Amended  IN  Assembly  May 01, 2023
Amended  IN  Assembly  April 17, 2023
Amended  IN  Assembly  March 23, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 918

Introduced by Assembly Member Garcia

February 14, 2023

An act to add Chapter 11 (commencing with Section 32499.5) to Division 23 of the Health and Safety Code, and to amend Section 7286.21 of the Revenue and Taxation Code, relating to health care districts.


LEGISLATIVE COUNSEL'S DIGEST


AB 918, as amended, Garcia. Health care district: County of Imperial.
Existing law, the Local Health Care District Law, authorizes the organization and incorporation of local health care districts and specifies the powers of those districts, including, among other things, the power to establish, maintain, and operate, or provide assistance in the operation of, one or more health facilities or health services, including, but not limited to, outpatient programs, services, and facilities; retirement programs, services, and facilities; chemical dependency programs, services, and facilities; or other health care programs, services, and facilities and activities at any location within or without the district for the benefit of the district and the people served by the district.

This bill would dissolve the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District within the County of Imperial. The bill would form a local health care district within the County of Imperial, designated as the Imperial County Healthcare District, that includes all of the County of Imperial. The bill would transfer the assets, rights, and responsibilities of the dissolved health care districts to the Imperial County Healthcare District. The bill would require the initial board of directors of the district to be composed of specified members, including among others, board members appointed from and by the dissolved district boards and members from and appointed by the El Centro Regional Medical Center Board of Directors. The bill would require the board of directors to conduct a financial feasibility study regarding the acquisition of El Centro Regional Medical Center and health care service integration within the district. The bill would require the board of directors to initiate conversations with El Centro Regional Medical Center to decide the terms of acquiring the hospital and require the board to finalize those conversations by November 1, 2026. The bill would require the initial board of directors to create a staggered board of directors, as specified. The bill would require the board of directors to adopt a resolution to divide the Imperial County Healthcare District into voting districts for the purpose of electing members of the board of directors from and by the electors of those voting districts beginning with the next district election after January 1, 2024, as specified. By imposing new duties on the County of Imperial, the bill would impose a state-mandated local program.

This bill would rename the Pioneers Memorial Healthcare District as the Imperial Valley Healthcare District. The bill would authorize the expansion of the district to include all of the County of Imperial. The bill would require the district to submit a resolution of application to the Imperial County Local Agency Formation Commission to initiate proceedings to expand the district. The bill would require the commission to order the expansion of the district subject to a vote of the registered voters residing within the territory to be annexed at an election following the completion of those proceedings. The bill would require the Board of Supervisors of the County of Imperial, upon direction by the commission, to place approval of district expansion on the ballot at the next countywide election following the completion of commission proceedings, including a public hearing. The bill would provide for expansion of the district upon voter approval, if a funding source sufficient to support the operations of the expanded district is, if required, approved, as specified. The bill would require the district to pay for election costs, as specified. The bill, following expansion, would dissolve the Heffernan Memorial Healthcare District and would transfer the assets, rights, and responsibilities of that district to the Imperial Valley Healthcare District. The bill would require the board of directors of the Imperial Valley Healthcare District, following expansion, to adopt a resolution to increase the number of members of the district’s board of directors from 5 to 7, and to appoint 2 members who are residents of the territory annexed by the district to fill the vacant positions, as specified. Following the expansion of the board of directors, the bill would require the board of directors to adopt a resolution to divide the Imperial Valley Healthcare District into voting districts for the purpose of electing members of the board of directors from and by the electors of those voting districts beginning with the next district election, as specified. By imposing new duties on the County of Imperial, the bill would impose a state-mandated local program.
This bill would state the intent of the Legislature that the Imperial County Valley Healthcare District maximize the use of its assets to provide direct health care services to individuals within the district, as specified.
This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Imperial.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 Chapter 11 (commencing with Section 32499.5) is added to Division 23 of the Health and Safety Code, to read:
CHAPTER  11. Imperial County Valley Healthcare District
32499.5.

(a)The Pioneers Memorial Healthcare District and the Heffernan Memorial Healthcare District are hereby dissolved. A local hospital district designated as the Imperial County Healthcare District is hereby formed within the County of Imperial. All other provisions of this division shall apply to the Imperial County Healthcare District following its formation, except as provided in this chapter.

(b)As used in this chapter, “district” means the Imperial County Healthcare District.

(c)The territory of the district shall be all of the County of Imperial, including those areas formerly under the jurisdiction of the Pioneers Memorial Healthcare District and the Heffernan Memorial Healthcare District.

(d)Following the formation of the district, the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code) governs any change of organization.

32499.6.

(a)The Imperial County Healthcare District shall be the successor to the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District.

(b)All assets, rights, and responsibilities of the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District are transferred to the Imperial County Healthcare District. As of the effective date of the dissolution, the Imperial County Healthcare District shall have ownership, possession, and control of all books, records, papers, offices, equipment, supplies, moneys, funds, appropriations, licenses, permits, entitlements, agreements, contracts, claims, judgments, land, and other assets and property, real or personal, owned or leased by, connected with the administration of, or held for the benefit or use of the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District. Accounts payable and all other contract obligations shall be transferred to the Imperial County Healthcare District.

