BILL ANALYSIS                                                                                                                                                                                                    �







                      SENATE COMMITTEE ON PUBLIC SAFETY
                            Senator Loni Hancock, Chair              S
                             2013-2014 Regular Session               B

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          SB 191 (Padilla)                                            
          As Introduced February 7, 2013 
          Hearing date:  April 30, 2013
          Government and Health and Safety Codes
          MK:mc

                              EMERGENCY MEDICAL SERVICES  

                                       HISTORY

          Source:  California Chapter, American College of Emergency  
          Physicians

          Prior Legislation: AB 1475 (Solorio) - Chapter 537, Stats. 2009
                       SB 1236 (Padilla) - Chapter 60,  Stats. 2008
                       SB 1773 (Alarcon) - Chapter 841, Stats. 2006
                       SB 57 (Alarcon) - 2005, vetoed
                                  SB 635 (Dunn) - Chapter 524, Stats. 2004
                                  SB 807 (Dunn) - vetoed, 2002
                                  AB 1398 (Florez) - not heard Senate  
          Public Safety, 2002
                                  AB 1685 (Thomson) - failed Senate Public  
          Safety, 8-6-02
                                 SB 1489 (Perata) - to the Governor, 2002
                        SB 776 (Torlakson) - Chapter 857, Stats. 2001  
                           (increase in DUI fines removed in Senate Public  
                           Safety)
                                  AB 2592 (Maddox) - failed Senate Public  
          Safety, 6-4-02
                                  AB 2288 (Aguiar) - Chapter 884, Stats.  
          1996
                                 SB 833 - Chapter 922, Stats. 1995
                                  SB 1738 - Chapter 1221, Stats. 1994




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                                  AB 5 - Chapter 3, Stats. 1959

          Support: Los Angeles County Board of Supervisors; Health  
                   Officers Association of California; Rural County  
                   Representatives of California; California Academy of  
                   Physician Assistants; Santa Clara County Board of  
                   Supervisors; California Nurses Association; League of  
                   California Cities; Urban Counties Caucus; California  
                   Hospital Association; Paramedics Plus; Ventura County  
                   Board of Supervisors; Emergency Medical Services  
                   Administrators Association

          Opposition:Automobile Club of Southern California

                                         KEY ISSUE
           
          SHOULD THE SUNSET DATE BE DELETED ON THE LAW THAT ESTABLISHES THE  
          MADDY EMERGENCY MEDICAL SERVICES FUND?


                                       PURPOSE

          The purpose of this bill is to delete the sunset date on the  
          Maddy Emergency Medical Services Fund.
          
           Existing law  provides that for the purpose of supporting  
          emergency medical services, a county board of supervisors may  
          elect to levy an additional penalty of $2 on every $10, or  
          fraction thereof, upon every fine, penalty or forfeiture imposed  
          and collected by the courts for criminal offenses including  
          Vehicle Code offenses, violations of the Alcoholic Beverage  
          Control Act and local ordinances but not including parking  
          violations.  (Government Code � 76000.5.)

           Existing law provides the assessment sunsets on January 1, 2014.  
           (Government Code � 7600.5.)
           
           This bill  deletes that sunset.





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           Existing law  authorizes a county to establish a Maddy Emergency  
          Medical Services Fund (EMS Fund) to be used to reimburse  
          physicians and hospitals for patients who do not make payment  
          for emergency medical services and for other emergency medical  
          services purposes as determined by each county.  Existing law  
          requires each county establishing the fund to report to the  
          Legislature annually on the implementation and status of the  
          fund.  (Health and Safety Code � 1797.98a et seq.; Government  
          Code � 76104.)
           
           Existing law  , as part of the Maddy Emergency Medical Services  
          Fund, provides that of the money deposited into the EMS Fund  
          pursuant to this section, 15% shall be utilized to provide  
          funding for pediatric trauma centers.  (Health and Safety Code �  
          1797.98a(e).)
           
           Existing law  further provides that expenditure of money  
          deposited in a Maddy Fund pursuant to Government Code Section  
          7600.5 shall be limited to reimbursement to physicians and  
          surgeons, and hospitals for patients who do not make payment for  
          services, or to hospitals for expanding the services provided at  
          pediatric trauma centers, including the purchase of equipment.   
          (Health and Safety Code � 1797.98a(e).)

           Existing law  provides that counties that do not maintain a  
          pediatric trauma center shall utilize the money deposited under  
          Government Code Section 7600.5 to improve access to pediatric  
          trauma emergency services in the county with a preference for  
          funding given to hospitals that specialize in services to  
          children, and physicians and surgeons who provide care for  
          children.  (Health and Safety Code � 1797.98a(e).)
           
           Existing law  has a sunset of January 1, 2014, for the provisions  
          regarding the use of money deposited pursuant to Government Code  
          section 7600.5.

