BILL ANALYSIS
SB 1773
Page 1
Date of Hearing: June 20, 2006
ASSEMBLY COMMITTEE ON HEALTH
Wilma Chan, Chair
SB 1773 (Alarcon) - As Introduced: February 24, 2006
SENATE VOTE : 24-11
SUBJECT : Fines and Forfeitures.
SUMMARY : Authorizes counties to elect to levy an additional $2
for every $10 in base fines for purposes of supporting emergency
medical services (EMS), and requires the additional assessment
to be deposited in local Maddy EMS Funds, with 15% to be
directed to pediatric trauma services. Authorizes up to 10% to
be used for administrative expenses and sunsets the provisions
of this bill on January 1, 2009. Specifically, this bill :
1)Authorizes, 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 certain
criminal and vehicle code violations.
2)Requires funds to be collected pursuant to #1) above only if
the county board of supervisors provides that the increased
penalties do not offset or reduce the funding of other
programs from other sources, but that these additional
revenues result in increased funding to those programs.
3)Requires moneys collected pursuant to #1) above to be taken
from fines and forfeitures deposited with the county treasurer
prior to other specified assessments.
4)Requires funds collected pursuant to #1) to be deposited into
the Maddy EMS Fund, as specified.
5)Requires 15% of the money deposited in the Maddy EMS Fund
pursuant to #1) above to be used to provide funding for
publicly and privately owned and operated pediatric trauma
centers through out the county. Limits expenditure of this
money to reimbursement to physicians and surgeons, hospitals
for patients who do not make payment for services, or for
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expanding the services provided at pediatric trauma centers,
including the purchase of equipment.
6)Requires counties that do not maintain pediatric trauma
centers to use the pediatric trauma money deposited into the
Maddy EMS Fund to improve access to pediatric trauma and
emergency services in the county, with preference for funding
given to hospitals that specialize in services to children,
and physicians and surgeons who provide care for children.
Refers to funds spent for these purposes to be known as
"Richie's Fund."
7)Requires costs of administering money deposited into the Maddy
EMS Fund pursuant to #5) above to be reimbursed from the money
collected, not to exceed 10%.
8)Sunsets provisions of this bill on January 1, 2009, and
requires that as of, and after that date, these provisions
have no force or effect unless a later enacted state, that is
chaptered before January 1, 2009, deletes or extends the
sunset date.
EXISTING LAW :
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 used 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 a specified schedule.
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5)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.
6)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 #5) 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
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 2006-07 2007-08 2008-09
Fund
Assessments Potentially significant revenues;
Special* see staff comments
Court programming costs $213
Special*
*Maddy Emergency Medical Services Fund; 15% of total
slated for
counties' pediatric trauma units
In addition, the Senate Appropriations Committee analysis
indicates the following:
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1)Until fiscal year 2002-03, 170% in penalty assessments were
applied to every fine. The current penalty assessments are up
to 250% and are assessed as follows:
2)State penalty assessment: Penal Code Sec. 1464 authorizes the
assessment of $10 for every $10 in base fines with 30% going
to the assessing county and 70% transmitted to the state and
allocated as follows: 0.33% to the Fish & Game Preservation
Fund; 32.02% to the Restitution Fund; 23.99% to the Peace
Officers Training Fund; 25.7% to the Driver Training Penalty
Assessment Fund; 7.88% to the Corrections Training Fund; 0.78%
(not to exceed $850,000 per year) to the Local Public
Prosecutors and Public Defenders Fund; 8.64% to the
Victim-Witness assistance Fund; and 0.66% to the Traumatic
Brain Injury Fund.
3)County penalty assessment: Government Code Sec. 76000 et. Seq.
authorizes the assessment of $7 for every $10 in base fines.
The money collected is to be placed in any of the following
funds if established by a county's board of supervisors:
Courthouse Construction Fund; Criminal Justice Facilities
Construction Fund; Automated Fingerprint Identification Fund;
Emergency Medical Services Fund; and DNA Identification Fund.
4)State surcharge: As part of the 2002-03 Budget Act, the
Legislature imposed a temporary state surcharge of 20% on
every base fine collected by the court. The surcharge took
effect on Sept. 30, 2002, and all money collected is deposited
into the General Fund.
5)State court facilities construction: Two years ago, as part of
the Trial Court Facilities Act of 2002, the Legislature
established the State Court Facilities Construction Fund and
added a state court construction penalty assessment of up to
$5 for every $10 in base fines. The variation in the
assessment amount is dependent on the amount collected by the
county for deposit into the local Courthouse Construction Fund
established pursuant to Government Code Sec. 76100. As a
result the penalty assessment ranges from 0 for every $10 in
two counties to the full $5 for every $10 in nine counties.
