BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       AB 2248                                      
          A
          AUTHOR:        Hernandez                                    
          B
          AMENDED:       June 10, 2010                               
          HEARING DATE:  June 30, 2010                                
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          CONSULTANT:                                                 
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          Tadeo/jl                                                    
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                                     SUBJECT
                                         
                             Emergency medical care

                                     SUMMARY  

          Requires a county, that establishes a Maddy Emergency  
          Medical Services Fund (Maddy Fund) for reimbursement of  
          emergency medical services (EMS) related costs, to provide  
          additional information regarding the moneys collected and  
          disbursed in a report required to be submitted to the  
          Legislature on an annual basis.  

                             CHANGES TO EXISTING LAW  

          Existing law:
          Authorizes counties to establish a Maddy Fund for  
          reimbursement 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.  

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

          Authorizes, until January 1, 2014, counties to levy an  
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          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.  

          Requires costs of administering the additional $2 penalties  
          in the Maddy Fund to be reimbursed based on administrative  
          costs, not to exceed 10 percent of the amount of the Maddy  
          Fund.

          Requires a county that has established a Maddy Fund to  
          submit an annual report to the Legislature on the  
          implementation and status of the Fund, including the Fund  
          balance, and amount of money disbursed to physicians and  
          surgeons, hospitals, and for other emergency medical  
          purposes. 
          
          This bill:
          Requires a county that establishes a Maddy Fund to include  
          the following in the county's annual Maddy Fund report  
          submitted to the Legislature:

                 A breakdown of the total amounts of penalty  
               assessments by statute section that provides the  
               authority for the penalty assessment;
                 A description of the process used for obtaining  
               input from physicians, surgeons and hospitals to  
               create the payment methodology;
                 An identification of the fee schedule used by the  
               county; and, 
                 A description of the methodology used to disburse  
               money(s) to hospitals.

          Additionally, if no money was deposited in the Fund, the  
          reason(s) why would also be required to be stated. 

                                  FISCAL IMPACT  

          According to the Assembly Appropriations analysis of AB  
          2248, no direct fiscal impact to counties or state agencies  
          would result due to the expansion of reporting established  
          by this bill. 
                                         
                           BACKGROUND AND DISCUSSION  
           




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           The author states that, while Maddy Funds only reimburse a  
          small portion of the cost of emergency services, they are  
          nevertheless a critical source of funding to help preserve  
          the safety net.  The author adds that, physicians report  
          that the annual administrative reports do not contain  
          sufficient information to determine if the Maddy Fund is  
          being properly administered.  The author further adds that,  
          in one county, an error was discovered by a local ER  
          physician which led to the recovery of $2.4 million that  
          should have been deposited into the Maddy Fund. 

          Maddy Fund
          In 1987, the Legislature concluded that EMS providers bore  
          higher costs for their services than did providers of other  
          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 come from  
          people attending traffic violator schools. 

          Funds from penalty assessments must be used to reimburse  
          physicians and hospitals for patients who do not make  
          payments 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, twenty-five percent to  
          hospitals providing disproportionate levels of trauma and  
          EMS, and seventeen 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 bills
          AB 1503 (Lieu) requires emergency room physicians to  
          provide a discount payment policy for uninsured and  
          specified low-income patients and revises the conditions  
          under which physicians may seek uncompensated care payments  
          through a Maddy Fund. This bill is in the Senate  
          Appropriations Committee. 




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          SB 1368 (Senate Committee on Health) requires each county  
          establishing a Maddy Fund to send an annual report on the  
          implementation and status of the fund to State Emergency  
          Medical Services Authority (EMSA) instead of to the  
          Legislature.  Requires EMSA to compile and forward a  
          summary of each Maddy Fund and forward that summary to the  
          appropriate policy and fiscal committees of the  
          Legislature.  This bill is set to be heard in Assembly  
          Health Committee on June 29, 2010. 

          Prior legislation
          AB 1475 (Solorio), Chapter 537, Statutes of 2009, limits  
          the administrative costs for money deposited into county  
          Maddy EMS Funds to actual administrative costs, or 10  
          percent of the money collected, whichever amount is lower.   
          Limits administrative costs of money deposited into the  
          Maddy EMS Fund from an additional penalty assessment  
          authorized until January, 2014 to the actual administrative  
          costs, or 10 percent of  the money collected, whichever  
          amount is lower.

          SB 1236 (Padilla), Chapter 60, Statutes of 2008, extends  
          the sunset date from January 1, 2009 to January 1, 2014,  
          county boards of supervisors to levy additional penalties  
          on criminal offenses for EMS.
          
          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 EMS.

          SB 57 (Alarcon) of  2005 would have amended the Maddy  
          Emergency Medical Services Fund to earmark funds for  
          pediatric trauma centers, as specified.  This bill was  
          vetoed by the Governor. 

          SB 941 (Alquist), Chapter 671, Statutes of  2005,  
          establishes the Emergency Medical Services (EMS) Funding  
          Act, which revises existing law governing administration of  
          the Maddy EMS Fund and the California Tobacco Tax and  
          Health Promotion Act of 1988 (Proposition 98) Physician  
          Services Account to make the statutes more consistent.

