(a) Subject to any terms, conditions, and limitations as
may be imposed by the enabling ordinance, the authority, in addition
to any other powers granted pursuant to this chapter, shall have the
following powers:
(1) To have the duties, privileges, immunities, rights,
liabilities, and limitations of a local unit of government within the
state.
(2) To have perpetual existence, subject to Article 5 (commencing
with Section 101856).
(3) To adopt, have, and use a seal, and to alter it at its
pleasure.
(4) To sue and be sued in the name of the authority in all actions
and proceedings in all courts and tribunals of competent
jurisdiction.
(5) To purchase, lease, trade, exchange, or otherwise acquire,
maintain, hold, improve, mortgage, lease, sell, and dispose of real
and personal property of any kind necessary or convenient to perform
its functions and fully exercise its powers.
(6) To appoint and employ or otherwise engage a chief executive
officer and other officers and employees that may be necessary or
appropriate, including legal counsel, to establish their
compensation, provide for their health, retirement, and other
employment benefits, and to define the power and duties of officers
and employees.
(7) (A) To incur indebtedness and to borrow money and issue bonds
evidencing the same, including the authority to issue, from time to
time, notes and revenue bonds in principal amounts that the authority
determines to be necessary to provide sufficient funds for achieving
any of its purposes, including, but not limited to, assumption or
refinancing of debt service for capital projects eligible for
Medi-Cal supplemental payments pursuant to Section 14085.5 of the
Welfare and Institutions Code, or any successor or modified Medi-Cal
debt service reimbursement program, the payment of principal and
interest on notes and bonds of the authority, the establishment of
reserves to secure those notes and bonds, and all other expenditures
of the authority incident to and necessary or convenient to carry out
its purposes and powers.
(B) Any notes, bonds, or other securities issued, and the income
from them, including any profit from the sale thereof, shall at all
times be free from taxation by the state or any agency, political
subdivision, or instrumentality of the state.
(C) Notwithstanding the provisions of subparagraph (A), for any
indebtedness, notes, bonds, or other securities that require voter
approval pursuant to state law, the prior approval of the board of
supervisors shall be required. Notwithstanding the required prior
approval of the board of supervisors and except as otherwise provided
in this chapter, any indebtedness incurred, or notes, bonds, or
other securities issued pursuant to this subparagraph shall be the
indebtedness, notes, bonds, or securities of the authority and not of
the county, and the credit of the county shall not be pledged or
relied upon in any manner in order to incur the indebtedness, or
issue the notes, bonds, or other securities, unless the board of
supervisors explicitly authorizes the use of the county's credit. The
authority shall reimburse the county for all costs associated with
the county's consideration of the indebtedness, notes, bonds, or
securities, and the authority shall defend, indemnify, and hold
harmless the county from any and all liability, costs, or expenses
arising from or related to the indebtedness, notes, bonds, or
securities.
(D) Nothing in this section shall preclude the authority from
repayment of its debts or other liabilities, using funds that are not
otherwise encumbered.
(8) To pursue its own credit rating.
(9) To enter into one or more contracts or agreements consistent
with this chapter and other applicable laws of this state, including,
but not limited to, contracting with any public or private entity or
person for management or other services and personnel, and to
authorize the chief executive officer to enter into contracts,
execute all instruments, and do all things necessary or convenient in
the exercise of the powers granted in this chapter.
(10) To purchase supplies, equipment, materials, property, and
services.
(11) To establish policies relating to its purposes.
(12) To acquire or contract to acquire, rights-of-way, easements,
privileges, and property, and to construct, equip, maintain, and
operate any and all works or improvements wherever located that are
necessary, convenient, or proper to carry out any of the provisions,
objects, or purposes of this chapter, and to complete, extend, add
to, repair, or otherwise improve any works or improvements acquired
by it.
(13) To participate in, contract for, and to accept, gifts,
grants, and loans of funds, property, or other aid or finance
opportunity in any form from the federal government, the state, a
state agency, or other source, or combination thereof, as otherwise
would be available to a public, government, or private entity, and to
comply, subject to this chapter, with the terms and conditions
thereof.
(14) If not otherwise required pursuant to the enabling ordinance
to deposit its funds in the county treasury, the authority may
establish its own treasury, invest surplus money in its own treasury,
manage investments, and engage third-party investment managers, in
accordance with state law.
(15) To arrange for guarantees or insurance of its bonds, notes,
or other obligations by the federal or state government or by a
private insurer, and to pay the premiums thereof.
