BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 412|
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THIRD READING
Bill No: AB 412
Author: Williams (D)
Amended: 5/27/11 in Assembly
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 06/29/11
AYES: Hernandez, Strickland, Alquist, Anderson, Blakeslee,
De León, DeSaulnier, Wolk
NO VOTE RECORDED: Rubio
SENATE PUBLIC SAFETY COMMITTEE : 7-0, 07/05/11
AYES: Hancock, Anderson, Calderon, Harman, Liu, Price,
Steinberg
ASSEMBLY FLOOR : 72-0, 06/02/11 - See last page for vote
SUBJECT : Emergency medical services
SOURCE : American College of Emergency Physicians,
California
Chapter
DIGEST : This bill reenacts, until January 1, 2014,
provisions that sunset on January 1, 2011, authorizing
Santa Barbara County to collect a penalty of $5 for every
$10 in base fines imposed on criminal offenses and
specified vehicle code offenses to be deposited in a Maddy
Emergency Services Fund (Maddy EMS Fund), for the purpose
of supporting emergency medical services (EMS).
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ANALYSIS : Existing law:
1.Authorizes counties to establish a Maddy EMS Fund, funded
by specified revenue penalties, and specifies a
distribution formula for the funds, including
reimbursement to physicians and hospitals for patients
when payment is not otherwise made for those services,
pediatric trauma centers, administrative expenses and
other local EMS purposes.
2.Requires any county that establishes a Maddy EMS Fund to
deposit $2 for every $7 of penalties imposed by the
courts for criminal offenses into the fund.
3.Establishes an additional EMS penalty assessment of $2
for every $10 on every fine, penalty, forfeiture or
criminal offense and all offenses dealing with the
Vehicle Code except parking offenses, for local Maddy EMS
Funds.
4.Until January 1, 2011, authorized Santa Barbara County,
for purposes of supporting EMS in the county, to collect
an additional specified penalty assessment on every fine,
penalty, or forfeiture collected for all criminal
offenses, except as specified, if the Santa Barbara
County Board of Supervisors adopts a resolution stating
that implementation of this provision is necessary to the
county for purposes of providing payment for EMS.
5.Until January 1, 2011, required, upon the establishment
of a Maddy EMS Fund in Santa Barbara County, that the
amount that would have been collected as penalty
assessments be deposited in the Maddy EMS Fund
established by the county.
6.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, Maddy EMS 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 General Fund.
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7.Establishes a $4 EMS penalty assessment on every
conviction of a violation of the Vehicle Code, or a local
ordinance adopted pursuant to the Vehicle Code, except
parking offenses, to augment emergency medical air
transportation reimbursement payments made through the
Medi-Cal program and to offset the state portion of the
Medi-Cal reimbursement rate for emergency medical air
transportation services.
This bill:
1.Reenacts provisions that sunset on January 1, 2011,
authorizing Santa Barbara County to impose a penalty of
$5 for every $10, or part of $10, on fines, penalties,
and forfeitures collected for all criminal offenses and
specified vehicle code offenses related to driving under
the influence, to be deposited in a Maddy Fund,
established by the county, for the purpose of supporting
EMS, until January 1, 2014.
2.Requires the proceeds of the penalty assessment to be
payable for the same purposes as prior EMS assessment
revenue.
3.Conditions implementation of this bill upon adoption of a
resolution of necessity by the Santa Barbara County Board
of Supervisors.
4.Requires the Santa Barbara County Board of Supervisors to
report to the Legislature on the actions taken to
implement alternative local sources of funding for EMS.
5.Exempts restitution fines, specified penalties, and
parking offenses from imposition of the additional
penalty calculation.
Background
In 1987, the Legislature concluded that EMS providers bore
higher costs for their services than did providers of other
medical services, but often received only partial or no
payment from patients. The state enacted a series of bills
to compensate physicians and medical facilities for EMS
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provided to patients who do not have health insurance and
cannot pay for their medical care.
Funds from penalty assessments must be used to reimburse
physicians and hospitals for patients who do not make
payment for EMS services and have no third-party or
government source of payment. Fifty-eight percent of these
funds, after administrative costs, must be distributed to
physicians for emergency services, 25 percent to hospitals
providing disproportionate levels of trauma and EMS, and 17
percent to other EMS purposes as determined by each county,
including regional poison centers. Physicians can be
reimbursed for up to 50 percent of the losses submitted.
According to a March 2004 California State Auditor Report
on County Maddy EMS Funds, as of November 2003, 49 counties
had established Maddy EMS Funds, 40 of which were
established prior to June 1, 1991.
The Legislature has increasingly turned to penalty
assessments on criminal and traffic offenses as a method of
raising revenue for various projects. The state now has
over 269 programs or services that rely on court fines,
fees, forfeitures, surcharges and penalty assessments that
are levied on offenders and violators. The current
assessment is almost quadruple the base fine on individuals
who commit traffic violations. A study conducted by the
California Research Bureau (CRB) in February 2006 found, in
counties in which the data was available, that the majority
of penalties and assessments collected were from Vehicle
Code violations. Many criminal defendants who commit more
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.
Judges have the discretion to reduce the base fine, which
then reduces revenue to state and local governments, as
well as to assessments. As current penalty assessments can
almost quadruple the base fine, increasing fines and
assessments may have the unintended consequence of reducing
fine collections. Indigent defendants facing
ever-increasing fees may simply choose to spend time in
jail in lieu of paying the fine, causing taxpayers to pay
the jail costs while state and local government receive
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fewer penalty funds. Moreover, county jail population caps
may provide additional incentives to opt for jail time over
fines, as the time served for nonviolent offenders may be
minimal. The 2006 CRB report also noted that high penalty
assessments may result in higher rates of default by the
guilty parties.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 6/29/11)
American College of Emergency Physicians, California
Chapter (source)
California Medical Association
Santa Barbara County Board of Supervisors
ARGUMENTS IN SUPPORT : The California Chapter of the
American College of Emergency Physicians (CAL/ACEP), the
sponsor of AB 412, states that Santa Barbara County is home
to five hospitals serving the large Central Coast area.
According to CAL/ACEP, the number of ED visits to these 5
hospitals has doubled from 61,500 visits in 2005 to over
131,000 visits in 2009. CAL/ACEP further argues that
California's emergency rooms have become the health care
safety net and are the front line of any public health
emergency. CAL/ACEP contends that while the Maddy EMS
funds only reimburse a small portion of the cost of care,
they are nevertheless a critical source of funding helping
to preserve the emergency care safety net.
ASSEMBLY FLOOR : 72-0, 06/02/11
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall,
Bill Berryhill, Block, Blumenfield, Bonilla, Bradford,
Brownley, Buchanan, Butler, Charles Calderon, Campos,
Carter, Cedillo, Chesbro, Cook, Davis, Dickinson,
Donnelly, Eng, Feuer, Fletcher, Fong, Fuentes, Furutani,
Beth Gaines, Galgiani, Gatto, Gordon, Grove, Hagman,
Harkey, Hayashi, Roger Hernández, Hill, Huber, Hueso,
Huffman, Jeffries, Jones, Knight, Lara, Logue, Bonnie
Lowenthal, Ma, Mendoza, Miller, Mitchell, Monning,
Morrell, Nestande, Nielsen, Norby, Olsen, Pan, Perea, V.
Manuel Pérez, Portantino, Skinner, Smyth, Solorio,
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Swanson, Torres, Valadao, Wagner, Williams, Yamada, John
A. Pérez
NO VOTE RECORDED: Conway, Garrick, Gorell, Halderman,
Hall, Mansoor, Silva, Wieckowski
CTW:nl 7/6/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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