BILL ANALYSIS
AB 1272
Page 1
Date of Hearing: May 5, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
AB 1272 (Hill) - As Introduced: February 27, 2009
SUBJECT : Emergency medical services: trauma center:
helicopter landing pad.
SUMMARY : Prohibits the Emergency Medical Services System and
Prehospital Emergency Medical Care Personnel Act (EMS Act), and
two sections of the State Aeronautics Act (Aeronautics Act),
from being construed as authorizing a county to prohibit a
trauma center from installing a helicopter landing pad at or
near its facility for the purpose of receiving emergency trauma
care patients.
EXISTING LAW :
1)Permits, under the EMS Act, a county, upon the recommendation
of its local emergency medical services agency (LEMSA), to
adopt ordinances governing the transport of a patient who is
receiving care in the field from prehospital emergency medical
personnel, when the patient meets specific criteria for
trauma, burn, or pediatric centers adopted by the LEMSA.
2)Prohibits the EMS Act from being construed as restricting the
use of a helicopter of the California Highway Patrol (CHP)
from performing missions which CHP determines are in the best
interests of the people of the state of California.
3)Makes it unlawful, under the State Aeronautics Act, for any
political subdivision, or any person, to operate an airport
unless an appropriate airport permit required by rule of the
California Department of Transportation (CalTrans) has been
issued by CalTrans and has not subsequently been revoked.
4)Prohibits, under the State Aeronautics Act, a political
subdivision, or any person, from submitting any application
for the construction of a new airport to any local, regional,
state, or federal agency unless the plan for construction is
first approved by the board of supervisors of the county, or
the city council of the city, in which the airport is to be
located and unless the plan is submitted to the airport land
use commission, and acted upon by that commission in
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accordance with specified provisions of existing law.
5)Permits a county board of supervisors or a city council to
delegate its responsibility under 4) above for the approval of
a construction plan of new helicopter landing and takeoff
areas to the county or city planning agency.
6)Permits, under the State Aeronautics Act an officer authorized
by a public safety agency, at or as near as practical to the
site of a medical emergency and at a medical facility, to
designate an area for the landing and taking off of an
emergency service helicopter, in accordance with regulations.
FISCAL EFFECT : None
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill will
save lives by ensuring that if a proposed helicopter landing
pad at a trauma center is approved by the Office of Statewide
Health Planning and Development (OSHPD) and CalTrans, then a
county government cannot disapprove the helicopter landing
pad. The author argues patient survival rates are
significantly improved with the use of air ambulance services,
and rural communities and high traffic zones depend on air
ambulances to immediately deliver a patient to the appropriate
hospital. Additionally, the author states many rural
hospitals use air ambulances to deliver patients to tertiary
care centers that can appropriately treat a patient in crisis
when the rural hospital does not have the services available
to treat the patient. Air ambulances ensure that
traumatically injured patients can receive care in the time
period immediately following traumatic injury referred to as
the "golden hour" where lives can be saved if treatment is
immediately provided.
The author states that, in some communities throughout
California, hospitals have been unable to secure a permit for
a helipad through their local governing board, including
trauma hospitals in Alameda, Marin, San Francisco, and Santa
Barbara counties. In some cases, the author states,
neighborhoods concerned about noise have blocked the addition
of this critical service through the county board of
supervisors' approval process or through the local land use
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process. In these incidents, the author argues neighborhood
concerns about noise have taken precedence over the health
needs of the community. In addition, the author argues this
bill will protect current hospital helicopter landing pads as
hospitals retrofit or rebuild their buildings to meet state
seismic safety requirements for hospitals.
2)BACKGROUND . This bill affects helicopter landing pads at
trauma centers. CalTrans data indicates there are currently
145 approved helicopter landing pads that have received a
permit from CalTrans at 138 hospitals (seven hospitals have
more than one helicopter landing pad permit). According to
the state Emergency Medical Services Authority (EMSA), there
are currently 63 trauma centers in California, 49, or 76.7%
which have helicopter landing pads. All trauma centers are
licensed acute care hospitals designated by a LEMSA as a
trauma center. Trauma centers must have personnel, services,
and equipment necessary for the care of trauma patients.
