Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 1350


Introduced by Assembly Member Salas

February 27, 2015


An act to amendbegin delete Section 101852end deletebegin insert Sections 101852, 101852.1, 101853, 101853.1, 101855, and 101855.1end insert of the Health and Safety Code, relating tobegin delete the healthend deletebegin insert hospitalend insert authorities.

LEGISLATIVE COUNSEL’S DIGEST

AB 1350, as amended, Salas. Kern County Hospital 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.begin delete The act makes related findings and declarations.end deletebegin insert 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.end insert

begin delete

This bill would make nonsubstantive, technical changes to those findings and declarations.

end delete
begin insert

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.

end insert

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

Section 101852 of the Health and Safety Code
2 is amended to read:

3

101852.  

(a) This chapter shall be known, and may be cited,
4as the Kern County Hospital Authority Act.

5(b) The Legislature finds and declares all of the following:

6(1) Kern Medical Center, an acute care hospital currently
7operated as a constituent department of the County of Kern, is a
8designated public hospital, as defined in subdivision (d) of Section
914166.1 of the Welfare and Institutions Code, and a critical
10component of the state’s health care safety net.

11(2)  A county is authorized under existing law to integrate its
12county hospital services with those of other hospitals into a system
13of community service that offers free choice of hospitals to those
14requiring hospital care, with the objective of eliminating
15discrimination or segregation based on economic disability, so that
16the county hospital and other hospitals in the community share in
17providing services to paying patients and to those who qualify for
18care in public medical care programs. However, in a new era of
P3    1health care delivery, it is necessary to pursue approaches that
2transition beyond acute care-centric orientations.

3(3) The ongoing evolution of the health care environment
4requires public entities providing or arranging health care services
5to pursue innovative health care delivery models that proactively
6improve the quality of patient care services and patient experience,
7efficiently and effectively increase access to needed health care
8 services across the care continuum, provide services in a
9patient-centered manner, and moderate the rate of growth of health
10care expenditures.

11(4) The board of supervisors of the County of Kern has
12determined that providing access to affordable, high-quality health
13care services, and ensuring the full engagement and viability of
14the health care safety net in the county are essential for improving
15the health status of the people of the County of Kern. To further
16this imperative, it is necessary that the Kern Medical Center, while
17continuing as a designated public hospital and maintaining its
18mission, is provided with an organizational and operational
19structure that facilitates and improves its ability to function with
20flexibility, responsiveness, and innovation to promote a
21patient-centric system of care delivery featuring community-based
22care. This can best be accomplished by allowing the operation of
23the Kern Medical Center, along with other health-related resources,
24under a new hospital authority that is able to pursue efforts towards
25a delivery system that embraces population health management
26strategies, is effectively positioned for health plan-provider
27alignment, and maximizes opportunities for employees and
28enhancement of staff morale.

29(5) This chapter is necessary to allow the formation of abegin insert new
30political subdivision, aend insert
public hospitalbegin delete authorityend deletebegin insert authority,end insert for the
31purposes described above.

32begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 101852.1 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
33amended to read:end insert

34

101852.1.  

For purposes of this chapter, the following
35definitions shall apply:

36(a) “Authority” means the Kern Hospital System Authority
37established pursuant to this chapter.

38(b) “Board of supervisors” means the board of supervisors of
39the County of Kern.

P4    1(c) “Board of governors” means the governing body of the
2authority.

3(d) “County” means the County of Kern.

4(e) “Enabling ordinance” means the county ordinance enacted
5by the board of supervisors pursuant to this chapter to establish
6the authority, as it may be amended from time to time.

7(f) “Medical center” means the assets and liabilities comprising
8the Kern Medical Center, including, without limitation, a licensed
9acute care hospital and related public health care programs,
10facilities, care organizations, physician practice plans and delivery
11systems, which may be hospital-based or nonhospital-based, as
12specified by the board of supervisors or the authority now or in
13the future, as the case may be, depending on which entity controls
14the medical center.

begin insert

15(g) “Transfer of control of the medical center” means the
16transfer by the county to the authority of the maintenance,
17operation, management, and personnel of the medical center,
18whether by lease, transfer of ownership, or other means, as
19provided by, and subject to, any conditions and limitations
20specified by the board of supervisors in the enabling ordinance.

end insert
21begin insert

begin insertSEC. 3.end insert  

end insert

begin insertSection 101853 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
22amended to read:end insert

23

101853.  

(a) Pursuant to this chapter, the board of supervisors
24may establish by ordinance the Kern County Hospital Authority,
25which shall be a public agency that is a local unit of government
26separate and apart from the county and any other public entity for
27all purposes. The authority established pursuant to this chapter
28shall file the statement required by Section 53051 of the
29Government Code, and is a public entity for purposes of Division
303.6 (commencing with Section 810) of Title 1 of the Government
31Code.

32(b) The purpose of the authority shall be to do all of the
33following:

34(1) Provide management, administration, and other controls
35consistent with this chapter as needed to operate the medical center
36 and maintain its status as a designated public hospital, as defined
37in subdivision (d) of Section 14166.1 of the Welfare and
38Institutions Code, and for the operation of additional programs,
39clinics and other facilities, care organizations, health care service
40and physician practice plans, and delivery systems that may be
P5    1affiliated or consolidated with the medical center, to ensure the
2viability of the health care safety net in the county in a manner
3consistent with the county’s requirements under Section 17000 of
4the Welfare and Institutions Code.

5(2) Provide management, administration, and other controls
6consistent with this chapter to negotiate and enter into contracts
7to provide or arrange, or provide directly, on a fee-for-service,
8capitated, or other basis, health care services to individuals
9including, but not limited to, those covered under Subchapters
10XVIII (commencing with Section 1395), XIX (commencing with
11Section 1396), and XXI (commencing with Section 1397aa) of
12Chapter 7 of Title 42 of the United States Code, those entitled to
13coverage under private group coverage, private individual coverage,
14including without limitation, coverage through Covered California,
15other publicly supported programs, those employed by public
16agencies or private businesses, and uninsured or indigent
17individuals.

18(c) Subject to the requirements of this chapter, the authority
19shall havebegin insert,end insert and be charged withbegin insert,end insert authority for thebegin delete management,
20administration, and controlend delete
begin insert maintenance, operation, management,
21control, ownership, or leaseend insert
of the medical center and other
22health-related resourcesbegin insert, as provided by the enabling ordinanceend insert.
23The State Department of Health Care Services shall take all
24necessary steps to ensure all of the following:

25(1) The authoritybegin delete is permittedend deletebegin insert has all of the licenses, permits,
26and approvals neededend insert
to operate the medical center.

