BILL ANALYSIS
SB 57
Page 1
Date of Hearing: June 28, 2005
ASSEMBLY COMMITTEE ON HEALTH
Wilma Chan, Chair
SB 57 (Alarcon) - As Amended: May 27, 2005
SENATE VOTE : 24-13
SUBJECT : Fines and forfeitures.
SUMMARY : Permits an additional penalty assessment of $2 for
every $10 or fraction thereof to be collected upon Alcohol
Beverage Control (ABC) Act and Vehicle Code offenses. Requires
revenue generated from the assessment to be deposited into the
Maddy Emergency Medical Services (EMS) Fund, with 15% designated
for pediatric trauma centers. Specifically, this bill :
1)Permits, for purposes of supporting EMS, as specified, a
county board of supervisors to elect to levy an additional
penalty of $2 for every $10 or fraction thereof, which is to
be collected together with and in the same manner as existing
assessments, as specified, upon every fine, penalty, or
forfeiture imposed and collected by the courts for criminal
offenses, including violations relating to the ABC Act, and
Vehicle Code violations, and local ordinances adopted pursuant
to the Vehicle Code except parking offenses, as specified.
2)Requires moneys collected pursuant to #1) above to be taken
from fines and forfeitures deposited with the county treasurer
prior to other specified assessments.
3)Requires funds collected pursuant to #1) to be deposited into
the Maddy EMS Fund, as specified.
4)Requires 15% of the money deposited in the Maddy EMS Fund
pursuant to #1) above to be utilized to provide funding for
pediatric trauma centers. Limits expenditure of this money to
reimbursement to physicians and surgeons, hospitals for
patients who do not make payment for services, or for
expanding the services provided at pediatric trauma centers,
including the purchase of equipment. Refers to this provision
as the "Pediatric Care Allocation."
5)Requires counties that do not maintain pediatric trauma
centers to utilize the money deposited into the Maddy EMS Fund
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to reimburse physicians and surgeons and hospitals for
patients who do not make payment for EMS and for other EMS
purposes as determined by the county according to a specified
schedule. Permits funding to be used for administrative
costs, as specified.
6)Requires costs of administering money deposited into the Maddy
EMS Fund pursuant to #1) above to be reimbursed from the money
collected, not to exceed 10%.
EXISTING LAW :
1)Establishes the ABC Act, which is an exercise of the police
powers of the State for the protection of the safety, welfare,
health, peace, and morals of the people of the state, to
eliminate the harmful consequences of unlicensed and unlawful
manufacture, selling, and disposing of alcoholic beverages,
and to promote temperance in the use and consumption of
alcoholic beverages.
2)Establishes the Maddy EMS Fund, which permits each county to
establish an EMS fund, upon adoption of a resolution by the
board of supervisors. Requires the fund to be administered by
each county, except that a county electing to have the state
administer its medically indigent services program may elect
to have its Maddy EMS Fund administered by the state.
3)Permits up to 10% of the amount of the Maddy EMS Fund to be
used to reimburse costs of administering the fund. Permits
each administering agency to maintain a reserve of up to 15%
of the amount in the portions of the fund reimbursable to
physicians and surgeons, and hospitals, as specified, and any
amount that is distributed for other EMS purposes, as
specified.
4)Requires the amount in the fund, reduced by the amount for
administration, and the reserve to be utilized to reimburse
physicians and surgeons and hospitals for patients who do not
make payment for EMS and for other EMS purposes as determined
by each county according to the following schedule:
a) 58% of the balance to be distributed to physicians and
surgeons for emergency services provided by all physicians
and surgeons, except those employed by county hospitals, in
general acute care hospitals that provide basic or
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comprehensive emergency services up to the time the patient
is stabilized;
b) 25% of the fund to be distributed only to hospitals
providing disproportionate trauma and emergency medical
care services; and,
c) 17% of the fund to be distributed for other EMS purposes
as determined by each county, including, but not limited
to, the funding of regional poison control centers.
Permits funding to be used for purchasing equipment and for
capital projects only to the extent that these expenditures
support the provision of emergency services.
