BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     SB 867


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          SENATE THIRD READING


          SB  
          867 (Roth)


          As Amended  April 12, 2016


          Majority vote


          SENATE VOTE:  36-1


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Public Safety   |7-0  |Jones-Sawyer,         |                    |
          |                |     |Melendez, Lackey,     |                    |
          |                |     |Lopez, Low, Quirk,    |                    |
          |                |     |Santiago              |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
           ------------------------------------------------------------------ 


          SUMMARY:  Extends until January 1, 2027, the Maddy Emergency  
          Medical Services (EMS) Fund, which authorizes each county to  
          levy an additional $2 for every $10 of criminal fines to  
          establish an emergency medical services fund for reimbursement  
          of costs related to emergency medical services based on fees on  
          criminal convictions. 
          EXISTING LAW:









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          1)States that for the purposes of supporting emergency medical  
            services as specified, in addition to other specified criminal  
            penalties, the county board of supervisors may elect to levy  
            an additional penalty in the amount of two dollars ($2) for  
            every ten dollars ($10), or part of ten dollars ($10), upon  
            every fine, penalty, or forfeiture imposed and collected by  
            the courts for all criminal offenses. 
          2)Specifies that the additional penalty for emergency medical  
            services does not apply to the restitution fine, parking  
            violations, the state surcharge and specified penalty  
            assessments. 


          3)Provides that the emergency medical services funds shall be  
            collected only 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. 


          4)States that moneys collected for the emergency medical  
            services fund shall be taken from fines and forfeitures  
            deposited with the county treasurer prior to any division. 


          5)Specifies that funds collected pursuant to this section shall  
            be deposited into the Maddy Emergency Medical Services (EMS)  
            Fund. 


          6)States the EMS Fund will be repealed on January 1, 2017. 


          7)Provides that each county may establish an emergency medical  
            services fund, upon the adoption of a resolution by the board  
            of supervisors. 









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          8)Specifies that the costs of administering the fund shall be  
            reimbursed by the fund in an amount that does not exceed the  
            actual administrative costs or 10% of the amount of the fund,  
            whichever amount is lower. 


          9)States that all interest earned on moneys in the fund shall be  
            deposited in the fund for disbursement as specified in this  
            section. 


          10)States that the amount in the fund, reduced by the amount for  
            administration and the reserve, shall be utilized to reimburse  
            physicians and surgeons 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 according to the following schedule:


             a)   Fifty-eight percent of the balance of the fund shall 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 pursuant to  
               paragraph (3) or (5) of subdivision (f) of Section 1797.98e  
               up to the time the patient is stabilized. 
             b)   Twenty-five percent of the fund shall be distributed  
               only to hospitals providing disproportionate trauma and  
               emergency medical care services. 


             c)   Seventeen percent of the fund shall be distributed for  
               other emergency medical services purposes as determined by  
               each county, including, but not limited to, the funding of  
               regional poison control centers.  Funding may be used for  
               purchasing equipment and for capital projects only to the  
               extent that these expenditures support the provision of  








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               emergency services and are consistent with the intent of  
               this chapter. 


          11)States that the source of the moneys in the fund shall be the  
            penalty assessment made for this purpose. 
          12)Specifies that of the money deposited into the fund as  
            specified, 15% shall be utilized to provide funding for all  
            pediatric trauma centers throughout the county, both publicly  
            and privately owned and operated. 


          13)States that counties that do not maintain a pediatric trauma  
            center shall utilize the money deposited into the fund to  
            improve access to, and coordination of, pediatric trauma and  
            emergency services in the county, with preference for funding  
            given to hospitals that specialize in services to children,  
            and physicians and surgeons who provide emergency care for  
            children. 


          FISCAL EFFECT:  Unknown.  This bill is keyed non-fiscal by the  
          Legislative Counsel.


          COMMENTS:  According to the author, "The Maddy Emergency Medical  
          Services Fund acts as a critical source of funding to ensure  
          patients have access to high quality emergency care.   
          Eliminating these funds will lead to a reduction in emergency  
          physicians staffing.  Fewer emergency physicians per shift are a  
          significant contributor to longer wait times, worse outcomes,  
          and poorer access to care for all patients with emergencies -  
          whether they are insured or uninsured. California's Emergency  
          Departments are the healthcare safety net and front line of any  
          public health emergency.  The demand on Emergency Departments is  
          only increasing. Despite the implementation of the Affordable  
          Care Act (ACA), Emergency Room visits are up, and millions of  
          Californians remain uninsured.  In fact, a joint report by the  
          UC [University of California] Berkeley Labor Center and the UCLA  








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          [University of California, Los Angeles] Center for Health Policy  
          Research, found that between 3.1 and 4 million Californians will  
          remain uninsured in 2019, even with full implementation SB 867,  
          and the continuation of the Maddy Fund, is critical to  
          maintaining access to quality emergency care for all  
          Californians for the foreseeable future."


          Analysis Prepared by:                          David Billingsley  
          / PUB. S. / (916) 319-3744                       FN: 0003455