27(2) The medical center continues its status as a designated public
28hospital to at least the same extent as it would be designated in the
29absence of its transfer to the authority pursuant to this chapter.

30(3) The authority may participate as a contributing public agency
31for all of the purposes specified in Section 433.51 of Title 42 of
32the Code of Federal Regulations, to the extent permitted by federal
33law.

34(d) The board of supervisors, in the enabling ordinance, shall
35establish the terms and conditions of the transfer to the authority
36from the county, including, but not limited to, all of the following:

37(1) Any transfer of real and personal property, assets, and
38liabilities, including, but not limited to, liabilities of the medical
39center determined and assigned by the county for county funds
P6    1previously advanced, but not repaid or otherwise recovered, to
2fund the operations of the medical center.

3(2) Transfer of employees, including any necessary personnel
4transition plan, as specified in Section 101853.1, allocation of
5credit for funded pension assets and responsibility for any unfunded
6pension liabilities under the Kern County Employees’ Retirement
7Association or other retirement plans, and funding of the accrued
8benefits of employees of the authority in the event of withdrawal
9from the plan or dissolution of the authority. Any allocation of
10credit for funded pension assets and responsibility for any unfunded
11pension liabilities with respect to the Kern County Employees’
12Retirement Association must be approved by its governing board
13of retirement after consideration of legal and actuarial analysis,
14and no such allocation may be made that would jeopardize the
15qualified status of the Kern County Employees’ Retirement
16Association under the federal Internal Revenue Code.

17(3) Maintenance, operation, begin delete and management or ownershipend delete
18begin insert management, control, ownership, or leaseend insert of the medical center.

19(4) Transfer of licenses.

begin insert

20(5) Whether funds of the authority shall be deposited in the
21custody of, and paid out solely through, the county treasurer’s
22office.

end insert
begin delete

23(5)

end delete

24begin insert(6)end insert Any other matters as the board of supervisors deems
25necessary, appropriate, or convenient for the conduct of the
26authority’s activities.

27(e) (1) Notwithstanding any other law, a transfer of
28begin delete maintenance, operation, and management or ownership or leaseend delete
29begin insert controlend insert of the medical center to the authority may be made, with
30or without the payment of a purchase price by the authority, and
31otherwise upon the terms and conditions as found necessary by
32the board of supervisors and specified in the enabling ordinance
33to ensure that the transfer will constitute an ongoing material
34benefit to the county and its residents.

35(2) A transfer ofbegin delete the maintenance, operation, and management,
36or ownership or leaseend delete
begin insert controlend insert of the medical center to the authority
37shall not be construed as empowering the authority to transfer any
38ownership interest of the county in any portion of the medical
39center except as otherwise approved by the board of supervisors.

P7    1(3) The authority shall not transfer the maintenance, operation,
2begin delete and management or ownershipend deletebegin insert management, control, ownership,end insert
3 or lease of the medical center to any other person or entity without
4the prior written approval of the board of supervisors. This
5paragraph shall not prevent the county, by ordinance, from allowing
6the disposal of obsolete or surplus equipment, supplies, or
7furnishings of the medical center by the authority.

8(4) With respect tobegin delete theend deletebegin insert itsend insert maintenance, operation,begin delete and
9management or ownershipend delete
begin insert management, control, ownership,end insert or
10lease of the medical center, the authority shall conform to both of
11the following requirements:

12(A) Comply with any applicable requirements of Section
1314000.2 of the Welfare and Institutions Code.

14(B) Comply with any applicable requirements of Section 1442.5.

15(5) The board of supervisors may retain control of the medical
16center physical plant and facilities, as specifically provided for in
17the enabling ordinance or other lawful agreements entered into by
18the board of supervisors. Any lease agreement between the county
19and the authority shall provide that county premises shall not be
20sublet without the approval of the board of supervisors.

21(6) Notwithstanding any other provision of this chapter, and
22whether or not accompanied by a change in licensing, the
23authority’s responsibility for the maintenance, operation,begin delete and
24managementend delete
begin insert management, or controlend insert of the medical center, or any
25ownership or leasehold interest of the authority in the medical
26center, does not relieve the county of the ultimate responsibility
27for indigent care pursuant to Section 17000 of the Welfare and
28Institutions Code.

29(7) For purposes of Article 12 (commencing with Section
3017612.1) of Chapter 6 of Part 5 of Division 9 of the Welfare and
31Institutions Code, and the definition set forth in subdivision (f) of
32Section 17612.2 of the Welfare and Institutions Code, the medical
33center, excluding components that provide predominately public
34health services, and the county are affiliated governmental entities.

35(f) The board of supervisors may contract with the authority for
36the provision of indigent care services on behalf of the county.
37The contract shall specify that county policies, as may be modified
38from time to time and consistent with the county’s obligations
39under Section 17000 of the Welfare and Institutions Code, shall
40be applicable. Notwithstanding any other provision of this chapter,
P8    1the authority shall not undertake any of the county’s obligations
2under Section 17000 of the Welfare and Institutions Code, nor
3shall the authority have an entitlement to receive any revenue for
4the discharge of the county’s obligations, without a written
5agreement with the county. Any contract executed by and between
6the county and the authority shall provide for the indemnification
7of the county by the authority for liabilities as specifically set forth
8in the contract, except that the contract shall include a provision
9that the county shall remain liable for its own negligent acts.
10Indemnification by the authority shall not divest the county from
11its ultimate responsibility for compliance with Section 17000 of
12the Welfare and Institutions Code.

13(g) Unless otherwise agreed to by the authority and the board
14of supervisors, an obligation of the authority, statutory, contractual,
15or otherwise, shall be the obligation solely of the authority and
16shall not be the obligation of the county or any other entity, and
17any contract executed by and between the county and the authority,
18or any other entity and the authority, shall contain a provision that
19liabilities or obligations of the authority with respect to its activities
20pursuant to the contract shall be the liabilities or obligations of the
21authority and shall not be or become the liabilities or obligations
22of the county or the other entity, respectively. An obligation of the
23authority, statutory, contractual, or otherwise, shall not be the
24obligation of the state.

25(h) The authority shall not be a “person” subject to suit under
26the Cartwright Act (Chapter 2 (commencing with Section 16700)
27of Part 2 of Division 7 of the Business and Professions Code).

28(i)  The authority is not subject to the jurisdiction of a local
29agency formation commission pursuant to the
30Cortese-Knox-Hertzberg Local Government Reorganization Act
31of 2000 (Division 3 (commencing with Section 56000) of Title 5
32of the Government Code), or any successor statute.

