(a) The authority, in addition to any other powers granted
to the authority 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.
(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 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, the payment of interest on notes and
bonds of the authority, the establishment of reserves to secure these
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, 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.
(8) To pursue its own credit rating.
(9) To enter into any contract or agreement consistent with this
chapter or the laws of this state, 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, and to secure the payment of bonds.
(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 contract for and to accept gifts, grants, and loans of
funds, property, or other aid in any form from the federal
government, the state, a state agency, or other source, or
combination thereof, and to comply, subject to this chapter, with the
terms and conditions thereof.
(14) To 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.
(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 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, the board 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
these 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) To contract with the county for the provision of indigent
care services on behalf of the county. The contract shall specify
that county policies consistent with the county's obligations under
Section 17000 of the Welfare and Institutions Code shall be
applicable. Notwithstanding any other provision of this chapter, the
authority shall not undertake any of the county's obligations under
Section 17000 of the Welfare and Institutions Code, nor shall the
authority have an entitlement to receive any revenue for the
discharge of the county's obligations, without a written agreement
with the county.
(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 trustees, in order to respond to
changes in the health care industry.
(b) The authority shall conform to the following requirements:
(1) Be a government entity 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 policies or operational rules of the county or any
other public entity.
(2) Be subject to state and federal taxation laws that are
applicable to public entities generally, except that the authority
may, to the extent permitted by federal law, apply for an exemption
from social security taxation if there is a mutual agreement with the
exclusive representatives of the affected employees.
(3) 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 Division 2 of Title 5 of the Government Code).
(4) To the extent the authority is permitted by federal law to
participate in the Public Employees' Retirement System, assume the
assets and liabilities for Public Employees' Retirement System
benefits, consistent with the requirements of Section 20508 and other
applicable provisions of Part 3 (commencing with Section 20000) of
Division 5 of Title 2 of the Government Code and assume workers'
compensation liabilities and other employee benefits and liabilities
with respect to employees of the authority, unless otherwise agreed
to by the authority, the county, and the governing board.
(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) Meet all local, state, and federal data reporting
requirements.
(8) Be subject to the jurisdiction of the Public Employment
Relations Board.
(c) Open sessions of the authority 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 apply to open sessions of the authority.
(d) The authority is a public agency for purposes of eligibility
with respect to grants and other funding and loan guarantee programs.
Contributions to the authority are tax deductible to the extent
permitted by state and federal law. Nonproprietary income of the
authority is exempt from state income taxation.
(e) The authority is not 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).
(f) 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,
apply to the authority and the board of trustees.
(g) Unless otherwise agreed to by the authority and the board of
supervisors, or the authority and a governing board, an obligation of
the authority, statutory, contractual or otherwise, is the
obligation solely of the authority and not the obligation of the
county or any other entity, and any contract executed by and between
the county and the authority, or any other entity and the authority,
shall contain a provision that liabilities or obligations of the
authority with respect to its activities pursuant to the contract
shall be the liabilities or obligations of the authority and shall
not be or become the liabilities or obligations of the county or the
other entity, respectively.
(h) An obligation of the authority, statutory, contractual or
otherwise, is the obligation solely of the authority and not the
obligation of the state.
(i) In the event of a change of license ownership, the board of
trustees 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 authority is the responsible party with respect
to compliance with these obligations, terms, and conditions.
(j) (1) 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 apply to the peer review activities of the
authority. Peer review proceedings 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 apply to peer review proceedings of the
authority. 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 does 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.
(2) Notwithstanding any other law, Section 1461 applies to
hearings on reports of hospital medical audit or quality assurance
committees.
(k) (1) A transfer by the county to the authority, or by the
governing board to the authority, of the maintenance, operation, and
management or ownership of the medical center or the other health
care facility, respectively, whether or not the transfer includes the
surrendering by the county or the governing board of any existing
general acute care hospital license and corresponding application for
a change of ownership of the license, does not affect the
eligibility of the county or the governing board to undertake, and
authorizes the authority, subject to applicable requirements, to do,
any of the following:
(A) 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 for indigent health care services of the type provided by the
medical center.
(B) 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 for indigent health care services of the type
provided by the medical center.
(C) Participate in the financing of, 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.
(D) Participate in the financing of, and receive, Medi-Cal
supplemental reimbursements, including, but not limited to, payments
made pursuant to Sections 14105.96, 14105.965, 14166.4, and 14182.15
of the Welfare and Institutions Code, payments described in paragraph
(4) of subdivision (b) of Section 14301.4 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.
(E) Participate in the financing of, 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.
(F) 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.
(G) Participate in and receive direct grant and payment
allocations pursuant to Article 5.228 (commencing with Section
14169.1) 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.
(H) Receive Medi-Cal capital supplements pursuant to Section
14085.5 of the Welfare and Institutions Code. Notwithstanding any
other provision of law, supplemental payments shall be made to the
medical center under Section 14085.5 of the Welfare and Institutions
Code 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.
(I) Receive any other funds that would otherwise be available to a
county provider or designated public hospital, or governmental
entity with which it is affiliated.
(2) A transfer described in paragraph (1) shall not otherwise
disqualify the county or the governing board, or in the case of a
change in license ownership, the authority, from participating in any
of the following:
(A) Local, state, and federal funding sources either specific to
county or district hospitals, county or district ambulatory care
clinics, designated public hospitals, or government entities with
which they are affiliated, for which there are special provisions
specific to those hospitals, ambulatory care clinics, or government
entities.
(B) Funding programs in which the county or the governing board,
by themselves or on behalf of the medical center or the other health
care facility, respectively, 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,
and management or ownership of the medical center and the other
health care facility not been transferred by the county and the
governing board to the authority pursuant to this chapter.
(l) The authority, the county, and the governing board, 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) The board of trustees has authority over procurement and
contracts for the authority. The board of trustees shall adopt
written rules, regulations, and procedures with regard to these
functions. Contracts by and between the authority and any 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. Notwithstanding any
other provision of this section, the authority shall not subcontract
work performed by classifications represented by employee
organizations without mutual agreement between the authority and the
exclusive representatives, except that a subcontract entered into
prior to the formation of the authority may remain in effect until
its termination or completion and may be modified or renewed to a
later termination or completion date upon agreement between the
authority and the exclusive representatives of the affected
classifications.
(n) The authority shall be responsible for human resource
functions, including, but not limited to, position classification,
compensation, recruitment, selection, hiring, discipline,
termination, grievance, equal opportunity, performance management,
probationary periods, training, promotion, and maintenance of
records. The board of trustees shall adopt written rules,
regulations, and procedures with regard to these functions. Until the
time that the board of trustees adopts its own rules, regulations,
or procedures with regard to these functions, the existing rules,
regulations, and procedures set forth in any memorandum of
understanding described in paragraph (3) of subdivision (d) of
Section 101658 apply. If the memoranda do not provide for the
exercise of these functions, the rules, regulations, and procedures
of the county apply.
(o) The authority may contract with the county or the governing
board for services and personnel upon mutually agreeable terms.
(p) 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, a member of the authority's administrative
staff shall not be considered to be engaged in activities
inconsistent and incompatible with his or her duties as a result of
prior employment or affiliation with the county or the governing
board.
(q) The board of trustees 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.
(r) Except for Part 3 (commencing with Section 20000) of Division
5 of Title 2 of the Government Code, this chapter shall prevail over
any inconsistent statutes governing employees of the authority,
including, but not limited to, the Meyers-Milias-Brown Act (Chapter
10 (commencing with Section 3500) of Division 1 of Title 1 of the
Government Code).