Amended in Assembly April 28, 2015

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 amend Sections 101852, 101852.1, 101853, 101853.1, 101855, and 101855.1 of the Health and Safety Code, relating to hospital 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. 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, asbegin delete specified.end deletebegin insert 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.end insert 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.

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
P3    1providing services to paying patients and to those who qualify for
2care in public medical care programs. However, in a new era of
3health care delivery, it is necessary to pursue approaches that
4transition beyond acute care-centric orientations.

5(3) The ongoing evolution of the health care environment
6requires public entities providing or arranging health care services
7to pursue innovative health care delivery models that proactively
8improve the quality of patient care services and patient experience,
9efficiently and effectively increase access to needed health care
10 services across the care continuum, provide services in a
11patient-centered manner, and moderate the rate of growth of health
12care expenditures.

13(4) The board of supervisors of the County of Kern has
14determined that providing access to affordable, high-quality health
15care services, and ensuring the full engagement and viability of
16the health care safety net in the county are essential for improving
17the health status of the people of the County of Kern. To further
18this imperative, it is necessary that the Kern Medical Center, while
19continuing as a designated public hospital and maintaining its
20mission, is provided with an organizational and operational
21structure that facilitates and improves its ability to function with
22flexibility, responsiveness, and innovation to promote a
23patient-centric system of care delivery featuring community-based
24care. This can best be accomplished by allowing the operation of
25the Kern Medical Center, along with other health-related resources,
26under a new hospital authority that is able to pursue efforts towards
27a delivery system that embraces population health management
28strategies, is effectively positioned for health plan-provider
29alignment, and maximizes opportunities for employees and
30enhancement of staff morale.

31(5) This chapter is necessary to allow the formation of a new
32political subdivision, a public hospital authority, for the purposes
33described above.

34

SEC. 2.  

Section 101852.1 of the Health and Safety Code is
35amended to read:

36

101852.1.  

For purposes of this chapter, the following
37definitions shall apply:

38(a) “Authority” means the Kern Hospital System Authority
39established pursuant to this chapter.

P4    1(b) “Board of supervisors” means the board of supervisors of
2the County of Kern.

3(c) “Board of governors” means the governing body of the
4authority.

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

6(e) “Enabling ordinance” means the county ordinance enacted
7by the board of supervisors pursuant to this chapter to establish
8the authority, as it may be amended from time to time.

9(f) “Medical center” means the assets and liabilities comprising
10the Kern Medical Center, including, without limitation, a licensed
11acute care hospital and related public health care programs,
12facilities, care organizations, physician practice plans and delivery
13systems, which may be hospital-based or nonhospital-based, as
14specified by the board of supervisors or the authority now or in
15the future, as the case may be, depending on which entity controls
16the medical center.

17(g) “Transfer of control of the medical center” means the transfer
18by the county to the authority of the maintenance, operation,
19management, and personnel of the medical center, whether by
20lease, transfer of ownership, or other means, as provided by, and
21subject to, any conditions and limitations specified by the board
22of supervisors in the enabling ordinance.

23

SEC. 3.  

Section 101853 of the Health and Safety Code is
24amended to read:

25

101853.  

(a) Pursuant to this chapter, the board of supervisors
26may establish by ordinance the Kern County Hospital Authority,
27which shall be a public agency that is a local unit of government
28separate and apart from the county and any other public entity for
29all purposes. The authority established pursuant to this chapter
30shall file the statement required by Section 53051 of the
31Government Code, and is a public entity for purposes of Division
323.6 (commencing with Section 810) of Title 1 of the Government
33Code.

34(b) The purpose of the authority shall be to do all of the
35following:

36(1) Provide management, administration, and other controls
37consistent with this chapter as needed to operate the medical center
38 and maintain its status as a designated public hospital, as defined
39in subdivision (d) of Section 14166.1 of the Welfare and
40Institutions Code, and for the operation of additional programs,
P5    1clinics and other facilities, care organizations, health care service
2and physician practice plans, and delivery systems that may be
3affiliated or consolidated with the medical center, to ensure the
4viability of the health care safety net in the county in a manner
5consistent with the county’s requirements under Section 17000 of
6the Welfare and Institutions Code.

7(2) Provide management, administration, and other controls
8consistent with this chapter to negotiate and enter into contracts
9to provide or arrange, or provide directly, on a fee-for-service,
10capitated, or other basis, health care services to individuals
11including, but not limited to, those covered under Subchapters
12XVIII (commencing with Section 1395), XIX (commencing with
13Section 1396), and XXI (commencing with Section 1397aa) of
14Chapter 7 of Title 42 of the United States Code, those entitled to
15coverage under private group coverage, private individual coverage,
16including without limitation, coverage through Covered California,
17other publicly supported programs, those employed by public
18agencies or private businesses, and uninsured or indigent
19individuals.

20(c) Subject to the requirements of this chapter, the authority
21shall have, and be charged with, authority for the maintenance,
22operation, management, control, ownership, or lease of the medical
23center and other health-related resources, as provided by the
24enabling ordinance. The State Department of Health Care Services
25shall take all necessary steps to ensure all of the following:

26(1) The authority has all of the licenses, permits, and approvals
27needed to operate the medical center.

28(2) The medical center continues its status as a designated public
29hospital to at least the same extent as it would be designated in the
30absence of its transfer to the authority pursuant to this chapter.

31(3) The authority may participate as a contributing public agency
32for all of the purposes specified in Section 433.51 of Title 42 of
33the Code of Federal Regulations, to the extent permitted by federal
34law.

35(d) The board of supervisors, in the enabling ordinance, shall
36establish the terms and conditions of the transfer to the authority
37from the county, including, but not limited to, all of the following:

38(1) Any transfer of real and personal property, assets, and
39liabilities, including, but not limited to, liabilities of the medical
40center 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, management, control, ownership,
18or lease of the medical center.

19(4) Transfer of licenses.

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

23(6) Any other matters as the board of supervisors deems
24necessary, appropriate, or convenient for the conduct of the
25authority’s activities.

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

33(2) A transfer of control of the medical center to the authority
34shall not be construed as empowering the authority to transfer any
35ownership interest of the county in any portion of the medical
36center except as otherwise approved by the board of supervisors.