33(j) The authority is a “district” within the meaning set forth in
34the County Employees Retirement Law of 1937 (Chapter 3
35(commencing with Section 31450) of Part 3 of Division 4 of Title
363 of the Government Code). Employees of the authority are eligible
37to become members or maintain membership, as applicable, in the
38Kern County Employees’ Retirement Association, to the extent
39described in subdivision (g) of Section 101853.1.

P9    1(k) Any determination with respect to the manner in which the
2authority qualifies as a governmental plan sponsor under Section
3414(d) of the Internal Revenue Code shall be limited to relevant
4employee benefits purposes of that code only, and shall not change
5or otherwise modify the authority’s status as a public agency that
6is abegin delete unit of localend deletebegin insert local unit ofend insert government for other purposes
7specified in this chapter.

8begin insert

begin insertSEC. 4.end insert  

end insert

begin insertSection 101853.1 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
9amended to read:end insert

10

101853.1.  

(a) In exercising its powers to employ personnel,
11the authority shall implement, and the board of supervisors shall
12adopt, a personnel transition plan. The personnel transition plan
13shall require all of the following:

14(1) Ongoing communication to employees and recognized
15employee organizations regarding the impact of the transition on
16existing medical center, county, and other health care facility
17employees and employee classifications.

18(2) Meeting and conferring with representatives of affected
19bargaining unit employees on both of the following issues:

20(A) A timeframe for which the transfer of personnel shall occur.

21(B) Specified periods of time during which county or medical
22center employees affected by the establishment of the authority
23may elect to be considered for appointment and exercise
24reinstatement rights, if applicable, to funded, equivalent, vacant
25county positions for which they are qualified and eligible. An
26employee who first elects to remain with the county may
27subsequently seek reinstatement with the authority within 30 days
28of the election to remain with the county and shall be subject to
29the requirements of this article.

30(3) Acknowledgment that the authority, to the extent permitted
31by federal and state law,begin insert and consistent with paragraph (3) of
32subdivision (d),end insert
shall be bound by the terms ofbegin delete theend deletebegin insert thoseend insert
33 memoranda of understanding executed between the county and its
34exclusive employee representatives that are in effect on the date
35begin delete the county adopts the enabling ordinance pursuant to this chapter.end delete
36begin insert of the transfer of control of the medical center to the authority.end insert
37 Subsequent memoranda of understanding with exclusive employee
38representatives shall be subject to approval only by the board of
39governors.

P10   1(4) Communication to the Board of Retirement of the Kern
2County Employees’ Retirement Association or other retirement
3plan of any personnel transition plan, memoranda of understanding,
4or other arrangements that are related to the participation of the
5authority’s employees or the addition of new employees in the
6 retirement plan.

7(b) Implementation of this chapter shall not be a cause for the
8modification of the medical center or county employment benefits.
9begin delete Upon the execution of the enabling ordinance, employeesend delete
10begin insert Employeesend insert of the medical center or county on the date ofbegin delete execution,end delete
11begin insert transfer,end insert who become authority employees, shall retain their
12existing or equivalent classifications and job descriptions upon
13transfer to the authority, comparable pension benefits (if
14permissible pursuant to relevant plan terms), and their existing
15salaries and other benefits that include, but are not limited to,
16accrued and unused vacation, sick leave, personal leave, health
17care, retiree health benefits, and deferred compensation plans. The
18transfer of an employee from the medical center or county shall
19not constitute a termination of employment for purposes of Section
20227.3 of the Labor Code, or employee benefit plans and
21arrangements maintained by the medical center or county, except
22as otherwise provided in the enabling ordinance or personnel
23transition plan, nor shall it be counted as a break in uninterrupted
24employment for purposes of Section 31641 of the Government
25Code with respect to the Kern County Employees’ Retirement
26Association, or state service for purposes of the Public Employees’
27Retirement System (Part 3 (commencing with Section 20000) of
28Division 5 of Title 2 of the Government Code).

29(c) Subject to applicable state law, the authority shall recognize
30the exclusive employee representatives of those authority
31employees who are transferred from the county or medical center
32to the authority pursuant to this chapter.

33(d) In order to stabilize labor and employment relations and
34provide continuity of care and services to the people of the county,
35and notwithstanding any other law, the authority shall do all of the
36following for a period of 24 months after the effective date of the
37transfer ofbegin insert control ofend insert the medical center to the authority:

38(1) Continue to recognize each exclusive employee
39representative of each bargaining unit.

P11   1(2) Continue to provide the same level of employee benefits to
2authority employees, whether the obligation to provide those
3benefits arise out of a memorandum of understanding, or other
4agreements or law.

5(3) Extend and continue to be bound by any existing memoranda
6of understanding covering the terms and conditions of employment
7for employees of the authority, including the level of wages and
8benefits, and any county rules, ordinances, or policies specifically
9identified and incorporated by reference in a memoranda of
10understanding for 24 months or through the term of the
11memorandum of understanding, whichever shall be the longer,
12unless modified by mutual agreement with each of the exclusive
13employee representatives. The authority shall continue to provide
14those pension benefits specified in any memoranda of agreement
15as long as doing so does not conflict with any Kern County
16Employee Retirement Association plan provisions, or federal or
17state law including the County Employees Retirement Law of 1937
18(Chapter 3 (commencing with Section 31450) of Part 3 of Division
194 of Title 3 of the Government Code and the federal Internal
20Revenue Code).

21(4) Meet and confer with the exclusive employee representatives
22to develop processes and procedures to address employee
23disciplinary action taken against permanent employees. If the
24authority terminates, suspends, demotes, or reduces the pay of a
25permanent employee for disciplinary reasons, those actions shall
26only be for cause consistent with state law, and an employee shall
27be afforded applicable due process protections granted to public
28 employees under state law. Permanent employees laid off by the
29authority within six months of the datebegin delete the ordinance is adoptedend delete
30begin insert of the transfer of control of the medical centerend insert shall remain on the
31county reemployment list for two years. Inclusion on the county
32reemployment list is not a guarantee of reemployment. For the
33purposes of this paragraph, the term “permanent employees”
34excludes probationary employees, temporary employees, seasonal
35employees, provisional employees, extra help employees, and per
36diem employees.

37(5) To the extent layoffs occur, and provided that all other
38previously agreed upon factors are equal, ensure that seniority
39shall prevail. The authority shall meet and confer with the exclusive
40employee representatives to address layoff procedures and the
P12   1manner in which, and the extent to which, seniority shall be
2measured for employees who transfer from the medical center or
3county.

