2007 California Health and Safety Code Article 2. Hospital Authority

CA Codes (hsc:101827-101849.4)

101827.  The board of supervisors of the county may, by ordinance,
establish a hospital authority separate and apart from the county for
the purpose of effecting a transfer of the management,
administration, and control of General Hospital and the Family Care
Centers in accordance with Section 14000.2 of the Welfare and
Institutions Code.  A hospital authority established pursuant to this
chapter shall be strictly and exclusively dedicated to the
management, administration, and control of General Hospital and the
Family Care Centers within parameters set forth in this chapter, and
in accordance with ordinances, bylaws, and contracts adopted by the
board of supervisors, which shall not be in conflict with this
chapter, Section 1442.5 of this code, or Section 17000 of the Welfare
and Institutions Code.



101828.  (a) A hospital authority established pursuant to this
chapter shall be governed by a board that is comprised of San Luis
Obispo County residents and subject to final approval by a majority
vote of the county board of supervisors.
   (b) The governing board shall consist of 11 members as follows:
   (1) One member from each of the five supervisorial districts.
Each district member shall be appointed by the supervisor elected
from that supervisorial district.  Supervisors shall avoid
appointment of individuals who may be expected to have significant or
frequent conflicts of interest with the hospital authority's
interests or goals.
   (2) One member recommended by the exclusive representative for the
employee association with the largest membership in San Luis Obispo
County.
   (3) One member recommended by the San Luis Obispo County Health
Commission to serve as a health care consumer representative.
   (4) One member recommended by the San Luis Obispo County Medical
Society.
   (5) One member shall be either the Family Care Center Medical
Director or the county health officer.
   (6) One member shall be the General Hospital's Chief of Medical
Staff or Vice Chief of Staff, or the designee of the Chief of Medical
Staff of the General Hospital.
   (7) One member shall be the county auditor-controller or the
designee of the county auditor-controller.
   (c) Members of the board of directors for the hospital authority
shall meet qualifications specified in the enabling ordinance for the
hospital authority.
   (d) The board of supervisors may, upon a majority vote and after
duly noticed public hearing, amend the composition of the board of
directors, but shall neither increase nor decrease the number of
members of the board of directors.
   (e) The mission of the hospital authority shall be consistent with
the mission statement adopted by the San Luis Obispo County Board of
Supervisors as part of the 1998-99 final budget and shall consist of
the management, administration, and other control, as determined by
the board of supervisors, of General Hospital and the Family Care
Centers, in a manner that ensures appropriate, quality, and
cost-effective medical care as required of counties by Section 17000
of the Welfare and Institutions Code, and, to the extent feasible,
other populations to the extent feasible and appropriate.
   (f) The board of supervisors shall adopt bylaws for General
Hospital and the Family Care Centers that set forth those matters,
related to the operation of General Hospital and the Family Care
Centers by the hospital authority, that the board of supervisors
deems necessary and appropriate.  The bylaws shall become operative
upon approval by a majority vote of the governing board.  Any changes
or amendments to the bylaws shall be by majority vote of the
governing board.
   (g) The hospital authority created and appointed pursuant to this
section is a duly constituted governing body within the meaning of
Sections 1250 and 70035 of Title 22 of the California Code of
Regulations as currently written or subsequently amended.




101829.  Unless otherwise provided by the board of supervisors by
way of resolution, the hospital authority is empowered, or the board
of supervisors is empowered on behalf of the hospital authority, to
apply as a public agency for one or more licenses for the provision
of health care pursuant to statutes and regulations governing
licensing as currently written or subsequently amended.



101830.  In the event of a change of license ownership, the
governing body of the hospital authority shall comply with the
obligations of governing bodies of general acute care hospitals
generally as set forth in Section 70701 of Title 22 of the California
Code of Regulations, as currently written or subsequently amended,
as well as the terms and conditions of the license.  The hospital
authority shall be the responsible party with respect to compliance
with these obligations, terms, and conditions.