32499.7.

(a)The initial board of directors of the district shall be composed of the following members:

(1)Two members from and appointed by the dissolved Pioneers Memorial Healthcare District Board of Directors.

(2)Two members from and appointed by the dissolved Heffernan Memorial Healthcare District Board of Directors.

(3)Two members from and appointed by the El Centro Regional Medical Center Board of Directors.

(4)One member from and appointed by the County of Imperial Board of Supervisors.

(b)The appointing bodies shall have 60 days from January 1, 2024, to appoint members of the initial board. If a board position is not filled within this time frame, the County of Imperial Board of Supervisors shall appoint the remaining members of the initial board of directors.

(c)(1)The initial board of directors, appointed pursuant to this section, shall create a staggered board of directors by choosing a number of board members to remain on the board following the first district election occurring pursuant to subdivision (a) of Section 32499.8.

(2)The initial board of directors shall determine the years that the voting districts and associated board positions will be up for election by July 1, 2024.

(3)The board of directors shall consist of all elected members by the conclusion of the next district election occurring after January 1, 2026.

(d)The board of directors shall conduct a financial feasibility study, by November 1, 2026, regarding the acquisition of El Centro Regional Medical Center and health care service integration within the district.

(e)The board of directors shall initiate conversations with El Centro Regional Medical Center to decide the terms of acquiring the hospital. The board of directors shall finalize conversations about acquiring the hospital by November 1, 2026.

(f)A vacancy in a board position shall be filled by the methods prescribed in Section 1780 of the Government Code, and, after January 1, 2028, shall be filled by the methods prescribed in Section 32499.8.

32499.5.
 (a) The Pioneers Memorial Healthcare District is renamed the Imperial Valley Healthcare District. The Imperial Valley Healthcare District may be expanded in accordance with this chapter. All other provisions of this division shall apply to the Imperial Valley Healthcare District following its reorganization, except as provided in this chapter.
(b) (1) On or before January 5, 2024, the Imperial Valley Healthcare District shall file a resolution of application with the Imperial County Local Agency Formation Commission, pursuant to subdivision (a) of Section 56654 of the Government Code, to initiate proceedings by the Imperial County Local Agency Formation Commission for the purpose of expanding the Imperial Valley Healthcare District to include all of the County of Imperial. The resolution of application shall comply with Section 56652 of the Government Code and shall specify the source of funding for the expanded district. The Imperial Valley Healthcare District shall pay any fees associated with the resolution of application.
(2) The Imperial County Local Agency Formation Commission proceeding shall be deemed initiated on the date the resolution of application is accepted for filing. Subsequent to initiation of the proceeding, the commission shall hold a hearing pursuant to Section 56666 of the Government Code. The commission shall comply with the notice requirements of Sections 56660 and 56661 of the Government Code in connection with the hearing.
(3) The Imperial County Local Agency Formation Commission shall complete its proceedings and direct the election required by paragraph (2) of subdivision (c) no later than 150 days following receipt of the completed resolution of application. Notwithstanding any other law, the Imperial County Local Agency Formation Commission shall not have the power to disapprove the resolution of application.
(4) Notwithstanding any other law, the resolution of application filed by the Imperial Valley Healthcare District pursuant to this subdivision shall not be subject to any protest proceedings.
(c) (1) The Imperial County Local Agency Formation Commission shall order the expansion of the district subject to a vote of the registered voters residing within the territory to be annexed at an election following the completion of proceedings pursuant to subdivision (b). The commission may condition the annexation on the district’s imposition of sufficient revenues to provide services within the territory to be annexed, including, but not limited to, the concurrent approval of special taxes or benefit assessments that will generate those sufficient revenues.
(2) The Imperial County Local Agency Formation Commission shall direct the Board of Supervisors of the County of Imperial to direct county officials to conduct the necessary election for approval of district expansion by placing approval of district expansion, pursuant to subdivision (d) of Section 57118 of the Government Code, and approval of any necessary funding source for the expanded district that requires voter approval on the ballot at the next countywide election.
(3) If a majority of the voters within the territory ordered to be annexed vote in favor of the expanded district and if a number of voters required under applicable law to approve any necessary funding source that requires voter approval vote in favor of that funding source, the district shall be expanded in accordance with this chapter.
(4) The district shall pay to the county the actual cost of the services rendered in conducting the election.
(d) The Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000 (Division 3 (commencing with Section 56000) of Title 5 of the Government Code) shall not apply to the expansion of the district pursuant to subdivisions (b) and (c), except as specified in this part. The act shall apply to any other change of organization or reorganization as defined in that act, following the reorganization of the district pursuant to this section.
(e) As used in this chapter, “district” means the Imperial Valley Healthcare District.