4(e) Permanent employees of the medical center or county on
5the effective date of the transfer ofbegin insert control ofend insert the medical center
6to the authority, shall be deemed qualified for employment in
7equivalent positions at the authority, and no other qualifications
8shall be required except as otherwise required by state or federal
9law. Probationary employees on the effective date of the transfer,
10as set forth in this paragraph, shall retain their probationary status
11and rights and shall not be required to serve a new probationary
12or extend their probationary period by reason of the transfer. To
13the extent possible, employees who transfer to equivalent positions
14at the authority shall retain their existing classifications and job
15descriptions, but if there is a dispute over this issue, the authority
16agrees to meet and confer with the exclusive employee
17representatives of the transferred employees.

18(f) Employees who transfer from the medical center or county
19to the authority shall retain the seniority they earned at the medical
20center or county and any benefits or privileges based on the
21seniority.

22(g) Notwithstanding any other law, employees of the authority
23may participate in the Kern County Employees’ Retirement
24Association, operated pursuant to the County Employees
25Retirement Law of 1937 (Chapter 3 (commencing with Section
2631450) of Part 3 of Division 4 of Title 3 of the Government Code)
27as set forth below. However, the authority and employees of the
28authority, or certain designated parts thereof, shall not participate
29in the Kern County Employees’ Retirement Association if the
30board of retirement, in its sole discretion, determines that their
31participation could jeopardize the Kern County Employees’
32Retirement Association’s tax-qualified or governmental plan status
33under federal law, or if a contract or related contract amendment
34proposed by the authority contains any benefit provisions that are
35not specifically authorized by Chapters 3 (commencing with
36Section 31450) and 3.9 (commencing with Section 31899) of Part
373 of Division 4 of Title 3 of the Government Code or Article 4
38(commencing with Section 7522) of Chapter 21 of Division 7 of
39Title 1 of the Government Code, and that the board determines
40would adversely affect the administration of the system. There
P13   1shall not be any individual employee elections regarding
2participation in the Kern County Employees’ Retirement
3Association or other retirement plans except to the extent such
4retirement plans provide for elective employee salary deferral
5contributions in accordance with federal Internal Revenue Code
6rules.

7(1) Employees transferred from the county or medical center to
8the authority who are subject to a memorandum of understanding
9between the authority and an exclusive employee representative,
10as described in paragraphs (2) and (3) of subdivision (d), and who
11were members of the Kern County Employees’ Retirement
12 Association at the time of their transfer of employment, shall
13continue to be a member of the Kern County Employees’
14Retirement Association, retaining service credit earned to the date
15of transfer, to the extent provided for in the applicable
16memorandum of understanding.

17(2) Employees transferred from the county or medical center to
18the authority who are subject to a memorandum of understanding
19between the authority and an exclusive employee representative,
20as described in paragraphs (2) and (3) of subdivision (d), and who
21were not members of the Kern County Employees’ Retirement
22Association at the time of their transfer of employment, shall
23subsequently become a member of the Kern County Employees’
24Retirement Association only to the extent provided for in the
25applicable memorandum of understanding.

26(3) Employees transferred from the county or medical center to
27the authority who are not subject to a memorandum of
28understanding between the authority and an exclusive employee
29representative, as described in paragraphs (2) and (3) of subdivision
30(d), and who were members of the Kern County Employees’
31Retirement Association at the time of their transfer of employment,
32shall continue to be a member of the Kern County Employees’
33Retirement Association, retaining service credit earned to the date
34of transfer, as provided in the enabling ordinance or the personnel
35transition plan.

36(4) Employees transferred from the county or medical center to
37the authority who are not subject to a memorandum of
38understanding between the authority and an exclusive employee
39representative, as described in paragraphs (2) and (3) of subdivision
40(d), and who were not members of the Kern County Employees’
P14   1Retirement Association at the time of their transfer of employment,
2shall subsequently become a member of the Kern County
3Employees’ Retirement Association only to the extent provided
4in the enabling ordinance or the personnel transition plan.

5(5) Employees hired by the authority on or after the effective
6date of thebegin delete enabling ordinanceend deletebegin insert transfer of control of the medical
7centerend insert
shall become a member of the Kern County Employees’
8Retirement Association only to the extent provided in the enabling
9ordinance or personnel transition plan described in subdivision
10(a), or, if subject to a memorandum of understanding between the
11authority and an exclusive employee representative as described
12in paragraphs (2) and (3) of subdivision (d), to the extent provided
13for in the applicable memorandum of understanding.

14(6) begin insert(A)end insertbegin insertend insertNotwithstanding any other law, for purposes of
15California Public Employees’ Pension Reform Act of 2013 (Article
164 (commencing with Section 7522) of Chapter 21 of Division 7
17of Title 1 of the Government Code), an individual who was
18employed by the county or the medical center when it was a
19constituent department of the county, and is a member of the Kern
20County Employees’ Retirement Association or the Public
21Employees’ Retirement System, as set forth in Part 3 (commencing
22with Section 20000) of Division 5 of Title 2 of the Government
23Code,begin insert or current or contingent member of a plan of replacement
24for members whose retirement benefits are limited by Section 415
25of Title 26 of the United States Code as provided in Section 7522.43
26of the Government Code,end insert
prior to January 1, 2013, and who
27transfers, directly or after a break in service of less than six months,
28to the authority, in which the individual continues to be a member
29of either the Kern County Employees’ Retirement Association or
30the Public Employees’ Retirement System, as applicable, shall not
31be deemed to be a new employee or a new member within the
32meaning of Section 7522.04begin insert or 7522.43end insert of the Government Code,
33and shall continue to be subject to the same defined benefit
34formula, as defined in Section 7522.04 of the Government Code,
35begin insert or plan of replacement benefits for members whose retirement
36benefits are limited by Section 415 of Title 26 of the United States
37Code, as provided in Section 7522.43 of the Government Code,end insert
to
38which the member was subject immediately prior to the transfer.

begin insert

39(B) For purposes of Section 7522.43 of the Government Code,
40the authority shall be treated as a public employer that offered a
P15   1plan of replacement benefits for members whose retirement benefits
2are limited by Section 415 of Title 26 of the United States Code
3prior to January 1, 2013, with respect to current or contingent
4members of that plan who were employed by the county or the
5medical center when it was a constituent department of the county
6prior to January 1, 2013, and who transfer, directly or after a
7break in service of less than six months, to the authority and
8continue to be a member of either the Kern County Employees’
9Retirement Association or the Public Employees’ Retirement
10System, as applicable.

end insert

11(h) This chapter shall not prohibit the authority from contracting
12with the Public Employees’ Retirement System, in accordance
13with the requirements of Section 20508 and any other applicable
14provisions of Part 3 (commencing with Section 20000) of Division
155 of Title 2 of the Government Code, for the purpose of providing
16employee participation in that system, or from establishing an
17alternative or supplemental retirement system or arrangement,
18including, but not limited to, deferred compensation arrangements,
19to the extent permitted by law and subject to any applicable
20agreement between the authority and the exclusive employee
21representatives, and as provided in the enabling ordinance or the
22personnel transition plan. Notwithstanding any other law, the
23authority and employees of the authority shall not participate in
24the Public Employees’ Retirement System if the Board of
25Administration of the Public Employees’ Retirement System, in
26its sole discretion, determines that their participation could
27jeopardize the Public Employees’ Retirement System’s
28tax-qualified or governmental plan status under federal law, or if
29a contract or related contract amendment proposed by the authority
30contains any benefit provisions that are not specifically authorized
31by Part 3 (commencing with Section 20000) of Division 5 of Title
322 of the Government Code, and that the board determines would
33adversely affect the administration of the system.