37(3) The authority shall not transfer the maintenance, operation,
38management, control, ownership, or lease of the medical center to
39any other person or entity without the prior written approval of
40the board of supervisors. This paragraph shall not prevent the
P7    1county, by ordinance, from allowing the disposal of obsolete or
2surplus equipment, supplies, or furnishings of the medical center
3by the authority.

4(4) With respect to its maintenance, operation, management,
5control, ownership, or lease of the medical center, the authority
6shall conform to both of the following requirements:

7(A) Comply with any applicable requirements of Section
814000.2 of the Welfare and Institutions Code.

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

10(5) The board of supervisors may retain control of the medical
11center physical plant and facilities, as specifically provided for in
12the enabling ordinance or other lawful agreements entered into by
13the board of supervisors. Any lease agreement between the county
14and the authority shall provide that county premises shall not be
15sublet without the approval of the board of supervisors.

16(6) Notwithstanding any other provision of this chapter, and
17whether or not accompanied by a change in licensing, the
18authority’s responsibility for the maintenance, operation,
19management, or control of the medical center, or any ownership
20or leasehold interest of the authority in the medical center, does
21not relieve the county of the ultimate responsibility for indigent
22care pursuant to Section 17000 of the Welfare and Institutions
23Code.

24(7) For purposes of Article 12 (commencing with Section
2517612.1) of Chapter 6 of Part 5 of Division 9 of the Welfare and
26Institutions Code, and the definition set forth in subdivision (f) of
27Section 17612.2 of the Welfare and Institutions Code, the medical
28center, excluding components that provide predominately public
29health services, and the county are affiliated governmental entities.

30(f) The board of supervisors may contract with the authority for
31the provision of indigent care services on behalf of the county.
32The contract shall specify that county policies, as may be modified
33from time to time and consistent with the county’s obligations
34under Section 17000 of the Welfare and Institutions Code, shall
35be applicable. Notwithstanding any other provision of this chapter,
36the authority shall not undertake any of the county’s obligations
37under Section 17000 of the Welfare and Institutions Code, nor
38shall the authority have an entitlement to receive any revenue for
39the discharge of the county’s obligations, without a written
40agreement with the county. Any contract executed by and between
P8    1the county and the authority shall provide for the indemnification
2of the county by the authority for liabilities as specifically set forth
3in the contract, except that the contract shall include a provision
4that the county shall remain liable for its own negligent acts.
5Indemnification by the authority shall not divest the county from
6its ultimate responsibility for compliance with Section 17000 of
7the Welfare and Institutions Code.

8(g) Unless otherwise agreed to by the authority and the board
9of supervisors, an obligation of the authority, statutory, contractual,
10or otherwise, shall be the obligation solely of the authority and
11shall not be the obligation of the county or any other entity, and
12any contract executed by and between the county and the authority,
13or any other entity and the authority, shall contain a provision that
14liabilities or obligations of the authority with respect to its activities
15pursuant to the contract shall be the liabilities or obligations of the
16authority and shall not be or become the liabilities or obligations
17of the county or the other entity, respectively. An obligation of the
18authority, statutory, contractual, or otherwise, shall not be the
19obligation of the state.

20(h) The authority shall not be a “person” subject to suit under
21the Cartwright Act (Chapter 2 (commencing with Section 16700)
22of Part 2 of Division 7 of the Business and Professions Code).

23(i)  The authority is not subject to the jurisdiction of a local
24agency formation commission pursuant to the
25Cortese-Knox-Hertzberg Local Government Reorganization Act
26of 2000 (Division 3 (commencing with Section 56000) of Title 5
27of the Government Code), or any successor statute.

28(j) The authority is a “district” within the meaning set forth in
29the County Employees Retirement Law of 1937 (Chapter 3
30(commencing with Section 31450) of Part 3 of Division 4 of Title
313 of the Government Code). Employees of the authority are eligible
32to become members or maintain membership, as applicable, in the
33Kern County Employees’ Retirement Association, to the extent
34described in subdivision (g) of Section 101853.1.

35(k) Any determination with respect to the manner in which the
36authority qualifies as a governmental plan sponsor under Section
37414(d) of the Internal Revenue Code shall be limited to relevant
38employee benefits purposes of that code only, and shall not change
39or otherwise modify the authority’s status as a public agency that
P9    1is a local unit of government for other purposes specified in this
2chapter.

3

SEC. 4.  

Section 101853.1 of the Health and Safety Code is
4amended to read:

5

101853.1.  

(a) In exercising its powers to employ personnel,
6the authority shall implement, and the board of supervisors shall
7adopt, a personnel transition plan. The personnel transition plan
8shall require all of the following:

9(1) Ongoing communication to employees and recognized
10employee organizations regarding the impact of the transition on
11existing medical center, county, and other health care facility
12employees and employee classifications.

13(2) Meeting and conferring with representatives of affected
14bargaining unit employees on both of the following issues:

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

16(B) Specified periods of time during which county or medical
17center employees affected by the establishment of the authority
18may elect to be considered for appointment and exercise
19reinstatement rights, if applicable, to funded, equivalent, vacant
20county positions for which they are qualified and eligible. An
21employee who first elects to remain with the county may
22subsequently seek reinstatement with the authority within 30 days
23of the election to remain with the county and shall be subject to
24the requirements of this article.

25(3) Acknowledgment that the authority, to the extent permitted
26by federal and state law, and consistent with paragraph (3) of
27subdivision (d), shall be bound by the terms of those memoranda
28of understanding executed between the county and its exclusive
29employee representatives that are in effect on the date of the
30transfer of control of the medical center to the authority.
31Subsequent memoranda of understanding with exclusive employee
32representatives shall be subject to approval only by the board of
33governors.

34(4) Communication to the Board of Retirement of the Kern
35County Employees’ Retirement Association or other retirement
36plan of any personnel transition plan, memoranda of understanding,
37or other arrangements that are related to the participation of the
38authority’s employees or the addition of new employees in the
39 retirement plan.