101831.  Any transfer by the county to the hospital authority of the
administration, management, and control of General Hospital and the
Family Care Centers, whether or not the transfer includes the
surrendering by the county of the existing general acute care
hospital license and corresponding application for a change of
ownership of the license, shall not affect the eligibility of the
county, or in the case of a change of license ownership, the hospital
authority, to do any of the following:
   (a) Participate in, and receive allocations pursuant to, the
California Healthcare for the Indigent Program (CHIP).
   (b) Receive supplemental reimbursements from the Emergency
Services and Supplemental Payments Fund created pursuant to Section
14085.6 of the Welfare and Institutions Code.
   (c) Receive appropriations from the Medi-Cal Inpatient Payment
Adjustment Fund without relieving the county of its obligation to
make intergovernmental transfer payments related to the Medi-Cal
Inpatient Payment Adjustment Fund pursuant to Section 14163 of the
Welfare and Institutions Code.
   (d) Receive Medi-Cal capital supplements pursuant to Section
14085.5 of the Welfare and Institutions Code.
   (e) Receive any other funds that would otherwise be available to a
county hospital.



101832.  Any transfer described in Section 101831 shall not
otherwise disqualify the county, or in the case of a change in
license ownership, the hospital authority, from participating in any
of the following:
   (a) Other funding sources either specific to county hospitals or
county ambulatory care clinics or for which there are special
provisions specific to county hospitals or to county ambulatory care
clinics.
   (b) Funding programs in which the county, on behalf of General
Hospital, the Family Care Centers, and the San Luis Obispo County
Health Agency had participated prior to the creation of the hospital
authority, or would otherwise be qualified to participate in had the
hospital authority not been created, and administration, management,
and control not been transferred by the county to the hospital
authority, pursuant to this chapter.
   (c) A hospital authority created pursuant to this chapter shall be
a legal entity separate and apart from the county and shall file the
statement required by Section 53051 of the Government Code.  The
hospital authority shall be a government entity separate and apart
from the county, and shall not be considered to be an agency,
division, or department of the county.  The hospital authority shall
not be governed by, nor be subject to, the charter of the county and
shall not be subject to policies or operational rules of the county,
including, but not limited to, those relating to personnel and
procurement.



101833.  Any contract executed by and between the county and the
hospital authority shall provide that liabilities or obligations of
the hospital authority with respect to its activities pursuant to the
contract shall be the liabilities or obligations of the hospital
authority, and shall not become the liabilities or obligations of the
county.  Any contract executed by and between the county and the
hospital authority shall provide for the indemnification of the
county by the hospital authority for liabilities as specifically set
forth in the contract, except that the contract shall include a
provision that the county shall remain liable for its own negligent
acts.  Indemnification by the hospital authority shall not be
construed as divesting the county from its ultimate responsibility
for compliance with Section 17000 of the Welfare and Institutions
Code.


101834.  Any liabilities or obligations of the hospital authority
with respect to the liquidation or disposition of the hospital
authority's assets upon termination of the hospital authority shall
not become the liabilities or obligations of the county, except for
any liabilities or obligations to the State of California.




101835.  Any obligation of the hospital authority, statutory,
contractual, or otherwise, shall be the obligation solely of the
hospital authority and shall not be the obligation of the county,
except for any obligations, statutory, contractual, or otherwise, due
the State of California.



101836.  Notwithstanding any other provision of this section, any
transfer of the administration, management, or assets of General
Hospital or the Family Care Centers, or both, whether or not
accompanied by a change in licensing, shall not relieve the county of
the ultimate responsibility for indigent care pursuant to Section
17000 of the Welfare and Institutions Code.



101837.  Notwithstanding the provisions of this article relating to
the obligations and liabilities of the hospital authority, a transfer
of control or ownership of General Hospital and the Family Care
Centers shall confer onto the hospital authority all the rights and
duties set forth in state law with respect to hospitals owned or
operated by a county.



101838.  A transfer of the maintenance, operation, and management or
ownership of General Hospital to the hospital authority shall comply
with the provisions of Section 14000.2 of the Welfare and
Institutions Code.