(16) To engage in managed care contracting, joint ventures,
affiliations with other health care facilities, other health care
providers and payers, management agreements, or to participate in
alliances, purchasing consortia, health insurance pools, accountable
care organizations, alternative delivery systems, or other
cooperative arrangements, with any public or private entity.
(17) To enter into joint powers agreements pursuant to Chapter 5
(commencing with Section 6500) of Division 7 of Title 1 of the
Government Code. Notwithstanding any other law, the authority may
enter into a joint powers agreement as described in Section 6523.5 of
the Government Code as though that section applied to hospitals and
other health care facilities in the County of Kern.
(18) To establish nonprofit, for-profit, or other entities
necessary to carry out the duties of the authority.
(19) To elect to transfer funds to the state and incur certified
public expenditures in support of the Medi-Cal program and other
programs for which federal financial participation is available.
(20) To use a computerized management information system,
including an electronic health records system, in connection with its
operations, including, without limitation the administration of its
facilities.
(21) To request that the board of supervisors levy a tax on behalf
of the authority. If the board of supervisors approves the proposal
to levy the tax, it shall call the election to seek voter approval
and place the appropriate measure on the ballot for that election.
The proceeds of these taxes shall be tax proceeds of the authority
and not of the county. The authority shall reimburse the county for
all costs associated with the county's consideration of those taxes,
and shall defend, indemnify, and hold harmless the county from any
liability, costs, or expenses arising from or related to the
imposition of these taxes.
(22) Notwithstanding the provisions of this chapter relating to
the obligations and liabilities of the authority, or any other law,
the authority shall have the same rights, privileges, exemptions,
preferences, and authority of a county with respect to owning,
operating, and providing coverage and services through hospitals,
clinics and other health facilities, health programs, care
organizations, physicians and physician practice plans, delivery
systems, health care service plans, and other provider types and
coverage mechanisms.
(23) To engage in other activities that may be in the best
interests of the authority and the persons served by the authority,
as determined by the board of governors, in order to respond to
changes in the health care industry.
(b) The authority shall conform to the following requirements:
(1) (A) Be a government agency that is a local unit of government
separate and apart for all purposes from the county and any other
public entity, and shall not be considered to be an agency, division,
or department of the county or any other public entity. The
authority shall not be governed by or subject to the civil service
requirements of the county. Notwithstanding any other law, except as
otherwise provided for in the enabling ordinance enacted pursuant to
this chapter, and as set forth in Section 101853.1 relating to the
personnel transition plan, the authority shall not be governed by, or
subject to, other policies or operational rules applicable to the
county, the medical center prior to its transfer, or any other public
entity, including, but not limited to, those relating to personnel
and procurement.
(B) The board of governors shall adopt written rules, regulations,
and procedures with regard to basic human resource functions not
inconsistent with memoranda of understanding covering employees
represented by employee organizations or the provisions of this
chapter. Until the time that the board of governors adopts its own
rules, regulations, or procedures with regard to these functions, the
existing rules, regulations, and procedures set forth in any
memoranda of understanding described in Section 101853.1, and the
rules and regulations adopted by the county and described in
paragraph (4), shall continue to apply.
(2) Be subject to state and federal taxation laws that are
applicable to public entities generally.
(3) Except as otherwise specifically provided in this chapter,
comply with the Meyers-Milias-Brown Act (Chapter 10 (commencing with
Section 3500) of Division 4 of Title 1 of the Government Code), the
Public Records Act (Chapter 3.5 (commencing with Section 6250) of
Division 7 of Title 1 of the Government Code), and the Ralph M. Brown
Act (Chapter 9 (commencing with Section 54950) of Part 1 of Division
2 of Title 5 of the Government Code).
(4) Be subject to the jurisdiction of the Public Employment
Relations Board. Until the authority adopts rules and regulations
pursuant to subdivision (a) of Section 3507 of the Government Code,
the existing rules adopted by the county and contained in the county'
s employer-employee relations resolution, as amended, shall apply,
modified to account for the creation of the authority, and provided
further that the resolution shall not contain any incorporation of
the county's civil service rules or county ordinances unless
specifically addressed in this chapter.
(5) Carry professional and general liability insurance or programs
to the extent sufficient to cover its activities.
(6) Comply with the requirements of Sections 53260 and 53261 of
the Government Code.
(7) Maintain financial and accounting records.
(8) Meet all local, state, and federal data reporting
requirements.
(c) (1) Subject to any restrictions applicable to public agencies,
and subject to any limitations or conditions set forth in the
enabling ordinance adopted by the board of supervisors, the authority
may borrow money from the county, repay debt it owes to the county,
and use the borrowed funds to provide for its operating and capital
needs. The county may lend the authority funds and may issue debt
instruments, including, without limitation, revenue anticipation
notes to obtain funds to provide, by loan or otherwise, amounts
necessary for the authority to meet its operating and capital needs.
