BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 215|
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THIRD READING
Bill No: AB 215
Author: Beall (D)
Amended: 6/27/11 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 7/6/11
AYES: Hernandez, Strickland, Alquist, Anderson, Blakeslee,
De León, DeSaulnier, Rubio, Wolk
ASSEMBLY FLOOR : 51-25, 5/19/11 - See last page for vote
SUBJECT : Emergency services: Emergency Medical Air
Transportation Act
SOURCE : California Association of Air Medical Services
DIGEST : This bill requires a county or court that has
imposed a vehicle code fine, as specified, to transfer
earmarked penalty assessment moneys to the State Treasurer
for deposit into the Emergency Medical Air Transportation
Act Fund on a monthly basis.
ANALYSIS :
Existing law:
1. Establishes the Medi-Cal program, the state's Medicaid
program, administered by the Department of Health Care
Services (DHCS), which provides comprehensive health
benefits to low-income children; their parents or
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caretaker relatives; pregnant women; elderly, blind or
disabled persons; nursing home residents and refugees.
2. Establishes the Emergency Medical Air Transportation Act
(EMATA), which imposes a $4 penalty on each conviction
of a violation of the Vehicle Code or of a local
ordinance adopted pursuant to the Vehicle Code, except
parking offenses.
3. Requires this penalty to be in addition to the
established penalty, and exclude from the base fine any
other surcharges used to calculate any other penalties.
4. Establishes the EMATA Fund, to be administered by DHCS.
5. Requires each county to deposit the proceeds of the
revenues from the above penalty in a county EMATA Fund
and to transfer the funds on a quarterly basis to the
EMATA Fund.
6. Requires the EMATA Fund to be available, upon
appropriation by the Legislature, to DHCS for payment of
the administrative costs of DHCS, and for the actual,
reasonable and necessary costs of the courts, and the
counties in administering this program. Twenty percent
of the remaining funds are to offset the state portion
of the Medi-Cal reimbursement rate for emergency medical
air transportation services, and eighty percent are to
augment emergency medical air transportation
reimbursement payments made through the Medi-Cal
program.
7. Requires DHCS to seek federal matching funds, as
specified, by using the moneys in the EMATA Fund for the
purpose of augmenting Medi-Cal reimbursement paid to
providers after June 30, 2011.
8. Sunsets the assessment of penalties on January 1, 2016;
however, penalties assessed prior to the fee sunset are
required to be collected, administered and distributed
until June 30, 2017, or the funds are extinguished.
9. Requires any unused monies in the EMATA Fund on March 3,
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2017, to be transferred to the General Fund and made
available, upon appropriation by the Legislature, for
purposes of offsetting the state portion of the Medi-Cal
reimbursement rate for emergency medical air
transportation services and augmenting emergency medical
air transportation reimbursement payments made through
the Medi-Cal program, as specified.
10.Establishes various other penalty assessments on
specified fines, penalties and offenses for distribution
to funds established by local governments, including,
but not limited to the Courthouse Construction Fund,
Criminal Justice Facilities Construction Fund, and the
Maddy Emergency Medical Services Funds. State portions
of these penalty assessments include, but are not
limited to, the Fish and Game Preservation Fund, Peace
Officers Training Fund, Corrections Training Fund,
Traumatic Brain Injury Fund, and the General Fund.
This bill:
1. Requires a county or court that imposes a fine on the
violation of the Vehicle Code or of a local ordinance
adopted pursuant to the Vehicle Code, except parking
offenses to transfer earmarked penalty assessment
moneys, collected for deposit into the Emergency EMATA
Fund, directly to the State Treasurer, on a monthly
basis.
2. Deletes the requirement that a county establish an EMATA
Fund to receive the proceeds of the penalty and transfer
the funds on a quarterly basis to the EMATA Fund.
Background
Air ambulance services . Air ambulance services provide
emergency transportation for the most critical patients
from accident scenes directly to trauma centers and other
advanced care centers. According to a Foundation for
Air-Medical Research and Education (FARE) 2006 report, the
most serious car accidents are located in rural areas,
where 60 percent of fatal car accidents occur, a rate
double that of similar accidents in suburban or urban
areas. The FARE report also states that the closure of
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rural hospitals in recent years has created large
geographical gaps in the availability of specialized
surgical resources.
Helicopter ambulances provide medical care at an advanced
life support level, and conduct specialty care transports.
