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WHAT'S NEW IN MARCH

CEO MESSAGE

I come to you today on the other side of a very busy week for the ACHD Board of Directors. Last week, the Board met in Sacramento for a two-day retreat to develop the Association’s 2025-28 Strategic Plan. Through engaging discussion and idea sharing, the Board and staff designed a plan that will build upon the solid foundation that was created by the success of our 2022-25 plan. The 2025-28 Strategic Plan is bold and puts member needs at the very center. It strikes a balance between being ambitious, while also recognizing the factors that drive politics and eventually influence legislative outcomes in the Capitol City.

A discussion during the retreat that I would like to highlight is the Board’s discussion about the collective impact that healthcare districts have upon their districts’ residents through their partnerships and support of non-profit organizations. California’s healthcare districts are doing amazing work in their communities, but when you take a global view of the impact districts are having, you see that their partnerships with non-profits are having a multiplier effect by magnifying the footprint of improved health and wellness in the communities they serve. Be on the lookout for more as we lift up these partnerships through our social channels and the ACHD News page on our website.

February 21^st was the bill introduction deadline in Sacramento. Sarah Bridge, ACHD’s Vice President of Advocacy and Strategy, is currently pouring over all 2300-plus bills that were introduced this session, assessing their impact, if any, on healthcare districts. ACHD’s sponsored bill, AB 533, to reinstate allowing all healthcare districts to use the design-build process, is authored by Assemblymember Heath Flora. Be sure to check Sarah’s message below for more information on what she’s seeing coming our way this year. When ACHD has officially positioned on proposals, our website will be updated in real time.

March is the time of year when we kick off the Annual Meeting planning season. If you haven’t already, be sure to mark your calendars to join us at the Sheraton San Diego Resort, September 24-26. If you missed our Call for Proposals for ACHD's 73rd Annual Meeting,  we are now accepting proposals for both general sessions and our wildly popular District Best Practices breakout sessions. Registration for the event will open in late May and we will provide updates regarding keynote speakers and other exciting news, as the event gets closer.

Enjoy the additional sunlight hour we are about to get this weekend! As always, feel free to reach out directly if ACHD can be helpful or provide assistance in any way.

With gratitude,

As we move into the spring of 2025, the California legislative session is in full swing. ACHD is currently in the process of carefully analyzing over 2,300 introduced bills to assess their potential impact on healthcare districts and the communities you serve.

California State Budget Process Update

The California state budget process for fiscal year 2025-26 is progressing, with several key developments:

• Governor Newsom presented his proposed $322.3 billion state budget on January 10, 2025, including $228.9 billion in General Fund spending.
• The budget is currently balanced, thanks to proactive measures taken in June 2024 to address anticipated shortfalls.
• Legislative budget committees are now conducting hearings to review the Governor's proposed plan.
• Upcoming milestones include:
• May 14, 2025: Governor's "May Revision" update
• June 15, 2025: Constitutional deadline for the Legislature to pass the budget bill

As a reminder, the budget did have a modest surplus, which is encouraging coming out of a bad budget year. However, the Los Angeles fires and disaster response efforts alongside anticipated federal cuts, make budgeting incredibly challenging for the state at this juncture. Those who work on the budget anticipate significant shortfalls.

Assembly Budget Subcommittee No. 1 Hearing

On March 3, 2025, the Assembly Budget Subcommittee No. 1 on Health and Human Services, chaired by Assemblymember Dawn Addis, held a hearing that included a discussion on the Office of Health Care Affordability (OHCA). The subcommittee reviewed OHCA's progress in implementing health care spending targets and its efforts to improve affordability in the state's health care system. ACHD alongside other stakeholders delivered public comment, stressing the unique nature of district hospitals and healthcare districts broadly. A general plea was made to HCAI and the Legislature to be thoughtful about approaches that may further exacerbate financial pressures faced by our public healthcare system.

Office of Health Care Affordability Update

OHCA has set statewide health care spending growth targets, which will be phased in over time:

• 3.5% for 2025 and 2026
• 3.2% for 2027 and 2028
• 3% for 2029

The OHCA board has also approved defining a health care sector consisting of all hospitals and established stricter spending targets for high-cost hospitals. Regulations to codify these definitions and targets are currently undergoing public comment, with formal approval expected in April or May 2025.

The ACHD team continues to monitor the budget process closely, particularly aspects that may impact healthcare districts and services.

