Chapter 11Imperial Valley Healthcare District

Section § 32499.5

Explanation

This law creates a new health care district called the Imperial Valley Healthcare District in Imperial County. Once formed, it will follow all applicable rules for health care districts, except for specific exceptions noted in the chapter. The district's boundaries cover all of Imperial County, including areas managed by the Pioneers Memorial and Heffernan Memorial Healthcare Districts. Any organizational changes after its formation will be guided by a law known as the Cortese-Knox-Hertzberg Local Government Reorganization Act of 2000. In this chapter, 'district' refers specifically to the Imperial Valley Healthcare District.

(a)CA Health and Safety Code § 32499.5(a) A local health care district designated as the Imperial Valley Healthcare District is hereby formed within the County of Imperial. All other provisions of this division shall apply to the Imperial Valley Healthcare District following its formation, except as provided in this chapter.
(b)CA Health and Safety Code § 32499.5(b) The territory of the district shall include all of the County of Imperial, including those areas under the jurisdiction of the Pioneers Memorial Healthcare District and the Heffernan Memorial Healthcare District.
(c)CA Health and Safety Code § 32499.5(c) 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.
(d)CA Health and Safety Code § 32499.5(d) As used in this chapter, “district” means the Imperial Valley Healthcare District.
Imperial Valley Healthcare District Imperial County Pioneers Memorial Healthcare District Heffernan Memorial Healthcare District health care district formation territory inclusion Local Government Reorganization Act Cortese-Knox-Hertzberg Act district governance organizational change county-wide district local health care
(Added by Stats. 2023, Ch. 549, Sec. 2. (AB 918) Effective October 8, 2023.)

Section § 32499.6

Explanation

This law outlines the structure and responsibilities of the initial board of directors for a new healthcare district in Imperial County, California. The board will consist of different representatives from local healthcare districts, cities, and the Quechan tribe, each with specific eligibility criteria for appointees. If the board positions are not filled within 60 days, the Imperial County Board of Supervisors will appoint the members.

The board is tasked with creating a staggered election schedule for board positions, finding a permanent funding source, and negotiating the potential acquisition of the El Centro Regional Medical Center, including its assets, liabilities, and agreements. The board must also propose dissolution dates for existing healthcare districts and hold public meetings to inform and get feedback from the community.

Additionally, until these districts are dissolved, the Heffernan Memorial Healthcare District will have a clerical role, providing administrative support without taking on executive positions. All board positions should be filled through elections by 2028, and any vacancies will follow specific government code procedures. The board can also form a nonvoting advisory committee from local health professionals.

