BILL ANALYSIS Ó
AB 1578
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Date of Hearing: April 12, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
AB 1578
(Rodriguez) - As Amended March 28, 2016
SUBJECT: Emergency medical services: mobile field hospitals.
SUMMARY: Appropriates $2 million from the General Fund (GF) to
the Emergency Medical Services Authority (EMSA) to provide
maintenance and upkeep of mobile field hospitals (MFHs) within
the Mobile Field Hospital Program.
EXISTING LAW establishes EMSA in the Health and Human Services
Agency to administer a statewide system of coordinated emergency
medical care, injury prevention, and disaster medical response.
FISCAL EFFECT: This bill has not yet been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, California
currently owns three mobile field hospital units with combined
bed capacities in excess of 600 beds. Because of neglect and
past fiscal budgetary crises, the state by not maintaining
these assets, has in effect gambled that it would not
experience a major disaster. We have been fortunate that this
has not happened. We have seen the incidence of increasing
seismic activity and earthquakes throughout the state and we
are not adequately prepared. The author states that the time
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to prepare for disaster and emergency preparedness is now. A
modest investment in these mobile field hospitals will save
lives in the Bay area, Southern California and central and
northern California.
2)BACKGROUND.
a) Historical Background. According to EMSA, in 2007, the
state purchased three MFHs with the intent to replace or
augment acute hospital care capacity during catastrophic
emergencies. AB 1811 (Laird), Chapter 48, Statutes of 2006,
which amended the Budget Act of 2006, authorized the
purchase of the three MFHs at an initial GF cost of $18.3
million. Additionally, $1.7 million GF was authorized in
fiscal year (FY) 2006-07 to provide for ongoing costs
associated with program staff, storage, maintenance and
readiness. These ongoing funds were eliminated in FY
2011-12. The MFHs have been deployed three times for
exercises, but never for a response to a real event.
b) Deployment Capabilities. Each MFH can be deployed as a
200-bed acute care facility that includes: 20 bed
Emergency Department; two Operating Room stations; 20
Intensive Care Unit beds; 10 Reverse Isolation beds; 170
medical-surgical ward beds; digital X-Ray; point of care
laboratory testing; Pharmacy; cascade oxygen system to
generate and refill oxygen tanks; and, 130 ventilators; and
a 30' x 50' climate controlled supply warehouse and staff
quarters for 150. Power is provided by up to eight diesel
generators, depending on the number of modules used. Each
MFH could be deployed as one integrated facility or in
smaller modules of 50, 100, or 150 beds. If divided into
smaller units, each would not have the same capabilities.
The shelf life for the MFHs' infrastructure items is a
minimum of twenty years; the current age is eight years.
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c) Operational Status. Currently, all three MFHs are
stored in the Sacramento area in delayed deployment status
and cannot be mobilized in time to treat patients during
the initial phase of a response. Until June 30, 2015, one
MFH was maintained with ongoing biomedical equipment
maintenance for a target deployment time of one week. If
the other MFHs were needed in the event of a disaster, they
would require additional maintenance and recertification of
all biomedical equipment, which would require an estimated
minimum of 30 days before deployment.
d) Program Costs. The cost estimates provided by EMSA and
outlined below are to restore one MFH to rapid deployment
condition and status. These are point-in-time estimates
and are based on past contracts.
i) Storage. To store one MFH requires 15,000-20,000
sq. ft. of clean storage space where biomedical equipment
maintenance can be performed. The facility requires a
forklift for movement of boxes to access the equipment
for maintenance and to move the generators outside to be
run once per month. Warehouse space for one MFH is
estimated to cost between $175,000 and $250,000 per year
if stored in Southern California. There are no
additional costs to store one hospital in Sacramento at
EMSA Station 1.
ii) Transportation. To move one MFH by ground, the
requirements are as follows: three 42' box trucks and
eighteen 42' flatbed trucks. The cost varies by distance.
iii) Maintenance. To maintain one MFH a maintenance
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contract would include: 24/7/365 logistical support,
setup teams immediately available for deployment,
maintenance of all support services contracts, and
ongoing maintenance and replacement of equipment beyond
its service life, including biomedical, batteries,
generators, medical supplies, shelters, and other items.
Some equipment needs replacement, as it is beyond its
service life. The maintenance for one MFH is estimated
to cost between $825,000 and $900,000 per year.
3)SUPPORT. The Rural County Representatives of California argue
that disaster preparedness is vital to the State's ability to
respond to all types of disasters. Rural communities face
unique challenges in dealing with disaster preparedness,
response and recovery. Disasters resulting in significant
medical emergencies would overwhelm rural hospitals and
transporting patients to other facilities would overtax
available medical transportation delaying timely care. That
is why this bill to restore MFHs to ready use condition is so
important. The California Ambulance Association supports this
bill because MFHs are needed in case California faces a
catastrophic event. The American Red Cross argues that having
fully equipped MFHs guarantees readiness in case of any
emergency situation.
4)RELATED LEGISLATION. AB 1827 (Kim) makes an appropriation of
$2 million from the GF to the Office of Emergency Services to
maintain one or more MFHs. AB 1827 is scheduled to be heard
by the Assembly Health Committee on April 12, 2016.
5)PREVIOUS LEGISLATION. AB 355 (Cooley) of 2013 would have
appropriated $1 million from the GF to EMSA to continue the
MFH Program. AB 355 was held on the Senate Appropriations
Committee Suspense File.
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REGISTERED SUPPORT / OPPOSITION:
Support
American Red Cross
California Ambulance Association
Rural County Representatives of California
Opposition
None on file.
Analysis Prepared by:John Gilman / HEALTH / (916) 319-2097
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