BILL ANALYSIS �
AB 355
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Date of Hearing: April 10, 2013
ASSEMBLY COMMITTEE ON GOVERNMENTAL ORGANIZATION
Isadore Hall, Chair
AB 355 (Cooley) - As Amended: March 19, 2013
SUBJECT : Emergency medical services: mobile field hospitals
SUMMARY : Appropriates $1,700,000 from the General Fund to the
Office of Emergency Services (OES) to continue the Mobile Field
Hospital (MFH) Program and makes legislative findings and
declarations.
EXISTING LAW
1)Establishes the California Emergency Medical Services
Authority (EMSA), which is responsible for the coordination
and integration of all state agencies concerning emergency
medical services, including the MFH program.
2)Creates OES and requires it to perform a variety of duties
with respect to specified emergency preparedness, mitigation,
and response activities in the state, including emergency
medical services.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of the bill : According to the author California has a
history of devastating disasters including, but not limited to,
floods and earthquakes. Based on the Uniform Earthquake Rupture
Forecast model, California has over a 99% chance of experiencing
a magnitude 6.7 or larger earthquake during the next 30 years.
The author states that AB 355 will strengthen California's
preparedness for natural disasters and catastrophic emergencies
by restoring $1.7 million of funding to continue to maintain
three rapid deployment mobile field hospitals. In addition, if
funding for the program is not restored, the State of California
will be forced to sell the MFHs and related equipment at a
fraction of the cost of their initial investment.
Background : The MFH Program was established in 2006 with the
majority of funds, $18.3 million, provided by the State General
AB 355
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Fund. Federal Funds from the Department of Homeland Security and
the Hospital Preparedness Program were provided for hospital
equipment and program development to ensure disaster medical
preparedness for California's hospital surge needs during
catastrophic emergencies. The three hospitals, capable of
deploying 200-beds each, were strategically located in
Sacramento, the Bay Area, and Southern California to allow for
transportation, set-up and patient treatment within 72 hours or
less anywhere in the State after a disaster.
The MFHs serve as full General Acute Care Hospitals that can be
transported by ground, sea, or air. Each of the three MFHs
contain:
1. 20 Emergency Department stations
2. 2 Operating Room stations
3. 20 Intensive Care Unit beds
4. 10 Reverse Isolation beds
5. 170 Flexible medical-surgical
ward beds
6. Digital X-ray
7. Point of Care lab testing
8. Pharmacy
9. Cascade oxygen system with
concentrators to re-supply the oxygen system
10. 130 ventilators
MPHs have been deployed twice for exercises and have been placed
on alert four times for potential deployments in California in
response to wildfires and H1N1. They have not been deployed for
a real world medical mission as California has not had a
catastrophic disaster that exceeded available hospital bed
capacity in the past four years.
The MFHs were fully maintained until the 2011-12 budget year,
when Governor Brown eliminated the MFH program's funding due to
budget constraints. Faced with the elimination, the EMSA struck
a one-year deal with manufacturer Blu-Med, which the state
previously paid $1 million a year to handle maintenance and
subcontractors. Blu-Med agreed to waive its annual fee in
exchange for being able to lease out two of California's three
MFHs to other governments. The EMSA found other agency funds to
pay the remaining costs for storage. It is unclear if the deal
with Blu-med, which expires in June 2013, will again forgo its
$1 million annual fee.
AB 355
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Arguments in support : The American Medical Response (AMR)
states, "With the passage of AB 355, the citizens of California
will not lose a critical tool, in our all-risk disaster
preparedness/response plans for the State of California in our
three MFHs. While we can't predict the next California
catastrophic disaster it is only a matter of time."
The AMR also points out that they, as the nation's leading
medical transportation company, have firsthand experience of
just how valuable these MFHs assets are in restoring services
throughout a community during the response and recovery during a
disaster. While MFHs were not available during the 1971 Sylmar
Earthquake or the 2003 Wild land fires in San Diego, MFHs would
have been a great benefit during these disasters as hospitals
needed to be evacuated and relocated.
Furthermore, Scripps Health argues that the mobile field
hospital program is a low cost-high consequence public safety
program that should be continued. The mobile field hospitals
provide immediate options to emergency responders for the
provision of medical care, evacuation centers, senior centers,
hospital replacement, surge capacity and care continuity. The
program is beneficial and effective. It has been placed on
alert an average of twice per year since its inception and
deployment guidelines are in every county and state emergency
plan. The state has no ability or plan to fill the public
safety void if this program is unfunded. It is a critical asset
for the State of California. The State of California will be hit
by a natural disaster in the future. It isn't "if" it is
"when".
Suggested Amendments : The MFH program is administered by the
California Emergency Medical Services Authority and not the
Office of Emergency Services; therefore the committee suggests
the following amendment, beginning on page 2, line 12:
SEC. 2. The sum of one million seven hundred thousand
dollars ($1,700,000) is hereby appropriated from the
General Fund to the Office of Emergency Services California
Emergency Medical Services Authority for purposes of
continuing the Mobile Field Hospital program.
REGISTERED SUPPORT / OPPOSITION :
AB 355
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Support
American Medical Response
California Fire Chiefs Association
California State Firefighters' Association
Sacramento Metro Fire District
Scripps Health
Opposition
None on file
Analysis Prepared by : Felipe Lopez / G. O. / (916) 319-2531