(a)Copy CA Health and Safety Code § 32499.6(a)
(1)Copy CA Health and Safety Code § 32499.6(a)(1) The initial board of directors of the district shall be composed of the following members:
(A)CA Health and Safety Code § 32499.6(a)(1)(A) One member from and appointed by the Pioneers Memorial Healthcare District Board of Directors.
(B)CA Health and Safety Code § 32499.6(a)(1)(B) One member from and appointed by the Heffernan Memorial Healthcare District Board of Directors.
(C)CA Health and Safety Code § 32499.6(a)(1)(C) One member from the City of El Centro and appointed by the public health director for the County of Imperial. This member shall be a resident of the City of El Centro, but not a City of El Centro employee, an elected official of the City of El Centro, or an employee or board member or former board member of the El Centro Regional Medical Center.
(D)CA Health and Safety Code § 32499.6(a)(1)(D) One member of the public appointed by the Imperial County Board of Supervisors. This member shall be a resident of the unincorporated areas in the areas of Seely or Ocotillo, or a county board supervisor that represents that area.
(E)CA Health and Safety Code § 32499.6(a)(1)(E) One tribal member from and appointed by the Quechan tribe. If a member is not appointed by the tribe within the 60-day timeframe, then the county board of supervisors may appoint a member of the public from the Winterhaven area.
(F)CA Health and Safety Code § 32499.6(a)(1)(F) One member from the City of Imperial and appointed by the City of Imperial.
(G)CA Health and Safety Code § 32499.6(a)(1)(G) One member from the City of Holtville and appointed by the City of Holtville.
(2)CA Health and Safety Code § 32499.6(a)(2) With the exception of the Pioneers Memorial Healthcare District and Heffernan Memorial Healthcare District appointments, any member appointed to the initial Imperial Valley Healthcare District Board of Directors cannot be a current or former employee of the El Centro Regional Medical Center, the Pioneers Memorial Hospital, or Pioneers Memorial Healthcare District.
(b)CA Health and Safety Code § 32499.6(b) The appointing bodies shall have 60 days from the effective date of this chapter to appoint members of the initial board of directors. If a board position is not filled within this timeframe, the Imperial County Board of Supervisors shall appoint the remaining members of the initial board of directors.
(c)Copy CA Health and Safety Code § 32499.6(c)
(1)Copy CA Health and Safety Code § 32499.6(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 32499.7.
(2)CA Health and Safety Code § 32499.6(c)(2) The initial board of directors, in collaboration with the Imperial County Local Agency Formation Commission (LAFCO), shall determine the years that the voting districts and associated board positions will be up for election by July 1, 2024.
(3)CA Health and Safety Code § 32499.6(c)(3) The initial board of directors, elected board of directors, or a combination of the initial and elected board of directors shall recommend a permanent funding source mechanism to be presented to voters via ballot measure. The funding source mechanism shall be placed on the ballot on or before the November 2026 election. The initial board of directors, elected board of directors, or a combination of the initial and elected board of directors, in collaboration with the Imperial County LAFCO, shall use the financial feasibility studies conducted by the Imperial County LAFCO and Kaufman Hall to determine the funding source mechanism.
(4)Copy CA Health and Safety Code § 32499.6(c)(4)
(A)Copy CA Health and Safety Code § 32499.6(c)(4)(A) The initial board of directors shall enter negotiations with the El Centro Regional Medical Center to decide the terms of the acquisition of the hospital. Upon reviewing the financial feasibility studies conducted by the Imperial County LAFCO and Kaufman Hall and confirming the financial viability of integrating the El Centro Regional Medical Center into the district, the initial board of directors shall determine the terms of the acquisition of the hospital. If the initial board of directors chooses to acquire the El Centro Regional Medical Center, the hospital shall be acquired with all of its assets and liabilities. All existing hospital licenses and certifications of the Pioneers Memorial Hospital and Healthcare District shall be transferred to the Imperial Valley Healthcare District when applicable in order to avoid a disruption in providing health care services. The initial board of directors shall initiate the process of applying for any licenses and certifications that cannot be transferred to the Imperial Valley Healthcare District within a year of formation. The initial board of directors shall finalize the terms of acquiring the hospital by November 5, 2024. The City of El Centro shall negotiate in good faith with the district, but is not required to sell the hospital to the district or agree to the terms that the initial board of directors finalizes.
(B)CA Health and Safety Code § 32499.6(c)(4)(A)(B) The terms of the acquisition shall include the district or any successor entity assuming the duties and obligations of El Centro Regional Medical Center’s collective bargaining agreements and retirement plans, at the El Regional Medical Center. This paragraph does not require any successor entity to adopt the collective bargaining agreement and retirement plan across to other facilities owned by the same operator.
(5)Copy CA Health and Safety Code § 32499.6(c)(5)
(A)Copy CA Health and Safety Code § 32499.6(c)(5)(A) The initial board of directors shall recommend to the Imperial County LAFCO a date for the dissolution of the Pioneers Memorial Healthcare District. The dissolution date shall be between July 1, 2024, and January 1, 2025. The initial board of directors may recommend a date that differs from the dissolution date of the Heffernan Memorial Healthcare District.
