In it's latest "Executive Director Update" Ken Cohen, Executive Director of the Association of California Healthcare Districts(ACHD) congratulates Alta Healthcare District for finally paying off its creditors from a decades old bankruptcy. Numerous Healthcare Districts have closed their hospitals and declared bankruptcy, but it is rare for a District to pay off all creditors in full. With this landmark achievement, the District will continue on in existence to provide the legally mandated services to the residents of the District. Web Link
I sent the following to Mr. Cohen:
"As an elected Director of the Sequoia Healthcare District, I am unaware of
any “legally mandated” services applying to districts. Please enlighten me."
His response:
"Regarding legally mandated services, the term was used to describe that the District will now continue to exist to provide Healthcare services (this is the legal mandate) to the district. The specific array and range of services within the broad healthcare district legal mandate is
discretionary.
This is the mandate:
“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.”
To which I responded:
Ken,districts ostensibly have been given powers by the Legislature. They
are not mandated to use those powers. The only mandates I can think of,
occurred when voters approved creation of the Districts for the specific
purpose of establishing hospitals.
CAHSC
32121. Each local district shall have and may exercise the following
powers(no mandate here): See:Web Link
Ken responded:
I think we may end up with a difference of opinion on this. Technically, a
mandate is the authority to carry out a policy or course of action, regarded
as given by the electorate. This is my view but it is shared by others, when
the electorate establishes a District, the give the District a mandate to
provide healthcare services with certain powers granted by the legislature.
The type and/or level of service is discretionary. A healthcare district
has a mandate to provide healthcare services and facilities (as determined
by the Board) to benefit the district. They do not have a mandate to provide
"water, sewer, roads, etc", this would be operating outside of their
mandate.
If the District elects to provide zero service, they are not meeting their
mandate. It might then be up to the voters to determine if the district
should continue to exist, collect taxes or revenues, and provide no
services.
In this instance, mandate and obligation are nearly identical.
For CA law, mandate / obligation are different from judicial mandates or
court orders.
Anyway, I hope all is well. Look forward to seeing you/Sequoia Healthcare
District in the near future. Your questions, as always, are provocative and
challenging.
My response:
Ken, see: Web Link for the electorate mandate
for Sequoia Healthcare District.
I also sent this dialogue and the following, to Martha Poyatos(LAFC0) and cc'd Marianne O'Malley, Managing Principal Analyst, State and Local Finance Section, Legislative Analyst's Office
"Martha, doesn't this "mandate" question arise when determining whether an
activity of the District, (all of it discretionary IMHO) needs to be
continued by a successor agency? I see no mandate for a successor agency of Sequoia Healthcare District to continue the Nursing Program. Or to
subsidize schools, Ravenswood Clinic, Samaritan House, etc."
