BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1475
                                                                  Page  1

          Date of Hearing:   April 21, 2009

                            ASSEMBLY COMMITTEE ON HEALTH
                                  Dave Jones, Chair
                AB 1475 (Solorio) - As Introduced:  February 27, 2009
           
          SUBJECT  :   Emergency medical services.

           SUMMARY  :   Limits the administrative costs for money deposited  
          into county Maddy Emergency Medical Services Funds (Maddy Fund)  
          to actual administrative costs, or 10% of the money collected,  
           whichever amount is lower  .  Limits administrative costs of money  
          deposited into the Maddy Fund from an additional penalty  
          assessment authorized until January 2014 to the  actual   
          administrative costs, or 10% of the money collected,  whichever  
          amount is lower  .
           
          EXISTING LAW  :

          1)Authorizes each county to establish a Maddy Fund for  
            reimbursement of EMS-related costs.

          2)Requires the costs of administering the Maddy Fund to be  
            reimbursed based on actual administrative costs, not to exceed  
            10% of the amount of the Maddy Fund.

          3)Authorizes, until January 1, 2014, counties to levy an  
            additional penalty in the amount of $2 for every $10 upon  
            fines, penalties, and forfeitures collected for criminal  
            offenses for deposit into the Maddy Fund.

          4)Requires the costs of administering money deposited into the  
            Maddy Fund pursuant to 3) above to be reimbursed from the  
            money collected, not to exceed 10%. 

           FISCAL EFFECT  :   This bill has not been analyzed by a fiscal  
          committee.

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  This bill is sponsored by the  
            California Chapter of the American College of Emergency  
            Physicians (Cal-ACEP) to make the language providing  
            reimbursement of the administrative costs to the counties  
            consistent by limiting county administrative costs to the  








                                                                  AB 1475
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            actual administrative costs, or 10% of the money collected,  
            whichever amount is lower.  The administrative cost  
            reimbursement provisions for the Maddy Fund are different in  
            the code section establishing an additional penalty assessment  
            than it is for the language in the underlying Maddy Fund  
            statute.  For the additional assessment, the language  
            pertaining to the administrative costs states administrative  
            costs must be reimbursed from the money collected, not to  
            exceed 10% of the Maddy Fund.  For the other administrative  
            cost cap for Maddy Funds, the language states that the  actual   
            administrative costs must be reimbursed not to exceed 10% of  
            the Maddy Fund.  This bill would require both provisions to be  
            reimbursed in an amount that does not exceed the actual  
            administrative costs or 10% of the money collected,  whichever  
            amount is lower  .

           2)MADDY FUNDS  .  Existing law authorizes each county to establish  
            a Maddy Fund.  After the costs of administration are deducted,  
            the Maddy Fund is required 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, as follows:

             a)   Fifty-eight percent for physicians for emergency  
               services provided by physicians in general acute care  
               hospitals, except those physicians employed by county  
               hospitals, that provide basic or comprehensive emergency  
               services up to the time the patient is stabilized;

             b)   Twenty-five percent for hospitals providing  
               disproportionate trauma and emergency medical care  
               services; and 

             c)   Seventeen percent for other emergency medical services  
               purposes as determined by each county, including, but not  
               limited to, the funding of regional poison control centers.

            Approximately 50 counties have established Maddy Funds.   
            Counties finance these funds through several revenue sources,  
            including penalty assessments on certain criminal and traffic  
            violations and a portion of the fees from people attending  
            traffic violator schools.  Existing law authorizes counties to  
            levy an additional penalty assessment until January 1, 2014  
            for emergency medical services. 









                                                                  AB 1475
                                                                  Page  3

           3)PREVIOUS LEGISLATION  .  

             a)   SB 1773 (Alarcon) Chapter 841, Statutes of 2006,  
               authorizes, until January 1, 2009, county boards of  
               supervisors to levy additional penalties on criminal  
               offenses for emergency medical services.  

             b)   SB 1236 (Padilla), Chapter 60, Statutes of 2008 extends  
               the sunset date from January 1, 2009 to January 1, 2014,  
               the provisions of SB 1773.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Chapter of the American College of Emergency  
          Physicians (sponsor)
          California Ambulance Association

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Scott Bain / HEALTH / (916) 319-2097