell), Chapter 899, Statues of 1999], Santa Barbara, and Sonoma (for dental).
Most recently, the Legislature passed AB 2546 (Salas), Chapter 613, Statues of 2014, which authorized the Board of Supervisors to establish a separate Authority to govern the KMC. AB 2546 contains several provisions to ensure that healthcare services remain accessible to patients regardless of their ability to pay and that the Authority, as a separate entity from the County, will still continue to serve as a hospital. AB 2546 also established requirements for the Authority upon the transfer of KMC employees.
Bill Summary. This bill builds upon the authority granted to the Kern County Board of Supervisors by AB 2546 to establish the Authority and to transfer the medical center to the separate Authority. This bill makes a number of changes to the laws governing the transfer of KMC.
This bill is author-sponsored.
Author's Statement. According to the author, "KMC serves a community of over 650,000 residents, including indigent individuals with no other means of obtaining medical care. KMC provides the only trauma care between Los Angeles and Fresno, and is vital to training physicians through academic residency and education programs.
"A hospital authority allows Kern County to benefit from the cost savings that can be generated by operating under a separate governance structure and provide opportunities for increased flexibility, responsiveness, and innovation. The law established extensive provisions intended to ensure the medical center will continue to provide affordable, high-quality health care services and that medical center employees will have a seamless transition of wages, benefits, and contracts without loss of rights or status. This bill contains technical and clarifying changes to ensure the successful transfer of KMC to an Authority."
Arguments in Support. Supporters argue that this bill makes a number of changes to provide for a smooth and equitable transition of KMC to a hospital authority.
Arguments in Opposition. None on file.
Analysis Prepared by: Misa Lennox / L. GOV. / (916) 319-3958 FN: 0000347
AB 1350
Page 3
Date of Hearing: May 6, 2015
ASSEMBLY COMMITTEE ON LOCAL GOVERNMENT
Brian Maienschein, Chair
AB 1350
(Salas) – As Amended April 28, 2015
SUBJECT: Kern County Hospital Authority.
SUMMARY: Makes changes to existing law which authorizes the Kern County Board of Supervisors (Board of Supervisors) to establish the Kern County Hospital Authority (Authority). Specifically, this bill:
Makes a number of changes to existing law which authorizes the Board of Supervisors to establish by ordinance the Authority and to allow for the transfer of the county-run Kern Medical Center (KMC) to the Authority.
Defines "transfer of control of the medical center" to mean "the transfer by the County to the Authority of the maintenance, operation, management, and personnel of the medical center, whether by lease, transfer of ownership, or other means, as provided by, and subject to, any conditions and limitations specified by the Board of Supervisors in the enabling ordinance."
Adds to the list of terms and conditions the Board of Supervisors may include in the enabling ordinance to transfer control to the Authority from Kern County (County), whether funds of the Authority shall be deposited in the custody of, and paid out solely through, the County's treasurer's office.
Changes the effective date from the date the County adopts the enabling ordinance to transfer control to the Authority instead to the actual date of the transfer of control to the Authority in a number of provisions in existing law which require the Authority to be bound by the terms of memoranda of understanding (MOU) between the County and its employee representatives and in several other provisions that provide protections for employee benefits.
Requires the Authority to be treated as a public employer that offered a plan of replacement benefits prior to January 1, 2013. Provides that the County's plan of replacement benefits that was in effect prior to January 1, 2013, is deemed to be the Authority's replacement plan for the sole purpose of allowing the Authority to continue to offer the plan of replacement benefits, immediately after the transfer for Kern County Employees' Retirement Association members who meet specified requirements.
Authorizes the Authority, if not otherwise required pursuant to the enabling ordinance to deposit its funds in the county treasury, to establish its own treasury.
Provides that the powers granted to the Authority, pursuant to existing law, may be subject to any terms, conditions, and limitations imposed by the County's enabling ordinance.
Adds physicians and other provider types and coverage mechanisms to the list of services, coverage, and programs that the Authority has the same rights as the county with respect to owning, operating, and providing.
Expands the County's authority to issue debt instruments, beyond revenue anticipation notes, to provide by loan or otherwise amounts necessary to the Authority to meets its operating and capital needs.
Provides that existing law, which governs the Authority, shall not be construed to limit the borrowing authority of the County.
Authorizes the Board of Supervisors, as applicable, to hold meetings relating to the Authority's trade secrets, as specified.
Authorizes the Board of Supervisors to contract for services or purchase items on behalf
of the Authority.Provides that the Authority's governing body (Board of Governors) has authority over procurement and contracts, unless otherwise provided for and subject to the limitations and conditions established in the enabling ordinance. Requires the Authority to adopt written rules, regulations and procedures with regard to procurement and contract functions.
Requires the Authority's ability to contract for personnel or other services and items, as specified, to only be limited by the provisions in this chapter and the Meyers-Milias-Brown Act.
Makes other technical and conforming changes.
Makes minor changes to the findings and declarations.
EXISTING LAW authorizes the Board of Supervisors to establish the Authority, and specifies the Authority's governance, powers, and procedures.
FISCAL EFFECT: None
COMMENTS:
Prior Legislation. Facing escalating costs, some county hospitals have sought to restructure their governance or affiliate with other hospitals in their areas. In these instances, the Legislature has granted several counties the ability to create health authorities, including Alameda [AB 2374 (Bates), Chapter 816, Statues of 1996], Monterey [AB 276 (Alejo), Chapter 686, Statutes of 2012], San Luis Obispo [SB 538 (O'Connell), Chapter 899, Statues of 1999], Santa Barbara, and Sonoma (for dental).
Most recently, the Legislature passed AB 2546 (Salas), Chapter 613,
Statues of 2014, which authorized the Board of Supervisors to
establish a separate Authority to govern the County's medical center
(KMC). AB 2546 contains several provisions to ensure that healthcare
services remain accessible to patients regardless of their ability to
pay and that the Authority, as a separate entity from the County,
will still continue to serve as a hospital. AB 2546 also established
requirements for the Authority upon the transfer of KMC employees.
Bill Summary. This bill builds upon the authority granted to the Kern County Board of Supervisors by AB 2546 to establish the Authority and to transfer the medical center to the separate Authority. This bill makes a number of changes to the laws governing the transfer of KMC.
This bill is author-sponsored.
Author's Statement. According to the author, "KMC serves a community of over 650,000 residents, including indigent individuals with no other means of obtaining medical care. KMC provides the only trauma care between Los Angeles and Fresno, and is vital to training physicians through academic residency and education programs.
"A hospital authority allows Kern County to benefit from the cost savings that can be generated by operating under a separate governance structure and provide opportunities for increased flexibility, responsiveness, and innovation. The law established extensive provisions intended to ensure the medical center will continue to provide affordable, high-quality health care services and that medical center employees will have a seamless transition of wages, benefits, and contracts without loss of rights or status. This bill contains technical and clarifying changes to ensure the successful transfer of KMC to an Authority."
Arguments in Support. Supporters argue that this bill makes a number of changes to provide for a smooth and equitable transition of KMC to a hospital authority.
Arguments in Opposition. None on file.
REGISTERED SUPPORT / OPPOSITION:
Support
California State Council of the Service Employees International Union (If Amended)
Kern County Board of Supervisors
Kern Health Systems
Opposition
None on file
Analysis Prepared by: Misa Lennox / L. GOV. / (916) 319-3958
Discussed in Hearing
42SEC
Assembly Floor
59SEC
Assembly Floor
4MIN
Assembly Standing Committee on Local Government
Bill Author
Bill Co-Author(s):