BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           2173 (Beall)
          
          Hearing Date:  8/2/2010         Amended: 7/15/2010
          Consultant: Katie Johnson       Policy Vote: Health 5-0 Pub.  
          Safe. 7-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  AB 2173 would impose a $3 flat fee on each  
          Vehicle Code violation in the state, excepting parking tickets,  
          to provide for increased Medi-Cal reimbursement of emergency air  
          ambulance transportation.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2010-11      2011-12       2012-13     Fund
                                                                  
          Estimated fee revenue    ($13,000)  ($26,000)($26,000) Special*

          Estimated corresponding  $13,000             $26,000    
          $26,000Special/**
          increase in Medi-Cal rates      $13,000                 
          $26,000$26,000Federal

          DHCS staff               $50        $100     $100       
          Special/**
                                                                 Federal

          *Emergency Air Medical Transportation Act Fund
          **Costs would be shared 50 percent Emergency Air Medical  
          Transportation Act Fund, 50 percent federal funds
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          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.

          This bill would impose a $3 penalty on every conviction for a  
          violation of the Vehicle Code or a local ordinance adopted  
          pursuant to the Vehicle Code, except parking offences. Every  
          quarter, counties would be required to remit the revenues to the  
          state Controller for deposit into the Emergency Air Medical  
          Transportation Act Fund, which is created by this bill. The  










          actual revenue that would be generated is unknown, but it would  
          depend on the number of Vehicle Code violations annually. In  
          2009, there were 7,184,415 court abstracts with convictions for  
          Vehicle Code violations. If 20 percent of the convictions per  
          abstract had 2 violations and the other 80 percent had 1  
          violation per abstract, and if $3 were collected for every  
          conviction, revenues would be approximately $26 million  
          annually. To the extent that violators would choose jail time  
          over paying the fine, the revenue estimate could be less.

          The Department of Health Care Services (DHCS) would use the  
          funds and any matching federal funds made available, upon  
          appropriation by the Legislature, to augment the Medi-Cal  
          reimbursement rates paid to emergency air ambulance  
          transportation services providers. Additionally, revenues could  
          be used to reimburse the department, the courts, and each county  
          for its expenses incurred in administering these provisions.  
          Since the source of the revenues would not be health-care  
          related, 

          Page 2
          AB 2173 (Beall)

          DHCS would not need to seek federal approval to use the funds as  
          the non-federal match.

          These provisions would sunset January 1, 2016. Any unused monies  
          that would remain in the Emergency Air Medical Transportation  
          Act Fund on January 1, 2016, would be available to DHCS for the  
          purposes of these provisions, upon appropriation by the  
          Legislature.

          To the extent that these provisions are not extended beyond  
          January 1, 2016, there would be considerable cost pressure on  
          the General Fund and federal funds in the amount of  
          approximately $52 million annually to maintain the augmented  
          emergency air transportation providers rate.

          This bill would state that the Legislature finds and declares,  
          among other statements, that: 1) ambulance services providers do  
          not receive payment from the county Maddy Emergency Medical  
          Services Fund when they provide treatment to indigent patients;  
          2) the Medi-Cal program reimburses air ambulance services  
          providers far below what it costs the providers to provide  
          transportation and pays nothing if the patient is indigent; and  
          3) Medi-Cal reimbursement rates for air ambulances have not  










          increased in over 15 years.