BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1272
                                                                  Page  1

          Date of Hearing:   May 11, 2009

                       ASSEMBLY COMMITTEE ON TRANSPORTATION  
                                   Mike Eng, 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            issued by Caltrans and has not subsequently been revoked.  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  :  

           PURPOSE OF THE BILL  :  According to the author, 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 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  








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          rebuild their buildings to meet state seismic safety  
          requirements for hospitals.  

           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.  
           
          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:  

          1)Two copies of scaled drawings of the heliport and adjoining  
            areas.  

          2)Topographic map that shows the location of the approach  
            surfaces relative to the heliport.  

          3)Local area map or drawing depicting the heliport and the  








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            location of schools, places of public gathering, and  
            residential areas within 1,000 feet of the center of a  
            proposed heliport.  

          4)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.  

          5)Documentation of action by the Airport Land Use Commission of  
            the county in which the heliport is to be located (as  
            appropriate).  

          6)Documentation of compliance with the California Environmental  
            Quality Act.  

          7)Documentation showing ownership of the heliport.  

          8)A Federal Aviation Administration Airspace Determination  
            regarding the heliport.  

           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 argues that it  
          is critical that patients have access to air-medical transport  
          and that trauma hospitals have helipads.  

           AUTHOR'S AMENDMENTS  :  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.  The bill will be amended to  
          extend its provisions to apply also to  cities  .  

           DOUBLE REFERRAL  :  This bill was heard in the Assembly Health  
          Committee and passed out on unanimous vote.  








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           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  
          Emergency Medical Services Administrators Association of  
          California (support as amended)
           
          Opposition 
           
          None on file
           

          Analysis Prepared by  :   Ed Imai / TRANS / (916) 319-2093