32499.6.
 (a) Thirty days after the expansion of the district, and notwithstanding Sections 32100.01 and 32100.02, the Board of Directors of the Imperial Valley Healthcare District shall adopt a resolution to increase the number of members of its board of directors from five to seven without the necessity of a petition or approval thereof by voters residing within the district. The resolution shall become effective on the date of, and subject to any conditions specified in, the resolution.
(b) The additional vacancies created by the expansion shall be filled by appointment by the board of directors. A person appointed to fill a vacancy created by subdivision (a) shall be a registered voter and a resident of the territory annexed by the district pursuant to Section 32499.5.
(c) Upon appointment, the board shall, by lot, designate one member appointed pursuant to subdivision (a) who shall leave office when their successor takes office pursuant to Section 10554 of the Elections Code, and one member appointed pursuant to subdivision (a) who shall leave office two years thereafter.
(d) A vacancy in one or both of the board positions created by subdivision (a) after the first appointments to those positions pursuant to subdivision (b) shall be filled by the methods prescribed in Section 1780 of the Government Code, and, as soon as feasible, shall be filled by the methods prescribed in Section 32499.7.
(e) This section shall only become operative if the Imperial Valley Healthcare District is expanded in accordance with Section 32499.5.

32499.8.32499.7.
 (a) (1)Following appointment, the expansion of the Board of Directors of the Imperial Valley Healthcare District, and notwithstanding Section 32100.1, the Board of Directors of the Imperial County Healthcare District board of directors shall adopt a resolution to divide the district into seven voting districts, number the voting districts consecutively, and elect members of the board of directors by voting district beginning with the next district election after January 1, 2024. first district election occurring, at least, 30 days after the expansion of the Imperial Valley Healthcare District in accordance with Section 32499.5.

(2)The board of directors may collaborate with the Imperial County Local Agency Formation Commission to establish the voting districts.

(b) In establishing the voting districts described in subdivision (a), the board of directors shall provide for representation in accordance with demographic, including population, and geographic factors of the entire area of the district. The board of directors shall fix the time and place and give public notice for a hearing on the proposed establishment of the voting districts, at which any elector of the district may present their views and plans in relation to the proposed division, but the board of directors shall not be bound thereby and their decision, in the resolution adopted, shall be final.
(c) The resolution adopted pursuant to subdivision (a) shall declare the voting districts and describe the boundaries of each voting district.
(d) The voting districts described in subdivision (a) and any necessary procedures for implementing the election of the board of directors by voting districts shall be established and implemented on or before July 1, 2024. within 30 days of an expansion of the Imperial Valley Healthcare District in accordance with Section 32499.5.
(e) The voting districts established pursuant to this section shall be effective for the next district election after January 1, 2024. subsequent district elections, commencing with the next district election occurring after their establishment. At the expiration of the terms of office of the members of the board of directors then in office, and thereafter, these members of the board of directors shall be elected by voting districts. One member of the board of directors shall be elected by the electors of each of the voting districts. A person shall not be eligible to hold the office of member of the board of directors unless they have been a resident of the voting district from which they are elected for 30 days next preceding the date of the election. A member of the initial board of directors, appointed pursuant to Section 32499.7, shall not be eligible to become an elected board member of the district.
(f) A vacancy upon the board that results in a voting district left unrepresented prior to the expiration of the term of that board position shall be filled by appointment of the remaining members of the board of directors. A member of the board of directors appointed pursuant to this subdivision shall be a resident of the voting district left unrepresented on the board of directors.
(g)  This section shall become operative only if the Imperial Valley Healthcare District is expanded in accordance with Section 32499.5.

32499.9.32499.8.
 It is the intent of the Legislature that the Imperial County Valley Healthcare District maximize the use of its assets to provide direct health care services to individuals within the district through direct operation of or funding provided to organizations that own or operate hospitals, medical clinics, ambulance services, transportation programs for seniors or persons with disabilities, wellness centers, health education services, promotoras, mental health services, veterans’ health services, and other similar services.

32499.9.
 (a) The Heffernan Memorial Healthcare District shall hereby be dissolved.
(b) The Imperial Valley Healthcare District shall be the successor to the Heffernan Memorial Healthcare District. All assets, rights, and responsibilities of the Heffernan Memorial Healthcare District are transferred to the Imperial Valley Healthcare District. As of the effective date of the dissolution, the Imperial Valley Healthcare District shall have ownership, possession, and control of all books, records, papers, offices, equipment, supplies, moneys, funds, appropriations, licenses, permits, entitlements, agreements, contracts, claims, judgments, land, and other assets and property, real or personal, owned or leased by, connected with the administration of, or held for the benefit or use of the Heffernan Memorial Healthcare District. Accounts payable and all other contract obligations shall be transferred to the Imperial Valley Healthcare District.
(c) This section shall become operative only if the Imperial Valley Healthcare District is expanded in accordance with Section 32499.5.

SEC. 2.Section 7286.21 of the Revenue and Taxation Code is amended to read:
7286.21.

The net proceeds of the tax imposed by Section 7286.20 shall be used exclusively for the Imperial County Healthcare District.

SEC. 3.SEC. 2.

 The Legislature finds and declares that a special law is necessary and that a general law cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution because of the unique community needs in the County of Imperial that would be served by the formation expansion of the Imperial County Valley Healthcare District to include all of the County of Imperial to provide health care services for an underserved population that suffers from a higher than average prevalence of preventable disease.

SEC. 4.SEC. 3.

 If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.