Under the Hospital Lien Act (HLA) at Civil Code §3045.1, et seq., a hospital lien is subject to any prior liens. The language in the statute that the lien “shall not be effective” until proper service is made equates to the hospital lien not being created until the lien is properly served. In contrast, an attorney fee lien is created when the retainer agreement is signed. Thus, where a patient is treated by the hospital before the patient retains counsel, but the hospital lien is served after the attorney is retained, the attorneys’ fee lien is a “prior lien” to the hospital lien. County of San Bernardino v. Calderon (2007) 148 Cal.App.4th 1103
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