P10   1(b) Implementation of this chapter shall not be a cause for the
2modification of the medical center or county employment benefits.
3 Employees of the medical center or county on the date of transfer,
4who become authority employees, shall retain their existing or
5equivalent classifications and job descriptions upon transfer to the
6authority, comparable pension benefits (if permissible pursuant to
7relevant plan terms), and their existing salaries and other benefits
8that include, but are not limited to, accrued and unused vacation,
9sick leave, personal leave, health care, retiree health benefits, and
10deferred compensation plans. The transfer of an employee from
11the medical center or county shall not constitute a termination of
12employment for purposes of Section 227.3 of the Labor Code, or
13employee benefit plans and arrangements maintained by the
14medical center or county, except as otherwise provided in the
15enabling ordinance or personnel transition plan, nor shall it be
16counted as a break in uninterrupted employment for purposes of
17Section 31641 of the Government Code with respect to the Kern
18County Employees’ Retirement Association, or state service for
19purposes of the Public Employees’ Retirement System (Part 3
20(commencing with Section 20000) of Division 5 of Title 2 of the
21Government Code).

22(c) Subject to applicable state law, the authority shall recognize
23the exclusive employee representatives of those authority
24employees who are transferred from the county or medical center
25to the authority pursuant to this chapter.

26(d) In order to stabilize labor and employment relations and
27provide continuity of care and services to the people of the county,
28and notwithstanding any other law, the authority shall do all of the
29following for a period of 24 months after the effective date of the
30transfer of control of the medical center to the authority:

31(1) Continue to recognize each exclusive employee
32representative of each bargaining unit.

33(2) Continue to provide the same level of employee benefits to
34authority employees, whether the obligation to provide those
35benefits arise out of a memorandum of understanding, or other
36agreements or law.

37(3) Extend and continue to be bound by any existing memoranda
38of understanding covering the terms and conditions of employment
39for employees of the authority, including the level of wages and
40benefits, and any county rules, ordinances, or policies specifically
P11   1identified and incorporated by reference in a memoranda of
2understanding for 24 months or through the term of the
3memorandum of understanding, whichever shall be the longer,
4unless modified by mutual agreement with each of the exclusive
5employee representatives. The authority shall continue to provide
6those pension benefits specified in any memoranda of agreement
7as long as doing so does not conflict with any Kern County
8Employee Retirement Association plan provisions, or federal or
9state law including the County Employees Retirement Law of 1937
10(Chapter 3 (commencing with Section 31450) of Part 3 of Division
114 of Title 3 of the Government Code and the federal Internal
12Revenue Code).begin insert If a memoranda of understanding is expired on
13the date of the transfer of control of the medical center, then the
14authority shall continue to be bound by the terms and conditions
15of the most recent memoranda of understanding, unless modified
16by a mutual agreement with each of the exclusive employee
17 representatives, and the benefits and wages of transferred
18employees shall be retained consistent with subdivision (b).end insert

19(4) Meet and confer with the exclusive employee representatives
20to develop processes and procedures to address employee
21disciplinary action taken against permanent employees. If the
22authority terminates, suspends, demotes, or reduces the pay of a
23permanent employee for disciplinary reasons, those actions shall
24only be for cause consistent with state law, and an employee shall
25be afforded applicable due process protections granted to public
26 employees under state law. Permanent employees laid off by the
27authority within six months of the date of the transfer of control
28of the medical center shall remain on the county reemployment
29list for two years. Inclusion on the county reemployment list is not
30a guarantee of reemployment. For the purposes of this paragraph,
31the term “permanent employees” excludes probationary employees,
32temporary employees, seasonal employees, provisional employees,
33extra help employees, and per diem employees.

34(5) To the extent layoffs occur, and provided that all other
35previously agreed upon factors are equal, ensure that seniority
36shall prevail. The authority shall meet and confer with the exclusive
37employee representatives to address layoff procedures and the
38manner in which, and the extent to which, seniority shall be
39measured for employees who transfer from the medical center or
40county.

P12   1(e) Permanent employees of the medical center or county on
2the effective date of the transfer of control of the medical center
3to the authority, shall be deemed qualified for employment in
4equivalent positions at the authority, and no other qualifications
5shall be required except as otherwise required by state or federal
6law. Probationary employees on the effective date of the transfer,
7as set forth in this paragraph, shall retain their probationary status
8and rights and shall not be required to serve a new probationary
9or extend their probationary period by reason of the transfer. To
10the extent possible, employees who transfer to equivalent positions
11at the authority shall retain their existing classifications and job
12descriptions, but if there is a dispute over this issue, the authority
13 agrees to meet and confer with the exclusive employee
14representatives of the transferred employees.

15(f) Employees who transfer from the medical center or county
16to the authority shall retain the seniority they earned at the medical
17center or county and any benefits or privileges based on the
18seniority.

19(g) Notwithstanding any other law, employees of the authority
20may participate in the Kern County Employees’ Retirement
21Association, operated pursuant to the County Employees
22Retirement Law of 1937 (Chapter 3 (commencing with Section
2331450) of Part 3 of Division 4 of Title 3 of the Government Code)
24as set forth below. However, the authority and employees of the
25authority, or certain designated parts thereof, shall not participate
26in the Kern County Employees’ Retirement Association if the
27board of retirement, in its sole discretion, determines that their
28participation could jeopardize the Kern County Employees’
29Retirement Association’s tax-qualified or governmental plan status
30under federal law, or if a contract or related contract amendment
31proposed by the authority contains any benefit provisions that are
32not specifically authorized by Chapters 3 (commencing with
33Section 31450) and 3.9 (commencing with Section 31899) of Part
343 of Division 4 of Title 3 of the Government Code or Article 4
35(commencing with Section 7522) of Chapter 21 of Division 7 of
36Title 1 of the Government Code, and that the board determines
37would adversely affect the administration of the system. There
38shall not be any individual employee elections regarding
39participation in the Kern County Employees’ Retirement
40Association or other retirement plans except to the extent such
P13   1retirement plans provide for elective employee salary deferral
2contributions in accordance with federal Internal Revenue Code
3rules.

4(1) Employees transferred from the county or medical center to
5the authority who are subject to a memorandum of understanding
6between the authority and an exclusive employee representative,
7as described in paragraphs (2) and (3) of subdivision (d), and who
8were members of the Kern County Employees’ Retirement
9 Association at the time of their transfer of employment, shall
10continue to be a member of the Kern County Employees’
11Retirement Association, retaining service credit earned to the date
12of transfer, to the extent provided for in the applicable
13memorandum of understanding.