101839.  A transfer of maintenance, operation, and management or
ownership to the hospital authority may be made with or without the
payment of a purchase price by the hospital authority and otherwise
upon the terms and conditions that the parties may mutually agree,
which terms and conditions shall include those found necessary by the
board of supervisors to ensure that the transfer will constitute an
ongoing material benefit to the county and its residents.  In the
event of such a transfer:
   (a) A transfer of the maintenance, operation, and management to
the hospital authority shall not be construed as empowering the
hospital authority to transfer any ownership interest of the county
in General Hospital and the Family Care Centers except as otherwise
approved by the board of supervisors.
   (b) The board of supervisors shall retain control over the use of
General Hospital and the Family Care Centers physical plant and
facilities except as otherwise specifically provided for in lawful
agreements entered into by the board of supervisors.  Any lease
agreement or other agreement between the county and the hospital
authority shall provide that county premises shall not be sublet
without the approval of the board of supervisors.



101840.  The statutory authority of a board of supervisors to
prescribe rules that authorize a county hospital to integrate its
services with those of other hospitals into a system of community
service that offers free choice of hospitals to those requiring
hospital care, as set forth in Section 14000.2 of the Welfare and
Institutions Code, shall apply to the hospital authority upon a
transfer of maintenance, operation, and management or ownership of
General Hospital or the Family Care Centers, or both, to the hospital
authority.


101841.  (a) The hospital authority shall have the power to acquire
and possess real or personal property and may dispose of real or
personal property other than that owned by the county, as may be
necessary for the performance of its functions.  The hospital
authority shall have the power to sue or be sued, to employ
personnel, and to contract for services required to meet its
obligations.
   (b) This section shall not be construed to authorize the hospital
authority to contract for services that were performed by county
civil service employees on June 30, 1999, unless the hospital
authority determines that contracting for these services is either of
the following:
   (1) Necessary to ensure the continued availability of certain
health care services.
   (2) Necessary to meet the funding constraints presented by
available financing.
   (c) If the hospital authority determines that contracting out for
the services pursuant to subdivision (b) is necessary, the authority
shall provide for full communication between the hospital authority
and county civil services employees, pursuant to Section 3505 of the
Government Code.  The communications shall include, but not be
limited to, the extent to which the decision to contract out for
services could result in the termination or unemployment of county
civil service employees.


101842.  Members of the governing board of the hospital authority
shall not be vicariously liable for injuries caused by the act or
omission of the hospital authority to the extent that protection
applies to members of governing boards of local public entities
generally under Section 820.9 of the Government Code.



101843.  The hospital authority shall be a public agency subject to
the Meyers-Milias-Brown Act (Chapter 10 (commencing with Section
3500) of Division 4 of Title 1 of the Government Code).



101844.  The county, the hospital authority, the governing board,
employees of the county working at General Hospital or the Family
Care Centers, and employees of the hospital authority shall comply
with the following requirements, in addition to any general
requirements of law that are not inconsistent with the following
requirements:
   (a) Any transfer of functions from county employee classifications
to a hospital authority established pursuant to this section shall
result in the recognition by the hospital authority of the employee
organization that represented the classifications performing those
functions at the time of the transfer.
   (b) In exercising its powers to employ personnel, as set forth in
Section 101840, the board of supervisors shall adopt, and the
hospital shall implement, a personnel transition plan.  The personnel
transition plan shall require all of the following:
   (1) Ongoing communications to employees and recognized employee
organizations regarding the impact of the transition on existing
General Hospital and Family Care Centers employees and employee
classifications.
   (2) Meeting and conferring on all of the following issues:
   (A) The timeframe for which the transfer of personnel shall occur.
  The timeframe shall be subject to modification by the board of
supervisors as appropriate, but in no event shall it exceed one year
from the effective date of transfer of governance from the board of
supervisors to the hospital authority.
   (B) A specified period of time during which employees of the
county impacted by the transfer of governance may elect to be
appointed to vacant positions with the county for which they are
qualified.
   (C) A specified period of time during which employees of the
county impacted by the transfer of governance may elect to be
considered for reinstatement into positions with the county for which
they are qualified and eligible.
   (D) The possible preservation of pensions, health benefits, and
other applicable accrued benefits of employees of the county impacted
by the transfer of governance.  Notwithstanding any other provision
of law, the personnel transition plan may provide for participation
by hospital authority employees in the San Luis Obispo County Pension
Trust.
   (c) Nothing in subdivision (b) shall be construed as prohibiting
the hospital authority from determining the number of employees, the
number of full-time equivalent positions, the job descriptions, and
the nature and extent of classified employment positions, subject to
all applicable laws and regulations for licensed medical providers.
   (d) Employees of the hospital authority are public employees for
purposes of Division 3.6 (commencing with Section 810) of Title 1 of
the Government Code relating to claims and actions against public
entities and public employees.
   (e) Any hospital authority created pursuant to this chapter shall
have sole authority to negotiate memorandums of understanding with
appropriate employee organizations.


