BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 191|
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UNFINISHED BUSINESS
Bill No: SB 191
Author: Padilla (D)
Amended: 6/25/13
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 4/10/13
AYES: Hernandez, Anderson, Beall, De León, DeSaulnier, Monning,
Nielsen, Pavley, Wolk
SENATE PUBLIC SAFETY COMMITTEE : 7-0, 4/30/13
AYES: Hancock, Anderson, Block, De León, Knight, Liu, Steinberg
ASSEMBLY FLOOR : 70-2, 7/1/13 - See last page for vote
SUBJECT : Emergency medical services
SOURCE : California Chapter of American College of Emergency
Physicians
California District of the American Academy of
Pediatrics
California Medical Association
Los Angeles County Board of Supervisors
DIGEST : This bill extends the January 1, 2014, sunset date to
January 1, 2021, on two provisions of existing law 1)
authorizing counties to assess an additional $2 on every $10 of
certain fines and penalties, including Vehicle Code violations,
to supplement revenues for county Maddy Emergency Medical
Services Funds (Maddy Funds), and 2) requiring 15% of these
additional funds to be used for pediatric trauma care.
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Assembly Amendments add a sunset date of January 1, 2021.
ANALYSIS :
Existing law:
1. Permits each county to establish an emergency medical
services (EMS) fund, known as the Maddy Fund, and specifies
how these funds are to be used.
2. Assesses additional penalties on every fine and penalty
imposed and collected by the courts for all criminal
offenses, including all offenses involving a violation of the
Vehicle Code, and requires funds from these additional
penalties to be deposited into a county Maddy Fund, if the
county has established a Maddy Fund, to pay for EMS, as
specified.
3. Requires each county establishing a Maddy Fund to report to
the Legislature annually on the implementation and status of
the fund.
4. Permits a county board of supervisors to levy an additional
penalty, in addition to the additional penalties already
assessed under #2) above, in the amount of $2 for every $10
upon every fine and penalty imposed and collected by the
courts for all criminal offenses, in order to supplement
county Maddy Funds. Sunsets this provision on January 1,
2014.
5. Permits the additional fines authorized in #2) above to only
be collected if the county board of supervisors provides that
the increased penalties do not offset or reduce the funding
of other programs from other sources, but that these
additional revenues result in increased funding to those
programs. Sunsets this provision on January 1, 2014.
6. Requires that of the additional money deposited into county
Maddy Funds pursuant to #4) above, 15% be used to provide
funding for pediatric trauma centers, as specified. This
separate allocation for pediatric trauma is known as Richie's
Funds, and requires counties that do not maintain a pediatric
trauma center to utilize the money to improve access to, and
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coordination of, pediatric trauma and emergency services in
the county, with preference for funding given to hospitals
that specialize in services to children. Sunsets this
provision on January 1, 2014.
This bill:
1. Extends the January 1, 2014, sunset date to January 1, 2021,
on existing law permitting an additional $2 on every $10 fine
or penalty imposed by a county for purposes of supplementing
county Maddy Funds.
2. Extends the January 1, 2014, sunset dates to January 1, 2021,
on existing law requiring that 15% of the additional penalty
revenue be used for pediatric trauma services, and that no
more than 10% of the additional penalty revenue be used for
administrative costs of these additional funds.
Background
Existing penalty assessments . Until budget year 2002-03, there
was 170% in penalty assessments applied to every fine. Current
penalty assessments are approximately 310% plus $79 in
additional flat assessments.
The Maddy Fund . The Maddy 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. 10% 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 EMS.
Additional 20% Assessment . Existing law, which sunsets on
January 1, 2014, provides that a 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 assessment for the purposes of supporting EMS is in
addition to the existing 20% penalty assessment for these
purposes.
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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. 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.
Prior legislation
SB 623 (Speier, Chapter 679, Statutes of 1999) 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.
SB 1236 (Padilla, Chapter 60, Statutes of 2008) extended the
sunset dates, from January 1, 2009, to January 1, 2014, on
provisions of law authorizing counties to assess an additional
$2 on every $10 in fines to supplement Maddy Funds, with 15% of
these additional funds allocated to pediatric trauma care.
These are the sunset dates that this bill is proposing to
delete.
SB 1773 (Alarcon, Chapter 841, Statutes of 2006) enacts the
provisions of law that authorize counties to assess an
additional $2 on every $10 in fines to supplement Maddy Funds,
with 15% of these additional funds allocated to pediatric trauma
care. These are the provisions of law that this bill is seeking
to make permanent.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No Local:
No
SUPPORT : (Verified 7/2/13)
California Chapter, American College of Emergency Physicians
(co-source)
California District of the American Academy of Pediatrics
(co-source)
California Medical Association (co-source)
Los Angeles County Board of Supervisors (co-source)
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California Center for Rural Policy
California Children's Hospital Association
California Fire Chiefs Association
California Hospital Association
California Nurses Association
California School Nurses Association
California State Association of Counties
California State Council of Emergency Nurses Association
Children Now
City Ambulance of Eureka, Inc.