           This bill  removes the sunset.
                                          
                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION




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          For the last several years, severe overcrowding in California's  
          prisons has been the focus of evolving and expensive litigation  
          relating to conditions of confinement.  On May 23, 2011, the  
          United States Supreme Court ordered California to reduce its  
          prison population to 137.5 percent of design capacity within two  
          years from the date of its ruling, subject to the right of the  
          state to seek modifications in appropriate circumstances.   

          Beginning in early 2007, Senate leadership initiated a policy to  
          hold legislative proposals which could further aggravate the  
          prison overcrowding crisis through new or expanded felony  
          prosecutions.  Under the resulting policy known as "ROCA" (which  
          stands for "Receivership/ Overcrowding Crisis Aggravation"), the  
          Committee held measures which created a new felony, expanded the  
          scope or penalty of an existing felony, or otherwise increased  
          the application of a felony in a manner which could exacerbate  
          the prison overcrowding crisis.  Under these principles, ROCA  
          was applied as a content-neutral, provisional measure necessary  
          to ensure that the Legislature did not erode progress towards  
          reducing prison overcrowding by passing legislation which would  
          increase the prison population.  ROCA necessitated many hard and  
          difficult decisions for the Committee.

          In January of 2013, just over a year after the enactment of the  
          historic Public Safety Realignment Act of 2011, the State of  
          California filed court documents seeking to vacate or modify the  
          federal court order issued by the Three-Judge Court three years  
          earlier to reduce the state's prison population to 137.5 percent  
          of design capacity.  The State submitted in part that the, ". .  
          .  population in the State's 33 prisons has been reduced by over  
          24,000 inmates since October 2011 when public safety realignment  
          went into effect, by more than 36,000 inmates compared to the  
          2008 population . . . , and by nearly 42,000 inmates since 2006  
          . . . ."  Plaintiffs, who opposed the state's motion, argue in  
          part that, "California prisons, which currently average 150% of  
          capacity, and reach as high as 185% of capacity at one prison,  
          continue to deliver health care that is constitutionally  
          deficient."  In an order dated January 29, 2013, the federal  




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          court granted the state a six-month extension to achieve the  
          137.5 % prisoner population cap by December 31st of this year.  

          In an order dated April 11, 2013, the Three-Judge Court denied  
          the state's motions, and ordered the state of California to  
          "immediately take all steps necessary to comply with this  
          Court's . . . Order . . . requiring defendants to reduce overall  
          prison population to 137.5% design capacity by December 31,  
          2013."         

          The ongoing litigation indicates that prison capacity and  
          related issues concerning conditions of confinement remain  
          unresolved.  However, in light of the real gains in reducing the  
          prison population that have been made, although even greater  
          reductions are required by the court, the Committee will review  
          each ROCA bill with more flexible consideration.  The following  
          questions will inform this consideration:

                 whether a measure erodes realignment;
                 whether a measure addresses a crime which is directly  
               dangerous to the physical safety of others for which there  
               is no other reasonably appropriate sanction; 
                 whether a bill corrects a constitutional infirmity or  
               legislative drafting error; 
                 whether a measure proposes penalties which are  
               proportionate, and cannot be achieved through any other  
               reasonably appropriate remedy; and
                 whether a bill addresses a major area of public safety  
               or criminal activity for which there is no other  
               reasonable, appropriate remedy.

                                      COMMENTS

          1.  Existing Penalty Assessments  

          Until budget year 2002-2003, there was 170% in penalty  
          assessments applied to every fine.  Current penalty  
          assessments are approximately 310% plus $79 in additional  
          flat assessments.  In addition to the $2 for every $10 that  




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          will be continued by this bill, the existing penalty  
          assessments are:

                 Existing law provides for an additional "state  
               penalty" of $10 for every $10 or fraction thereof, upon  
               every fine, penalty or forfeiture imposed and collected  
               by the courts for criminal offenses including all  
               offenses, except parking offenses, involving the  
               Vehicle Code.  Of the money collected, 70 percent is  
               transmitted to the state and 30 percent remains with  
               the county.  The state portion of the money collected  
               from the penalty is distributed in specified  
               percentages among: the Fish and Game Preservation Fund  
               (0.33 percent); the Restitution Fund (32.02 percent);  
               the Peace Officers Training Fund (23.99 percent); the  
               Driver Training Penalty Assessment Fund (25.70  
               percent); the Corrections Training Fund (7.88 percent);  
               the Local Public Prosecutors and Public Defenders Fund  
               (0.78 percent, not to exceed $850,000 per year); the  
               Victim-Witness Assistance Fund (8.64 percent); and the  
               Traumatic Brain Injury Fund (0.66 percent).  (Penal  
               Code � 1464.)