101845.  The hospital authority created pursuant to the chapter may
borrow from the county and the county may lend the hospital authority
funds or issue revenue anticipation notes to obtain those funds
necessary to operate General Hospital and the Family Care Centers and
otherwise provide medical services.


101845.1.  The hospital authority shall be subject to state and
federal taxation laws that are applicable to counties generally.



101845.2.  The hospital authority, the county, or both, may engage
in marketing, advertising, and promotion of the medical and health
care services made available to the community at General Hospital and
the Family Care Centers.


101846.  The hospital authority shall not be a "person" subject to
suit under the Cartwright Act (Chapter 2 (commencing with Section
16700) of Part 2 of Division 7 of the Business and Professions Code).



101847.  Notwithstanding Article 4.7 (commencing with Section 1125)
of Chapter 1 of Division 4 of Title 1 of the Government Code relating
to incompatible activities, no member of the hospital authority
administrative staff shall be considered to be engaged in activities
inconsistent and incompatible with his or her duties as a result of
employment or affiliation with the county.



101848.  The hospital authority may use a computerized management
information system in connection with the administration of the
medical center.


101848.1.  Information maintained in the management information
system or in other filing and records maintenance systems that is
confidential and protected by law shall not be disclosed except as
provided by law.


101848.2.  The records of the hospital authority, whether paper
records, records maintained in the management information system, or
records in any other form that relate to trade secrets or to payment
rates or the determination thereof, or which relate to contract
negotiations with providers of health care, shall not be subject to
disclosure pursuant to the California Public Records Act (Chapter 5
(commencing with Section 6250) of Division 7 of Title 1 of the
Government Code).  The transmission of the records, or the
information contained therein in an alternative form, to the board of
supervisors shall not constitute a waiver of exemption from
disclosure, and the records and information once transmitted shall be
subject to this same exemption.  The information, if compelled
pursuant to an order of a court of competent jurisdiction or
administrative body in a manner permitted by law, shall be limited to
in camera review, which, at the discretion of the court, may include
the parties to the proceeding, and shall not be made a part of the
court file unless sealed.



101848.3.  Notwithstanding any other law, the governing board may
order that a meeting held solely for the purpose of discussion or
taking action on hospital authority trade secrets, as defined in
subdivision (d) of Section 3426.1 of the Civil Code, shall be held in
closed session.  The requirements of making a public report of
actions taken in closed session and the vote or abstention of every
member present may be limited to a brief general description devoid
of the information constituting the trade secret.



101848.4.  The governing board may delete the portion or portions
containing trade secrets from any documents that were finally
approved in the closed session that are provided to persons who have
made the timely or standing request.


101848.45.  Nothing in this chapter shall be construed as preventing
the governing board from meeting in closed session as otherwise
provided by law.


101848.5.  The provisions of this chapter shall not prevent access
to any records by the Joint Legislative Audit Committee in the
exercise of its powers pursuant to Article 1 (commencing with Section
10500) of Chapter 4 of Part 2 of Division 2 of Title 2 of the
Government Code.