(B)CA Health and Safety Code § 32499.6(c)(5)(A)(B) The initial board of directors shall recommend to the Imperial County LAFCO a date for the dissolution of the Heffernan Memorial Healthcare District. The dissolution date shall be between July 1, 2024, and January 1, 2025. The initial board of directors may recommend a date that differs from the dissolution date of the Pioneers Memorial Healthcare District.
(6)CA Health and Safety Code § 32499.6(c)(6) The board of directors shall hold a minimum of three public meetings between the effective date of this chapter and January 1, 2025, as follows:
(A)CA Health and Safety Code § 32499.6(c)(6)(A) During the first public meeting, the board of directors shall inform the public of the establishment of the Imperial Valley Healthcare District, the cost savings of having one countywide health care district, and the findings of the financial feasibility studies conducted by the Imperial County LAFCO and Kaufman Hall. The first public meeting shall be held by March 1, 2024.
(B)CA Health and Safety Code § 32499.6(c)(6)(B) During the second public meeting, the board of directors shall inform the public of the recommended permanent funding source mechanism for the Imperial Valley Healthcare District.
(C)CA Health and Safety Code § 32499.6(c)(6)(C) During the third public meeting, the board of directors shall inform the public about the acquisition of the El Centro Regional Medical Center.
(D)CA Health and Safety Code § 32499.6(c)(6)(D) If the board of directors votes to acquire the El Centro Regional Medical Center, the board of directors shall hold a fourth meeting. During this meeting, the board of directors shall disclose the terms of the acquisition to the public and present a financial plan to finance the acquisition and ongoing operations of hospitals in the district.
(E)CA Health and Safety Code § 32499.6(c)(6)(E) At each public meeting held pursuant to this paragraph, the board of directors shall allow time for public comment.
(d)Copy CA Health and Safety Code § 32499.6(d)
(1)Copy CA Health and Safety Code § 32499.6(d)(1) Until both the Heffernan Memorial Healthcare District and Pioneers Memorial Healthcare District are dissolved, the Heffernan Memorial Healthcare District shall hold a temporary clerical role to the Board of Directors of the Imperial Valley Healthcare District.
(2)CA Health and Safety Code § 32499.6(d)(2) For purposes of this subdivision, Heffernan Memorial Healthcare District’s clerical responsibilities shall be limited to:
(A)CA Health and Safety Code § 32499.6(d)(2)(A) Providing administrative employees or the financial means to hire administrative employees.
(B)CA Health and Safety Code § 32499.6(d)(2)(B) Providing financial resources to complete clerical tasks for board meetings and public meetings. These tasks include:
(i)CA Health and Safety Code § 32499.6(d)(2)(B)(i) Creating agendas for public meetings and board meetings.
(ii)CA Health and Safety Code § 32499.6(d)(2)(B)(ii) Setting meeting locations, dates, and times.
(iii)CA Health and Safety Code § 32499.6(d)(2)(B)(iii) Upon direction of the Board of Directors of the Imperial Valley Healthcare District and the Imperial County LAFCO, ensuring the transfer of the existing health care districts into the Imperial Valley Healthcare District with minimal interruptions to ongoing health care services.
(C)CA Health and Safety Code § 32499.6(d)(2)(C) Providing a venue for the board meetings and public meetings to take place or providing the financial means for a venue.
(D)CA Health and Safety Code § 32499.6(d)(2)(D) Providing the financial means to hire legal counsel.
(3)CA Health and Safety Code § 32499.6(d)(3) It is the intent of the Legislature that Heffernan Memorial Healthcare District will hold a purely clerical role to the Board of Directors of the Imperial Valley Healthcare District. It is further the intent of the Legislature that Heffernan Memorial Healthcare District will not hold a CEO or CFO role.
(e)CA Health and Safety Code § 32499.6(e) The board of directors shall consist of all elected members by the conclusion of the 2028 general election.
(f)CA Health and Safety Code § 32499.6(f) A vacancy in a board position shall be filled by the methods prescribed in Section 1780 of the Government Code, and, after the board of directors consists of all elected members, shall be filled by the methods prescribed in Section 32499.7.
(g)Copy CA Health and Safety Code § 32499.6(g)
(1)Copy CA Health and Safety Code § 32499.6(g)(1) The board of directors may establish a nonvoting community advisory committee consisting of at least seven community members of the County of Imperial in the health care industry, including:
(A)CA Health and Safety Code § 32499.6(g)(1)(A) A member with an active medical license who is employed by a hospital or clinic in the County of Imperial.
(B)CA Health and Safety Code § 32499.6(g)(1)(B) A promotor or promotora.
(C)CA Health and Safety Code § 32499.6(g)(1)(C) A health care worker from a federally qualified health center in the County of Imperial.
(D)CA Health and Safety Code § 32499.6(g)(1)(D) A member from a health related or environmental justice nonprofit group in the County of Imperial.
(2)CA Health and Safety Code § 32499.6(g)(2) The nonvoting advisory board may be dissolved at the discretion of the board of directors.
Imperial Valley Healthcare District board of directors Pioneers Memorial Healthcare District Heffernan Memorial Healthcare District El Centro Regional Medical Center acquisition Imperial County Board of Supervisors Quechan tribe representation public meetings permanent funding source dissolution of healthcare districts clerical role community advisory committee healthcare district elections Seely and Ocotillo areas financial feasibility studies
(Amended by Stats. 2024, Ch. 1013, Sec. 1. (SB 1070) Effective January 1, 2025.)