          SB 476 (Florez), Chapter 707, Statutes of 2003, authorizes  




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          each administering agency of an emergency medical services  
          fund to maintain a reserve in specified portions of its  
          Maddy Emergency Medical Services Fund.  Requires  
          administering agencies to distribute all funds remaining at  
          the end of the fiscal year in excess of any reserve held  
          and rolled over to the next year.  

          AB 883 (Florez) of 2001 would have raised the level of  
          possible reimbursement for physicians and surgeons from the  
          Maddy Fund from 50 to 75 percent.  Would have established a  
          state Emergency Medical Services Equalization Fund for  
          redistribution of excess funds and required the county  
          administering officer of emergency medical services to  
          establish an advisory committee to review methodologies and  
          payment processes.  This bill died on the Assembly Floor  
          pending concurrence. 
          SB 254 (Dunn) of  2001 would have appropriated $300 million  
          from the General Fund to EMSA, with $200 million for  
          critical emergency service facilities and $100 million for  
          payment of uncompensated emergency services provided by  
          physicians and hospitals.  Would have created the Critical  
          Emergency Facility Fund for payments to these critical  
          facilities and limits the portion of this Fund that can be  
          used for administrative purposes to no more than 10  
          percent.  Would have required the money for uncompensated  
          emergency care to be paid through county Maddy Funds, which  
          each county would have been required to create.  This bill  
          was returned to the Secretary of the Senate pursuant to  
          Joint Rule 56. 
          
          SB 623 (Speier), Chapter 679, Statutes of 1999, requires,  
          in a county that has established an EMS Fund, an amount  
          equal to $2 for every $7 that would have been collected in  
          traffic penalty assessments to be deposited into the Fund.  
          Requires counties with EMS Funds to add to an existing  
          report to the Legislature the total amount of traffic fines  
          and forfeitures collected, the total amount of penalty  
          assessments collected, and the total amount of penalty  
          assessments deposited into the EMS Fund.  Requires each  
          county to make this report available to the public upon  
          request. 

          Arguments in support
          The California Chapter of the American College of Emergency  
          Physicians (CAL/ACEP), co-sponsor of AB 2248, argues that  




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          this bill is important because it would provide  
          accountability and transparency to the administration of  
          Maddy EMS Funds collected and distributed at the county  
          level.  CAL/ACEP adds that AB 2248 would require counties  
          to report on the collection and distribution of the Maddy  
          EMS Funds to ensure that every dollar is spent to support  
          the emergency care safety net as required by current law. 

          The California Medical Association (CMA), co-sponsor of AB  
          2248, states that the current economic downturn has led to  
          a substantial increase in the number of uninsured, placing  
          additional pressure on counties' Maddy EMS Funds to provide  
          care for this population. CMA argues that this bill is  
          needed because, due to the budget crisis California has  
          endured in recent years, the Proposition 99 tobacco tax  
          funds that county Maddy EMS Funds used to receive have been  
          redirected, and as a result, thorough accounting and  
          efficient use of these funds has become critical.  

          The California Hospital Association (CHA) states that AB  
          2248 would increase transparency and accountability for  
          Maddy Fund expenditures and reimbursements by counties that  
          administer this fund.  CHA adds that Maddy Fund  
          reimbursement is a critical program to reimburse providers  
          for uncompensated emergency care.  
           

                                    COMMENTS

           1.  Author's amendment.  The author will propose additional  
          amendments in committee
          to ensure that the hospital portion of the Maddy Fund  
          operates in a transparent  
          manner:




              Proposed language:
          
              Page 3, lines 3 - 5:
          
              (8)   (9) (a)  A description of the methodology used to  
          disburse moneys to hospitals per 
             subparagraph (B) of paragraph (5) of subdivision (b) of  




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          Section 1797.98a. 
                 (b) The amount of moneys available to be disbursed  
          to hospitals, 
              (c) If moneys are disbursed to hospitals on a claims  
          basis, the dollar amount of the  
             total allowable claims submitted and the percentage at  
          which those claims were
              reimbursed to hospitals.
               
          2.  Technical amendments.
          
               Page 2, lines 36 - 38:
          
                     (7) A description of the process                   
                  used for obtaining input from
                  physicians and surgeons and hospitals to create the  
          payment methadology. (8) An 
                  Identification

                       (7) A description of the process used for  
          obtaining input from physicians and
                  surgeons and hospitals to create the payment  
          methodology.
                       (8) An identification

                                 PRIOR ACTIONS

           Assembly Health:    19-0
          Assembly Appropriations: 17-0 
          Assembly Floor:          74-0      
          
                                    POSITIONS  
                                        
          Support:  California Chapter of the American College of  
          Emergency Physicians
                                  (co-sponsor)
                           California Medical Association  
          (co-sponsor)  
                           California Hospital Association 

          Oppose:  None received








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