Article 1. Administration of California Health And Safety Code >> Division 2. >> Chapter 2.5. >> Article 1.
As used in this chapter the term "board" means the board of
supervisors of a county.
The board of supervisors in each county may establish and
maintain a county hospital, prescribe rules for the government and
management thereof, appoint a county physician and other necessary
officers and employees thereof, who shall hold office during the
pleasure of the board and authorize said hospital to be a member of
and maintain membership in any local, state or national group or
association organized and operated for the promotion of the public
health and welfare or the advancement of the efficiency of hospital
administration and in connection therewith to use tax funds for the
payment of dues and fees.
(a) A member of a county hospital's medical or allied
health professional staff who is an officer of the board of
supervisors, or of a board or commission appointed by the board of
supervisors for the operation of a county hospital shall not be
deemed to be "financially interested," for purposes of Section 1090
of the Government Code, in any of the contracts set forth in
subdivision (b) made by any county body or board of which the officer
is a member if all of the following conditions are satisfied:
(1) The officer abstains from any participation in the making of
(2) The officer's relationship to the contract is disclosed to the
body or board and noted in its official records.
(3) If the requirements of paragraphs (1) and (2) are satisfied,
the body or board does both of the following, without any
participation by the officer:
(A) Finds that the contract is fair to the county hospital and in
its best interest.
(B) Authorizes the contract in good faith.
(b) Subdivision (a) shall apply to the following contracts:
(1) A contract between the county hospital and the officer for the
officer to provide professional services to the hospital's patients,
employees, or medical staff members and their respective dependents,
provided that similar contracts exist with other staff members and
the amounts payable under the contract are no greater than the
amounts payable under similar contracts covering the same or similar
(2) A contract to provide services to covered persons between the
county hospital and any insurance company, health care service plan,
employer, or other entity which provides health care coverage, and
which also has a contract with the officer to provide professional
services to its covered persons.
(3) A contract in which the county hospital and the officer are
both parties if other members of the county hospital's medical or
allied health professional staff are also parties, directly or
through their professional corporations or other practice entities,
provided the officer is offered terms no more favorable than those
offered any other party who is a member of the county hospital's
medical or allied health professional staff.
(c) This section does not permit an otherwise prohibited
individual to be a member of the board of supervisors or any
committee or commission thereof. Nothing in this section shall
authorize a contract that would otherwise be prohibited by Section
2400 of the Business and Professions Code.
(d) For purposes of this section, a contract entered into by a
professional corporation or other practice entity in which the
officer has an interest shall be deemed the same as a contract
entered into by the officer directly.
(a) Prior to (1) closing , (2) eliminating or reducing the
level of medical services provided by, or (3) the leasing, selling,
or transfer of management of, a county facility, the board shall
provide public notice, including notice posted at the entrance to all
county health care facilities, of public hearings to be held by the
board prior to its decision to proceed. The notice shall be posted
not less than 14 days prior to the public hearings. The notice shall
contain a list of the proposed reductions or changes, by facility and
service. The notice shall include the amount and type of each
proposed change, the expected savings, and the number of persons
(b) Notwithstanding the board's closing of, the elimination of or
reduction in the level of services provided by, or the leasing,
selling, or transfer of management of, a county facility subsequent
to January 1, 1975, the county shall fulfill its duty to provide care
to all indigent people, either directly through county facilities or
indirectly through alternative means.
(1) Where the county duty is fulfilled by a contractual
arrangement with a private facility or individual, the facility or
individual shall assume the county's full obligation to provide care
to those who cannot afford it, and make their services available to
Medi-Cal and Medicare recipients.
(2) Where the county duty is fulfilled by alternative means, the
facility or individual providing services shall be in compliance with
Sections 441.18 and 1277.
(3) The board shall designate an agency to provide a 24-hour
information service that can give eligible people immediate
information on the available services and access to them, and an
agency to receive and respond to complaints from people eligible for
services under this chapter. The designated agency may be the agency
that operates the facility. This subdivision applies only in
instances in which there is (1) a closing of, (2) an elimination or
reduction in the level of services provided by, or (3) the leasing,
selling, or transfer of, a county facility.
(4) The board shall arrange for all facilities or individuals
contracting to provide services to indigent people to be listed in
the local telephone directory under county listings, and shall
specify therein that the facilities or individuals fulfill the
obligations of county facilities.