(2) Notwithstanding paragraph (1), nothing in this chapter shall
be construed to limit the borrowing powers the county otherwise has
under law for the purposes specified in paragraph (1) or any other
purposes.
(d) Open sessions of the authority shall constitute official
proceedings authorized by law within the meaning of Section 47 of the
Civil Code. The privileges set forth in that section with respect to
official proceedings shall apply to open sessions of the authority.
(e) (1) Notwithstanding any other law, the board of governors or
board of supervisors, as applicable, may order that a meeting held
solely for the purpose of discussion or taking action on authority
trade secrets, as defined in subdivision (d) of Section 3426.1 of the
Civil Code, or to consider and take action on matters pertaining to
contracts and contract negotiations concerning all matters related to
rates of payment for health care services arranged or provided by
the authority, shall be held in closed session. Trade secrets for
purposes of this chapter shall also include information for which the
secrecy of the information is necessary for the authority to
initiate a new service, program, marketing strategy, business plan,
or technology, or to add a benefit or product, and premature
disclosure of the trade secret would create a substantial probability
of depriving the authority of a substantial economic benefit or
opportunity.
(2) The requirements of making a public report of actions taken in
closed session and the vote or abstention of every member present
may be limited to a brief general description devoid of the
information constituting the trade secret or concerning the matters
related to rates of payment.
(3) Those records of the authority or board of supervisors, as
applicable, that reveal the authority's trade secrets are exempt from
disclosure pursuant to the California Public Records Act (Chapter
3.5 (commencing with Section 6250) of Division 7 of Title 1 of the
Government Code), or any similar local law requiring the disclosure
of public records. This exemption shall apply for a period of two
years after the service, program, marketing strategy, business plan,
technology, benefit, or product that is the subject of the trade
secret is formally adopted by the governing body of the authority,
provided that the service, program, marketing strategy, business
plan, technology, benefit, or product continues to be a trade secret.
The board of governors or board of supervisors, as applicable, may
delete the portion or portions containing trade secrets from any
documents that were finally approved in the closed session that are
provided to persons who have made the timely or standing request.
(4) This chapter shall not prevent the board of governors or board
of supervisors, as applicable, from meeting in closed session as
otherwise provided by law.
(f) Notwithstanding any other law, those records of the authority
and of the county that reveal the authority's rates of payment for
health care services arranged or provided by the authority or its
deliberative processes, strategies, discussions, communications, or
any other portion of the negotiations with providers of health care
services or Medi-Cal, health care plans, or other payers for rates of
payment, shall not be required to be disclosed pursuant to the
California Public Records Act (Chapter 3.5 (commencing with Section
6250) of Division 7 of Title 1 of the Government Code), or any
similar local law requiring the disclosure of public records.
However, three years after a contract or amendment to a contract is
fully executed, the portion of the contract or amendment containing
the rates of payment shall be open to inspection.
(g) The authority shall be a public agency that is a local unit of
government for purposes of eligibility with respect to grants and
other funding and loan guarantee programs. Contributions to the
authority shall be tax deductible to the extent permitted by state
and federal law. Nonproprietary income of the authority shall be
exempt from state income taxation.
(h) Unless otherwise provided by the board of supervisors by way
of resolution, the authority is empowered, or the board of
supervisors is empowered on behalf of the authority, to apply as a
public agency for one or more licenses for the provision of health
care or the operation of a health care service plan pursuant to
statutes and regulations governing licensing as currently written or
subsequently amended.
(i) The statutory authority of a board of supervisors to prescribe
rules that authorize a county hospital to integrate its services
with those of other providers into a system of community service that
offers free choice of hospitals to those requiring hospital care, as
set forth in Section 14000.2 of the Welfare and Institutions Code,
shall apply to the authority and the board of governors.
(j) (1) Except as otherwise provided in this chapter, provisions
of the Evidence Code, the Government Code, including the Public
Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7
of Title 1 of the Government Code), the Civil Code, the Business and
Professions Code, and other applicable law pertaining to the
confidentiality of peer review activities of peer review bodies shall
apply to the peer review activities of the authority, or any peer
review body, as defined in paragraph (1) of subdivision (a) of
Section 805 of the Business and Professions Code, formed pursuant to
the powers granted to the authority. The laws pertaining to the
confidentiality of peer review activities shall be together construed
as extending, to the extent permitted by law, the maximum degree of
protection of confidentiality.