Helicopters are used for the transport of patients to
trauma centers, heart/stroke centers, burn units, and
children's specialty hospitals. Medical care is provided
in fixed wing ambulances (airplanes) on longer
inter-hospital flights when the closest appropriate medical
facility is either inaccessible, difficult to reach, or
distantly located. The FARE report estimates that a
half-million air ambulance transports are conducted each
year.
Patient transports are overseen by referring physicians and
receiving specialist physicians using guidelines developed
by the National Association of EMS Physicians, the Air
Medical Physician Association, and the Association of Air
Medical Services.
Air ambulance services are also used for disaster response.
In times of either man-made or natural disasters, air
ambulance services provide highly experienced resources
that can be rapidly deployed. Air ambulance service
providers are comprised of a mix of public and private
entities. For example, the city of Los Angeles provides
its own services, whereas the California Shock Trauma Air
Rescue (CALSTAR) is a non-profit, community-based provider
that provides services throughout central and northern
California.
Reimbursement for air ambulance services . Private air
ambulance services are reimbursed by third-party payers in
the same fashion as other health care services. According
to information provided by CALSTAR based on May 31, 2007,
audited financial statements, the average private insurance
payment for air ambulance services between June 1, 2006,
and May 31, 2007, was $20,795; the average Medicare payment
was $5,400, and the average Medi-Cal payment was $2,838.
Medi-Cal rates for air ambulance transportation were set in
1993, and have not been increased since.
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Penalty assessments . The Legislature has increasingly
turned to penalty assessments on criminal and traffic
offenses as a method of raising revenue for various
projects. Currently, the amount of assessments on
individuals who commit traffic violations is almost
quadruple the base fine. For example:
1. The fine for speeding up to 15 MPH over the 65 MPH limit
has a base penalty of $35, but amounts to $111 after
additional penalties and assessments are applied.
2. The fine for driving without insurance has a base
penalty of $200, but amounts to $825 after additional
penalties and assessments are applied.
3. The fine for driving under the influence has a base
penalty of $390, but amounts to $1,547 after additional
penalties and assessments are applied.
4. The fine for improper transport of hazardous materials
has a base penalty of $300, but amounts to $1,205 after
additional penalties and assessments are applied.
According to a February 2006 California Research Bureau
study, in counties in which the data was available, the
majority of penalties and assessments collected were from
Vehicle Code violations. The study noted that, many
criminal defendants who commit serious offenses under the
Penal Code are unlikely to have the ability to pay any
fines assessed in addition to other punishments, such as
county jail or state prison sentences.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 7/7/11)
California Association of Air Medical Services (source)
Regional Council of Rural Counties
ARGUMENTS IN SUPPORT : The California Association of Air
Medical Services (CAAMS), the bill's sponsor, argues that
this bill will make the submission of penalty assessment
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funds on a monthly basis more efficient for counties and
will remove an unnecessary requirement that the counties
provide detailed information on these funds. CAAMS adds
that the current TC30 process Ýa form and submittal process
used to transfer and identify various funds provided to the
state] within the State Controller's Office includes a
detailed account of funds transmitted by each county,
providing sufficient data to allow DHCS and stakeholders to
determine any fund trends and dynamics for their current
process of establishing a rate methodology.
ASSEMBLY FLOOR : 51-25, 5/19/11
AYES: Allen, Ammiano, Atkins, Beall, Block, Blumenfield,
Bonilla, Bradford, Brownley, Buchanan, Butler, Charles
Calderon, Campos, Carter, Cedillo, Chesbro, Davis,
Dickinson, Eng, Feuer, Fletcher, Fong, Fuentes, Furutani,
Galgiani, Gatto, Gordon, Hall, Hayashi, Roger Hernández,
Hill, Huber, Hueso, Huffman, Lara, Bonnie Lowenthal,
Mendoza, Mitchell, Monning, Pan, Perea, V. Manuel Pérez,
Portantino, Skinner, Solorio, Swanson, Torres,
Wieckowski, Williams, Yamada, John A. Pérez
NOES: Achadjian, Bill Berryhill, Conway, Cook, Donnelly,
Beth Gaines, Garrick, Grove, Hagman, Harkey, Jeffries,
Jones, Knight, Logue, Mansoor, Miller, Morrell, Nestande,
Nielsen, Norby, Olsen, Silva, Smyth, Valadao, Wagner
NO VOTE RECORDED: Alejo, Gorell, Halderman, Ma
CTW:mw 7/7/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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