5)Permits any physician and surgeon to be reimbursed for up to
50% of the amount claimed, as specified, for the initial cycle
of reimbursements made by the administering agency in a given
year, as specified. Requires funds remaining at the end of
the fiscal year in excess of the reserve to roll over to the
next year, and be distributed proportionately, based on the
dollar amount of claims submitted and paid to all physicians
and surgeons who submitted qualifying claims during the year.
6)Requires a state penalty to be levied, in the amount of $10
for every $10 or fraction thereof, on fines, penalties, or
forfeitures imposed and collected by the courts for criminal
offenses, including all offenses, except parking offenses as
defined, involving violations of the Vehicle Code or local
ordinances adopted pursuant to the Vehicle Code. Requires the
money collected from the penalty to be distributed in
specified percentages among: the Fish and Game Preservation
Fund; the Restitution Fund; the Peace Officers Training Fund;
the Driver Training Penalty Assessment Fund; the Corrections
Training Fund; the Local Public Prosecutors and Public
Defenders Fund; the Victim-Witness Assistance Fund; and the
Traumatic Brain Injury Fund.
7)Requires, in each county, an additional penalty to be levied,
in the amount of $7 for every $10 or fraction thereof which is
to be collected together with and in the same manner as the
amounts established in #4) above, upon every fine, penalty, or
forfeiture imposed and collected by the courts for criminal
offenses, including all offenses involving a violation of the
Vehicle Code or any local ordinances adopted pursuant to the
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Vehicle Code, except parking offenses, as specified.
Requires, if established by a county board of supervisors, the
money to be placed in one or more funds, including the
Courthouse Construction Fund, the Criminal Justice Facilities
Construction Fund, the Automated Fingerprint Identification
Fund, the Forensic Laboratory Fund, the Maddy EMS Fund, or the
DNA Identification Fund.
FISCAL EFFECT : According to the Senate Appropriations
Committee analysis,
Fiscal Impact (in thousands)
Major Provisions 2005-06 2006-07 2007-08 Fund
Assessments Potentially significant revenues; Special *
Court programming costs $184 ** Special *
(first assessment)
Manual processing $180 $180 $180 Special *
(statewide)
________________
* Maddy Emergency Medical Services Fund; 15% of total slated for
counties' pediatric trauma units
**Based on number of counties that participate; cost of $25,000
per county
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill
seeks to generate funding to help alleviate a $365 million
shortfall facing trauma centers. The author states that this
bill would create a specific mechanism for the Maddy EMS Fund
to allow counties to collect an additional $2 penalty on every
$10 penalty for specified criminal offenses, which would be a
$20 to $40 increase on an average $340 ticket payment. The
author asserts that this bill will result in funding for
emergency and trauma care estimated at $60 million per year.
In addition, this bill establishes a Pediatric Care Allocation
for equipment and facilities, which will be instrumental in
maintaining the financial stability of the emergency and
trauma centers, decreasing the diversion time and patient wait
time, and improving overall services.
2)TRAUMA CENTERS . A 2002 California HealthCare Foundation study
indicates that California's trauma centers provide the highest
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levels of emergency care to the most critically ill and
injured patients, maintaining the highest level of service in
terms of specialized equipment, and a wider array of
specialized medical personnel, including panels of on-call
specialist physicians. Under state law, hospitals with trauma
centers also must maintain emergency departments. The
California Emergency Medical Services Authority (EMSA)
establishes the standards for trauma systems. EMSA reviews
and approves trauma care plans developed by local emergency
services agencies, and local agencies are responsible for the
designation of trauma centers based on an approved plan.
Focus groups of experts report growing concerns with the
state's lack of a coordinated trauma care system and with
inadequate funding for existing trauma centers, which care for
large numbers of uninsured and underinsured patients.
3)PEDIATRIC TRAUMA CENTERS . The chart below outlines the
pediatric trauma centers in California, as of January 2005.
