A state agency on Tuesday approved the sale of $1.9 billion in tax-exempt bonds to help Kaiser Foundation Hospitals build six new medical centers, expand an existing one and construct a specialty medical office.

It was the largest transaction ever approved by the California Health Facilities Financing Authority.

The authority was created in 1979 to enable the state to assist public and nonprofit health care providers such as Kaiser through loans funded by tax-exempt bonds.

Kaiser plans to use the money to help pay for replacing its Oakland, Hayward, Redwood City and, in Southern California, Harbor City, Fontana and Anaheim medical centers to meet state seismic requirements.

It will also use a portion of the money to help finance expansion of its Los Angeles Medical Center and construction of an Antelope Valley medical office building.

"We're pleased to help Kaiser finance projects that will help improve the delivery of health care for millions of their patients throughout California," said state Treasurer Bill Lockyer, chairman of the authority.

"This deal will also help residents in underserved communities," Lockyer said in a written statement. "Unlike any other issuer in the state, (the financing authority) uses fee revenues not needed to cover its operational costs to provide low-cost loans and grants to small and rural clinics so they can build facilities, buy equipment and expand access to care."

A Kaiser executive lauded the deal, saying it will enable Kaiser to better serve its patients.

Sandy Kleffman covers health. Contact her at 510-293-2478.

Follow her at Twitter.com/skleffman.