34(i) Provided that this is not inconsistent with anything in this
35chapter, this chapter does not prohibit the authority from
36determining the number of employees, the number of full-time
37equivalent positions, job descriptions, the nature and extent of
38classified employment positions, and salaries of employees.

39begin insert

begin insertSEC. 5.end insert  

end insert

begin insertSection 101855 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
40amended to read:end insert

P16   1

101855.  

(a) begin deleteThe end deletebegin insertSubject to any terms, conditions, and
2limitations as may be imposed by the enabling ordinance, the end insert

3authority, in addition to any other powers granted pursuant to this
4chapter, shall have the following powers:

5(1) To have the duties, privileges, immunities, rights, liabilities,
6and limitations of a local unit of government within the state.

7(2) To have perpetual existence, subject to Article 5
8(commencing with Section 101856).

9(3) To adopt, have, and use a seal, and to alter it at its pleasure.

10(4) To sue and be sued in the name of the authority in all actions
11and proceedings in all courts and tribunals of competent
12jurisdiction.

13(5) To purchase, lease, trade, exchange, or otherwise acquire,
14maintain, hold, improve, mortgage, lease, sell, and dispose of real
15and personal property of any kind necessary or convenient to
16perform its functions and fully exercise its powers.

17(6) To appoint and employbegin insert or otherwise engageend insert a chief executive
18officer and other officers and employees that may be necessary or
19appropriate, including legal counsel, to establish their
20compensation, provide for their health, retirement, and other
21employment benefits, and to define the power and duties of officers
22and employees.

23(7) (A) To incur indebtedness and to borrow money and issue
24bonds evidencing the same, including the authority to issue, from
25time to time, notes and revenue bonds in principal amounts that
26the authority determines to be necessary to provide sufficient funds
27for achieving any of its purposes, including, but not limited to,
28assumption or refinancing of debt service for capital projects
29eligible for Medi-Cal supplemental payments pursuant to Section
3014085.5 of the Welfare and Institutions Code, or any successor or
31modified Medi-Cal debt service reimbursement program, the
32payment ofbegin insert principal andend insert interest on notes and bonds of the
33authority, the establishment of reserves to secure those notes and
34bonds, and all other expenditures of the authority incident to and
35 necessary or convenient to carry out its purposes and powers.

36(B) Any notes, bonds, or other securities issued, and the income
37from them, including any profit from the sale thereof, shall at all
38times be free from taxation by the state or any agency, political
39subdivision, or instrumentality of the state.

P17   1(C) Notwithstanding the provisions of subparagraph (A), for
2any indebtedness, notes, bonds, or other securities that require
3voter approval pursuant to state law, the prior approval of the board
4of supervisors shall be required. Notwithstanding the required prior
5approval of the board of supervisors, any indebtedness incurred,
6or notes, bonds, or other securities issued pursuant to this
7subparagraph shall be the indebtedness, notes, bonds, or securities
8of the authority and not of the county, and the credit of the county
9shall not be pledged or relied upon in any manner in order to incur
10the indebtedness, or issue the notes, bonds, or other securities,
11unless the board of supervisors explicitly authorizes the use of the
12county’s credit. The authority shall reimburse the county for all
13costs associated with the county’s consideration of the
14indebtedness, notes, bonds, or securities, and the authority shall
15defend, indemnify, and hold harmless the county from any and all
16liability, costs, or expenses arising from or related to the
17indebtedness, notes, bonds, or securities.

18(D) Nothing in this section shall preclude the authority from
19repayment of its debts or other liabilities, using funds that are not
20otherwise encumbered.

21(8) To pursue its own credit rating.

22(9) To enter intobegin delete a contract or agreementend deletebegin insert one or more contracts
23or agreementsend insert
consistent with this chapterbegin delete or theend deletebegin insert and other
24applicableend insert
laws of this state, including, but not limited to,
25contracting with any public or private entity or person for
26management or other services and personnel, and to authorize the
27chief executive officer to enter into contracts, execute all
28instruments, and do all things necessary or convenient in the
29exercise of the powers granted in this chapter.

30(10) To purchase supplies, equipment, materials, property, and
31services.

32(11) To establish policies relating to its purposes.

33(12) To acquire or contract to acquire, rights-of-way, easements,
34privileges, and property, and to construct, equip, maintain, and
35operate any and all works or improvements wherever located that
36are necessary, convenient, or proper to carry out any of the
37provisions, objects, or purposes of this chapter, and to complete,
38extend, add to, repair, or otherwise improve any works or
39improvements acquired by it.

P18   1(13) To participate in, contract for, and to accept, gifts, grants,
2and loans of funds, property, or other aid or finance opportunity
3in any form from the federal government, the state, a state agency,
4or other source, or combination thereof, as otherwise would be
5available to a public, government, or private entity, and to comply,
6subject to this chapter, with the terms and conditions thereof.

7(14) begin deleteTo end deletebegin insertIf not otherwise required pursuant to the enabling
8ordinance to deposit its funds in the county treasury, the authority
9may establish its own treasury, end insert
invest surplus money in its own
10treasury, manage investments, and engage third-party investment
11managers, in accordance with state law.

12(15) To arrange for guarantees or insurance of its bonds, notes,
13or other obligations by the federal or state government or by a
14private insurer, and to pay the premiums thereof.

15(16) To engage in managed care contracting, joint ventures,
16affiliations with other health care facilities, other health care
17providers and payers, management agreements, or to participate
18in alliances, purchasing consortia, health insurance pools,
19accountable care organizations, alternative delivery systems, or
20other cooperative arrangements, with any public or private entity.