Coachella Valley Association of Governments
Counties of Alameda, Butte, Contra Costa, Del Norte, Humboldt,
Lassen, Marin, Merced, San Bernardino, San Diego, San Joaquin,
Santa Barbara, Santa Clara, Stanislaus, Ventura, and Yolo
County of Los Angeles Sheriff's Department
Del Norte Ambulance
Emergency Medical Services Administrators Association of
California
Health Officers Association of California
Hospital Corporation of America
Lake County Health Services Department
League of California Cities
Local Health Plans of California
North Coast Emergency Medical Services
Paramedics Plus
Rural County Representatives of California
San Fernando Valley Dental Society
Sutter Lakeside Hospital
OPPOSITION : (Verified 7/2/13)
Automobile Club of Southern California
ARGUMENTS IN SUPPORT : One of the bill's sponsors, the
California Chapter of the American College of Emergency
Physicians (California ACEP), states that emergency care is
California is in crisis. California ACEP states that in the
past decade, more than 65 emergency departments have closed,
emergency department visits are up, wait times continue to
increase, and hospital diversion is on the rise. California
ACEP states that in response to these challenges, SB 1773
(Alarcon) was signed into law in 2006 to raise approximately $50
million to augment county Maddy Funds. The Maddy Fund is
intended to mitigate the losses for treating the uninsured,
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particularly in rural and urban emergency departments.
California ACEP points out that a recent study by the UCLA
Center for Health Policy Research indicates that despite the
implementation of the Affordable Care Act (ACA), three to four
million Californians will still remain uninsured, and that this
bill is critical to maintaining access to high quality emergency
services.
The Los Angeles County Board of Supervisors (Board) states that
since the inception of the funding Richie's Funds, $11.6 million
in these funds have been allocated to implement and to expand
pediatric trauma care and EMS at both county and non-county
facilities. The Board states that it will continue to provide
emergency care for the thousands of persons in the county who
will remain without insurance cove rage even after the
implementation of the ACA. Retaining the availability of
Richie's Funds is critical to maintaining the county's fragile
trauma and emergency care system. Numerous other counties have
written in support with similar arguments.
The California Hospital Association also supports this bill,
stating that it is estimated that through the optional
implementation of both the original Maddy Fund and the
supplemental assessment funds, counties, physicians, hospitals,
local EMS providers, and Richie's Fund, will receive
approximately $94 million annually statewide.
ARGUMENTS IN OPPOSITION : The Automobile Club of Southern
California (Auto Club) states in opposition that according to
the Uniform Bail and Penalty Schedule, published by the Judicial
Council of California, current penalty assessments are in excess
of about 380% of the base fine. This means that for every $10,
about $38 is added, with a share going to the state and
counties. The Auto Club states that about 70% - 80% of penalty
assessment revenue is generated from Vehicle Code moving
violations. The Auto Club states that penalty assessments were
originally established in the 1950s to fund drivers training in
public schools, but over time, the amount of assessments has
increased exponentially and today they fund a plethora of
programs largely unrelated to traffic safety.
The Auto Club asserts that although some people involved in
vehicular collisions utilize emergency room services, many
arrive in emergency rooms due to causes or circumstances
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unrelated to driving or traffic crashes, including violent
crimes, sporting activities, or general illness. The Auto Club
argues that while emergency room services are a necessary and
laudable effort to support, funding the program through
assessments on Vehicle Code tickets places a disproportionate
burden upon the motoring public to achieve this goal.
ASSEMBLY FLOOR : 70-2, 7/1/13
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Chesbro, Conway, Cooley, Dahle, Daly,
Dickinson, Eggman, Fong, Fox, Beth Gaines, Garcia, Gatto,
Gomez, Gonzalez, Gordon, Gorell, Gray, Grove, Hagman, Harkey,
Roger Hernández, Holden, Jones, Jones-Sawyer, Levine, Linder,
Lowenthal, Mansoor, Medina, Melendez, Mitchell, Morrell,
Mullin, Muratsuchi, Nazarian, Nestande, Olsen, Pan, Perea, V.
Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,
Stone, Ting, Wagner, Waldron, Weber, Wilk, Williams, Yamada,
John A. Pérez
NOES: Chávez, Donnelly
NO VOTE RECORDED: Frazier, Hall, Logue, Maienschein, Patterson,
Wieckowski, Vacancy, Vacancy
JL:d 7/2/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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