(2) Notwithstanding Article 9 (commencing with Section 11120) of
Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9
(commencing with Section 54950) of Part 1 of Division 2 of Title 5
of, the Government Code, or any other provision of law, any peer
review body formed pursuant to the powers granted to the authority,
may, at its discretion and without notice to the public, meet in
closed session, so long as the purpose of the meeting is the peer
review body's discharge of its responsibility to evaluate and improve
the quality of care rendered by health facilities and health
practitioners. The peer review body and its members shall receive, to
the fullest extent, all immunities, privileges, and protections
available to those peer review bodies, their individual members, and
persons or entities assisting in the peer review process, including
those afforded by Section 1157 of the Evidence Code and Section 1370.
Peer review proceedings shall constitute an official proceeding
authorized by law within the meaning of Section 47 of the Civil Code
and those privileges set forth in that section with respect to
official proceedings shall apply to peer review proceedings of the
authority.
(3) Notwithstanding the California Public Records Act (Chapter 3.5
(commencing with Section 6250) of Division 7 of Title 1 of the
Government Code), or Article 9 (commencing with Section 11120) of
Chapter 1 of Part 1 of Division 3 of Title 2 of, and Chapter 9
(commencing with Section 54950) of Part 1 of Division 2 of Title 5
of, the Government Code, or any other provision of state or local law
requiring disclosure of public records, those records of a peer
review body formed pursuant to the powers granted to the authority,
shall not be required to be disclosed. The records and proceedings of
the peer review body and its individual members shall receive, to
the fullest extent, all immunities, privileges, and protections
available to those records and proceedings, including those afforded
by Section 1157 of the Evidence Code and Section 1370 of the Health
and Safety Code.
(4) If the authority is required by law or contractual obligation
to submit to the state or federal government peer review information
or information relevant to the credentialing of a participating
provider, that submission shall not constitute a waiver of
confidentiality.
(5) Notwithstanding any other law, Section 1461 shall apply to
hearings on reports of hospital medical audit or quality assurance
committees.
(k) Except as expressly provided by other provisions of this
section, all exemptions and exclusions from disclosure as public
records pursuant to this chapter and the California Public Records
Act, including, but not limited to, those pertaining to trade secrets
and information withheld in the public interest, shall be fully
applicable to the authority, and for the board of supervisors, and
all state and local agencies with respect to all writings that the
authority is required to prepare, produce, or submit, and which shall
not constitute a waiver of exemption from disclosure.
(l) The authority and the county, or any combination thereof, may
engage in marketing, advertising, and promotion of the medical and
health care services made available to the community by the
authority.
(m) (1) The board of supervisors may contract for services or
purchase items on behalf of the authority.
(2) Unless otherwise provided for, and subject to the limitations
and conditions set forth in the enabling ordinance, the board of
governors shall have authority over procurement and contracts for the
authority and shall adopt written rules, regulations, and procedures
with regard to these functions. The authority's ability to contract
for personnel or other services and items it deems necessary,
appropriate, or convenient for the conduct of its activities
consistent with its purposes shall only be limited by the provisions
in this chapter and obligations under the Meyers-Milias-Brown Act
(Chapter 10 (commencing with Section 3500) of Division 4 of Title 1
of the Government Code).
(3) Contracts by and between the authority and a public agency,
and contracts by and between the authority and providers of health
care, goods, or services, may be let on a nonbid basis and shall be
exempt from Chapter 2 (commencing with Section 10290) of Part 2 of
Division 2 of the Public Contract Code.
(n) The authority may contract with the county for services and
personnel upon mutually agreeable terms.
(o) Notwithstanding Article 4.7 (commencing with Section 1125) of
Chapter 1 of Division 4 of Title 1 of the Government Code, related to
incompatible activities, Section 1099 of the Government Code,
related to incompatible offices, or any other law, a member of the
authority's administrative staff shall not be considered to hold an
incompatible office or to be engaged in activities inconsistent and
incompatible with his or her duties as a result of his or her
employment or affiliation with the county or an agency of the county.
(p) The board of governors and the officers and employees of the
authority are public employees for purposes of Division 3.6
(commencing with Section 810) of Title 1 of the Government Code,
relating to claims and actions against public entities and public
employees, and shall be protected by the immunities applicable to
public entities and public employees governed by Part 2 (commencing
with Section 814) of Division 3.6 of Title 1 of the Government Code,
except as provided by other statutes or regulations that apply
expressly to the authority.