14(2) Employees transferred from the county or medical center to
15the authority who are subject to a memorandum of understanding
16between the authority and an exclusive employee representative,
17as described in paragraphs (2) and (3) of subdivision (d), and who
18were not members of the Kern County Employees’ Retirement
19Association at the time of their transfer of employment, shall
20subsequently become a member of the Kern County Employees’
21Retirement Association only to the extent provided for in the
22applicable memorandum of understanding.

23(3) Employees transferred from the county or medical center to
24the authority who are not subject to a memorandum of
25understanding between the authority and an exclusive employee
26representative, as described in paragraphs (2) and (3) of subdivision
27(d), and who were members of the Kern County Employees’
28Retirement Association at the time of their transfer of employment,
29shall continue to be a member of the Kern County Employees’
30Retirement Association, retaining service credit earned to the date
31of transfer, as provided in the enabling ordinance or the personnel
32transition plan.

33(4) Employees transferred from the county or medical center to
34the authority who are not subject to a memorandum of
35understanding between the authority and an exclusive employee
36representative, as described in paragraphs (2) and (3) of subdivision
37(d), and who were not members of the Kern County Employees’
38Retirement Association at the time of their transfer of employment,
39shall subsequently become a member of the Kern County
P14   1Employees’ Retirement Association only to the extent provided
2in the enabling ordinance or the personnel transition plan.

3(5) Employees hired by the authority on or after the effective
4date of the transfer of control of the medical center shall become
5a member of the Kern County Employees’ Retirement Association
6only to the extent provided in the enabling ordinance or personnel
7transition plan described in subdivision (a), or, if subject to a
8memorandum of understanding between the authority and an
9exclusive employee representative as described in paragraphs (2)
10and (3) of subdivision (d), to the extent provided for in the
11applicable memorandum of understanding.

12(6) (A) Notwithstanding any other law, for purposes of
13California Public Employees’ Pension Reform Act of 2013 (Article
144 (commencing with Section 7522) of Chapter 21 of Division 7
15of Title 1 of the Government Code), an individual who was
16employed by the county or the medical center when it was a
17constituent department of the county, and is a member of the Kern
18County Employees’ Retirement Association or the Public
19Employees’ Retirement System, as set forth in Part 3 (commencing
20with Section 20000) of Division 5 of Title 2 of the Government
21begin delete Code, or current or contingent member of a plan of replacement
22for members whose retirement benefits are limited by Section 415
23of Title 26 of the United States Code as provided in Section
247522.43 of the Government Code,end delete
begin insert Code or a memberend insert prior to
25January 1, 2013, and who transfers, directly or after a break in
26service of less than six months, to the authority, in which the
27individual continues to be a member of either the Kern County
28Employees’ Retirement Association or the Public Employees’
29Retirement System, as applicable, shall not be deemed to be a new
30employee or a new member within the meaning of Section 7522.04
31begin delete or 7522.43end delete of the Government Code, and shall continue to be
32begin delete subjectend deletebegin insert subject, immediately after the transfer,end insert to the same defined
33benefit formula, as defined in Section 7522.04 of the Government
34Code,begin delete orend deletebegin insert andend insert plan of replacement benefitsbegin delete for members whose
35retirement benefits are limited by Section 415 of Title 26 of the
36United States Code, as provided in Section 7522.43 of the
37Government Code, to which the member was subject immediately
38prior to the transfer.end delete
begin insert offered by the county pursuant to Section
3931899.4 of the Government Code and the Kern County
P15   1Replacement Benefits Plan for retirement benefits limited by
2Section 415 of Title 26 of the United States Code.end insert

3(B) For purposes ofbegin insert subdivision (c) ofend insert Section 7522.43 of the
4Government Code, the authority shall be treated as a public
5employer that offered a plan of replacement benefitsbegin delete for members
6whose retirement benefits are limited by Section 415 of Title 26
7of the United States Code prior to January 1, 2013, with respect
8to current or contingent members of that plan who were employed
9by the county or the medical center when it was a constituent
10department of the county prior to January 1, 2013, and who
11transfer, directly or after a break in service of less than six months,
12to the authority and continue to be a member of either the Kern
13County Employees’ Retirement Association or the Public
14Employees’ Retirement System, as applicable.end delete
begin insert prior to January
151, 2013. The county’s plan of replacement benefits that was in
16effect prior to January 1, 2013, is deemed to also be the authority’s
17replacement plan for the sole purpose of allowing the authority
18to continue to offer the plan of replacement benefits, immediately
19after the transfer, for Kern County Employees’ Retirement
20Association members who meet both of the following requirements,
21and the qualifying survivors or beneficiaries of those members:end insert

begin insert

22(i) The employee was employed as of January 1, 2013, by the
23county or the medical center when it was a constituent department
24of the county.

end insert
begin insert

25(ii) The employee is part of a member group to which the county
26offered a plan of replacement benefits prior to January 1, 2013.

end insert

27(h) This chapter shall not prohibit the authority from contracting
28with the Public Employees’ Retirement System, in accordance
29with the requirements of Section 20508 and any other applicable
30provisions of Part 3 (commencing with Section 20000) of Division
315 of Title 2 of the Government Code, for the purpose of providing
32employee participation in that system, or from establishing an
33alternative or supplemental retirement system or arrangement,
34including, but not limited to, deferred compensation arrangements,
35to the extent permitted by law and subject to any applicable
36agreement between the authority and the exclusive employee
37representatives, and as provided in the enabling ordinance or the
38personnel transition plan. Notwithstanding any other law, the
39authority and employees of the authority shall not participate in
40the Public Employees’ Retirement System if the Board of
P16   1Administration of the Public Employees’ Retirement System, in
2its sole discretion, determines that their participation could
3jeopardize the Public Employees’ Retirement System’s
4tax-qualified or governmental plan status under federal law, or if
5a contract or related contract amendment proposed by the authority
6contains any benefit provisions that are not specifically authorized
7by Part 3 (commencing with Section 20000) of Division 5 of Title
82 of the Government Code, and that the board determines would
9adversely affect the administration of the system.

