BILL ANALYSIS �
SB 191
Page 1
SENATE THIRD READING
SB 191 (Padilla)
As Amended June 25, 2013
Majority vote
SENATE VOTE :33-1
HEALTH 19-0
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|Ayes:|Pan, Logue, Ammiano, |
| |Atkins, Rendon, Bonta, |
| |Chesbro, Gomez, Roger |
| |Hern�ndez, Lowenthal, |
| |Maienschein, Mansoor, |
| |Mitchell, Nazarian, |
| |Nestande, |
| |V. Manuel P�rez, Wagner, |
| |Wieckowski, Wilk |
| | |
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SUMMARY : Extends to January 1, 2021, existing law: 1)
authorizing county Boards of Supervisors to elect to levy an
additional $2 for every $10 fine, penalty, or forfeiture imposed
or collected by the courts for all criminal offenses, including
violations of the Alcoholic Beverage Control Act and Vehicle
Code for purposes of the Maddy Emergency Medical Services (EMS)
Fund; 2) requiring 15% of the collected assessments to be
utilized for all pediatric trauma centers throughout the county,
as specified; and, 3) requiring costs of administering money
deposited into the fund pursuant to such assessments to be
reimbursed in an amount that does not exceed the actual
administrative costs or 10% of the money collected, whichever
amount is lower.
EXISTING LAW :
1)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 EMS 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.
SB 191
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2)Permits the following of the Maddy EMS Fund: a) up to 10% may
be used to reimburse costs of administering the fund; b) 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, c) any amount that is distributed for other
EMS purposes, as specified.
3)Requires that the amount in the Maddy EMS Fund, reduced by the
amounts specified in 2) above, to be utilized 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 the following schedule:
a) Fifty-eight percent of the fund to be distributed to
physicians and surgeons for emergency services provided by
all physicians and surgeons, except those physicians and
surgeons employed by county hospitals, in general acute
care hospitals that provide basic, comprehensive, or
standby emergency services up to the time the patient is
stabilized, as specified;
b) Twenty-five percent of the fund to be distributed only
to hospitals providing disproportionate trauma and
emergency medical care services; and,
c) Seventeen percent of the fund to be distributed for
other EMS purposes, as determined by each county, including
but not limited to, the funding of regional poison control
centers.
4)Requires, in each county, an additional penalty to be levied,
in the amount 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
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.
5)Allows, for purposes of supporting EMS pursuant to the Maddy
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EMS Fund, in addition to the penalties specified in 4) above,
the county Board of Supervisors to elect to levy an additional
penalty in the amount of $2 for every $10, or part of $10,
upon every fine, penalty, or forfeiture imposed and collected
by the courts for all criminal offenses, including violations
relating to the control of alcoholic beverages, as specified,
and all offenses involving a violation of the Vehicle Code or
a local ordinance adopted pursuant to the Vehicle Code.
Requires that 15% of the funds to be utilized to provide
funding for all pediatric trauma centers throughout the
county, both publicly and privately owned and operated, as
specified.
6)Requires each county establishing a Maddy EMS Fund, on January
1, 1989, and on each April thereafter, to report to the
Legislature on the implementation and status of the EMS Fund.
Requires the report to cover the preceding fiscal year, and to
include: total amount of fines and forfeitures collected, as
specified; amount of penalty assessment funds collected; fund
balance and the amount of moneys disbursed under the program
to physicians and surgeons, for hospitals, and for other EMS
purposes, and the amount of money disbursed for actual
administrative costs; the number of claims paid, as specified;
the amount of moneys available to be disbursed to physicians
and surgeons, as specified; and, the amount of moneys
available to be disbursed to hospitals.
FISCAL EFFECT : None
COMMENTS : According to the author, Californians, regardless of
geographic location, income, or ethnicity continue to face
either increased emergency room wait time, being rerouted to
other hospitals, or both. Additionally, pediatric trauma care
is still not widely available in California. There are only 14
pediatric trauma care centers in our state of 38 million people.
Too often, pediatric trauma patients must be transported by
helicopter to trauma centers and the time that elapses during
transport can impact survival and recovery rates. In 2006,
legislation was signed into law authorizing counties to
supplement their local Maddy EMS Fund by collecting an
additional $2 penalty on every $10 assessment on certain
criminal and vehicle code violations, and 15% of these funds are
allocated for pediatric trauma care. This is the only source of
funding for pediatric trauma care. This bill extends the sunset
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date of these assessments to continue to fund pediatric trauma
services.
In 1987, the Legislature approved the establishment of the Maddy
EMS Fund, and although counties are not required to establish
EMS Funds, there are currently 50 counties that have done so.
The Legislature intended the EMS Funds to reimburse physicians,
hospitals, and other providers of emergency services,
specifically to patients who do not have health insurance
coverage for emergency services and care, cannot afford to pay
for those services, and for whom payment will not be made
through any private coverage or by any program funded in whole
or in part by the federal government, as specified.
Counties have several sources of revenue for their EMS Funds:
Maddy revenues, derived from county penalty assessments on
various criminal offenses and motor vehicle violations; traffic
violator school fees; and, revenues from taxes on tobacco
products deposited in the State's Cigarette and Tobacco Products
Surtax Fund, including the EMS Appropriation.
Current law requires courts to collect the fines, penalties, and
forfeitures for various criminal offenses, motor vehicle and
traffic violations. Currently, the total penalty assessment is
$7 for every $10 of fines and forfeitures, a portion of which
goes to the Maddy EMS Fund. Courts collect the penalty
assessments and forward them to counties.
In 1988, voters passed the Tobacco Tax and Health Protection Act
of 1988 (Proposition 99) through the initiative process.
Proposition 99 imposes taxes on the distribution of cigarettes
and other tobacco products. The state collects these taxes for
deposit in the State's Cigarette and Tobacco Products Surtax
Fund to fund a variety of programs, including the California
Healthcare for Indigents Program (CHIP) and Rural Health
Services (RHS) program, which allocate funds to counties for
indigent care. Since 2000, the Legislature has appropriated
money from CHIP and RHS funds to provide counties with revenues
which are restricted to reimbursement of uncompensated emergency
room care by private physicians. This annual appropriation is
referred to as the EMS Appropriation.
SB 1773 (Alarcon), Chapter 841, Statutes of 2006, further
authorized county Boards of Supervisors to levy an additional
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penalty in the amount of $2 for every $10, or part of $10 for
criminal offenses, violations relating to the Vehicle Code and
alcoholic beverages. Under SB 1773, 15% of the funds collected
must be utilized to fund pediatric trauma centers (referred to
as Richie's Fund) through the county, both publicly and
privately owned and operated. The expenditure of money is
limited to reimbursement to physicians and surgeons, and to
hospitals for patients who do not make payment for emergency
care services in hospitals up to the point of stabilization, or
to hospitals for expanding the services provided to pediatric
trauma patients at trauma centers, other hospitals providing
care to pediatric trauma patients, or at pediatric trauma
centers, including the purchase of equipment. The remaining 75%
in these funds are distributed in accordance with the
percentages specified in Existing Law 3) above. SB 1773 was set
to originally sunset in 2009, but was extended to January 1,
2014, under SB 1236 (Padilla), Chapter 60, Statutes of 2008.
Analysis Prepared by : Rosielyn Pulmano / HEALTH / (916)
319-2097
FN: 0001255