BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 355
AUTHOR: Cooley
AMENDED: May 24, 2013
HEARING DATE: July 3, 2013
CONSULTANT: Norring
SUBJECT : Emergency medical services: mobile field hospitals.
SUMMARY : Appropriates $1 million from the General Fund to the
Emergency Medical Services Authority in order to continue the
Mobile Field Hospital program.
Existing law: Establishes the Emergency Medical Services
Authority (EMSA) within the California Health and Human Services
Agency. Requires EMSA, among other things, to develop planning
and implementation guidelines for emergency medical services
systems which address specified components, including manpower
and training, communications, transportation, system
organization and management, data collection and evaluation, and
disaster response.
This bill: Appropriates $1 million from the General Fund (GF) to
the Emergency Medical Services Authority (EMSA) in order to
continue the Mobile Field Hospital (MFH) program.
FISCAL EFFECT : Contains a $1 million appropriation from the GF
to EMSA.
PRIOR VOTES :
Assembly Governmental Organization:16- 1
Assembly Appropriations: 14- 0
Assembly Floor: 77- 1
COMMENTS :
1.Author's statement. MFHs are used to restore or replace
hospital services and provide medical surge capacity to local
communities in the event of a catastrophic disaster or public
health emergency. In 2006, California established its MFH
Program by purchasing three, 200-bed mobile hospitals with
$18.3 million. The hospitals were fully maintained until the
2011-12 budget year, when the Governor eliminated the
program's funding due to budget constraints. The state found a
short-term solution for the last two years, with the hospital
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management company waving their $1 million annual fee in
exchange for being able to lease two of the hospitals to other
governments. However, this short-term agreement expires in
June 2013 and no long-term funding solution has been found.
Therefore, if funding for the MFH Program is not added to the
2013-14 budget the program faces permanent decommission. In a
state of 37 million, the capacity these hospitals offer to
establish 600 hospital beds in any area within 72 hours is a
key part of preparedness. Without these hospitals,
California's ability to respond to catastrophic disasters will
be greatly diminished.
2.MFH program. According to EMSA, the MFH program was
established in 2006 with a majority of the approximately $20
million in funding coming from the state GF. The program
locates the three 200 bed MFHs in Sacramento, the Bay Area,
and Los Angeles. In the event of a disaster, this allows the
hospitals to be rapidly deployed and set up for patient
treatment within 72 hours, anywhere in the state. The MFH
program is designed as an all hazards approach to events that
trigger significant medical or health impacts. Each MFH serves
as a general acute care hospital, whose services may include
but are not limited to:
a. 20 Emergency Department stations;
b. 2 Operating Room stations;
c. 20 Intensive Care Unit beds;
d. Digital X-Ray;
e. Pharmacy; and,
f. 130 ventilators.
According to EMSA, MFHs are not required to be licensed
because they are considered alternate care sites, which
legally exempt them from hospital licensing requirements in
existing law.
California's MFHs have been used twice in exercises and placed
on alert four times since the inception of the program, but
have not been deployed in response to catastrophic disaster or
public health disaster.
1.Background. Though the MFHs have not been deployed during a
disaster, California has experienced floods, fires, and
earthquakes on multiple occasions. According to the Uniform
California Earthquake Rupture Forecast model, California is
poised to experience a magnitude 6.7 or higher earthquake
AB 355 | Page
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within the next 30 years. According to the Office of Statewide
Health Planning and Development (OSHPD), 75 percent of
California's hospitals are located in areas at high risk for
earthquake. Additionally, OSHPD reports that many of these
hospitals "pose a significant risk of collapse and a danger to
the public." In the case of such an event, the MFH program can
provide supplemental beds or provide hospital replacement if
necessary.
2.MFH Funding status. Budget constraints in the 2011-12 fiscal
year forced the Governor to eliminate the MFH program funding.
According to EMSA and the Department of Finance (DOF), EMSA
plans to divert $270,000 in funding from the Hospital
Preparedness Program (HPP) this year, but this is only a
temporary stop-gap measure and will not allow all three MFHs
to be maintained in deployment-ready status. According to EMSA
and DOF, they will only be able to maintain one MFH in
deployment-ready status with this funding, while the other two
MFHs will be kept in storage in the Sacramento area. EMSA
states storage will cause deployment delays of up to two weeks
in the event the MFHs are needed. The $1 million appropriated
in AB 355 will allow for strategic placement of the MFHs,
which will provide statewide coverage without undue delay.
3.Support. American Red Cross - California Chapter (ARC) writes
that this bill will allow California to maintain a critical
tool in disaster preparedness with the MFHs. MFHs provide
immediate options, in the event of a disaster, for emergency
responders to provide medical care, evacuation centers, and
hospital replacement, among other functions. ARC maintains
that this is a beneficial and effective program. Scripps
Health writes that the MFH program is a low-cost
high-consequence public safety program that should be
continued. If this program were unfunded, Scripps states that
the state would have no ability or plan to fill the public
safety void in the absence of the MFH program.
SUPPORT AND OPPOSITION :
Support: American Medical Response
America Red Cross (California Chapters)
California Fire Chiefs Association
California State Firefighters' Association
Emergency Medical Directors Association of California
Emergency Medical Services Administrators Association
of California
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Health Officers Association of California
Paramedics Plus
Sacramento Metropolitan Fire District
Scripps Health
Oppose: None received
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