10(i) Provided that this is not inconsistent with anything in this
11chapter, this chapter does not prohibit the authority from
12determining the number of employees, the number of full-time
13equivalent positions, job descriptions, the nature and extent of
14classified employment positions, and salaries of employees.

15

SEC. 5.  

Section 101855 of the Health and Safety Code is
16amended to read:

17

101855.  

(a) Subject to any terms, conditions, and limitations
18as may be imposed by the enabling ordinance, the authority, in
19addition to any other powers granted pursuant to this chapter, shall
20have the following powers:

21(1) To have the duties, privileges, immunities, rights, liabilities,
22and limitations of a local unit of government within the state.

23(2) To have perpetual existence, subject to Article 5
24(commencing with Section 101856).

25(3) To adopt, have, and use a seal, and to alter it at its pleasure.

26(4) To sue and be sued in the name of the authority in all actions
27and proceedings in all courts and tribunals of competent
28jurisdiction.

29(5) To purchase, lease, trade, exchange, or otherwise acquire,
30maintain, hold, improve, mortgage, lease, sell, and dispose of real
31and personal property of any kind necessary or convenient to
32perform its functions and fully exercise its powers.

33(6) To appoint and employ or otherwise engage a chief executive
34officer and other officers and employees that may be necessary or
35appropriate, including legal counsel, to establish their
36compensation, provide for their health, retirement, and other
37employment benefits, and to define the power and duties of officers
38and employees.

39(7) (A) To incur indebtedness and to borrow money and issue
40bonds evidencing the same, including the authority to issue, from
P17   1time to time, notes and revenue bonds in principal amounts that
2the authority determines to be necessary to provide sufficient funds
3for achieving any of its purposes, including, but not limited to,
4assumption or refinancing of debt service for capital projects
5eligible for Medi-Cal supplemental payments pursuant to Section
614085.5 of the Welfare and Institutions Code, or any successor or
7modified Medi-Cal debt service reimbursement program, the
8payment of principal and interest on notes and bonds of the
9authority, the establishment of reserves to secure those notes and
10bonds, and all other expenditures of the authority incident to and
11 necessary or convenient to carry out its purposes and powers.

12(B) Any notes, bonds, or other securities issued, and the income
13from them, including any profit from the sale thereof, shall at all
14times be free from taxation by the state or any agency, political
15subdivision, or instrumentality of the state.

16(C) Notwithstanding the provisions of subparagraph (A), for
17any indebtedness, notes, bonds, or other securities that require
18voter approval pursuant to state law, the prior approval of the board
19of supervisors shall be required. Notwithstanding the required prior
20approval of the board of supervisors, any indebtedness incurred,
21or notes, bonds, or other securities issued pursuant to this
22subparagraph shall be the indebtedness, notes, bonds, or securities
23of the authority and not of the county, and the credit of the county
24shall not be pledged or relied upon in any manner in order to incur
25the indebtedness, or issue the notes, bonds, or other securities,
26unless the board of supervisors explicitly authorizes the use of the
27county’s credit. The authority shall reimburse the county for all
28costs associated with the county’s consideration of the
29indebtedness, notes, bonds, or securities, and the authority shall
30defend, indemnify, and hold harmless the county from any and all
31liability, costs, or expenses arising from or related to the
32indebtedness, notes, bonds, or securities.

33(D) Nothing in this section shall preclude the authority from
34repayment of its debts or other liabilities, using funds that are not
35otherwise encumbered.

36(8) To pursue its own credit rating.

37(9) To enter into one or more contracts or agreements consistent
38with this chapter and other applicable laws of this state, including,
39but not limited to, contracting with any public or private entity or
40person for management or other services and personnel, and to
P18   1authorize the chief executive officer to enter into contracts, execute
2all instruments, and do all things necessary or convenient in the
3exercise of the powers granted in this chapter.

4(10) To purchase supplies, equipment, materials, property, and
5services.

6(11) To establish policies relating to its purposes.

7(12) To acquire or contract to acquire, rights-of-way, easements,
8privileges, and property, and to construct, equip, maintain, and
9operate any and all works or improvements wherever located that
10are necessary, convenient, or proper to carry out any of the
11provisions, objects, or purposes of this chapter, and to complete,
12extend, add to, repair, or otherwise improve any works or
13improvements acquired by it.

14(13) To participate in, contract for, and to accept, gifts, grants,
15and loans of funds, property, or other aid or finance opportunity
16in any form from the federal government, the state, a state agency,
17or other source, or combination thereof, as otherwise would be
18available to a public, government, or private entity, and to comply,
19subject to this chapter, with the terms and conditions thereof.

20(14) If not otherwise required pursuant to the enabling ordinance
21 to deposit its funds in the county treasury, the authority may
22establish its own treasury, invest surplus money in its own treasury,
23manage investments, and engage third-party investment managers,
24in accordance with state law.

25(15) To arrange for guarantees or insurance of its bonds, notes,
26or other obligations by the federal or state government or by a
27private insurer, and to pay the premiums thereof.

28(16) To engage in managed care contracting, joint ventures,
29affiliations with other health care facilities, other health care
30providers and payers, management agreements, or to participate
31in alliances, purchasing consortia, health insurance pools,
32accountable care organizations, alternative delivery systems, or
33other cooperative arrangements, with any public or private entity.

34(17) To enter into joint powers agreements pursuant to Chapter
355 (commencing with Section 6500) of Division 7 of Title 1 of the
36Government Code. Notwithstanding any other law, the authority
37may enter into a joint powers agreement as described in Section
386523.5 of the Government Code as though that section applied to
39hospitals and other health care facilities in the County of Kern.

P19   1(18) To establish nonprofit, for-profit, or other entities necessary
2to carry out the duties of the authority.

3(19) To elect to transfer funds to the state and incur certified
4public expenditures in support of the Medi-Cal program and other
5programs for which federal financial participation is available.

6(20) To use a computerized management information system,
7including an electronic health records system, in connection with
8its operations, including, without limitation the administration of
9its facilities.

10(21) To request that the board of supervisors levy a tax on behalf
11of the authority. If the board of supervisors approves the proposal
12to levy the tax, it shall call the election to seek voter approval and
13place the appropriate measure on the ballot for that election. The
14proceeds of these taxes shall be tax proceeds of the authority and
15not of the county. The authority shall reimburse the county for all
16costs associated with the county’s consideration of those taxes,
17and shall defend, indemnify, and hold harmless the county from
18any liability, costs, or expenses arising from or related to the
19imposition of these taxes.

