BILL ANALYSIS                                                                                                                                                                                                    



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          Date of Hearing:   April 27, 2016


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                               Lorena Gonzalez, Chair


          AB  
          1578 (Rodriguez) - As Amended April 19, 2016


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          Urgency:  Yes State Mandated Local Program:  NoReimbursable:  No


          SUMMARY:


          This bill 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.  It also contains an urgency  
          clause.


          FISCAL EFFECT:








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          1)$2 million GF one-time to EMSA.  EMSA indicates $900,000 would  
            be sufficient to bring all three MFHs to immediate deployable  
            status and $1.1 million would provide for one year of ongoing  
            maintenance and deployment capability for two Sacramento-based  
            MFHs.  


          2)Ongoing cost pressure of $2 million GF annually to maintain  
            funding for MFHs brought into deployment status. The  
            maintenance for each of the three MFHs is estimated to cost  
            $600,000, with an additional cost of $175,000 to $250,000 to  
            store a hospital in the Los Angeles area. 


          COMMENTS:


          1)Purpose. According to the author, California currently owns  
            three mobile field hospital units with combined bed capacities  
            in excess of 600 beds.  He indicates by not maintaining these  
            assets, the state has in effect gambled that it would not  
            experience a major disaster.  While we are fortunate that a  
            major disaster has not occurred, the author indicates a modest  
            investment in these hospitals will augment medical capability  
            and save lives if one should occur.  


          2)Background.  In 2007, the state purchased three MFHs with the  
            intent to replace or augment acute hospital care capacity  
            during catastrophic emergencies. Assembly Bill 1811 (Laird,  
            Chapter 48, Statutes 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 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 and put on alert several times for actual  








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            disasters, but never deployed for a response to a real event.  
            Each MFH can be deployed as a 200-bed fully functional acute  
            care hospital facility which includes an emergency department,  
            surgery suites, intensive care, a pharmacy, and other units.   
            Currently, all three MFHs are stored in the Sacramento area in  
            delayed deployment status and would take significant  
            refurbishment, restocking, and time to be brought into  
            deployment status.





          3)Prior Budget Actions. Assembly Budget Subcommittee #1 on  
            Health and Human Services approved an appropriation of $1.96  
            million GF to EMSA on May 23, 2014 to be used for the  
            department's MFH program. This sum, however, was not approved  
            during the budget process.


          4)Related Legislation.  AB 1827 (Kim), which was heard but not  
            voted on in Assembly Health Committee on April 12, 2016, is  
            similar to this bill. 


          5)Prior 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 Suspense File of the  
            Senate Appropriations Committee.


          Analysis Prepared by:Lisa Murawski / APPR. / (916)  
          319-2081














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