ACHD-sponsored Legislation: SB 957 (Hueso)

Healthcare districts: design-build process

 

After ACHD's Board of Directors advised the Advocacy Team to seek legislation that provided Healthcare Districts with the authority to utilize the design-build process for construction and rehabilitation of facilities, we began laying the groundwork for building support for such a proposal in the Legislature. After securing an author (Senator Ben Hueso, D-San Diego) and co-authors, we were able to secure a co-sponsor, the State Building and Construction Trades Council of California, an association representing a number of the state's trade unions. We spent a considerable amount of time reaching out to potential supporters, including a number of individual Healthcare Districts. The Advocacy Team also prepared written materials in support of SB 957, leading up to the bill's initial policy committee hearing in the Senate Governance and Finance Committee.

 

When the Governance and Finance committee staff requested additional language to SB 957 to limit its application, we worked with the ACHD Advocacy Committee to develop language that provided design-build authority to a District that owned or operated a hospital or clinic. This amendment was sufficient for the committee chair to recommend an "aye" vote and SB 957 was approved unanimously.

 

From then on, SB 957 was met positively by relevant policy and fiscal committees. In fact, the measure was on the consent calendar the entire time it was in the Assembly. SB 957 was sent to the Governor on August 11, 2016 without a single recorded "no" vote; Governor Brown signed the bill into law on August 26, 2016.

 

Priority Legislation:

 

AB 1306 (Burke)

Healing arts: certified nurse-midwives: scope of practice

 

While AB 1306 was introduced in 2015, the measure was amended in June 2016 and heard again in the Senate Business and Professions Committee in August 2016.  This measure, authored by Assembly Member Autumn Burke, would have authorized certified nurse-midwives, within their existing scope of practice, to manage a full range of health care services for women, including gynecologic and family planning services.  ACHD strongly supported this measure and met with a number of legislative offices to secure enough votes for passage.  While the bill passed out of the Senate, it ultimately failed to gain enough votes pass out of the Assembly on the last night of the legislative session due to strong opposition by the California Medical Association.    

 

AB 2024 (Wood)

Critical access hospitals: employment

 

When the ACHD Advocacy Team learned that Assembly Member Jim Wood was authoring AB 2024, a measure that sought to allow federally designated critical access hospitals to directly hire physicians, we reached out to his office with our enthusiastic support. ACHD was able to connect Dr. Wood's staff with Dr. Kevin Flanigan, CEO of Northern Inyo Healthcare District, for a "real world" discussion of this important ACHD priority. Dr. Flanigan provided lead testimony in support of the measure and was well-received by the Assembly Business and Professions Committee. ACHD made individual visits to legislators, as well as providing lead testimony in support of the bill. The Team also reviewed draft amendments and provided feedback to Dr. Wood's office, which was particularly important when they were considering amendments to address the concerns of the California Medical Association.

 

AB 2024 was sent to the Governor without a single recorded "no" vote and was signed on September 23, 2016. The law will take effect on January 1, 2017.

 

AB 2471 (Quirk)

Healthcare districts: dissolution

 

ACHD worked diligently with the Eden Township Healthcare District in opposition to 

AB 2471, a measure by Assembly Member Bill Quirk that sought to dissolve Eden without a LAFCO discussion or a vote of the affected residents. While our primary concern about the bill was its precedent-setting effort to impose a legislative solution when a local dialogue had not yet taken place, AB 2471 and AB 2737 (discussed further below) represented an opportunity for members of the Legislature with long-standing and deeply held concerns about Healthcare Districts to express those concerns loudly. Press and grand jury reports focused on the local controversies surrounding Eden and made those conversations even more difficult.

 

As a result, Assembly Local Government Committee Chair, Susan Eggman, raised the likelihood of the Committee convening an informational hearing about Healthcare Districts, particularly those that do not provide direct health care services.

 

During the legislative process, local leaders called upon the Alameda County LAFCO to conduct a special study of the Eden Township Healthcare District. The LAFCO approved the study in June and has embarked upon securing a consultant to conduct such a study. Concurrently, Assembly Member Quirk committed to holding his bill on the Senate Floor pending the outcome of the LAFCO study.

 

AB 2737 (Bonta)

Non-provider healthcare districts

 

AB 2737 by Assembly Member Rob Bonta was another effort to address concerns about the financial management and operation of the Eden Township Healthcare District. AB 2737 does not reference Eden specifically, but outlines a series of criteria that must be met for a Healthcare District to be subject to an administrative cost cap of 20 percent. ACHD again worked with the District and CSDA to oppose this precedent-setting bill. Regrettably, AB 2737 was approved by the Governor on September 21, 2016.

 

ACR 169 (Dahle)

Health Care District Month

 

ACHD once again sponsored "May as Healthcare District Month" with the introduction and subsequent approval of Assembly Concurrent Resolution 169 by Assembly Member Brian Dahle. With 77 co-authors, ACR 169 established May as Healthcare District Month in California and served to raise awareness about the programs and services provided by California's 79 Healthcare Districts.