(a) Transfer of control of the medical center, whether or
not the transfer includes the surrendering by the county of the
existing general acute care hospital license and corresponding
application for a change of ownership of the license, shall not
affect the eligibility of the county to undertake, and shall
authorize the authority, subject to applicable requirements, to do
any of the following:
(1) With the written consent of the county, participate in and
receive allocations pursuant to the California Health Care for
Indigents Program pursuant to Chapter 5 (commencing with Section
16940) of Part 4.7 of Division 9 of the Welfare and Institutions
Code, or similar programs, as may be identified or earmarked by the
county in support of uncompensated services of the type provided by
the medical center.
(2) With the written consent of the county, participate in and
receive allocations of local revenue fund amounts provided pursuant
to Chapter 6 (commencing with Section 17600) of Part 5 of Division 9
of the Welfare and Institutions Code as may be identified or
earmarked by the county in support of health care services of the
type provided by the medical center to low-income individuals.
(3) Participate in the financing of, as applicable, and receive,
Medicaid disproportionate share hospital payments available to a
county hospital or designated public hospital, or any other successor
or modified payment or funding that is intended to assist hospitals
that serve a disproportionate share of low-income patients with
special needs. The allocation of Medicaid disproportionate share
hospital payments shall be made in consultation with the State
Department of Health Care Services and other designated safety net
hospitals.
(4) Participate in the financing of, as applicable, and receive,
Medi-Cal payments and supplemental reimbursements, including, but not
limited to, payments made pursuant to Sections 14105.96, 14105.965,
14166.4, 14182.15, and 14199.2 of the Welfare and Institutions Code,
payments described in paragraph (4) of subdivision (b) of Section
14301.4 of, and Section 14301.5 of, the Welfare and Institutions
Code, and payments made available to a county provider or designated
public hospital, or governmental entity with which it is affiliated,
under any other successor or modified Medicaid payment system.
(5) Participate in the financing of, as applicable, and receive,
safety net care pool funding, stabilization funding, delivery system
reform incentive pool payments, and any other funding available to a
county provider or designated public hospital, or governmental
entities with which it is affiliated under the Medicaid demonstration
project authorized pursuant to Article 5.2 (commencing with Section
14166) and Article 5.4 (commencing with Section 14180) of Chapter 7
of Part 3 of Division 9 of the Welfare and Institutions Code, or
under any other successor or modified Medicaid demonstration project
or Medicaid payment system. The allocation of safety net care pool
funds shall be made in consultation with the State Department of
Health Care Services and other designated safety net hospitals.
(6) Participate in the financing, administration, and provision of
services under the Low Income Health Program authorized pursuant to
Part 3.6 (commencing with Section 15909) of Division 9 of the Welfare
and Institutions Code, or under any other successor or modified
Medicaid demonstration project or Medicaid payment system if the
authority enters into an agreement with the county concerning the
provision of services by, and payment for these services to, the
county.
(7) Participate in and receive direct grant and payment
allocations pursuant to Article 5.230 (commencing with Section
14169.50) of Chapter 7 of Part 3 of Division 9 of the Welfare and
Institutions Code, or under any other successor or modified direct
grant and payment systems funded by hospital or other provider fee
assessments.
(8) Receive Medi-Cal capital supplements pursuant to Section
14085.5 of the Welfare and Institutions Code, or any other successor
or modified Medi-Cal debt service reimbursement program.
Notwithstanding any other law, supplemental payments shall be made to
the medical center under those programs for the debt service costs
incurred by the county, and, if applicable, by the authority to the
extent that debt service responsibility is refinanced, transferred
to, or otherwise assumed by, directly or indirectly, the authority.
(9) Receive any other funds, or preference in the assignment of
health care plan enrollees, that would otherwise be available to a
county health plan, provider, or designated public hospital, or
governmental entity with which it is affiliated.
(b) The transfer of control of the medical center to the authority
pursuant to this chapter shall not otherwise disqualify the county
or the authority from participating in any of the following:
(1) Local, state, and federal funding sources either specific to
county or other publicly owned or operated health care service plans,
hospitals, or other health care providers, including, but not
limited to, ambulatory care clinics, health systems, practices,
designated public hospitals, or governmental entities with which they
are affiliated, for which there are special provisions specific to
those plans, hospitals, ambulatory care clinics, health systems,
practices, other health care providers or governmental entities with
which they are affiliated.
(2) All funding programs in which the county, by itself or on
behalf of the medical center had participated prior to the creation
of the authority, or would otherwise be qualified to participate in
had the authority not been created, and the maintenance, operation,
management, control, ownership, or lease of the medical center not
been transferred to the authority pursuant to this chapter.