This provision took effect on Jan. 1, 2003.
6)Court security: As part of the 2003-04 Budget Act, the
Legislature approved a flat fee of $20 on every conviction for
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a criminal offense to fund court security costs.
7)Proposition 69: Finally, as approved by voters in November
2004, Prop. 69 levied a $1 penalty assessment on every $10 in
fines and forfeitures resulting from criminal and traffic
offenses and dedicates these revenues to state and local
governments for DNA databank implementation purposes. The
state will receive 70% of these funds in the first two years,
50% in the third year and 25% annually thereafter. The
remainder goes to local governments.
8)The governor's proposed budget for 2006-07 estimates the state
will collect approximately $165 million in penalty revenue
next fiscal year. If all 58 counties were to elect to assess
the additional 20% assessment, revenues to their Maddy Funds
would exceed $13 million per year.
9)Judicial Council estimates one-time costs of $213,000 to
reprogram and reconfigure case management and accounting
systems, correct and reprint forms, train staff, modify
penalty assessment distribution schedules, amend bench guides,
prepare and transmit notices to the public, and update bail
schedules. These costs should be fully borne by the bill's 10%
allowance for administrative expenses.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, many hospitals
throughout California suffer from funding shortages. As a
result, hospitals are not prepared to adequately serve the
patients in their area and are often forced to close their
doors. Many of these hospitals offer trauma care services
that are essential to saving the lives of patients who without
them would have no choice but to go elsewhere for services.
Currently trauma centers face a $635 million dollar shortfall.
The author states that this bill seeks to generate funding to
help alleviate this problem.
2)TRAUMA CENTERS . A 2002 California HealthCare Foundation study
indicates that California's trauma centers provide the highest
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
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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 April 2006.
-------------------------------------------------------------
|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, |ler |Center - |
|of Los |Center - |Davis |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 - |
| |Center - |Los Angeles | |Los Angeles |
| |San Diego | | | |
-------------------------------------------------------------
4)FUNDING FOR TRAUMA . Since 2001-02, over $50 million has been
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appropriated for trauma centers. The Budget Conference
Committee has agreed to a $10 million appropriation in the
2006-07 Budget which would only go into affect if a statewide
initiative that will be presented to California voters during
the November 2006 election fails. The initiative would
increase the tax on tobacco and tobacco products to fund a
variety of health care programs including hospital emergency
care. According to the Senate Appropriations analysis, the
Maddy EMS fund could receive an annual assessment in excess of
$13 million with the passage of this bill. Of the $13
million, 15% or almost $2 million would be dedicated to
pediatric trauma services.
5)TOBACCO TAX OF 2006 . The Tobacco Tax of 2006 (initiative)
would increase the state's tobacco tax by $2.60 per pack of
cigarettes. Sponsors of the initiative claim $2.27 billion
will be raised to address some of state's major health
challenges. Assuming the initiative is approved, hospitals
would receive over $800 million annually for emergency
services and counties would receive approximately $72 million
to reimburse emergency physicians for uncompensated care.
6)COUNTY EMS FUNDS . As of November 2003, 49 counties had
established EMS Funds. Counties finance these funds through
several sources: a) penalty assessments on criminal and
traffic violations as authorized in legislation authored by SB
12 (Maddy), Chapter 1240, Statutes of 1987 (known as the Maddy
Fund); b) a portion of the fees from people attending traffic
violator schools; c) revenues from taxes on tobacco products
deposited in the State's Cigarette and Tobacco Products Surtax
Fund; and, d) redirected money from the State's Cigarette and
Tobacco Products Surtax Fund through an annual EMS
Appropriation.
7)PREVIOUS LEGISLATION .
a) SB 57 (Alarcon) of 2005 was substantially similar to
this bill. SB 57 was vetoed by the Governor. In his veto
message the Governor states:
"?the addition of new fines and fees tends to reduce
the imposition and collection of existing penalties,
which are passed out on a prorated basis to the
various funds. The Victim Compensation Program
receives a significant portion of its funding from
restitution fines.