General requirements for all trauma centers include a trauma
program medical director and a trauma nurse coordinator, a
basic emergency department (at minimum), a multidisciplinary
trauma team, and specified service capabilities. Trauma
center designations include Levels I - IV (with Level I being
the highest) and Level I and II pediatric (pediatric specific
trauma facilities).
In trauma care, the "golden hour" is the brief window of time in
which the lives of a majority of critically injured trauma
patients can be saved if appropriate treatment is provided.
The golden hour provides 60 minutes from the moment of injury,
to call 911, dispatch an ambulance, transport the victim to a
trauma center, and perform the necessary, life-saving
intervention. Trauma is the leading cause of death among
those under 44 years of age. More than 145,000 people die in
the United States from traumatic injury each year, and another
nine million suffer disabling injuries.
3)HELICOPTER LANDING PAD REQUIREMENTS . Hospitals seeking to
build a helicopter landing pad must have the approval of OSHPD
(which approves hospital construction), and must obtain a
heliport site permit from CalTrans. To obtain a heliport site
permit, hospitals must provide the following:
a) Two copies of scaled drawings of the heliport and
adjoining areas;
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b) Topographic map that shows the location of the approach
surfaces relative to the heliport;
c) Local area map or drawing depicting the heliport and the
location of schools, places of public gathering, and
residential areas within 1,000 feet of the center of a
proposed heliport;
d) Documentation of approval of the plan for construction
by either the board of supervisors of the county or the
city council of the city (as appropriate) in which the
heliport is to be located;
e) Documentation of action by the Airport Land Use
Commission of the county in which the heliport is to be
located (as appropriate);
f) Documentation of compliance with the California
Environmental Quality Act;
g) Documentation showing ownership of the heliport; and,
h) A Federal Aviation Administration Airspace Determination
regarding the heliport.
4)SUPPORT . Health care providers, including the California
Hospital Association (CHA), the California Ambulance
Association, the California Emergency Nurses Association
(CENA) and the California Medical Association (CMA) write in
support that helicopters are an important part of the
emergency response system and provide ready access to trauma
care centers, particularly in rural areas of the state. CHA
and CENA argue this bill will save lives by allowing public
health priorities to factor into the approval process for
helicopter landing pads at hospitals. CMA states this bill
will ensure patient access to trauma services, will improve
patient outcomes through the proper utilization of air
ambulance services, and CMA argues it is critical that
patients have access to air-medical transport and that trauma
hospitals have helipads.
5)SUPPORT IF AMENDED . Emergency Medical Services Administrators
Association of California (EMSAAC) writes it would support
this bill with amendments to require LEMSAs that implement a
trauma care system to include within their trauma plan
provisions for the air transport of trauma patients to and
from trauma centers, to strike from the bill the phrase that
the helicopter landing pad is "for the purpose of receiving
emergency trauma care patients," and to require EMSA to adopt
regulations that include transportation of trauma patients to
and between trauma centers for ground and air ambulance.
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6)DOUBLE REFERRAL . This bill has been double-referred. Should
this bill pass out of this committee, it will be referred to
the Assembly Transportation Committee.
7)POLICY QUESTIONS .
a) Scope of bill . As drafted, this bill prohibits the EMS
Act and the State Aeronautics Act from being construed to
authorize a county to prohibit a trauma center from
installing a helicopter landing pad at or near the facility
for the purpose of receiving trauma care patients. Should
the provisions of this bill be expanded to similarly affect
cities ?
b) Hospitals That Are Not Trauma Centers . According to
OSHPD data, in 2006 there were 454 licensed general acute
care hospitals, of which 300 had a comprehensive or basic
emergency department, and an additional 39 hospitals with a
standby emergency department. There are currently 138
hospitals with a helicopter landing pad permit from
CalTrans, but only 36% of the hospitals with such a permit
are trauma centers. Should the provisions of this bill be
expanded beyond the 63 trauma centers to include all
hospitals with a basic or comprehensive hospital emergency
department?
REGISTERED SUPPORT / OPPOSITION :
Support
American Federation of State, County and Municipal Employees,
AFL-CIO
California Ambulance Association
California Association of Air Medical Services
California Emergency Nurses Association
California Hospital Association
California Medical Association
California Shock Trauma Air Rescue
Opposition
None on file.
AB 1272
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Analysis Prepared by : Scott Bain / HEALTH / (916) 319-2097