21(17) To enter into joint powers agreements pursuant to Chapter
225 (commencing with Section 6500) of Division 7 of Title 1 of the
23Government Code. Notwithstanding any other law, the authority
24may enter into a joint powers agreement as described in Section
256523.5 of the Government Code as though that section applied to
26hospitals and other health care facilities in the County of Kern.

27(18) To establish nonprofit, for-profit, or other entities necessary
28to carry out the duties of the authority.

29(19) To elect to transfer funds to the state and incur certified
30public expenditures in support of the Medi-Cal program and other
31programs for which federal financial participation is available.

32(20) To use a computerized management information system,
33including an electronic health records system, in connection with
34its operations, including, without limitation the administration of
35its facilities.

36(21) To request that the board of supervisors levy a tax on behalf
37of the authority. If the board of supervisors approves the proposal
38to levy the tax, it shall call the election to seek voter approval and
39place the appropriate measure on the ballot for that election. The
40proceeds of these taxes shall be tax proceeds of the authority and
P19   1not of the county. The authority shall reimburse the county for all
2costs associated with the county’s consideration of those taxes,
3and shall defend, indemnify, and hold harmless the county from
4any liability, costs, or expenses arising from or related to the
5imposition of these taxes.

6(22) Notwithstanding the provisions of this chapter relating to
7the obligations and liabilities of the authority, or any other law, a
8transfer of controlbegin delete or ownershipend delete of the medical center to the
9authority pursuant to this chapter shall confer onto the authority
10all the rights, privileges, and authority set forth in state law to own,
11operate, and provide coverage and services through hospitals,
12clinics and other health facilities, health programs, care
13organizations, physician practice plans, delivery systems, health
14care service plans, and other coverage mechanisms that may be
15owned or operated by a county.

16(23) To engage in other activities that may be in the best interests
17of the authority and the persons served by the authority, as
18determined by the board of governors, in order to respond to
19changes in the health care industry.

20(b) The authority shall conform to the following requirements:

21(1) (A) Be a government agency that is a local unit of
22government separate and apart for all purposes from the county
23and any other public entity, and shall not be considered to be an
24agency, division, or department of the county or any other public
25entity. The authority shall not be governed by or subject to the
26civil service requirements of the county.begin delete Exceptend deletebegin insert Notwithstanding
27any other law, exceptend insert
as otherwise provided for in the enabling
28ordinancebegin delete consistent withend deletebegin insert enacted pursuant toend insert this chapter, and as
29set forth in Section 101853.1 relating to the personnel transition
30plan, the authority shall not be governed by, or subject to, other
31policies or operational rulesbegin delete ofend deletebegin insert applicable toend insert the county,begin insert theend insert
32 medical centerbegin insert prior to its transferend insert, or any other public entity,
33including, but not limited to, those relating to personnel and
34procurement.

35(B) The board of governors shall adopt written rules, regulations,
36and procedures with regard to basic human resource functions not
37inconsistent with memoranda of understanding covering employees
38represented by employee organizations or the provisions of this
39chapter. Until the time that the board of governors adopts its own
40rules, regulations, or procedures with regard to these functions,
P20   1the existing rules, regulations, and procedures set forth in any
2memoranda of understanding described in Section 101853.1, and
3the rules and regulations adopted by the county and described in
4paragraph (4), shall continue to apply.

5(2) Be subject to state and federal taxation laws that are
6applicable to public entities generally.

7(3) Except as otherwise specifically provided in this chapter,
8comply with the Meyers-Milias-Brown Act (Chapter 10
9(commencing with Section 3500) of Division 4 of Title 1 of the
10Government Code), the Public Records Act (Chapter 3.5
11(commencing with Section 6250) of Division 7 of Title 1 of the
12 Government Code), and the Ralph M. Brown Act (Chapter 9
13(commencing with Section 54950) of Part 1 of Division 2 of Title
145 of the Government Code).

15(4) Be subject to the jurisdiction of the Public Employment
16Relations Board. Until the authority adopts rules and regulations
17pursuant to subdivision (a) of Section 3507 of the Government
18Code, the existing rules adopted by the county and contained in
19the county’s employer-employee relations resolution, as amended,
20shall apply, modified to account for the creation of the authority,
21and provided further that the resolution shall not contain any
22incorporation of the county’s civil service rules or county
23ordinances unless specifically addressed in this chapter.

24(5) Carry professional and general liability insurance or
25programs to the extent sufficient to cover its activities.

26(6) Comply with the requirements of Sections 53260 and 53261
27of the Government Code.

28(7) Maintain financial and accounting records.

29(8) Meet all local, state, and federal data reporting requirements.

30(c) begin insert(1)end insertbegin insertend insertSubject to any restrictions applicable to public agencies,
31and subject to any limitations or conditions set forth in the enabling
32ordinance adopted by the board of supervisors, the authority may
33borrow money from the county, repay debt it owes to the county,
34and use the borrowed funds to provide for its operating and capital
35needs. The county may lend the authority fundsbegin delete or issueend deletebegin insert and may
36issue debt instruments, including, without limitation,end insert
revenue
37anticipation notes to obtainbegin delete thoseend delete fundsbegin insert to provide, by loan or
38otherwise, amountsend insert
necessarybegin insert for the authorityend insert to meet its operating
39begin delete orend deletebegin insert andend insert capital needs.

begin insert

P21   1(2) Notwithstanding paragraph (1), nothing in this chapter shall
2be construed to limit the borrowing powers the county otherwise
3has under law for the purposes specified in paragraph (1) or any
4other purposes.

end insert

5(d) Open sessions of the authority shall constitute official
6proceedings authorized by law within the meaning of Section 47
7of the Civil Code. The privileges set forth in that section with
8respect to official proceedings shall apply to open sessions of the
9authority.

10(e) (1) Notwithstanding any other law, the board of governors
11may order that a meeting held solely for the purpose of discussion
12or taking action on authority trade secrets, as defined in subdivision
13(d) of Section 3426.1 of the Civil Code, or to consider and take
14action on matters pertaining to contracts and contract negotiations
15concerning all matters related to rates of payment for health care
16services arranged or provided by the authority, shall be held in
17closed session. Trade secrets for purposes of this chapter shall also
18include information for which the secrecy of the information is
19necessary for the authority to initiate a new service, program,
20marketing strategy, business plan, or technology, or to add a benefit
21or product, and premature disclosure of the trade secret would
22create a substantial probability of depriving the authority of a
23substantial economic benefit or opportunity.

24(2) The requirements of making a public report of actions taken
25in closed session and the vote or abstention of every member
26present may be limited to a brief general description devoid of the
27information constituting the trade secret or concerning the matters
28related to rates of payment.

