BILL ANALYSIS Ó
SENATE COMMITTEE ON PUBLIC SAFETY
Senator Loni Hancock, Chair
2015 - 2016 Regular
Bill No: SB 867 Hearing Date: April 5, 2016
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|Author: |Roth |
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|Version: |January 11, 2016 |
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|Urgency: |No |Fiscal: |No |
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|Consultant:|MK |
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Subject: Emergency Medical Services
HISTORY
Source: The California Chapter of the American College of
Emergency Physicians
Prior Legislation:SB 191 (Padilla) - Chapter 600, Stats. 2013
AB 1475 (Solorio) - Chapter 537, Stats. 2009
SB 1236 (Padilla) - Chapter 60, Stats. 2008
SB 1773 (Alarcon) - Chapter 841, Stats. 2006
SB 57 (Alarcon) - Vetoed 2005
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
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AB 2288 (Aguiar) - Chapter 884, Stats.
1996
SB 833 (Kopp) - Chapter 922, Stats. 1995
SB 1738 (Leonard) - Chapter 1221, Stats.
1994
AB 5 - Chapter 3, Stats. 1959
Support: American Academy of Pediatrics; California Ambulance
Association; California Hospital Association;
California Children's Hospital Association; California
Fire Chiefs Association; California School Nurses
Organization; California State Association of
Counties; Emergency Medical Services Administrators
Association; Emergency Nurses Association; Fire
Districts Association of California; Los Angeles
County Board of Supervisors; The Osteopathic
Physicians and Surgeons; Private Essential Access
Community Hospitals; Providence Health and Services;
Rural County Representatives of California; San Diego
County
Opposition:None known
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, 2017.
(Government Code § 7600.5.)
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This bill deletes that sunset.
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, 2017, 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
For the past several years this Committee has scrutinized
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legislation referred to its jurisdiction for any potential
impact on prison overcrowding. Mindful of the United States
Supreme Court ruling and federal court orders relating to the
state's ability to provide a constitutional level of health care
to its inmate population and the related issue of prison
overcrowding, this Committee has applied its "ROCA" policy as a
content-neutral, provisional measure necessary to ensure that
the Legislature does not erode progress in reducing prison
overcrowding.
On February 10, 2014, the federal court ordered California to
reduce its in-state adult institution population to 137.5% of
design capacity by February 28, 2016, as follows:
143% of design bed capacity by June 30, 2014;
141.5% of design bed capacity by February 28, 2015; and,
137.5% of design bed capacity by February 28, 2016.
In December of 2015 the administration reported that as "of
December 9, 2015, 112,510 inmates were housed in the State's 34
adult institutions, which amounts to 136.0% of design bed
capacity, and 5,264 inmates were housed in out-of-state
facilities. The current population is 1,212 inmates below the
final court-ordered population benchmark of 137.5% of design bed
capacity, and has been under that benchmark since February
2015." (Defendants' December 2015 Status Report in Response to
February 10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge
Court, Coleman v. Brown, Plata v. Brown (fn. omitted).) One
year ago, 115,826 inmates were housed in the State's 34 adult
institutions, which amounted to 140.0% of design bed capacity,
and 8,864 inmates were housed in out-of-state facilities.
(Defendants' December 2014 Status Report in Response to February
10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge Court, Coleman
v. Brown, Plata v. Brown (fn. omitted).)
While significant gains have been made in reducing the prison
population, the state must stabilize these advances and
demonstrate to the federal court that California has in place
the "durable solution" to prison overcrowding "consistently
demanded" by the court. (Opinion Re: Order Granting in Part and
Denying in Part Defendants' Request For Extension of December
31, 2013 Deadline, NO. 2:90-cv-0520 LKK DAD (PC), 3-Judge Court,
Coleman v. Brown, Plata v. Brown (2-10-14). The Committee's
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consideration of bills that may impact the prison population
therefore will be informed by the following questions:
Whether a proposal erodes a measure which has contributed
to reducing the prison population;
Whether a proposal addresses a major area of public safety
or criminal activity for which there is no other
reasonable, appropriate remedy;
Whether a proposal addresses a crime which is directly
dangerous to the physical safety of others for which there
is no other reasonably appropriate sanction;
Whether a proposal corrects a constitutional problem or
legislative drafting error; and
Whether a proposal proposes penalties which are
proportionate, and cannot be achieved through any other
reasonably appropriate remedy.
COMMENTS
1. Need for This Bill
The Maddy Fund will sunset on January 1, 2017 if
nothing is done to eliminate or extend this date. The
Maddy Fund is used to reimburse physicians and
hospitals for treating uninsured patients, and is the
only source of funding for physicians treating
uninsured patients. Allowing this program to sunset
would result in the loss of approximately $50 million
from the emergency care safety net at a time when
drastically more funding is needed, not less. SB 867
removes the sunset date to the Maddy Fund. Making the
Maddy Fund permanent will allow counties, hospitals,
and physicians to continue providing emergency services
in their communities with these desperately needed
funds. Specifically, under the Maddy Fund, counties
can opt to collect an additional $2 for every $10
penalty for all criminal offenses and moving
violations. Most counties in the state have opted to
take advantage of this funding source to help their
community hospitals treat the uninsured patients they
see. The Maddy Fund also allocates 15% of the funds
collected to support pediatric trauma centers. Without
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this bill, there will be no statewide funding source
for pediatric trauma after the sunset date of January
1, 2017. California's Emergency Departments (EDs) are
the healthcare safety net and the front lines of any
public health emergency. The demand on EDs is only
increasing. Despite the implementation of the
Affordable Care Act (ACA), visits to the ED are up, and
millions of Californians remain uninsured. SB 867 is
critical to maintaining access to quality emergency
care for all Californians.
2. 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
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
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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.)
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.)
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.)
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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.)
3. 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.
4. Additional 20% Assessment
Existing law, which sunsets on January 1, 2017, 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 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
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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.
In past bills the sunset has been extended not eliminate. The
Committee may wish to consider whether an extension of the
sunset is more appropriate than the elimination of the sunset.
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