Section § 32499.7

Explanation

This law outlines how the Imperial Valley Healthcare District's Board of Directors must divide the district into seven voting districts and hold elections by these districts starting from the next election after January 1, 2024. They need to work with the Imperial County Local Agency Formation Commission to set up the districts, considering demographic and geographic factors. Public input is allowed in a hearing, but the board's final decision is conclusive. The voting districts need to be established by July 1, 2024. Elections will proceed with one board member elected per district, and board members must be residents of their respective districts for at least 30 days before the election. Current members cannot run in the first election, and any future vacancies must be filled by appointing a resident from the unrepresented district.

(a)Copy CA Health and Safety Code § 32499.7(a)
(1)Copy CA Health and Safety Code § 32499.7(a)(1) Following appointment, the Board of Directors of the Imperial Valley Healthcare District, notwithstanding Section 32100.1, 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 occurring after January 1, 2024.
(2)CA Health and Safety Code § 32499.7(a)(2) The board of directors shall collaborate with the Imperial County Local Agency Formation Commission to establish the voting districts.
(b)CA Health and Safety Code § 32499.7(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)CA Health and Safety Code § 32499.7(c) The resolution adopted pursuant to subdivision (a) shall declare the voting districts and describe the boundaries of each voting district.
(d)CA Health and Safety Code § 32499.7(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.
(e)CA Health and Safety Code § 32499.7(e) The voting districts established pursuant to this section shall be effective for subsequent district elections, commencing with the next district election occurring after January 1, 2024. 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 32499.6, shall not be eligible to become an elected board member of the district for the first round of elections for each respective board seat.
(f)CA Health and Safety Code § 32499.7(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.
Imperial Valley Healthcare District Board of Directors voting districts district elections Imperial County Local Agency Formation Commission demographic representation geographic factors public hearing voter eligibility election implementation board member residency requirement board vacancies appointment procedure district boundaries effective district elections
(Added by Stats. 2023, Ch. 549, Sec. 2. (AB 918) Effective October 8, 2023.)

Section § 32499.8

Explanation

This law requires that the district report annually to the Imperial County Local Agency Formation Commission (LAFCO) about the state of health care services in their area by the end of 2024 and 2025. These reports should follow specific criteria outlined in another legal section.

Additionally, starting by the end of 2026 and every five years after, LAFCO must conduct a comprehensive review of the health care services provided in the district.

(a)CA Health and Safety Code § 32499.8(a) The district shall make annual reports to the Imperial County Local Agency Formation Commission (LAFCO), by December 31, 2024, and December 31, 2025, regarding health care service provision within the boundaries of the district, using the indices outlined in paragraphs (1) to (6), inclusive, of subdivision (a) of Section 56430 of the Government Code.
(b)CA Health and Safety Code § 32499.8(b) By December 31, 2026, and by December 31 every five years thereafter, the Imperial County LAFCO shall conduct a municipal service review regarding health care service provision within the boundaries of the district pursuant to Section 56430 of the Government Code.
Imperial County Local Agency Formation Commission healthcare services annual reports municipal service review December 31 deadlines service provision indices Section 56430 healthcare district five-year review cycle LAFCO reporting health service review district obligations service assessment
(Added by Stats. 2023, Ch. 549, Sec. 2. (AB 918) Effective October 8, 2023.)

Section § 32499.9

Explanation

This law section expresses the intent for the Imperial Valley Healthcare District to use its resources effectively for providing healthcare services to local residents. The district should focus on directly operating or funding various healthcare services like hospitals, clinics, senior or disability transport, wellness centers, education, mental health, and veteran services.

It is the intent of the Legislature that the Imperial 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.
Imperial Valley Healthcare District direct health care services hospitals medical clinics ambulance services transportation programs seniors persons with disabilities wellness centers health education promotoras mental health services veterans' health services funding healthcare services community health resources
(Added by Stats. 2023, Ch. 549, Sec. 2. (AB 918) Effective October 8, 2023.)

Section § 32499.95

Explanation

This law establishes that the Imperial County Local Agency Formation Commission (LAFCO) must decide when to dissolve the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District, ensuring this is done by January 1, 2025. Different dissolution dates can be set for each district.

Once dissolved, the Imperial Valley Healthcare District will take over as the successor, acquiring all assets and responsibilities, including property, funds, and legal obligations.

The current board members of the dissolving districts will remain in their positions until the district is dissolved or until January 1, 2025, whichever comes first.

(a)CA Health and Safety Code § 32499.95(a) Upon receipt of the recommendation from the Board of Directors of the Imperial Valley Healthcare District pursuant to paragraph (5) of subdivision (c) of Section 32499.6, the Imperial County Local Agency Formation Commission (LAFCO) shall determine the appropriate dates to dissolve the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District. The Imperial County LAFCO may decide on different dissolution dates for the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District. The Imperial County LAFCO shall dissolve the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District by January 1, 2025.
(b)CA Health and Safety Code § 32499.95(b) The Imperial Valley Healthcare District shall be the successor to the Heffernan Memorial Healthcare District and the Pioneers Memorial Healthcare District. Effective on the respective date of their dissolution, all assets, rights, and responsibilities of the Heffernan Memorial Healthcare District and the Pioneers 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 or Pioneers Memorial Healthcare District. Accounts payable and all other contract obligations shall be transferred to the Imperial Valley Healthcare District.
(c)CA Health and Safety Code § 32499.95(c) The terms of the board members of the Pioneers Memorial Healthcare District and the Heffernan Memorial Healthcare District serving as of the effective date of this chapter are extended until January 1, 2025, or until each respective district is dissolved, whichever occurs first.
Imperial Valley Healthcare District Heffernan Memorial Healthcare District Pioneers Memorial Healthcare District succession of assets dissolution dates transfer of responsibilities ownership transfer board member terms asset acquisition Imperial County LAFCO healthcare district dissolution successor responsibilities property control legal obligations transfer administrative takeover
(Added by Stats. 2023, Ch. 549, Sec. 2. (AB 918) Effective October 8, 2023.)