(5) Section 25371 of the Government Code does not relieve the
county of the obligation to comply with this section.
The board may provide for transporting the needy sick to and
from hospitals to which they may be sent by authority of the board,
and may provide for transporting indigents to other counties or
states when such indigents will thereby cease to become public
charges, or when friends or relatives of such indigents agree to
assume the cost and expense of the care and maintenance of such
indigents, or when such indigents are legally public charges in the
places to which they are so transported.
The board of supervisors in each county or city and county,
having a population of one million or more, may purchase ambulances,
establish and maintain an ambulance service, and prescribe rules for
the government and management thereof. In any county where such a
service has been established, any person who has been injured in an
accident or is ill and in need of immediate transportation to a
hospital may be taken to any available hospital. If he is indigent
and unable to pay for the service, the cost shall be a proper charge
against the county. If he is not indigent, he shall reimburse the
county for the cost of transportation, which shall be in accordance
with a schedule to be adopted by the board, and in no case less than
the actual cost.
If a county hospital requests an ambulance to transfer a
mental health patient who is unstable and has a history of being
assaultive to another facility, notwithstanding any other provision
of law, the director of the hospital or a designee shall inform the
ambulance personnel of the instability and potential assaultiveness
of the mental health patient. The county hospital shall establish
procedures as are necessary to assure that the notification required
by this section is given in appropriate cases and to assure that
these notifications are documented.
Under such limitations and restrictions as are prescribed by
law, and in addition to jurisdiction and powers otherwise conferred,
the boards of supervisors in each county may provide for the care and
maintenance of the indigent sick or dependent poor of the county,
and may provide medical and dental care and health services and
supplies to persons in need thereof who are unable to provide the
same for themselves, and for these purposes may levy the necessary
taxes. Each county may, insofar as it is able to do so, provide the
means to meet promptly and adequately the health needs of the
indigent sick, the aged, and the poor, for the better prevention of
serious illness and incapacity, to the end that such persons will not
become public charges at the greater expense of those resources set
aside for the public health and welfare.
Except as otherwise provided in this chapter, a person, in
order to be eligible for care, shall be a resident of the state and
county wherein care is furnished as defined in Chapter 2 (commencing
with Section 17100) of Part 5 of Division 9 of the Welfare and
Notwithstanding any other provisions of the Welfare and
Institutions Code, the county which is responsible for the payment of
public assistance to any person or group of persons under Chapter 2
(commencing with Section 11200), Chapter 3 (commencing with Section
12000), or Chapter 4 (commencing with Section 12500) of Part 3 of
Division 9 of that code, and the needy relative in the case of aid to
needy children, shall provide the necessary hospital or medical
care, or both, if otherwise qualified for that care. If a recipient
of public assistance moves from one county to another county within
this state to make his or her home, the county to which the recipient
removes shall become responsible for providing medical or hospital
care or both upon notification by the first county that the recipient
has moved to the second county for the purpose of making his or her
home in that county, provided that the recipient is otherwise
qualified for the care, except that he or she need not meet the
residence qualifications set forth in Section 17105 of the Welfare
and Institutions Code.
(a) Except as otherwise provided in this section, the board
shall not let the care, maintenance, or attendance of the indigent
sick or dependent poor by contract to any person.
(b) The board may secure for the indigent sick, and other persons
admissible to the county hospital, at an agreed rate, hospital
service, or any portion thereof, from any public or private hospital,
clinic, rest home, sanitarium, or other suitable facility, or from
any corporation formed under Section 9201 of the Corporations Code or
under Chapter 11A (commencing with Section 11491) of Part 2of
Division 2 of the Insurance Code that operates in the state, in the
(1) Cases of unusual difficulty.
(2) Cases that require treatment, or hospital services, or the use
of facilities not immediately available in the county hospital.
(3) Cases requiring emergency care or continued treatment after
the emergency has ceased to exist.
(c) As used in this section, "hospital service" includes medical,
surgical, radiological, laboratory, nursing service, convalescent
care, and the furnishing of the necessary professional personnel,
equipment, and facilities to manage the needs of patients on a
continuing basis in accordance with accepted medical standards, with
a staff of professional nursing personnel who are assigned and
available under a clear and definite responsibility to the
institution rendering the service for the provision of services to
the patients, and any other care, service, or supplies that may be
necessary for the treatment of the sick or injured.
