BILL ANALYSIS
SENATE LOCAL GOVERNMENT COMMITTEE
Senator Patricia Wiggins, Chair
BILL NO: AB 1272 HEARING: 6/17/09
AUTHOR: Hill FISCAL: No
VERSION: 5/13/09 CONSULTANT: Ho
TRAUMA CENTERS' HELIPADS
Background and Existing Law
Emergency service helicopters transport critically injured
people to hospitals when ground transportation is
impractical. Based on protocols established by the local
emergency medical service agency (LEMSA), prehospital
personnel may decide to transport critically injured
patients by air to trauma centers, which are hospitals
designated by a LEMSA as part of a regional trauma care
system. Trauma centers must meet state standards regarding
personnel, services, and equipment necessary for the care
of trauma patients. There are 64 trauma centers in the
state; most have helicopter landing pads, or helipads, to
accomodate air transport of patients.
To install a helipad, a trauma center must obtain a state
heliport permit from the State Department of
Transportation's Division of Aeronautics. Caltrans
requires a permit applicant to provide site and design
plans and documentation showing that the construction plans
have been approved by a local government, acted upon by an
airport land use commission (ALUC), and complies with
California Environmental Quality Act and Federal Aviation
Administration regulations. If the proposed helipad is
attached to the trauma center building, such as the roof,
the trauma center also needs to get its construction plans
approved by the Office of Statewide Health Planning and
Development (OSHPD), which is the state agency that
oversees hospitals' compliance with building safety
standards.
Observers want legislators to prohibit local officials from
denying trauma centers' helipads for reasons other than
health and safety.
Proposed Law
AB 1272 -- 5/13/09 -- Page 2
I. Emergency Medical Services Act . The Emergency Medical
Services System and the Prehospital Emergency Medical Care
Personnel Act (EMS Act) permits a county, upon the
recommendation of its local emergency medical service
agency (LEMSA), to adopt an ordinance governing the
transport of patients that require treatment at trauma,
burn, or pediatric centers. The EMS Act also establishes
regulations related to the implementation of regional
trauma systems. Assembly Bill 1272 prohibits these
provisions of the EMS Act from being construed as
authorizing a city, county or city and county to prohibit a
trauma center from installing a helipad at or near its
facility for the purpose of receiving emergency trauma care
patients.
II. State Aeronautics Act . The State Aeronautics Act lays
out the procedures for siting new airports, including
heliports for helicopter landings and take-offs. Before
someone can apply to a local, regional, state, or federal
agency to construct a new airport, the county board of
supervisors or the city council must first approve the
airport's construction plan and the applicable ALUC must
take action on the airport's construction plan. The State
Aeronautics Act also permits an officer designated by a
public safety agency to designate areas at or near a
medical emergency and at a medical facility as emergency
medical service (EMS) landing sites. EMS landing sites do
not require state heliport permits. Assembly Bill 1272
prohibits these provisions of the State Aeronautics Act
from being construed as authorizing a city, county or city
and county to prohibit a trauma center from installing a
helipad at or near its facility for the purpose of
receiving emergency trauma care patients.
Comments
1. Safety first . Trauma is the third leading cause of
death in the United States and the leading cause of death
for people ages 1 - 44, regardless of gender, race, or
economic status. Patients with traumatic injuries have
better chances of survival if they receive specialized
trauma care within the first hour after injury, the "golden
hour." However, not everyone lives near a trauma center
and not all traumatic injuries occur near a trauma center.
AB 1272 -- 5/13/09 -- Page 3
Air ambulances can cut the time it takes to transport
patients with life-threatening injuries to trauma centers.
Nevertheless, local planning processes and politics can
hinder or block trauma centers from siting helipads at
their facilities. Neighbors may have concerns about noise
and local access impacts attributed to increased air
ambulance service to their neighborhood trauma center.
Yet, on the other hand, trauma centers are regional
resources that often serve populations outside the
hospitals' immediate neighborhoods. Local politics and
concerns should not outweigh broader public health
interests of air access to trauma centers. AB 1272 ensures
that local politics can't trump regional needs.
2. How big is the problem ? Trauma centers that want new
helipads must navigate bureaucracies: the Federal Aviation
Administration, OSHPD, Caltrans, the airport land use
commission, and the county board of supervisors or city
council. Local officials have been part of the heliport
approval process for almost 40 years. There's always some
degree of local opposition toward new heliports, but
there's no documented evidence that local officials have
blocked trauma centers from installing helipads.
Nevertheless, AB 1272 takes away local officials' ability
to make land use decisions within their own jurisdictions.
The Committee may wish to consider why the Legislature
should preempt local control over heliport siting at trauma
centers.
3. Say what you mean . When local officials review a
development project, they may approve the project, approve
the project with conditions, or deny the project. AB 1272
is not clear on how much control local governments would
still have over the siting of trauma centers' helipads. AB
1272 contains imprecise language which says that state law
doesn't authorize cities and counties from prohibiting
helipads at trauma centers. If legislators want to
prohibit local elected officials from denying trauma
centers' helipads, the Committee may wish to consider
amendments that retain their ability to impose conditions,
provided that the conditions don't make the project
infeasible.
4. How near is near ? AB 1272 prevents local governments
from prohibiting a trauma center from installing a helipad
at or near its facilities. This language suggests that a
AB 1272 -- 5/13/09 -- Page 4
trauma center can install a helipad on property that the
hospital doesn't own. Should the state preempt local
land-use authority on land separate from and not owned by
the trauma center? The Committee may wish to consider
amendments that strike "or near."
5. Double referral . The Senate Rules Committee referred
AB 1272 to two policy committees. First to the Senate
Local Government Committee because the bill affects local
land use authority, and then to the Senate Environmental
Quality Committee, which reviews bills that affect
California Environmental Quality Act requirements.
Assembly Actions
Assembly Health Committee: 19-0
Assembly Transportation Committee:14-0
Assembly Floor: 77-0
Support and Opposition (6/11/09)
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.
Opposition : League of California Cities.