 

AB 2910 (Assembly Local Government Committee)

Local government organization: omnibus

 

In order to clarify existing statutory direction to LAFCO about dissolution of special districts, ACHD worked with CALAFCO and the Assembly Local Government Committee staff on an amendment to explicitly include Healthcare Districts in the language that authorizes a LAFCO to do a dissolution without a vote of the people if a majority protest fails to occur. This amendment addresses questions that LAFCOs and District counsels have raised as to whether the Legislature intended to include Healthcare Districts in this provision of law previously.

 

SB 994 (Hill)/SB 468 (Allen)

Healthcare districts: design-build

 

Due to amended language in SB 957 (Hueso), Beach Cities Health District and Peninsula Health Care District would not be granted design-build authority if SB 957 were to be approved. As a result, Senator Jerry Hill introduced SB 994, a measure that would have provided a design-build pilot program specifically for Beach Cities and Peninsula Healthcare Districts for a five-year period. These two Districts had projects in the pipeline that would've benefited with design-build. ACHD strongly supported SB 994 and worked with the Districts, Senators Hill and Allen, and legislative staff on an approach that would pass legislative scrutiny. SB 994 was successful in the Senate, securing unanimous support in the Senate Governance and Finance Committee and on the Senate Floor. However, once it arrived in the Assembly, SB 994 could not move due to missing the policy committee deadline. Identical language was amended into SB 468 by Senator Ben Allen; that bill also did not receive the necessary rule waivers to move through an expedited process in the Assembly prior to the end of session.

 

Senate Business, Professions, and Economic Development Committee Informational Hearing

Corporate Practice of Medicine (CPM) bar

 

ACHD worked directly with the staff of the Senate Business and Professions Committee to secure a speaker for its informational hearing on the Corporate Practice of Medicine bar in early May. Once again, Dr. Kevin Flanigan, Northern Inyo Healthcare District, testified before the Committee on the practical effects of the corporate ban in his small, rural district. ACHD reviewed the Committee's written report, prepared talking points for Dr. Flanigan, and served as a resource for legislative staff for the hearing. Overall, Healthcare District involvement was positively received.

 

2016 Legislative Day

 

Building relationships between ACHD members and legislators is a key element of our advocacy strategy. ACHD's Legislative Day was designed to provide an opportunity for ACHD members to discuss priority legislation with key legislators, their staffs, and committee staff in Sacramento. In 2016, ACHD scheduled 15 meetings with members of the Senate and Assembly Health Committees, Senate Governance and Finance Committee, Assembly Local Government Committee, as well as Senate and Assembly leadership. In addition, ACHD hosted a legislative reception at the California Museum for members of the Legislature to meet ACHD members in a more informal, fun environment. The evening culminated in honoring Dr. Ed Hernandez, Senator from Los Angeles County, with ACHD's Legislator of the Year award.

 

Little Hoover Commission

 

In late summer, ACHD was contacted by staff for the Little Hoover Commission with an invitation to participate in a hearing regarding California's special districts. The Little Hoover Commission is an independent state oversight agency tasked with promoting efficiency, economy, and improved service in state government. Citizen members, appointed by the Governor and legislative leaders, in addition to two members of the Senate and two members of the Assembly, make up a commission of 13 members.

 

ACHD prepared an extensive written testimony as requested by the Commission and testified in a public hearing before the Commission on August 25, 2016. We coordinated our efforts with the California Special Districts Association, the California Association of Local Agency Formation Commissions (CALAFCO), and a variety of other special district organizations to present a united and consistent message to the Commission. Representatives from two Healthcare Districts also joined us for public testimony.

 

We have been invited to an additional discussion with the Commission on November 16, where we will present the work of ACHD's Working Group, as the Commission has specifically requested follow-up information on the reforms proposed by the Working Group. While we do not have a specific agenda for that discussion, we do believe that the Commission will be focused on the role of Healthcare Districts that do not operate a hospital.

 

In Conclusion

 

The ACHD Advocacy Team also made a concerted effort to promote and strengthen relationships with our partner organizations in Sacramento, including participating in meetings and working directly with staff of the California Special Districts Association, the California Hospital Association (CHA), the District Hospital Leadership Forum (DHLF), and the California Association of Local Agency Formation Commissions (CALAFCO), among others. We were able to work collaboratively with these partners to join our legislative advocacy efforts, to strategize, and to learn about - and potentially be supportive of - their legislative priorities.

 

These relationships, a commitment to the reform efforts suggested by the ACHD Working Group, and a continuous effort to educate members of the Legislature will be critical to a successful advocacy effort in 2017. We look forward to additional conversations with ACHD's Board of Directors about legislative strategy for the upcoming session.