29(3) Those records of the authority that reveal the authority’s
30trade secrets are exempt from disclosure pursuant to the California
31Public Records Act (Chapter 3.5 (commencing with Section 6250)
32of Division 7 of Title 1 of the Government Code), or any similar
33local law requiring the disclosure of public records. This exemption
34shall apply for a period of two years after the service, program,
35marketing strategy, business plan, technology, benefit, or product
36that is the subject of the trade secret is formally adopted by the
37governing body of the authority, provided that the service, program,
38marketing strategy, business plan, technology, benefit, or product
39continues to be a trade secret. The board of governors may delete
40the portion or portions containing trade secrets from any documents
P22   1that were finally approved in the closed session that are provided
2to persons who have made the timely or standing request.

3(4) This chapter shall not prevent the board of governors from
4meeting in closed session as otherwise provided by law.

5(f) Notwithstanding any other law, those records of the authority
6and of the county that reveal the authority’s rates of payment for
7health care services arranged or provided by the authority or its
8deliberative processes, strategies, discussions, communications,
9or any other portion of the negotiations with providers of health
10care services or Medi-Cal, health care plans, or other payers for
11rates of payment, shall not be required to be disclosed pursuant to
12the California Public Records Act (Chapter 3.5 (commencing with
13Section 6250) of Division 7 of Title 1 of the Government Code),
14or any similar local law requiring the disclosure of public records.
15However, three years after a contract or amendment to a contract
16is fully executed, the portion of the contract or amendment
17containing the rates of payment shall be open to inspection.

18(g) The authority shall be a public agency that is a local unit of
19government for purposes of eligibility with respect to grants and
20other funding and loan guarantee programs. Contributions to the
21authority shall be tax deductible to the extent permitted by state
22and federal law. Nonproprietary income of the authority shall be
23exempt from state income taxation.

24(h) Unless otherwise provided by the board of supervisors by
25way of resolution, the authority is empowered, or the board of
26supervisors is empowered on behalf of the authority, to apply as
27a public agency for one or more licenses for the provision of health
28care or the operation of a health care service plan pursuant to
29statutes and regulations governing licensing as currently written
30or subsequently amended.

31(i) The statutory authority of a board of supervisors to prescribe
32rules that authorize a county hospital to integrate its services with
33those of other providers into a system of community service that
34offers free choice of hospitals to those requiring hospital care, as
35set forth in Section 14000.2 of the Welfare and Institutions Code,
36shall apply to the authority and the board of governors.

37(j) (1) Except as otherwise provided in this chapter, provisions
38of the Evidence Code, the Government Code, including the Public
39Records Act (Chapter 3.5 (commencing with Section 6250) of
40Division 7 of Title 1 of the Government Code), the Civil Code,
P23   1the Business and Professions Code, and other applicable law
2pertaining to the confidentiality of peer review activities of peer
3review bodies shall apply to the peer review activities of the
4authority, or any peer review body, as defined in paragraph (1) of
5subdivision (a) of Section 805 of the Business and Professions
6Code, formed pursuant to the powers granted to the authority. The
7laws pertaining to the confidentiality of peer review activities shall
8be together construed as extending, to the extent permitted by law,
9the maximum degree of protection of confidentiality.

10(2) Notwithstanding Article 9 (commencing with Section 11120)
11of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9
12(commencing with Section 54950) of Part 1 of Division 2 of Title
135 of, the Government Code, or any other provision of law, any
14peer review body formed pursuant to the powers granted to the
15authority, may, at its discretion and without notice to the public,
16meet in closed session, so long as the purpose of the meeting is
17the peer review body’s discharge of its responsibility to evaluate
18and improve the quality of care rendered by health facilities and
19health practitioners. The peer review body and its members shall
20receive, to the fullest extent, all immunities, privileges, and
21protections available to those peer review bodies, their individual
22members, and persons or entities assisting in the peer review
23process, including those afforded by Section 1157 of the Evidence
24Code and Section 1370. Peer review proceedings shall constitute
25an official proceeding authorized by law within the meaning of
26Section 47 of the Civil Code and those privileges set forth in that
27section with respect to official proceedings shall apply to peer
28review proceedings of the authority.

29(3) Notwithstanding the California Public Records Act (Chapter
303.5 (commencing with Section 6250) of Division 7 of Title 1 of
31the Government Code), or Article 9 (commencing with Section
3211120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and
33Chapter 9 (commencing with Section 54950) of Part 1 of Division
342 of Title 5 of, the Government Code, or any other provision of
35state or local law requiring disclosure of public records, those
36records of a peer review body formed pursuant to the powers
37granted to the authority, shall not be required to be disclosed. The
38records and proceedings of the peer review body and its individual
39members shall receive, to the fullest extent, all immunities,
40privileges, and protections available to those records and
P24   1proceedings, including those afforded by Section 1157 of the
2Evidence Code and Section 1370 of the Health and Safety Code.

3(4) If the authority is required by law or contractual obligation
4to submit to the state or federal government peer review
5information or information relevant to the credentialing of a
6participating provider, that submission shall not constitute a waiver
7of confidentiality.

8(5) Notwithstanding any other law, Section 1461 shall apply to
9hearings on reports of hospital medical audit or quality assurance
10committees.

11(k) Except as expressly provided by other provisions of this
12section, all exemptions and exclusions from disclosure as public
13records pursuant to this chapter and the California Public Records
14Act, including, but not limited to, those pertaining to trade secrets
15and information withheld in the public interest, shall be fully
16applicable to the authority, and for the board of supervisors, and
17 all state and local agencies with respect to all writings that the
18authority is required to prepare, produce, or submit, and which
19shall not constitute a waiver of exemption from disclosure.

20(l) The authority and the county, or any combination thereof,
21may engage in marketing, advertising, and promotion of the
22medical and health care services made available to the community
23by the authority.

begin delete

24(m) The

end delete

25begin insert(m)end insertbegin insertend insertbegin insert(1)end insertbegin insertend insertbegin insertThe board of supervisors may contract for services or
26purchase items on behalf of the authority.end insert

27begin insert(2)end insertbegin insertend insertbegin insertUnless otherwise provided for, and subject to the limitations
28and conditions set forth in the enabling ordinance, the end insert
board of
29governors shall have authority over procurement and contracts for
30the begin delete authority. The board of governorsend delete begin insert authority andend insert shall adopt
31written rules, regulations, and procedures with regard to these
32functions.begin delete Contractsend deletebegin insert The authority’s ability to contract for
33personnel or other services and items it deems necessary,
34appropriate, or convenient for the conduct of its activities
35consistent with its purposes shall only be limited by the provisions
36in this chapter and obligations under the Meyers-Milias-Brown
37Act (Chapter 10 (commencing with Section 3500) of Division 4 of
38Title 1 of the Government Code).end insert

39begin insert(3)end insertbegin insertend insertbegin insertContractsend insert by and between the authority and a public agency,
40and contracts by and between the authority and providers of health
P25   1care, goods, or services, may be let on a nonbid basis and shall be
2exempt from Chapter 2 (commencing with Section 10290) of Part
32 of Division 2 of the Public Contract Code.