(d) The county may also contract with licensed boarding homes for
24-hour care for dependent children under the age of 18 years when
suitable facilities are not otherwise available in any institution or
establishment maintained and operated by the county.
(e) The county may also contract for medical treatment of persons
admissible to the county hospital with any licensed physician and
surgeon, or a corporation operating under Section 9201 of the
(f) The county may also contract for health care services when the
board determines that the hospital services or any portion thereof
rendered by the county hospital should be coordinated with those
provided by any other source.
The board may authorize payment for care provided, on or
after January 1, 1962, to an indigent resident of the county in a
hospital or medical facility located in another state, where that
care is provided in an emergency or can be secured at a lesser
expense than would be the case were the person to be transported to a
comparable facility in this State.
The board of supervisors of counties of the 20th class and
40th to 58th class, inclusive, in connection with the administration
of a county hospital may establish in the county treasury a special
fund to be known as the "Hospital Trust Fund," into which may be
placed deposits made voluntarily by patients entering such hospital.
At the time of any patient's dismissal from a county hospital,
there shall be refunded to him, upon the order of the business
manager or other person designated by the board of supervisors, such
portion of the deposit made voluntarily by the patient at the time of
his entrance into the hospital as was unneeded for his care while
confined therein. The portion earned by the hospital shall be
transferred to the hospital fund in the county treasury.
Upon presentation of an order for refund under this section, the
county auditor shall draw his warrant on the Hospital Trust Fund, and
the county treasurer shall pay the amount due thereon.
If no refund is made within 30 days after the patient's discharge,
the patient may file a claim against the county pursuant to Article
1 of Chapter 4 of Division 3 of Title 3 of the Government Code.
The board of supervisors of any county in connection with the
administration of any county hospital may establish in the county
treasury a special fund to be known as the "patients' personal
deposit fund." When such fund is established, any patient in the
hospital may request the superintendent thereof to deposit in the
fund any moneys belonging to the patient. Upon any such request by
any patient any moneys belonging to the patient shall be deposited in
the name of that patient in the patients' personal deposit fund,
except that if a guardian or conservator of the estate is appointed
for the patient, then the guardian or conservator shall have the
right to demand and receive such moneys or to withdraw either in
whole or in part the moneys theretofore deposited in the fund in the
name of the patient. Any of the funds belonging to a patient
deposited in the patients' personal deposit fund may be used for the
purchase of personal incidentals for the patient or otherwise used
for the personal needs and benefits of the patient upon his request.
At the time of the discharge from the hospital of any patient there
shall be refunded to him upon the order of the superintendent the
balance of any moneys standing to the credit of the patient in the
Prior to the time of the discharge of any patient, upon the demand
of the patient there shall be refunded to him upon the order of the
superintendent the whole or any portion of the balance of any moneys
standing to the credit of the patient in the fund. Upon such demand
of the patient, or upon the discharge of the patient from the
hospital, or upon the demand of the guardian or conservator of the
estate of the patient, the superintendent shall order the refund to
the patient or the payment to such guardian or conservator as
In any county where a county hospital has been established,
any expectant mother who is unable to pay for her necessary care
shall be admitted to the county hospital, and the cost of her
maintenance and care shall be a proper charge against and shall be
paid by the county of her residence.
The board shall appoint a suitable graduate, or graduates, in
medicine to attend such indigent sick or dependent poor in the
county hospitals and almshouses.
(a) In the interest of public health and safety the board of
supervisors of any county which maintains a county hospital may by
ordinance establish a hospital and safety commission. The commission
shall be advisory to the board of supervisors.
(b) The commission shall exercise such powers and perform such
duties relating to the administration of the county hospital as shall
be prescribed by the ordinance. The commission shall further
exercise such powers and perform such duties as shall be prescribed
by the ordinance and which may include the following:
1. To promote safety among all county officers and employees and
to develop a program of accident prevention.
2. To investigate all industrial, vehicular and all other
accidents to county personnel and county equipment, including
privately owned equipment operated by county personnel under contract
with the county.
3. To hold hearings in the course of such investigation and to
report to the board of supervisors upon all accidents reported to and
investigated by the commission.