20(22) Notwithstanding the provisions of this chapter relating to
21the obligations and liabilities of the authority, or any other law,begin delete a
22transfer of control of the medical center to the authority pursuant
23to this chapter shall confer ontoend delete
the authoritybegin delete allend deletebegin insert shall haveend insert the
24begin insert sameend insert rights, privileges,begin insert exemptions, preferences,end insert and authoritybegin delete set
25forth in state law to own, operate, and provideend delete
begin insert of a county with
26respect to owning, operating, and providingend insert
coverage and services
27through hospitals, clinics and other health facilities, health
28programs, care organizations,begin insert physicians andend insert physician practice
29plans, delivery systems, health care service plans, and other
30begin insert provider types andend insert coveragebegin delete mechanisms that may be owned or
31operated by a county.end delete
begin insert mechanisms.end insert

32(23) To engage in other activities that may be in the best interests
33of the authority and the persons served by the authority, as
34determined by the board of governors, in order to respond to
35changes in the health care industry.

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

37(1) (A) Be a government agency that is a local unit of
38government separate and apart for all purposes from the county
39and any other public entity, and shall not be considered to be an
40agency, division, or department of the county or any other public
P20   1entity. The authority shall not be governed by or subject to the
2civil service requirements of the county. Notwithstanding any other
3law, except as otherwise provided for in the enabling ordinance
4enacted pursuant to this chapter, and as set forth in Section
5101853.1 relating to the personnel transition plan, the authority
6shall not be governed by, or subject to, other policies or operational
7rules applicable to the county, the medical center prior to its
8transfer, or any other public entity, including, but not limited to,
9those relating to personnel and procurement.

10(B) The board of governors shall adopt written rules, regulations,
11and procedures with regard to basic human resource functions not
12inconsistent with memoranda of understanding covering employees
13represented by employee organizations or the provisions of this
14chapter. Until the time that the board of governors adopts its own
15rules, regulations, or procedures with regard to these functions,
16the existing rules, regulations, and procedures set forth in any
17memoranda of understanding described in Section 101853.1, and
18the rules and regulations adopted by the county and described in
19paragraph (4), shall continue to apply.

20(2) Be subject to state and federal taxation laws that are
21applicable to public entities generally.

22(3) Except as otherwise specifically provided in this chapter,
23comply with the Meyers-Milias-Brown Act (Chapter 10
24(commencing with Section 3500) of Division 4 of Title 1 of the
25Government Code), the Public Records Act (Chapter 3.5
26(commencing with Section 6250) of Division 7 of Title 1 of the
27 Government Code), and the Ralph M. Brown Act (Chapter 9
28(commencing with Section 54950) of Part 1 of Division 2 of Title
295 of the Government Code).

30(4) Be subject to the jurisdiction of the Public Employment
31Relations Board. Until the authority adopts rules and regulations
32pursuant to subdivision (a) of Section 3507 of the Government
33Code, the existing rules adopted by the county and contained in
34the county’s employer-employee relations resolution, as amended,
35shall apply, modified to account for the creation of the authority,
36and provided further that the resolution shall not contain any
37incorporation of the county’s civil service rules or county
38ordinances unless specifically addressed in this chapter.

39(5) Carry professional and general liability insurance or
40programs to the extent sufficient to cover its activities.

P21   1(6) Comply with the requirements of Sections 53260 and 53261
2of the Government Code.

3(7) Maintain financial and accounting records.

4(8) Meet all local, state, and federal data reporting requirements.

5(c) (1) Subject to any restrictions applicable to public agencies,
6and subject to any limitations or conditions set forth in the enabling
7ordinance adopted by the board of supervisors, the authority may
8borrow money from the county, repay debt it owes to the county,
9and use the borrowed funds to provide for its operating and capital
10needs. The county may lend the authority funds and may issue
11debt instruments, including, without limitation, revenue anticipation
12notes to obtain funds to provide, by loan or otherwise, amounts
13necessary for the authority to meet its operating and capital needs.

14(2) Notwithstanding paragraph (1), nothing in this chapter shall
15be construed to limit the borrowing powers the county otherwise
16has under law for the purposes specified in paragraph (1) or any
17other purposes.

18(d) Open sessions of the authority shall constitute official
19proceedings authorized by law within the meaning of Section 47
20of the Civil Code. The privileges set forth in that section with
21respect to official proceedings shall apply to open sessions of the
22authority.

23(e) (1) Notwithstanding any other law, the board of governors
24begin insert or board of supervisors, as applicable,end insert may order that a meeting
25held solely for the purpose of discussion or taking action on
26authority trade secrets, as defined in subdivision (d) of Section
273426.1 of the Civil Code, or to consider and take action on matters
28pertaining to contracts and contract negotiations concerning all
29matters related to rates of payment for health care services arranged
30or provided by the authority, shall be held in closed session. Trade
31secrets for purposes of this chapter shall also include information
32for which the secrecy of the information is necessary for the
33authority to initiate a new service, program, marketing strategy,
34business plan, or technology, or to add a benefit or product, and
35premature disclosure of the trade secret would create a substantial
36probability of depriving the authority of a substantial economic
37benefit or opportunity.

38(2) The requirements of making a public report of actions taken
39in closed session and the vote or abstention of every member
40present may be limited to a brief general description devoid of the
P22   1information constituting the trade secret or concerning the matters
2related to rates of payment.

3(3) Those records of the authoritybegin insert or board of supervisors, as
4applicable,end insert
that reveal the authority’s trade secrets are exempt
5from disclosure pursuant to the California Public Records Act
6(Chapter 3.5 (commencing with Section 6250) of Division 7 of
7Title 1 of the Government Code), or any similar local law requiring
8the disclosure of public records. This exemption shall apply for a
9period of two years after the service, program, marketing strategy,
10business plan, technology, benefit, or product that is the subject
11of the trade secret is formally adopted by the governing body of
12the authority, provided that the service, program, marketing
13strategy, business plan, technology, benefit, or product continues
14to be a trade secret. The board of governorsbegin insert or board of
15supervisors, as applicable,end insert
may delete the portion or portions
16containing trade secrets from any documents that were finally
17approved in the closed session that are provided to persons who
18have made the timely or standing request.