4(n) The authority may contract with the county for services and
5personnel upon mutually agreeable terms.

6(o) Notwithstanding Article 4.7 (commencing with Section
71125) of Chapter 1 of Division 4 of Title 1 of the Government
8Code, related to incompatible activities, Section 1099 of the
9Government Code, related to incompatible offices, or any other
10law, a member of the authority’s administrative staff shall not be
11considered to hold an incompatible office or to be engaged in
12activities inconsistent and incompatible with his or her duties as
13a result of his or her employment or affiliation with the county or
14an agency of the county.

15(p) The board of governors and the officers and employees of
16the authority are public employees for purposes of Division 3.6
17(commencing with Section 810) of Title 1 of the Government
18Code, relating to claims and actions against public entities and
19public employees, and shall be protected by the immunities
20applicable to public entities and public employees governed by
21Part 2 (commencing with Section 814) of Division 3.6 of Title 1
22of the Government Code, except as provided by other statutes or
23regulations that apply expressly to the authority.

24begin insert

begin insertSEC. 6.end insert  

end insert

begin insertSection 101855.1 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
25amended to read:end insert

26

101855.1.  

(a) Transferbegin delete by the county to the authority of the
27maintenance, operation, and management or ownershipend delete
begin insert of controlend insert
28 of the medical center, whether or not the transfer includes the
29surrendering by the county of the existing general acute care
30hospital license and corresponding application for a change of
31ownership of the license, shall not affect the eligibility of the
32county to undertake, and shall authorize the authority, subject to
33applicable requirements, to do any of the following:

34(1) With the written consent of the county, participate in and
35receive allocations pursuant to the California Health Care for
36Indigents Program pursuant to Chapter 5 (commencing with
37Section 16940) of Part 4.7 of Division 9 of the Welfare and
38Institutions Code, or similar programs, as may be identified or
39earmarked by the county for indigent health care services of the
40type provided by the medical center.

P26   1(2) With the written consent of the county, participate in and
2receive allocations of local revenue fund amounts provided
3pursuant to Chapter 6 (commencing with Section 17600) of Part
45 of Division 9 of the Welfare and Institutions Code as may be
5identified or earmarked by the county for indigent health care
6services of the type provided by the medical center.

7(3) Participate in the financing of, as applicable, and receive,
8Medicaid disproportionate share hospital payments available to a
9county hospital or designated public hospital, or any other
10successor or modified payment or funding that is intended to assist
11hospitals that serve a disproportionate share of low-income patients
12with special needs. The allocation of Medicaid disproportionate
13share hospital payments shall be made in consultation with the
14State Department of Health Care Services and other designated
15safety net hospitals.

16(4) Participate in the financing of, as applicable, and receive,
17Medi-Cal payments and supplemental reimbursements, including,
18but not limited to, payments made pursuant to Sections 14105.96,
1914105.965, 14166.4, 14182.15, and 14199.2 of the Welfare and
20Institutions Code, payments described in paragraph (4) of
21subdivision (b) of Section 14301.4 of, and Section 14301.5 of, the
22Welfare and Institutions Code, and payments made available to a
23county provider or designated public hospital, or governmental
24entity with which it is affiliated, under any other successor or
25modified Medicaid payment system.

26(5) Participate in the financing of, as applicable, and receive,
27safety net care pool funding, stabilization funding, delivery system
28reform incentive pool payments, and any other funding available
29to a county provider or designated public hospital, or governmental
30entities with which it is affiliated under the Medicaid demonstration
31project authorized pursuant to Article 5.2 (commencing with
32Section 14166) and Article 5.4 (commencing with Section 14180)
33of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
34Code, or under any other successor or modified Medicaid
35demonstration project or Medicaid payment system. The allocation
36of safety net care pool funds shall be made in consultation with
37the State Department of Health Care Services and other designated
38safety net hospitals.

39(6) Participate in the financing, administration, and provision
40of services under the Low Income Health Program authorized
P27   1pursuant to Part 3.6 (commencing with Section 15909) of Division
29 of the Welfare and Institutions Code, or under any other successor
3or modified Medicaid demonstration project or Medicaid payment
4system if the authority enters into an agreement with the county
5concerning the provision of services by, and payment for these
6services to, the county.

7(7) Participate in and receive direct grant and payment
8allocations pursuant to Article 5.230 (commencing with Section
914169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and
10Institutions Code, or under any other successor or modified direct
11grant and payment systems funded by hospital or other provider
12fee assessments.

13(8) Receive Medi-Cal capital supplements pursuant to Section
1414085.5 of the Welfare and Institutions Code, or any other
15successor or modified Medi-Cal debt service reimbursement
16 program. Notwithstanding any other law, supplemental payments
17shall be made to the medical center under those programs for the
18debt service costs incurred by the county, and, if applicable, by
19the authority to the extent that debt service responsibility is
20refinanced, transferred to, or otherwise assumed by, directly or
21indirectly, the authority.

22(9) Receive any other funds, or preference in the assignment of
23health care plan enrollees, that would otherwise be available to a
24county health plan, provider, or designated public hospital, or
25governmental entity with which it is affiliated.

26(b) The transfer ofbegin insert control ofend insert the medical center to the authority
27pursuant to this chapter shall not otherwise disqualify the county
28or the authority from participating in any of the following:

29(1) Local, state, and federal funding sources either specific to
30county or other publicly owned or operated health care service
31plans, hospitals, or other health care providers, including, but not
32limited to, ambulatory care clinics, health systems, practices,
33designated public hospitals, or governmental entities with which
34they are affiliated, for which there are special provisions specific
35to those plans, hospitals, ambulatory care clinics, health systems,
36practices, other health care providers or governmental entities with
37which they are affiliated.

38(2) All funding programs in which the county, by itself or on
39behalf of the medical center had participated prior to the creation
40of the authority, or would otherwise be qualified to participate in
P28   1had the authority not been created, and the maintenance, operation,
2begin delete and management or ownershipend deletebegin insert management, control, ownership,
3or leaseend insert
of the medical center not been transferred to the authority
4pursuant to this chapter.



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