-------------------------------------------------------------
|Pediatric|Pediatric |Adult/Pediat|Adult/Pediat|Adult |
| Level I |Level II |ric Level I |ric Level |I/Pediatric |
| | | |II |II |
| | | | | |
|---------+------------+------------+------------+------------|
|Children'|Children's |University |Long Beach |Cedars-Sinai|
|s |Hospital |of |Memorial/Mil| Medical |
|Hospital |Medical |California-D|ler |Center - |
|of Los |Center - |avis |Children's |Los Angeles |
|Angeles |Oakland |Medical |Center - | |
| | |Center - |Long Beach | |
| | |Sacramento | | |
| | | | | |
|---------+------------+------------+------------+------------|
| |Children's |Loma Linda | |Harbor UCLA |
| |Hospital |University | |Medical |
| |Central |Medical | |Center - |
| |California |Center - | |Los Angeles |
| |- Madera |Loma Linda | | |
| | | | | |
|---------+------------+------------+------------+------------|
| |Children's |UCLA | |LAC/USC |
| |Hospital & |Medical | |Medical |
| |Health |Center - | |Center - |
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| |Center - |Los Angeles | |Los Angeles |
| |San Diego | | | |
| | | | | |
-------------------------------------------------------------
4)SUGGESTED AMENDMENTS . The Emergency Medical Services
Administrators Association of California (EMSAAC) indicates
that there are very few pediatric trauma centers in the state
and many of these centers serve children from other counties.
EMSAAC asserts that since these trauma centers get patients
from other counties, this bill should be amended to allow
counties that do not have pediatric trauma centers to use the
funding to pay for pediatric trauma services for that county's
children delivered in other county's trauma centers.
5)SUPPORT . University of California (UC) writes in support that
current emergency medical services funds are insufficient to
cover the costs of providing emergency medical services and
trauma services to medically indigent, uninsured, and
underinsured Californians, and this bill will be instrumental
in maintaining the financial stability of hospitals that are
critical to California's health care system.
6)OPPOSTION . The Judicial Council writes in opposition that the
additional penalty assessment in this bill will impose
significant burdens on court administration, in counties that
adopt the assessments, courts will need to reprogram their
case management systems to perform the new calculations, and
some older systems are not even capable of reprogramming.
Calculations will have to be done by hand or systems will have
to be replaced resulting in substantial court costs. The
Teamsters and other labor organizations oppose this bill
indicating that assessments can total between 300 to 350% of
base violation fine, which goes against truth in government
principles, and unfairly impacts working men and women who
must transport themselves too and from work, or who use their
vehicles for work.
7)RELATED LEGISLATION . SB 941 (Alquist), also scheduled to be
heard in the Assembly Health Committee, coordinates the
administration of the Maddy EMS Fund and Proposition 99
funding.
8)CHAPTERING OUT CONCERNS . Both SB 941 and this bill amend
Section 1797.98 (a) of the Health and Safety Code. Amendments
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must be adopted to avoid chaptering out conflicts should both
bills become law.
9)DOUBLE REFERRAL : This bill is double referred and should it
pass this committee it will be referred to the Assembly
Committee on Public Safety.
REGISTERED SUPPORT / OPPOSITION :
Support
American College of Emergency Physicians State Chapter of
California, Inc. (sponsor)
American Federation of State, County and Municipal Employees
California Advocates for Nursing Home Reform
California Ambulance Association
California Hospital Association
California Nurses Association
California Professional Firefighters
El Proyecto del Barrio
Emergency Medical Services Administrators Association of
California
Lieutenant Governor Cruz Bustamante
Los Angeles County Board of Supervisors
New Horizons
Pacifica Hospital of the Valley
St. Mary Medical Center
The Los Angeles Free Clinic
Trauma Managers Association of California
University of California
Opposition
Automobile Club of Southern California
California Attorneys for Criminal Justice
California Conference Board of the Amalgamated Transit Union
California Conference of Machinists
California Public Defenders Association
California State Automobile Association
Coalition of Trial Court Clerk Associations
Commission on Peace Officer Standards and Training
Judicial Council of California
Teamsters
Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097
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