BILL ANALYSIS
AB 2173
Page 1
ASSEMBLY THIRD READING
AB 2173 (Beall)
As Amended May 28, 2010
Majority vote
HEALTH 15-2 APPROPRIATIONS 17-0
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|Ayes:|Monning, Fletcher, |Ayes:|Fuentes, Conway, Ammiano, |
| |Ammiano, Carter, Conway, | |Bradford, Charles |
| |Brownley, De Leon, Eng, | |Calderon, Coto, Davis, |
| |Hayashi, Hernandez, | |Monning, Ruskin, Harkey, |
| |Bonnie Lowenthal, Nava, | |Miller, Nielsen, Norby, |
| |V. Manuel Perez, Smyth, | |Skinner, Solorio, |
| |Audra Strickland | |Torlakson, Torrico |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Adams, Gaines | | |
| | | | |
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SUMMARY : Establishes a $3 penalty on every vehicle code
violation to be matched in the Medi-Cal Program and used to make
supplemental payments for emergency air medical transportation
services in the Medi-Cal Program. Specifically, this bill :
1)Imposes a penalty of $3 on every conviction of a violation of
the vehicle code or local ordinance adopted pursuant to the
vehicle code, except parking offences.
2)Requires the penalty to be in addition to the state
established penalty and excluded from the base fine or any
other surcharges used to calculate any other penalties.
3)Establishes the Emergency Air Medical Transportation Act
(EAMTA) Fund to be administered by the Department of Health
Care Services (DHCS) and requires each county to deposit the
proceeds of this penalty in a county emergency air medical
transportation act fund and transferred quarterly to the EAMTA
Fund.
4)Requires DHCS to use the proceeds of the EAMTA Fund to obtain
federal matching funds in the Medi-Cal Program for the purpose
of making supplemental payments to emergency air medical
transportation providers in an amount that does not exceed
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normal and customary charges.
5)Requires the EAMTA Fund to be available, upon appropriation by
the Legislature, to DHCS to augment emergency air medical
transportation reimbursement, to reimburse DHCS, the courts
and each county for it administrative costs.
6)States legislative intent with regard to air ambulance
service, current reimbursement rates, fines and penalties and
the relationships vehicle code violations.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Potential increased revenue in the range of $40 million.
Extrapolating from the 7,248,217 court abstracts with
convictions for typically multiple Vehicle Code violations,
which average about two per abstract, between March 2008 and
March 2009, a $3 penalty assessment on each traffic fine would
result in increased revenue of about $43.5 million, assuming
no diminishing returns as a result of changes in judicial
behavior, collections, or ability to pay.
2)Proliferation of assessments and charges has driven fines
upward. For example, a $500 criminal fine with current
maximum assessments would be $1,995, shocking defendants who
think $500 means $500.
3)Increasing assessments may result in diminishing returns.
Judges do have the discretion to reduce the base fine, which
then reduces revenue to state and local governments, as well
as to assessments. As current penalty assessments can almost
triple the base fine, increasing fines and assessments may
have the unintended consequence of reduced fine collections.
Indigent defendants facing ever-increasing fees may simply
choose to spend time in jail in lieu of paying the fine,
causing taxpayers to pay the jail costs while state and local
government receive fewer penalty funds. Moreover, county jail
population caps may provide additional incentives to opt for
jail time over fines, as the time served for nonviolent
offenders may be minimal.
As noted by the California Research Bureau in its 2006 review of
penalty assessments, "High penalty assessments may result in
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higher rates of default by the guilty parties. Some offenders
may spend time in jail, or plea for community service, rather
than pay the fine and penalty assessment. The end result may
be that a substantial amount of fines, fees and revenue is not
collected."
COMMENTS : According to the author, this bill intended to
provide a mechanism for supplemental payments for air ambulance
providers who serve Medi-Cal patients. The author states that
revenue generated by imposing a flat $3 fee on each motor
vehicle violation can be matched with federal funds through the
Medi-Cal Program. The author points out that Medi-Cal pays air
ambulance services far below the cost of providing emergency air
transportation and 40% of the average Medicare rate. The author
asserts that unlike hospitals, federal law does not permit a
provider fee to be assessed. Furthermore, air ambulance
providers must provide emergency services but are not covered by
other supplemental emergency payment funds that are collected
for m fines and penalties. They also do not receive any type of
disproportionate share provider supplemental payments.
Air ambulance services provide emergency transportation for the
most critical patients from automobile scenes directly to trauma
centers. Emergency helicopters also transport patients from
rural area or acute care hospitals to tertiary care hospitals
such as trauma centers, heart/stroke centers, burn units, and
children's specialty hospitals. They are also used for disaster
response. Air ambulance services providers are a mix of public
and private entities. For instance, the City of Los Angeles
provides its own services, whereas the California Shock Trauma
Air Rescue (CALSTAR) in a not-for profit community based
provider that provides services throughout Central and Northern
California. The services are not self-dispatched, but are
called for by on scene first responders, a hospital physician,
or other emergency medical services agency. No one is denied
service, regardless of ability to pay.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0004672