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Save California's 'hospitals in a box'

Op-Ed

The recent disasters in Japan and Joplin underscore that California's three portable hospitals are not luxuries. But the budget crisis leaves them vulnerable.

June 08, 2011|By Bonnie Lowenthal

We have watched a series of disasters sweep through the nation this spring, taxing the emergency services of states and the federal government. In Joplin, Mo., one of the scariest scenarios occurred when the tornado that leveled a third of the city also knocked out one of its main hospitals, St. John's Regional Medical Center, at the exact moment when hospital care was needed most.

We don't have killer tornadoes in California, of course, but our hospitals could be just as vulnerable to the disasters we do have.

So, for the last several years, California has maintained three portable field hospitals. Wherever you can get a big rig or a helicopter, you can set up a "hospital in a box." That means delivering extra capacity, beds and sterile surgical suites where they are needed, when they are needed. The state bought them in preparation for a flu pandemic that did not occur.

Now California isn't sure it can afford these top-of-the-line portable hospitals.

It's true that the state's deficit means that we can't afford everything we need, much less everything we want. But the field hospitals are worth saving.

California has about 73,000 acute-care beds among its 321 brick-and-mortar hospitals. A whopping 75% of those hospitals are in earthquake zones. State officials have identified nearly 600 separate hospital buildings that pose a real risk of collapse during a seismic event.

Of course, you can't plan for emergencies in California without planning for earthquakes. But shifting tectonics is only one of the ways our hospital system could be overwhelmed. Anything from a heavy storm to a terrorist attack could strain our system beyond capacity.

That's what the governor and Legislature had in mind in 2006 when they added three mobile hospitals to our stockpile of emergency preparations. At the time, California health officials were bracing for a deadly flu outbreak. So the hospital kits include hundreds of ventilators and respirators and millions of doses of antivirals. They can convert a parking lot into a village of Quonset-hut-shaped tents, providing 30,000 square feet of hospital space. Inside the tents are things like a digital X-ray machine, an oxygen concentration unit and most of the other equipment you'd find in a hospital. They have room for hundreds of beds, separate emergency rooms and surgical and trauma facilities.

They didn't come cheap. In 2006, the state spent $18 million on these three portable hospitals. It also bought a stockpile of pharmaceuticals and entered into contracts, which cost less than $2 million a year, to store the units, maintain the instruments inside and ensure that they can be dispatched quickly in an emergency. If the maintenance on the field hospitals is ignored, they're as good as useless in a disaster because of the time it would take to test and recalibrate the equipment and bring the medicines up to date.

Unfortunately, in the midyear 2011-12 budget cuts, legislators on both sides of the aisle agreed to strip the mobile hospitals of their maintenance funding. Now, as we prepare to vote on one more version of that budget, we should keep the hospitals in working order for at least another year while we more completely weigh the costs and benefits of having them or doing without them.

Personally, I want them, even though I hope we never have to use them. Because if we learned nothing else from the disasters in Joplin, and Japan, and the inundated towns of the Mississippi Basin, it's that mustering resources quickly makes all the difference. And though it's an open question whether California can afford all the tools we'd like, before we waste our investment in the hospitals, we'd better take a very close look at how the cost-cutting of the recession has affected our disaster preparedness. It's not something you want to learn too late.

Assemblywoman Bonnie Lowenthal (D-Long Beach) is chairwoman of the Assembly Transportation Committee and a member of the California Emergency Council.

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