Key Bills to Watch

Assembly Bill 533 (AB 533) - Health Care Districts: Design-Build Process- ACHD SPONSORED

Authored by Assembly Member Heath Flora, AB 533 aims to expand the use of the design-build process for all health care districts. This bill proposes allowing all health care districts to utilize the design-build process for hospital or health facility construction projects, potentially reducing costs and improving efficiency in delivering critical healthcare infrastructure. The bill will be heard in Assembly Local Government Committee. Please be on the lookout for a call to action for a support-letter sign on, early next week. ACHD’s sponsor letter can be read, here.

Senate Bill 669 (SB 669) - Rural Hospitals: Standby Perinatal Medical Services - ACHD SUPPORT

Authored by Senator Mike McGuire, SB 669 focuses on improving maternal and infant care in rural areas. The bill proposes a pilot program requiring selected rural hospitals to establish standby perinatal medical services, with specific requirements for staffing and equipment to handle perinatal emergencies. The bill will be heard in April in Senate Health Committee. You can read ACHD’s letter of support, here.

In addition, this week, ACHD participated in a group of 32 stakeholders, alongside Plumas District Hospital to meet and discuss SB 669. This discussion will help inform changes to the bill that, hopefully, will lead to its success.

Darren Beatty, COO, Plumas District Hospital, Dr. Kepple MD, Practicing Physician, Lori Link, Nurse Midwife, Tiffany Leonhardt, Director of Business and Organizational Development, Plumas District Hospital

Senate Bill 29 (SB 29) - Civil Actions: Decedent's Cause of Action- ACHD OPPOSE UNLESS AMENDED

Authored by Senator John Laird, SB 29 aims to amend Section 377.34 of the Code of Civil Procedure, relating to civil actions. The bill seeks to expand recoverable damages in civil actions involving a decedent's cause of action. Specifically, SB 29 would make permanent the ability for a decedent's estate to recover non-economic damages, including compensation for pain, suffering, or disfigurement. ACHD is a part of a larger coalition of stakeholders requesting an amendment to carve out claims covered under the Medical Injury Compensation Reform Act (MICRA), that was recently amended in 2023. The coalition opposition letter can be read, here.

Informational Hearing: Behavioral Health Transformation Updates

On March 4, 2025, the California State Assembly Health Committee convened an informational hearing titled "The State's Behavioral Health Transformation: Implementation and Planning Updates". The hearing provided critical updates on behavioral health initiatives, including:

• Proposition 1 Implementation Timelines: Will Owens from the Legislative Analyst's Office outlined fiscal and policy considerations.
• Behavioral Health Continuum Infrastructure Program Updates: Experts discussed infrastructure bond rollout plans and progress.
• Planning for Behavioral Health Service Act Milestones (2025 & 2026): Stephanie Welch (California Health and Human Services Agency), Marlies Perez (Department of Health Care Services), and other leaders highlighted key milestones and strategies.
• Public Comment: Community members shared insights and concerns about behavioral health services diminishing or all together being removed due to challenges with implementation.

This hearing underscored California's commitment to transforming behavioral health services through innovative programs and infrastructure development. ACHD provided written comments to the Committee which can be read, here.

HCAI Webinar on Seismic Compliance

The California Department of Health Care Access and Information (HCAI) hosted a free webinar on Tuesday, March 4th, 2025 regarding seismic compliance plans and extensions beyond the 2030 deadline. Key topics included the new automated seismic compliance plan webtool, 2030 Seismic Compliance Deadline recap, and AB 869 eligibility criteria for loan program recipients. The on-demand version of the webinar will be available for interested members here. 

As we progress through the 2025 legislative session, ACHD remains committed to advocating for policies that support healthcare districts and improve access to quality healthcare for all Californians. We encourage our members to stay engaged and be ready to advocate on these key issues affecting our communities.

Remember to check our website regularly for the most up-to-date information on legislative developments and opportunities to get involved in our advocacy efforts. Your participation is crucial in shaping the future of health care in California.

Sponsor Insights presented by:

New Approach To Infrastructure, Retrofit Financing

Sunstone Cities and American Lending Center look forward to joining the Association of California Healthcare Districts at its annual meeting once again this September in San Diego.

Sunstone Cities is a consulting firm focusing on municipalities and special districts, with emphasis on Public Infrastructure Financing Solutions. American Lending Center (ALC) is a private non-bank lending institution focused on government loan programs to foster development, job creation and economic growth.

Together, we provide new financing approaches that are typically less expensive, quicker and more advantageous than traditional bond financing. To explain these programs, we have written a white paper about the possibilities. ALC already has participated in rural hospital financing programs.

We look forward to discussing how these solutions can work for you.

See you in San Diego!