BILL ANALYSIS Ó
SB 326
Page 1
SENATE THIRD READING
SB
326 (Beall)
As Amended August 31, 2015
Majority vote
SENATE VOTE: 31-5
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |18-0 |Bonta, Maienschein, | |
| | |Bonilla, Burke, Chiu, | |
| | |Gomez, Gonzalez, | |
| | |Roger Hernández, | |
| | |Lackey, McCarty, | |
| | |Nazarian, Patterson, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Steinorth, | |
| | |Thurmond, Waldron, | |
| | |Wood | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bloom, Bonta, | |
| | |Calderon, Chang, | |
| | |Nazarian, Eggman, | |
| | |Gallagher, Eduardo | |
SB 326
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| | |Garcia, Holden, | |
| | |Jones, Quirk, Rendon, | |
| | |Wagner, Weber, Wood | |
| | | | |
| | | | |
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SUMMARY: Extends the sunset date of the $4 penalty assessment
for Vehicle Code violations, other than parking offenses, from
January 1, 2016, to January 1, 2018, and extends the resulting
revenue be deposited in the Emergency Medical Air Transportation
Act (EMATA) Fund from June 30, 2017, to June 30, 2019. States
it is the intent of the Legislature to cease collection of
penalty assessments on January 1, 2018, pursuant to EMATA and
that the Legislature identify alternative funding sources for
emergency medical air transportation and cease reliance on
penalty assessment revenue. Requires the Department of Health
Care Services, in coordination with the Department of Finance,
to develop a funding plan that ensures adequate reimbursement to
emergency medical air transportation providers following the
termination of the Vehicle Code penalty assessments.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
1)Penalty revenues of around $10 million per year for an
additional two years, until 2018 (EMATA Fund). Annual
revenues will fluctuate depending on the number of vehicle
code violations that result in convictions, as well as other
factors. The numbers below are based on an assumption of $10
million in annual revenue.
2)Administrative costs, likely in the low hundreds of thousands
(EMATA Fund).
3)Reduced General Fund (GF) expenditures of around $2 million
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per year for Medi-Cal payments, by using penalty revenues to
offset GF expenditures for emergency air ambulance services
for Medi-Cal beneficiaries.
4)Annual expenditures of around $16 million per year for
supplemental payments to private emergency air medical service
providers (EMATA Fund and federal funds).
5)Based on language stating intent to cease collection of
assessments for its current purpose and requiring a plan for
an alternate funding source for emergency medical air
transportation services, potential GF cost pressure to augment
GF spending on these services.
COMMENTS: According to the author, many emergency patients
transported by air ambulances have no insurance, are not
eligible for Medi-Cal, and have no ability to pay for the
service, yet these patients are given the same high level of
care as those with medical insurance. The Medi-Cal fee schedule
pays air ambulance services far below the cost of providing
emergency air transportation, and pays nothing if the patient is
indigent. Emergency air ambulance services provide coverage to
multiple counties within a 100-mile radius of their bases, and
as a result often their transports originate in a county other
than where they are based. This makes it difficult for them to
be funded by local tax support except in the largest of
counties. Emergency physicians and air ambulances do not
receive additional funding through the Disproportionate Share
Hospital program or the county Maddy Emergency Medical Services
(EMS) Fund when they provide treatment to indigent patients.
Prior to enactment of EMATA, Medi-Cal funding for air ambulances
had not increased for nearly 20 years. This bill will continue
to provide critical funding to these services and will prevent
funding for air ambulances from reverting back to 1993 levels by
continuing the $4 penalty to fund air ambulance services.
SB 326
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AB 2173 (Beall), Chapter 547, Statutes of 2010, levied a $4
additional penalty on Vehicle Code violations (excluding parking
tickets), with the resulting revenue being used as the state
match to draw down additional federal Medicaid matching funds to
fund Medi-Cal emergency air medical transportation services.
Between $11.2 million and $13.7 million has been raised annually
from the AB 2173 penalty assessment. Of that amount, $2.2
million to $2.7 million is used as the state match to fund
current emergency air ambulance Medi-Cal provider rates. The
remaining $9 million to $11 million is used to match with
federal dollars to augment Medi-Cal rates to emergency air
ambulance providers.
According to the Judicial Council, the calculation for a traffic
ticket in California, and determining where the money goes once
collected, is complex. The cost of a traffic ticket includes a
base fine amount plus penalty assessments and fees to fund
specific state and local activities. The base fine is collected
for, and distributed to, either the local government or local
government and county. The increase in the total cost of a
traffic ticket (above the base fine) in California over the last
20 years is primarily the result of the addition of mandatory
penalty assessments and fees.
This bill is sponsored by the California Association of Air
Medical Services (Cal-AAMS), which argues this bill will
maintain the current level of Medi-Cal funding of emergency air
ambulance transportation by extending the sunset clause on the
EMATA created in 2010. Cal-AAMSS states air ambulance services
provide life-saving emergency transportation to the most
critical patients from automobile accident scenes directly to
trauma centers.
The Rural County Representatives of California (RCRC) states in
support that air ambulance service is critical in rural and
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remote areas of California and a healthy air ambulance system
ensures rural communities have access to life-saving care for
both residents and tourists. RCRC states its member counties
have had no issues in their administrative role in administering
the penalty assessment, and they believe the EMATA should be
continued in order to promote a vital health care delivery
system that is so important in rural and remote areas.
The California Ambulance Association, also in support, notes
that ambulance service, including air ambulance, is critical to
the health care safety net, providing desperately needed care
immediately to all people without exception. Emergency
ambulance service providers are legally and morally bound to
provide emergency services regardless of a patient's ability to
pay. The funds collected under EMATA are needed for better
state funding of air ambulance activities.
There is no known opposition to this bill.
Analysis Prepared by:
Patty Rodgers / HEALTH / (916) 319-2097 FN:
0001744