BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K Alquist, Chair
BILL NO: AB 1475
A
AUTHOR: Solorio
B
AMENDED: As Introduced
HEARING DATE: June 10, 2009
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CONSULTANT:
4
Tadeo
7
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SUBJECT
Emergency medical services
SUMMARY
Limits the reimbursement for administering county Maddy
Emergency Medical Services Funds to actual administrative
costs or ten percent, whichever is lower, including
additional penalty assessment funds authorized until
January 2014.
CHANGES TO EXISTING LAW
Existing law:
Exiting law authorizes counties to establish a Maddy
Emergency Medical Services Fund (Maddy Fund) for
reimbursement of emergency medical services (EMS) related
costs. Counties are authorized to levy $7 for every $10,
or fraction thereof, upon fines, penalties and forfeitures
collected for criminal offenses for deposit into the Maddy
Fund.
Existing law requires costs of administering the Maddy Fund
to be reimbursed based on actual administrative costs, not
to exceed ten percent of the amount of the Maddy Fund.
Continued---
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Existing law authorizes, until January 1, 2014, counties to
levy an additional penalty in the amount of $2 for every
$10, or fraction thereof, upon fines, penalties, and
forfeitures collected for criminal offenses for deposit
into the Maddy Fund.
Existing law requires costs of administering the additional
$2 penalties in the Maddy Fund to be reimbursed based on
administrative costs, not to exceed ten percent of the
amount of the Maddy Fund.
This bill:
Makes the language in the code section established for
additional penalties as it relates to the Maddy Fund
consistent with the language in the code section
established for the original Maddy Fund penalty assessment,
limiting the reimbursement for administering Maddy Funds to
actual administrative costs.
Limits the reimbursement for administering the Maddy Funds
to actual administrative costs, or ten percent, whichever
is lower.
FISCAL IMPACT
This bill is keyed non-fiscal.
BACKGROUND AND DISCUSSION
According to the author, AB 1475 would make the language in
the code concerning the reimbursement of the administrative
costs to the counties for Maddy Funds consistent as it
pertains to both the supplemental penalty assessment funds
and the underlying Maddy Fund statute.
The California Chapter of the American College of Emergency
Physicians, sponsor of the bill, states that this
clarification will help ensure that counties understand how
to properly reimburse themselves for the administrative
costs related to the Maddy Fund.
Maddy Funds
In 1987, the Legislature concluded that EMS providers bore
higher costs for their services than did providers of other
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medical services, but often received only partial or no
payment from patients. The state enacted a series of bills
to compensate physicians and medical facilities for EMS
provided to patients who do not have health insurance and
cannot pay for their medical care. SB 12 (Maddy), Chapter
1240, Statutes of 1987, allows counties to establish EMS
funds, also known as Maddy Funds. Revenue sources for
Maddy Funds are penalty assessments on certain criminal and
traffic violations, and a portion of the fees from people
attending traffic violator schools.
Funds from penalty assessments must be used to reimburse
physicians and hospitals for patients who do not make
payment for EMS and have no third-party or government
source of payment. Fifty-eight percent of these funds,
after administrative costs, must be distributed to
physicians for emergency services, 25 percent to hospitals
providing disproportionate levels of trauma and EMS, and 17
percent to other EMS, including, but not limited to,
regional poison centers, as determined by each county.
Physicians can be reimbursed for up to 50 percent of the
losses submitted. Approximately 50 counties have
established Maddy Funds.
Related legislation:
AB 1503 (Lieu) requires emergency room physicians, in order
to bill patients who do not have coverage for emergency
care and services, as specified, to have a discount payment
policy that meets specified requirements, and revises the
conditions under which physicians may bill for
uncompensated care payments through the Maddy Fund. This
bill is currently in the Assembly Appropriations Committee.
Prior legislation:
SB 1236 (Padilla) Chapter 60, Statutes of 2008, extends the
sunset date on the statewide authority for counties to
collect an additional $2 penalty assessment for every $10
in base fines for purposes of providing payment for
EMS-related services, from January 1, 2009 to January 1,
2014.
SB 1773 (Alarcon) Chapter 841, Statutes of 2006, authorizes
counties, until January 1, 2009, to collect an additional
$2 penalty assessment for every $10 in base fines for
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purposes of providing payment for EMS, and requires revenue
generated from the assessment to be deposited into the
Maddy Fund, with 15 percent designated for pediatric trauma
centers.
SB 57 (Alarcon) of 2005 would have authorized counties to
collect an additional $2 penalty assessment for every $10
in base fines for purposes of providing payment for
EMS-related services. Required revenue generated from the
assessment to be deposited into the Maddy EMS Fund, with 15
percent designated for pediatric trauma centers. This bill
was vetoed by the Governor.
PRIOR ACTIONS
Assembly Floor: 79-0
Assembly Health: 19-0
POSITIONS
Support: American College of Emergency Physicians,
California Chapter, Inc.
(sponsor)
Oppose: None received
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