                 Existing law provides for an additional county  
               penalty assessment of $7 for every $10 or fraction  
               thereof, 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 ordinance adopted  
               pursuant to the Vehicle Code except parking offenses.   
               The money collected shall be placed in any of the  
               following funds if established by a County Board of  
               Supervisors:  Courthouse Construction Fund; a Criminal  
               Justice Facilities Construction Fund; Automated  
               Fingerprint Identification Fund; Emergency Medical  
               Services Fund; DNA Identification Fund.  (Government  
               Code � 76000 et seq.)






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                 Existing law, as a part of the 2002-03 Budget Act,  
               the Legislature imposed what was to be a temporary  
               state surcharge of 20 percent on every base fine  
               collected by the court.  All money collected shall be  
               deposited in the General Fund.  This section was made  
               permanent in the 2007 Budget.  (Penal Code � 1465.7.)

                 Existing law established the "State Court Facilities  
               Construction Fund" and added a state court construction  
               penalty assessment in an amount up to $5 for every $10  
               or fraction thereof, upon every fine, penalty, or  
               forfeiture imposed and collected by the courts for  
               criminal offenses.  The variation in the amount is  
               dependent on the amount collected by the county for  
               deposit into the local Courthouse Construction Fund  
               established pursuant to Government Code Section 76100.   
               As a result, the penalty assessment ranges from $0.00  
               for every $10 in two counties, to the full $5 for every  
               $10 in nine counties.  This provision took effect on  
               January 1, 2003.  (Government Code � 70372.)

                 Existing law, established by Prop 69, Nov. 2004,  
               levies 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 will go to local  
               governments.  (Government Code � 76104.6)

                 Existing law provides that in addition to the amount  
               in Government Code Section 76104.6, there shall be an  
               additional state-only penalty of $4 for every $10 on  
               every fine penalty or forfeiture imposed by the courts  
               for all criminal offenses, including all offences  
               involving a violation of the Vehicle Code or any local  
               ordinance adopted pursuant to the Vehicle Code.   
               (Government Code 76104.7.)




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                 Existing law provides for an additional $4 on every  
               Vehicle Code violation or local ordinance for the Emergency  
               Medical Air Transportation Act Fund.  (Government Code �  
               76000.10)

                 Existing law provides for a flat fee of $40 on every  
               conviction for a criminal offense to ensure adequate  
               funding for court security.  (Penal Code � 1465.8.)

                 Existing law imposes a $35 court facilities assessment  
               on every conviction for a criminal offense including a  
               traffic offense, excluding parking offenses, and on any  
               local ordinance adopted pursuant to the Vehicle Code.   
               (Government Code � 70373.)




          2.    The Maddy EMS Fund  

          The Emergency Medical Services fund was created (SB 12 (Maddy)  
          1987) to provide supplemental financing for local emergency  
          services.  The law permits, but does not require, each county to  
          levy a $2 penalty assessment to each $10 of traffic fines, with  
          the sums raised to be deposited in the EMS fund.  Ten percent of  
          the total revenue is annually deducted for administration; and  
          the remaining EMS revenues are divided 58% to physicians for  
          uncompensated ER costs, 25% to trauma centers and hospitals, and  
          17% for county emergency medical services.

          SB 623 (Speier) Chapter 679, Statutes of 1999, additionally  
          requires that in those counties that have established a Maddy  
          Fund, an amount equal to a specified sum is to be deposited by  
          the county treasurer in the Maddy Fund.

          3.  Additional 20% Assessment  

          Existing law, which sunsets on January 1, 2014,  provides that a  











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          county board of supervisors may elect to levy an additional  
          penalty of $2 for every $10 on every fine, penalty, forfeiture  
          for criminal offenses including those relating to the Alcoholic  
          Beverage Control Act and all offenses dealing with the Vehicle  
          Code except parking offenses.  The additional assessment for  
          "the purposes of supporting emergency medical services" is in  
          addition to the existing 20% penalty assessment for these  
          purposes.  

          Money collected under the statute to be continued under this  
          bill shall be deposited with the County Treasurer.  Of the money  
          deposited into the EMS fund under this statute, 15% shall be  
          utilized to provide funding for pediatric trauma centers,  
          although in another section of the bill it refers to trauma care  
          facilities providing trauma care.  The statute provides that  
          expenditures shall be limited to reimbursement to physicians,  
          and surgeons, and 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.   
          Counties that do not maintain a pediatric trauma center shall  
          utilize the money deposited pursuant to this provision to  
          improve access to pediatric trauma centers with a preference for  
          funding given to hospitals that specialize in services to  
          children, and physicians and surgeons who provide care to  
          children.

          SHOULD THE SUNSET BE REMOVED FROM THE PROVISION WHICH ALLOWS  
          COUNTIES TO IMPOSE AN ADDITIONAL 20% PENALTY ON ALL CRIMINAL  
          VIOLATIONS FOR THE PURPOSE OF SUPPORTING EMERGENCY MEDICAL  
          SERVICES?


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