COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

December 8, 2006

BOARD MEETING DATE:

January 23, 2007

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health

Barbara Pletz, EMS Administrator

SUBJECT:

Funding for Emergency Medical Services and Pediatric Trauma Care

RECOMMENDATION:

Adopt a resolution approving an increase in penalties on specific offenses including moving traffic violations by two dollars for every ten dollars collected to provide a specified share for pediatric trauma care and additional funding for Maddy Fund recipients.

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goal 5: Residents have access to healthcare and preventive care.

Goal 7: Maintain and enhance the public safety of all residents and visitors.

Increasing the penalties on specific offenses including moving traffic violations and distributing them as specified in legislation contributes to this commitment and goal by providing additional revenues to the Maddy Fund and for pediatric trauma care.

Performance Measure(s):

Measure

FY 2005-06
Actual

FY 2006-07
Projected

Percent of eligible physician claims paid within standard time period for payment.

100%

100%

BACKGROUND:

California law permits counties to establish an Emergency Medical Services (EMS) Fund or Maddy Fund for the purposes of reimbursing physicians and hospitals for uncompensated emergency medical care and for other EMS purposes as determined by the County. San Mateo County established its Maddy Fund more than 20 years ago. The source of the fund’s revenues is fines from moving traffic violations and other specified offenses. Current law has restricted use of the fund to 1) uncompensated emergency medical care provided by physicians, 2) payments to hospitals providing disproportionate trauma and emergency medical care services, and 3) other EMS purposes as determined by the County. Funds in this last category provide partial funding for the EMS budget.

DISCUSSION:

Senate Bill 1773, which was passed in September 2006, permits the Board of Supervisors to levy a penalty in the amount of two dollars for every ten dollars of fines, penalties, and forfeitures collected for offenses specified in the legislation (primarily moving traffic violations) to be used for designated EMS-related purposes, provided that the increased penalties do not offset or reduce the funding from other sources. Fifteen percent of the funds collected is to be earmarked for pediatric trauma care, ten percent is for administrative costs, and the balance is to be used to increase funding for all Maddy Fund recipients (including the EMS program), according to existing Maddy Fund sharing percentages. As written, the legislation will sunset in January 2009, unless additional action is taken.

Staff has discussed these new fees with representatives of the Courts to ensure that they will be assessed, collected, and distributed in accord with the new State law. In order to develop a plan for distribution of the funds for pediatric trauma care, staff will meet with representatives from Stanford/Lucille Packard to discuss distribution and use of these new revenues. Stanford/Lucille Packard is the only San Mateo County receiving hospital that has pediatric critical care services. Once agreement is reached, a Memorandum of Understanding with Stanford/Lucille Packard will be developed to describe the distribution plans and use of these restricted revenues.

FISCAL IMPACT:

At this time it is not clear how much additional revenue will be received by the Maddy Fund for distribution as a result of the new penalties. Staff analysis indicates that these additional penalties may result in an increase of about $800,000 per year, based on current collections for the Maddy Fund. This increase would result in about $120,000 available annually for pediatric trauma care, an additional $348,000 for physicians for uncompensated emergency medical care, $150,000 additional for hospitals providing disproportionate trauma and emergency medical care services, and an estimated $182,000 for EMS administration and other EMS purposes. In the current fiscal year the amount collected will be affected by the effective date for implementation of this new penalty and the date the courts begin to assess and collect these fees. If necessary to accommodate these revenues and expenses in the FY 2006-07 adopted EMS budget, an Appropriation Transfer Request will be brought to your Board later in the year to recognize additional revenues and to add appropriation. Revenues and expenses associated with these new penalties will be included in the EMS budget for FY 2007-08.