BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
2173 (Beall)
Hearing Date: 8/12/2010 Amended: 7/15/2010
Consultant: Katie Johnson Policy Vote: Health 5-0 Pub.
Safe. 7-0
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BILL SUMMARY: AB 2173 would impose a $3 flat fee on each
Vehicle Code violation in the state, excepting parking tickets,
to provide for increased Medi-Cal reimbursement of emergency air
ambulance transportation.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Estimated fee revenue ($17,250) ($34,500)($34,500) Special*
Estimated corresponding $17,250 $34,500
$34,500Special/**
increase in Medi-Cal payments $17,250
$34,500$34,500Federal
DHCS staff $50 $100 $100
Special/**
Federal
*Emergency Air Medical Transportation Act Fund
**Costs would be shared 50 percent Emergency Air Medical
Transportation Act Fund, 50 percent federal funds
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STAFF COMMENTS: SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
This bill would impose a $3 penalty on every conviction for a
violation of the Vehicle Code or a local ordinance adopted
pursuant to the Vehicle Code, except parking offences. Every
quarter, counties would be required to remit the revenues to the
state Controller for deposit into the Emergency Air Medical
Transportation Act Fund, which is created by this bill. The
actual revenue that would be generated is unknown, but it would
depend on the number of Vehicle Code violations annually. In
2009, there were 7,184,415 court abstracts with convictions for
Vehicle Code violations. If 20 percent of the convictions per
abstract had 2 violations and the other 80 percent had 1
violation per abstract, and if $3 were collected for every
conviction, revenues would be approximately $26 million
annually. To the extent that violators would choose jail time
over paying the fine, the revenue estimate could be less.
The Department of Health Care Services (DHCS) would use the
funds and any matching federal funds made available, upon
appropriation by the Legislature, to augment the Medi-Cal
reimbursement rates paid to emergency air ambulance
transportation services providers. Additionally, revenues could
be used to reimburse the department, the courts, and each county
for its expenses incurred in administering these provisions.
Since the source of the revenues would not be health-care
related,
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AB 2173 (Beall)
DHCS would need to amend its state plan in order to draw down
federal funds.
These provisions would sunset January 1, 2016. Any unused monies
that would remain in the Emergency Air Medical Transportation
Act Fund on January 1, 2016, would be available to DHCS for the
purposes of these provisions, upon appropriation by the
Legislature.
To the extent that these provisions are not extended beyond
January 1, 2016, there would be considerable cost pressure on
the General Fund and federal funds in the amount of
approximately $52 million annually to maintain the augmented
emergency air transportation providers rate.
This bill would state that the Legislature finds and declares,
among other statements, that: 1) ambulance services providers do
not receive payment from the county Maddy Emergency Medical
Services Fund when they provide treatment to indigent patients;
2) the Medi-Cal program reimburses air ambulance services
providers far below what it costs the providers to provide
transportation and pays nothing if the patient is indigent; and
3) Medi-Cal reimbursement rates for air ambulances have not
increased in over 15 years.
The author's proposed amendments would provide a supplemental
payment distribution methodology and timeline and would require
the department to seek any necessary federal approvals to amend
its state plan. The amendments would increase the fee to $4 per
vehicle violation and would provide that the moneys in the fund
could be used for the following purposes: 1) payment of
administrative costs of the department, and the actual
reasonable and necessary costs of the courts and the counties,
2) 20 percent, after the administrative costs, would be used to
offset the state portion of the Medi-Cal reimbursement rate for
emergency medical air transportation services, 3) 80 percent,
after administrative costs, would be used to augment emergency
medical air transportation reimbursement payments made through
Medi-Cal.
The amendments would also 1) sunset the fee on January 1, 2016,
2) provide that payments may be made from the fund for the
purposes specified by these provisions until Marcy 2, 2017, and
that any moneys remaining in the fund on that day would be
remitted to the General Fund, 3) and would sunset all of these
provisions Janaury 1, 2018.