1. Maddy EMS Fund Special Funding for Uncompensated Emergency Care

2. Maddy EMS Fund 2 Background In 1987, SB 12 authorized counties to create an Emergency Medical Services Fund –Enrolled as Health & Safety Code, Division 2.5, 1797.98 –Officially known as “Maddy Emergency Medical Services Fund” after the bill’s author, Ken Maddy Pays up to 50% reimbursement to physicians and hospitals for emergency medical services provided to patients who do not pay for medical care Provides limited funding for local EMS activities Implemented locally by Board of Supervisors

3. Maddy EMS Fund 3 Revenue Sources Penalty assessments are collected by the courts via: –Charges on fines, penalties and forfeitures for certain criminal offenses and motor vehicle violations –A portion of fees collected from violators attending traffic school A charge of $2 per $10 is levied on applicable fines, penalties and forfeitures –If a fine for a moving violation is $100, an additional $20 would also be collected by the court for the EMS Fund Collectively known as “Maddy Revenues”

4. Maddy EMS Fund 4 Original Maddy Fund Distribution Formula Courts collect penalty assessments or surcharges and forward them to County 90% remaining balance distributed as follows: 58% allocated to Physician Services 25% allocated to Hospital Services 17% allocated to Discretionary EMS 10% allocated to County for EMS Fund administration

5. Maddy EMS Fund 5 SB 1773 (Alarcon) Became state law as of January 1, 2007 Allows local option to assess up to an additional $2 per $10 from fines, penalties and forfeitures Requires a NEW 15% allocation be set aside for pediatric trauma care –Also known as “Richie’s Fund” Remaining revenues are distributed: –58% to physicians –25% to hospitals –17% to EMS

6. Maddy EMS Fund 6 Revised Maddy Fund Distribution Formula New revenue increment authorized by SB 1773 75% remaining balance distributed as follows: 58% allocated to Physician Services 25% allocated to Hospital Services 17% allocated to Discretionary EMS 10% allocated to County for Fund administration 15% allocated to Pediatric Trauma Care

7. Maddy EMS Fund 7 SB 1236 (Padilla) Original legislation (SB 1773) was to sunset January 1, 2009 SB 1236 extended the sunset date to January 1, 2014

8. Maddy EMS Fund 8 SB 92 Bill sponsored by CMA and Cal-ACEP: –Sunsets current Maddy funding (both SB 12/612 & SB 1773) –Creates new $4 per $10 collected by courts –Counties would keep 7.5% for pediatric trauma and 7% for local EMS –85.5% to be transferred monthly to new State Maddy Fund State Maddy Fund to be distributed: –53% up to $55M for Medi-Cal match –Remaining balance distributed: 10% up to $10M for administration 90% to physician claims for emergency services

9. Maddy EMS Fund 9 Proposed New Maddy Fund Distribution under SB 92 Courts collect $4 per $10 in penalty assessments and forward them to County All Maddy Deposits 85.5% of deposits transferred monthly to State Maddy Fund 53% up to $55M to Medi-Cal 10% of balance up to $10M to CDPH for Maddy Fund Administration 90% of balance to pay Physician claims for uncompensated emergency services Counties retain 7.5% of deposits for Pediatric Trauma Counties retain 7% of deposits for other EMS