BILL ANALYSIS �
AB 215
Page 1
Date of Hearing: May 3, 2011
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 215 (Beall) - As Amended: April 25, 2011
SUBJECT : Emergency services: Emergency Medical Air
Transportation Act.
SUMMARY : Requires each county to submit a report regarding the
Emergency Medical Air Transportation Act (EMATA), as specified,
to the Department of Health Care Services (DHCS) and to the
relevant policy and fiscal committees of the Legislature, no
later than March 1st of each year. Specifically, this bill :
1)Requires each county to submit a report regarding to DHCS:
2)Requires the report to include:
a) The total number of penalty assessments imposed pursuant
to the EMATA;
b) The total amount of funds collected from the $4 penalty
assessment; and,
c) The total amount deposited by the county in the EMATA
Fund, including the total amount withheld by the county for
administrative expenses.
EXISTING LAW :
1)Establishes Medi-Cal, administered by DHCS, to provide
comprehensive health care services and long-term care to
pregnant women, children, and people who are aged, blind, and
disabled.
2)Establishes the EMATA requiring a $4 fee to be assessed on
every vehicle code violation to be collected by each county
and transferred to DHCS for deposit in the EMATA Fund to be
used in the Medi-Cal Program to obtain federal funds and to
fund supplemental payments for emergency medical air
transportation services.
3)Establishes a State Penalty Assessment of $10 for every $10 on
every fine, penalty, or forfeiture. Of the funds collected,
70% goes to the state and 30% remains with the county. The
state portion is distributed among the Fish and Game
Preservation Fund, the Restitution Fund, the Peace Officers
Training Fund, the Driver Training Penalty Assessment Fund,
the Corrections Training Fund, the Local Public Prosecutors
AB 215
Page 2
and Public Defenders Fund, the Victim-Witness Assistance Fund,
and the Traumatic Brain Injury Fund.
4)Establishes a County Penalty Assessment of $7 for every $10 on
every fine, penalty, or forfeiture imposed and collected. The
proceeds are distributed to funds established by the county
board of supervisors, including: a Courthouse Construction
Fund, Criminal Justice Facilities Construction Fund, Automated
Fingerprint Identification Fund, Maddy Emergency Medical
Services (EMS) Fund, and, DNA Fund.
5)Establishes a State Surcharge of 20% on every base fine
collected by the court, deposited in the General Fund.
6)Establishes a State Court Facilities Construction Penalty
Assessment of up to $5 for every $10 or fraction thereof, upon
every fine, penalty or forfeiture collected by the courts for
criminal offenses.
7)Establishes a Court Security Fee of $40 on every conviction
for a criminal offense for court security.
8)Establishes a levy of a $4 penalty assessment on every $10 in
fines and forfeitures resulting from criminal and traffic
offenses for state and local governments for DNA databank
implementation purposes.
9)Establishes an additional $35 Conviction Assessment for the
existing State Court Facilities Construction Fund on every
criminal infraction, including traffic offenses.
10)Establishes an additional EMS Penalty Assessment of $2 for
every $10 on every fine, penalty, forfeiture, or criminal
offense and all offenses dealing with the Vehicle Code except
parking offenses for local Maddy EMS Funds.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill is
necessary to enable DHCS to estimate and project revenues to
the EMATA Fund. The author states that although AB
2173 (Beall), Chapter 547, Statutes of 2010, established the
protocol for the administration of the Fund, it does not
require sufficient data reporting to enable DHCS to estimate
and project revenues to the Fund.
AB 215
Page 3
The author reports that currently, DHCS does not have enough
traffic data to estimate and forecast the revenue anticipated
from this program. The author argues that at the present time
stakeholders are struggling to provide DHCS with the data
required to estimate revenue using quantifiable and verifiable
data reports. However, the author continues, unless a
sufficient data source is provided to project revenue, air
ambulance providers could be required to wait 18-24 months for
their first payment under this program. The author concludes
that the data provided in this bill would give DHCS better
data to estimate revenues and create a payment methodology
system. The author also states that while this data source
may be determined adequate to address the short-term issue,
long-term budgeting will be required. According to the
author, this bill will assist with understanding the dynamics
of the revenue stream, number of violations charged versus
number of violations paid for example, will ease future
budgeting issues and help with estimations.
2)BACKGROUND . AB 2173 was enacted to provide a mechanism for
supplemental payments for air ambulance providers who serve
Medi-Cal patients. The revenue generated by imposing a flat
$4 fee on each motor vehicle violation is to be matched with
federal funds through the Medi-Cal Program. Medi-Cal pays air
ambulance services far below the cost of providing emergency
air transportation at approximately 40% of the average
Medicare rate. Unlike hospitals, federal law does not permit
a provider fee to be assessed. In addition air ambulance
providers must provide emergency services but are not covered
by other supplemental emergency payment funds that are
collected from 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 areas 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 is a not-for profit community based
provider that provides services throughout Central and
Northern California. The services are not self-dispatched,
AB 215
Page 4
but are called for by on scene first responders, a hospital
physician, or other emergency medical services agency. As
with other emergency responders, no one is denied service,
regardless of ability to pay.
3)PREVIOUS LEGISLATION .
a) AB 2173 established the EMATA requiring a $4 fee to be
assessed on every vehicle code violation to be collected by
the county and transferred to DHCS for deposit in the EMATA
Fund to be used in the Medi-Cal Program to obtain federal
funds and to fund supplemental payments for emergency
medical air transportation services.
b) SB 13 X4, (Ducheny), Chapter 22, Statutes of 2009,
increases the fee used to fund court security from $20 to
$30.
c) AB 1153 (Torrico) of 2009, would have established a $3
penalty assessment on all Vehicle Code violations (except
parking offenses) to provide a funding source to augment
Medi-Cal reimbursement for air ambulance services. AB 1153
died in the Assembly Appropriations Committee.
d) AB 1407 (Perata), Chapter 311, Statutes of 2008, allows
the issuance of up to $5 billion in lease-revenue bonds to
finance the construction of critical needs courthouse
construction projects, and supports the debt service for
the bonds by raising specified criminal and civil fees and
fines.
e) SB 1236 (Padilla), Chapter 60, Statutes of 2008,
extended the sunset on SB 1773 until January 1, 2014.
f) SB 1773 (Alarcon), Chapter 841, Statutes of 2006,
authorized counties, until January 1, 2009, to elect to
levy an additional $2 for every $10 in base fines for
purposes of supporting EMS, and required the additional
assessment to be deposited in the local Maddy EMS Funds,
with 15% to be directed to pediatric trauma services
REGISTERED SUPPORT / OPPOSITION :
Support
California Association of Air Medical Services (sponsor)
AB 215
Page 5
Opposition
None on file
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097