Legislative Analyst's Office

Analysis of the 2000-01 Budget Bill
Emergency Medical Services Authority (4120)

The Emergency Medical Services Authority (EMSA) coordinates emergency medical services statewide. The agency's primary responsibilities are to (1) develop guidelines for local emergency medical services (EMS) systems, (2) review and approve local EMS plans, (3) coordinate medical and hospital disaster preparedness and response and assist the Office of Emergency Services in the preparation of the medical component of the State Emergency Plan, (4) establish standards for the education, training, and licensing of EMS personnel, (5) license EMS paramedics and conduct disciplinary investigations as necessary.

The budget proposes $13.1 million from all funds for support of EMSA programs in 2000-01, which is a decrease of 2.7 percent from estimated current-year expenditures. The budget proposes $9.1 million from the General Fund, which is a decrease of $135,000, or 1.5 percent, from estimated current-year expenditures.

Fund Condition in Jeopardy

We recommend enactment of legislation to reduce the required reserve of the Emergency Medical Services Personnel Fund from 25 percent to 5 percent of the fund's expenditures. We further recommend that the Emergency Medical Services Authority provide the budget committees with (1) a 2001-02 fiscal projection of the Emergency Medical Services Personnel Fund condition, and (2) a fiscal plan to bring the fund's reserve into compliance with current law (25 percent of reserve) and our recommendation above (5 percent).

Background. Fee revenues in the EMS Personnel Fund are derived from paramedics' license fees. The revenues support EMSA's Paramedic Program, which includes a Licensure Unit and an Enforcement Unit. The Enforcement Unit investigates complaints made about paramedics' actions and administers disciplinary action. The costs of disciplinary action, including legal counsel and representation at hearings, are paid for by the EMS Personnel Fund.

Governor's Proposal. The budget proposes to convert the Enforcement Unit's limited-term Special Investigator into a permanent position to meet the growing number of paramedic complaints brought before EMSA. Funding for this position ($78,000 annually) would continue to be provided by the EMS Personnel Fund.

Ease Statute's Reserve Requirement. The Health and Safety Code (Section 1797.112[c]) requires the EMSA to "maintain a reserve balance in the Emergency Medical Services Personnel Fund equal to at least three months of the annual authorized expenditures for the personnel licensure program . . ." In effect, this amounts to a 25 percent reserve requirement.

We believe that a 25 percent reserve is an unnecessary burden on the EMS Personnel Fund, given that its revenues and expenditures are relatively stable. A reserve of that magnitude would be appropriate only if the authority's expenditures and revenues were volatile. Accordingly, we recommend amending the statute to require a 5 percent reserve.

Fund's Condition At Risk. Based on proposed expenditures of $798,000, a 25 percent reserve would amount to $200,000, while 5 percent would be $40,000. As Figure 1 shows, the budget projects no reserve in 2000-01.

Consequently, we recommend that EMSA provide the budget committees with (1) a forecast of the EMS Personnel Fund's fiscal condition through 2001-02, and (2) a fiscal plan for bringing the fund's reserve into compliance with both current law (25 percent) and our recommendation (5 percent reserve).
Figure 1
Emergency Medical Services Personnel Fund Condition
1998-99 Through 2000-01

(In Thousands)

1998-99 1999-00 2000-01
Beginning balance $34 $35 $25
Prior-year adjustments 6 -- --
Balance, adjusted $40 $35 $25
Revenues and transfers
Other regulatory fees $709 $747 $766
Fingerprint identification card fees 42 13 --
Miscellaneous service to the public 2 -- --
Income from surplus money investments 4 7 7
Totals, revenues and transfers $757 $767 $773
Totals, resources $797 $802 $798
Emergency Medical Services Authority $762 $777 $798
Fund balance $35 $25 --

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