BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 355
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          ASSEMBLY THIRD READING
          AB 355 (Cooley)
          As Amended  May 24, 2013
          2/3 vote 

           GOVERNMENTAL ORGANIZATION 16-1  APPROPRIATIONS      14-0        
           
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          |Ayes:|Hall, Nestande, Bigelow,  |Ayes:|Gatto, Bigelow,           |
          |     |Chesbro, Cooley, Gray,    |     |Bocanegra, Bradford, Ian  |
          |     |Hagman,                   |     |Calderon, Campos, Eggman, |
          |     |Roger Hern�ndez, Jones,   |     |Gomez, Hall, Ammiano,     |
          |     |Jones-Sawyer, Levine,     |     |Linder, Pan, Quirk, Weber |
          |     |Medina, Perea, V. Manuel  |     |                          |
          |     |P�rez, Salas, Torres      |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Waldron                   |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Appropriates $1 million from the General Fund to the  
          Emergency Medical Services Authority (EMSA) to continue the  
          Mobile Field Hospital (MFH) Program and makes legislative  
          findings and declarations.  

           EXISTING LAW  : 

          1)Establishes the California EMSA, which is responsible for the  
            coordination and integration of all state agencies concerning  
            emergency medical services, including the MFH program.

          2)Creates the Office of Emergency Services (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  :  According to the Assembly Appropriations  
          Committee, the bill contains a $1 million General Fund  
          appropriation for EMSA.

           COMMENTS  :   

           Purpose of the bill  :  According to the author California has a  
          history of devastating disasters including, but not limited to,  








                                                                  AB 355
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          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 this bill 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  
          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.  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 is not "if" but  
          "when".

           
          Analysis Prepared by  :    Felipe Lopez / G. O. / (916) 319-2531 


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