4. To recommend to the board of supervisors safety rules and
regulations promoting the health and safety of all county officers
and employees and agents in the prosecution of their office or
employment and their use of all equipment in the course of their
duties as such officers, employees, and agents.
(c) The commission shall be appointed by the board of supervisors.
No person holding any elective office shall be appointed to the
commission. Members of the commission shall be residents of the
county. Members shall be appointed in the manner prescribed by the
ordinance and shall serve for such term as is prescribed therein;
subject, however, to the power of the board of supervisors to remove
any member of the commission at any time by three-fifths vote of the
(d) The members of the commission shall serve with or without
compensation as prescribed by the ordinance.
(e) Members of the commission may, when and if so provided in the
ordinance, receive actual and necessary expenses in traveling from
their place of residence to the place of meeting of the commission,
and return, and such expenses shall be a proper charge upon the
county; provided, however, that in no event shall any charge be made
upon the county for any expense incurred by any member for any meal
eaten at any meeting of the commission.
(f) Meetings of the commission shall be held in accord with the
provisions of Chapter 9 (commencing with Section 54950) of Part 1 of
Division 2 of Title 5 of the Government Code.
(g) The provisions of Section 54954 of the Government Code
notwithstanding, any meeting of the commission shall be held only in
a public building of the county and within the county in which such
commission is established.
(h) The ordinance establishing the commission shall specifically
prescribe the following:
(1) The name of the commission;
(2) The functions and duties thereof;
(3) Number of members, method of appointment and term of members;
(4) A statement of whether or not payment of compensation to
members of the commission is authorized and, if authorized, a
statement of the amount of such compensation and the maximum number
of meetings of the commission in any one calendar month for which
such compensation may be paid;
(5) A statement of whether or not traveling expenses are
authorized and, if authorized, a statement of the rate which will be
allowed for mileage.
(6) Subject to the limitations prescribed by this section, such
ordinance may contain such additional provisions as the board of
supervisors may deem expedient for the proper administration of the
affairs of the commission.
(i) Any ordinance of any county establishing a hospital or a
safety commission enacted prior to the effective date of this section
is hereby validated, provided that the provisions of the ordinance
substantially comply with the limitations and authorizations set
forth in this section; provided expressly, however, that any such
hospital or safety commission created by ordinance enacted prior to
the effective date of this section shall cease to exist at the close
of the 60th day following the effective date of this section, and no
hospital or safety commission established by any such ordinance, or
established in any other manner whatever, shall continue to exist or
function thereafter in any county unless and until such hospital or
safety commission is established by ordinance under the provisions of
(a) The State Department of Health Services, with the advice
of the State Department of Social Services, shall prescribe the
records to be kept by county hospitals of persons received into or
discharged from these institutions, including, but not limited to,
records for the admission and processing of county hospital patients.
(b) The records shall be preserved and maintained pursuant to
regulations adopted by the department, or at the request of the
county physician or other person in charge of the county hospital,
the board of supervisors of the county may authorize the destruction
of any record, paper or document prescribed by the department
following compliance with the conditions prescribed in Section 26205
of the Government Code.
(c) (1) Notwithstanding any other provision of law, those records
of a hospital, or any other county medical facility, subject to this
chapter that reveal the rates of payment for health care services
rendered by or purchased by the hospital or other medical facility,
or the deliberative processes, discussions, communications, or any
other portion or aspect of the negotiations leading to those payment
rates, shall not be considered public records subject to 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, nor shall they be subject to public disclosure
pursuant to any other law requiring the disclosure of records, for a
period of three years following execution of a related contract
establishing rates of payment.
(2) Notwithstanding paragraph (1), public disclosure or
nondisclosure of records relating to any matters or activities
connected with selective provider contracts entered into pursuant to
Article 2.6 (commencing with Section 14081) of Chapter 7 of Part 3 of
Division 9 of the Welfare and Institutions Code shall be determined
pursuant to Article 2.6 (commencing with Section 14081) of Chapter 7
of Part 3 of Division 9 of the Welfare and Institutions Code and
subdivision (q) of Section 6254 of the Government Code, and other
applicable provisions of Chapter 3.5 (commencing with Section 6250)
of Division 7 of Title 1 of the Government Code.