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While programs seeking new or additional funding in
this manner might in fact be deserving or
worthwhile, it is simply not possible to continue
adding new recipients to the existing program
distribution without reducing funding to current
deserving recipients. Local EMS funds currently
receive funds from penalty assessments. In
recognition of the need for funding, my 2005-2006
budget contains another $10 million dollars in
General Fund for trauma centers. However, I
cannot approve further attachment of this source of
funding at the expense of victims and others who are
likely to lose precious funding from this source if
SB 57 were to become law."
b) AB 131 (Committee on Budget), Chapter 80, Statutes of
2005, repeals all minimum distribution requirements for the
Trauma Care Fund, requires local EMS agencies to utilize a
competitive grant-base system for allocating the funds, and
requires local EMS agencies to determine distribution of
funds based on new criteria.
c) SB 266 (Romero) of 2005 would have required EMSA to
establish a trauma care advisory committee consisting of 21
voting members. SB 266 would have required the committee
to develop a statewide trauma care plan, to present the
plan to EMSA, and provide the plan to the Legislature along
with EMSA's comments by January 1, 2007. SB 266 was vetoed
by the Governor because he did not want to wait until 2007
for a report that could better inform California's policy
on trauma care. Instead, he directed EMSA, informed by its
Trauma Advisory Committee, to complete its statewide trauma
care plan and provide him recommendations no later than
June 1, 2006. The report has not been completed and it is
unclear whether or not the report will be public upon
completion.
d) AB 1988 (Diaz), Chapter 333, Statutes of 2002, requires
EMSA to convene a task force of specified members to study
the delivery and provision of EMSs in California. AB 1988
requires the task force to submit a report to the
Legislature providing recommendations for improving the
delivery of EMSs throughout California within two years
from the date that funding and positions have been provided
for the project. AB 1988 also requires its provisions to
be implemented only to the extent that EMSA obtains private
funding needed to support and monitor the work of the task
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force. EMSA has not convened the task force and has not
submitted a report.
e) AB 430 (Cardenas), Chapter 171, Statutes of 2001,
establishes the Trauma Care Fund, subject to an
appropriation by the Legislature or from any other source,
and continuously appropriates moneys in the Fund without
regard to fiscal years, to EMSA for specified purposes. AB
430 requires EMSA to allocate funds, with specified
exceptions, to eligible local EMS agencies for
distribution, based on a specified formula and within a
specified amount of time, to the local EMS
agency-designated trauma centers within the local EMSs
agency's jurisdiction. AB 430 also requires EMSA to
develop criteria for the standardized reporting of trauma
patients to local trauma registries and requires all local
EMSs agencies to utilize the criteria for reporting trauma
patients to the local trauma registries by July 1, 2003. AB
430 requires that any trauma center that receives funding
pursuant to the bill agree to remain a trauma center
through June 30 of the fiscal year in which it receives
funding, or if it ceases to exist, to reimburse the fund by
a specified formula. AB 430 permits each local EMSs agency
that does not have an existing trauma care plan to submit
proposals for funding for their preparation of a trauma
care system plan to EMSA by January 15, 2002. It also
authorizes EMSA to retain from any state appropriation up
to $107,000 to implement these provisions.
f) SB 447 (Vasconcellos) of 2001 would have required EMSA
to conduct an evaluation to assess the current state of
California's emergency and trauma care system, including a
historical perspective and a plan to improve future
emergency care and trauma services. SB 447 would have set
forth the subjects to be considered in the evaluation, and
would have required EMSA to report its findings to the
chairs of specified legislative committees on or before
July 1, 2003. The measure failed in the Assembly.
8)DOUBLE REFERRAL. This bill has been double-referred. Should
this bill pass out of this committee, it will be referred to
the Assembly Committee on Public Safety.
9)SUPPORT . The sponsor of this bill, the American College of
Emergency Physicians State Chapter of California, Inc.,
(Cal/ACEP) believes this bill could potentially raise $50
million to reimburse physicians and surgeons for care given to
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uninsured patients. Cal/ACEP asserts that a 2004 report by
the California Medical Association (CMA) indicates that losses
sustained by hospitals and physicians in 2001-02 were over
$635 million. This Maddy EMS Fund becomes more vital as
losses continue to grow. Cal/ACEP states that this bill will
help keep specialists on call to treat all patients, not just
the uninsured.
10)OPPOSITION . Labor organizations such as the California Labor
Federation, AFL-CIO, view assessments such as the one proposed
in this bill as a tax on their members and other workers who
drive for a living. Rising fine levels, high insurance rates,
and an inability to attend traffic school because of recent
law changes, makes it difficult to except increases in
assessments. The Commission on Peace Officer Standards and
Training (POST) shares the Governor's concern raised in his
veto message on SB 57 about the negative impact the additional
assessment may have on existing recipients of the State
Penalty Fund, such as Peace Officers Training Fund.
REGISTERED SUPPORT / OPPOSITION :
Support
American College of Emergency Physicians State Chapter of
California (sponsor)
California Children's Hospital Association
Emergency Nurses Association California State Council
California Hospital Association
California Medical Association
California Nurses Association
County of Los Angeles
University of California
Opposition
California Labor Federation, AFL-CIO
California Teamsters Public Affairs Council
Commission on Peace Officer Standards and Training
Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097