19(4) This chapter shall not prevent the board of governorsbegin insert or
20board of supervisors, as applicable,end insert
from meeting in closed session
21as otherwise provided by law.

22(f) Notwithstanding any other law, those records of the authority
23and of the county that reveal the authority’s rates of payment for
24health care services arranged or provided by the authority or its
25deliberative processes, strategies, discussions, communications,
26or any other portion of the negotiations with providers of health
27care services or Medi-Cal, health care plans, or other payers for
28rates of payment, shall not be required to be disclosed pursuant to
29the California Public Records Act (Chapter 3.5 (commencing with
30Section 6250) of Division 7 of Title 1 of the Government Code),
31or any similar local law requiring the disclosure of public records.
32However, three years after a contract or amendment to a contract
33is fully executed, the portion of the contract or amendment
34containing the rates of payment shall be open to inspection.

35(g) The authority shall be a public agency that is a local unit of
36government for purposes of eligibility with respect to grants and
37other funding and loan guarantee programs. Contributions to the
38authority shall be tax deductible to the extent permitted by state
39and federal law. Nonproprietary income of the authority shall be
40exempt from state income taxation.

P23   1(h) Unless otherwise provided by the board of supervisors by
2way of resolution, the authority is empowered, or the board of
3supervisors is empowered on behalf of the authority, to apply as
4a public agency for one or more licenses for the provision of health
5care or the operation of a health care service plan pursuant to
6statutes and regulations governing licensing as currently written
7or subsequently amended.

8(i) The statutory authority of a board of supervisors to prescribe
9rules that authorize a county hospital to integrate its services with
10those of other providers into a system of community service that
11offers free choice of hospitals to those requiring hospital care, as
12set forth in Section 14000.2 of the Welfare and Institutions Code,
13shall apply to the authority and the board of governors.

14(j) (1) Except as otherwise provided in this chapter, provisions
15of the Evidence Code, the Government Code, including the Public
16Records Act (Chapter 3.5 (commencing with Section 6250) of
17Division 7 of Title 1 of the Government Code), the Civil Code,
18the Business and Professions Code, and other applicable law
19pertaining to the confidentiality of peer review activities of peer
20review bodies shall apply to the peer review activities of the
21authority, or any peer review body, as defined in paragraph (1) of
22subdivision (a) of Section 805 of the Business and Professions
23Code, formed pursuant to the powers granted to the authority. The
24laws pertaining to the confidentiality of peer review activities shall
25be together construed as extending, to the extent permitted by law,
26the maximum degree of protection of confidentiality.

27(2) Notwithstanding Article 9 (commencing with Section 11120)
28of Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9
29(commencing with Section 54950) of Part 1 of Division 2 of Title
305 of, the Government Code, or any other provision of law, any
31peer review body formed pursuant to the powers granted to the
32authority, may, at its discretion and without notice to the public,
33meet in closed session, so long as the purpose of the meeting is
34the peer review body’s discharge of its responsibility to evaluate
35and improve the quality of care rendered by health facilities and
36health practitioners. The peer review body and its members shall
37receive, to the fullest extent, all immunities, privileges, and
38protections available to those peer review bodies, their individual
39members, and persons or entities assisting in the peer review
40process, including those afforded by Section 1157 of the Evidence
P24   1Code and Section 1370. Peer review proceedings shall constitute
2an official proceeding authorized by law within the meaning of
3Section 47 of the Civil Code and those privileges set forth in that
4section with respect to official proceedings shall apply to peer
5review proceedings of the authority.

6(3) Notwithstanding the California Public Records Act (Chapter
73.5 (commencing with Section 6250) of Division 7 of Title 1 of
8the Government Code), or Article 9 (commencing with Section
911120) of Chapter 1 of Part 1 of Division 3 of Title 2 of, and
10Chapter 9 (commencing with Section 54950) of Part 1 of Division
112 of Title 5 of, the Government Code, or any other provision of
12state or local law requiring disclosure of public records, those
13records of a peer review body formed pursuant to the powers
14granted to the authority, shall not be required to be disclosed. The
15records and proceedings of the peer review body and its individual
16members shall receive, to the fullest extent, all immunities,
17privileges, and protections available to those records and
18proceedings, including those afforded by Section 1157 of the
19Evidence Code and Section 1370 of the Health and Safety Code.

20(4) If the authority is required by law or contractual obligation
21to submit to the state or federal government peer review
22information or information relevant to the credentialing of a
23participating provider, that submission shall not constitute a waiver
24of confidentiality.

25(5) Notwithstanding any other law, Section 1461 shall apply to
26hearings on reports of hospital medical audit or quality assurance
27committees.

28(k) Except as expressly provided by other provisions of this
29section, all exemptions and exclusions from disclosure as public
30records pursuant to this chapter and the California Public Records
31Act, including, but not limited to, those pertaining to trade secrets
32and information withheld in the public interest, shall be fully
33applicable to the authority, and for the board of supervisors, and
34 all state and local agencies with respect to all writings that the
35authority is required to prepare, produce, or submit, and which
36shall not constitute a waiver of exemption from disclosure.

37(l) The authority and the county, or any combination thereof,
38may engage in marketing, advertising, and promotion of the
39medical and health care services made available to the community
40by the authority.

P25   1(m) (1) The board of supervisors may contract for services or
2purchase items on behalf of the authority.

3(2) Unless otherwise provided for, and subject to the limitations
4and conditions set forth in the enabling ordinance, the board of
5governors shall have authority over procurement and contracts for
6the authority and shall adopt written rules, regulations, and
7procedures with regard to these functions. The authority’s ability
8to contract for personnel or other services and items it deems
9necessary, appropriate, or convenient for the conduct of its
10activities consistent with its purposes shall only be limited by the
11provisions in this chapter and obligations under the
12Meyers-Milias-Brown Act (Chapter 10 (commencing with Section
133500) of Division 4 of Title 1 of the Government Code).