The board may provide a farm in connection with the county
hospital or almshouse and may make regulations for working the same.
No county hospital which permits sterilization operations for
contraceptive purposes to be performed therein, nor the medical
staff of such hospital, shall require the individual upon whom such a
sterilization operation is to be performed to meet any special
nonmedical qualifications, which are not imposed on individuals
seeking other types of operations in the hospital. Such prohibited
nonmedical qualifications shall include, but not be limited to, age,
marital status, and number of natural children.
Nothing in this section shall prohibit requirements relating to
the physical or mental condition of the individual or affect the
right of the attending physician to counsel or advise his patient as
to whether or not sterilization is appropriate. This section shall
not affect existing law with respect to individuals below the age of
(a) Upon a determination and establishment of the need to
recruit and retain registered nurses, licensed vocational nurses,
X-ray technicians, laboratory technologists, and other health care
professionals, the board of supervisors of a county may establish
nursing or health care professional scholarships. For purposes of
this section, "health care professional" shall not include a
physician and surgeon.
(b) The board of supervisors, or a designee of the board, shall
administer the scholarship program for students participating in a
nurse or health care professional training program and shall adopt
such rules and regulations as are reasonably necessary to carry out
the provisions of this section.
(c) Scholarships made pursuant to this section, shall be repayable
to the board of supervisors or canceled under the following
(1) A graduate nurse or health care professional who maintains
employment in a county-operated health facility for less than one
year after becoming licensed shall repay the scholarship in addition
to accrued interest charges. The scholarships shall be repayable to
the board of supervisors under the terms specified in the agreement.
(2) The total amount of the scholarship and all accrued interest
shall be canceled for a graduate nurse or graduate health care
professional who maintains employment in a county-operated facility
for more than a year from the date of licensure and may be canceled
under any other conditions established by rules and regulations
adopted by the board of supervisors. For the purposes of this
section, one year of employment in a county-operated health facility
shall be deemed to have lapsed one year from the date the licensed
nurse or health care professional presents proof, in writing, to the
board of supervisors, or designee of the board, that he or she is
licensed and is employed in a county-operated health facility.
(d) In addition to the principal amount of the scholarship,
interest shall accrue on the principal at a rate to be established by
the board of supervisors. Interest shall accrue from the date the
scholarship is made until it is repaid unless the scholarship is
canceled pursuant to paragraph (2) of subdivision (c).
Notwithstanding any other provisions of law, the board of
directors of any hospital subject to this chapter may order that any
hearings on the reports of hospital medical audit or quality
assurance committees be held in closed session. An applicant or
medical staff member whose staff privileges are the direct subject of
a hearing may request a public hearing. Deliberations of the board
of directors in connection with matters pertaining to these hearings
may be held in closed session.
(a) Except as provided in this section or Section 1461, all
of the sessions of the board of directors of any hospital subject to
this chapter, whether regular or special, shall be open to the
(b) The board of directors may order that a meeting held solely
for the purpose of discussion or deliberation, or both, of reports
involving hospital trade secrets to be held in closed session. Except
as provided in this subdivision, the closed session shall meet all
applicable requirements of Chapter 9 (commencing with Section 54950)
of Division 2 of Title 5 of the Government Code.
(c) "Hospital trade secrets," as used in this section, means a
"trade secret," as defined in subdivision (d) of Section 3426.1 of
the Civil Code, and which meets both of the following:
(1) Is necessary to initiate a new hospital service or program or
add a hospital facility.
(2) Would, if prematurely disclosed, create a substantial
probability of depriving the hospital of substantial economic
(d) The exemption provided in subdivision (b) to the general open
meeting requirements for a meeting of the board of directors, shall
not apply to a meeting where there is action taken, as defined in
Section 54952.6 of the Government Code.
(e) Nothing in this section shall be construed to permit the board
of directors to order a closed meeting for the purposes of
discussing or deliberating, or to permit the discussion or
deliberation in any closed meeting of, any proposals regarding:
(1) The sale, conversion, contract for management, or leasing of
any county hospital or the assets thereof, to any for-profit or
not-for-profit entity, agency, association, organization,
governmental body, person, partnership, corporation, or other
(2) The conversion of any county hospital to any other form of
ownership by the county.
(3) The dissolution of the county hospital.