101848.6.  Open sessions of the hospital authority shall constitute
official proceedings authorized by law within the meaning of Section
47 of the Civil Code.  The privileges set forth in that section with
respect to official proceedings shall apply to open sessions of the
hospital authority.


101848.7.  The hospital authority shall be a public agency for
purposes of eligibility with respect to grants and other funding and
loan guarantee programs.  Contributions to the hospital authority
shall be tax deductible to the extent permitted by state and federal
law.  Nonproprietary income of the hospital authority shall be exempt
from state income taxation.



101848.8.  Contracts by and between the hospital authority and the
state and contracts by and between the hospital authority and
providers of health care, goods, or services may be let on a nonbid
basis and shall be exempt from Chapter 2 (commencing with Section
10290) of Part 2 of Division 2 of the Public Contract Code.




101848.9.  Provisions of the Evidence Code, the Government Code,
including the Public Records Act (Chapter 5 (commencing with Section
6250) of Division 7 of Title 1 of the Government Code), the Civil
Code, the Business and Professions Code, and other applicable law
pertaining to the confidentiality of peer review activities of peer
review bodies shall apply to the peer review activities of the
hospital authority.  Peer review proceedings shall constitute an
official proceeding authorized by law within the meaning of Section
47 of the Civil Code and those privileges set forth in that section
with respect to official proceedings shall apply to peer review
proceedings of the hospital authority.  If the hospital authority is
required by law or contractual obligation to submit to the state or
federal government peer review information or information relevant to
the credentialing of a participating provider, that submission shall
not constitute a waiver of confidentiality.  The laws pertaining to
the confidentiality of peer review activities shall be together
construed as extending, to the extent permitted by law, the maximum
degree of protection of confidentiality.



101848.10.  Notwithstanding any other law, Section 1461 shall apply
to hearings on the reports of hospital medical audit or quality
assurance committees.


101848.11.  The hospital authority shall carry general liability
insurance to the extent sufficient to cover its activities.



101849.  In the event the board of supervisors determines that the
hospital authority should no longer function for the purposes as set
forth in this chapter, the board of supervisors may, by ordinance,
terminate the activities of the hospital authority and expire the
hospital authority as an entity, subject to Section 1442.5 in that
code and any applicable public hearing requirements.



101849.1.  A hospital authority that is created pursuant to this
article but which does not obtain the administration, management, and
control of General Hospital and the Family Care Centers or which has
those duties and responsibilities revoked by the board of
supervisors shall not be empowered with the powers enumerated in this
chapter.



101849.2.  The county shall establish baseline data reporting
requirements for General Hospital and the Family Care Centers
consistent with the Medically Indigent Health Care Reporting System
(MICRS) program established pursuant to Section 16910 of the Welfare
and Institutions Code and shall collect that data for at least one
year prior to the final transfer of General Hospital and the Family
Care Centers to the hospital authority established pursuant to this
chapter.  The baseline data shall include, but not be limited to, all
of the following:
   (a) Inpatient days by facility by quarter.
   (b) Outpatient visits by facility by quarter.
   (c) Emergency room visits by facility by quarter.
   (d) Number of unduplicated users receiving services within the
medical center.


101849.3.  Upon transfer of General Hospital and the Family Care
Centers, the county shall establish baseline data reporting
requirements for each of the General Hospital and the Family Care
Centers inpatient facilities consistent with data reporting
requirements of the Office of Statewide Health Planning and
Development, including, but not limited to, monthly average daily
census by facility for all of the following:
   (a) Acute care, excluding newborns.
   (b) Newborns.



101849.4.  From the date of transfer of General Hospital and the
Family Care Centers to the hospital authority, the hospital authority
shall provide the county with quarterly reports specified in
Sections 101849.2 and 101849.3 and any other data required by the
county.  The county, in consultation with health care consumer
groups, shall develop other data requirements that shall include, at
a minimum, reasonable measurements of the changes in medical care for
the indigent population of San Luis Obispo County that result from
the transfer of the administration, management, and control of
General Hospital and the Family Care Centers from the county to the
hospital authority.