14(3) Contracts by and between the authority and a public agency,
15and contracts by and between the authority and providers of health
16care, goods, or services, may be let on a nonbid basis and shall be
17exempt from Chapter 2 (commencing with Section 10290) of Part
182 of Division 2 of the Public Contract Code.

19(n) The authority may contract with the county for services and
20personnel upon mutually agreeable terms.

21(o) Notwithstanding Article 4.7 (commencing with Section
221125) of Chapter 1 of Division 4 of Title 1 of the Government
23Code, related to incompatible activities, Section 1099 of the
24Government Code, related to incompatible offices, or any other
25law, a member of the authority’s administrative staff shall not be
26considered to hold an incompatible office or to be engaged in
27activities inconsistent and incompatible with his or her duties as
28a result of his or her employment or affiliation with the county or
29an agency of the county.

30(p) The board of governors and the officers and employees of
31the authority are public employees for purposes of Division 3.6
32(commencing with Section 810) of Title 1 of the Government
33Code, relating to claims and actions against public entities and
34public employees, and shall be protected by the immunities
35applicable to public entities and public employees governed by
36Part 2 (commencing with Section 814) of Division 3.6 of Title 1
37of the Government Code, except as provided by other statutes or
38regulations that apply expressly to the authority.

39

SEC. 6.  

Section 101855.1 of the Health and Safety Code is
40amended to read:

P26   1

101855.1.  

(a) Transfer of control of the medical center, whether
2or not the transfer includes the surrendering by the county of the
3existing general acute care hospital license and corresponding
4application for a change of ownership of the license, shall not
5affect the eligibility of the county to undertake, and shall authorize
6the authority, subject to applicable requirements, to do any of the
7following:

8(1) With the written consent of the county, participate in and
9receive allocations pursuant to the California Health Care for
10Indigents Program pursuant to Chapter 5 (commencing with
11Section 16940) of Part 4.7 of Division 9 of the Welfare and
12Institutions Code, or similar programs, as may be identified or
13earmarked by the countybegin delete for indigent health careend deletebegin insert in support of
14uncompensatedend insert
services of the type provided by the medical center.

15(2) With the written consent of the county, participate in and
16receive allocations of local revenue fund amounts provided
17pursuant to Chapter 6 (commencing with Section 17600) of Part
185 of Division 9 of the Welfare and Institutions Code as may be
19identified or earmarked by the countybegin delete for indigentend deletebegin insert in support ofend insert
20 health care services of the type provided by the medicalbegin delete center.end delete
21begin insert center to low-income individuals.end insert

22(3) Participate in the financing of, as applicable, and receive,
23Medicaid disproportionate share hospital payments available to a
24county hospital or designated public hospital, or any other
25successor or modified payment or funding that is intended to assist
26hospitals that serve a disproportionate share of low-income patients
27with special needs. The allocation of Medicaid disproportionate
28share hospital payments shall be made in consultation with the
29State Department of Health Care Services and other designated
30safety net hospitals.

31(4) Participate in the financing of, as applicable, and receive,
32Medi-Cal payments and supplemental reimbursements, including,
33but not limited to, payments made pursuant to Sections 14105.96,
3414105.965, 14166.4, 14182.15, and 14199.2 of the Welfare and
35Institutions Code, payments described in paragraph (4) of
36subdivision (b) of Section 14301.4 of, and Section 14301.5 of, the
37Welfare and Institutions Code, and payments made available to a
38county provider or designated public hospital, or governmental
39entity with which it is affiliated, under any other successor or
40modified Medicaid payment system.

P27   1(5) Participate in the financing of, as applicable, and receive,
2safety net care pool funding, stabilization funding, delivery system
3reform incentive pool payments, and any other funding available
4to a county provider or designated public hospital, or governmental
5entities with which it is affiliated under the Medicaid demonstration
6project authorized pursuant to Article 5.2 (commencing with
7Section 14166) and Article 5.4 (commencing with Section 14180)
8of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
9Code, or under any other successor or modified Medicaid
10demonstration project or Medicaid payment system. The allocation
11of safety net care pool funds shall be made in consultation with
12the State Department of Health Care Services and other designated
13safety net hospitals.

14(6) Participate in the financing, administration, and provision
15of services under the Low Income Health Program authorized
16pursuant to Part 3.6 (commencing with Section 15909) of Division
179 of the Welfare and Institutions Code, or under any other successor
18or modified Medicaid demonstration project or Medicaid payment
19system if the authority enters into an agreement with the county
20concerning the provision of services by, and payment for these
21services to, the county.

22(7) Participate in and receive direct grant and payment
23allocations pursuant to Article 5.230 (commencing with Section
2414169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and
25Institutions Code, or under any other successor or modified direct
26grant and payment systems funded by hospital or other provider
27fee assessments.

28(8) Receive Medi-Cal capital supplements pursuant to Section
2914085.5 of the Welfare and Institutions Code, or any other
30successor or modified Medi-Cal debt service reimbursement
31 program. Notwithstanding any other law, supplemental payments
32shall be made to the medical center under those programs for the
33debt service costs incurred by the county, and, if applicable, by
34the authority to the extent that debt service responsibility is
35refinanced, transferred to, or otherwise assumed by, directly or
36indirectly, the authority.

37(9) Receive any other funds, or preference in the assignment of
38health care plan enrollees, that would otherwise be available to a
39county health plan, provider, or designated public hospital, or
40governmental entity with which it is affiliated.

P28   1(b) The transfer of control of the medical center to the authority
2pursuant to this chapter shall not otherwise disqualify the county
3or the authority from participating in any of the following:

4(1) Local, state, and federal funding sources either specific to
5county or other publicly owned or operated health care service
6plans, hospitals, or other health care providers, including, but not
7limited to, ambulatory care clinics, health systems, practices,
8designated public hospitals, or governmental entities with which
9they are affiliated, for which there are special provisions specific
10to those plans, hospitals, ambulatory care clinics, health systems,
11practices, other health care providers or governmental entities with
12which they are affiliated.

13(2) All funding programs in which the county, by itself or on
14behalf of the medical center had participated prior to the creation
15of the authority, or would otherwise be qualified to participate in
16had the authority not been created, and the maintenance, operation,
17 management, control, ownership, or lease of the medical center
18not been transferred to the authority pursuant to this chapter.



O

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