California's 'hospitals-in-a-box' are threatened

When I heard Wednesday that the last 300 patients were being evacuated at New York City’s Bellevue Hospital Center, I began thinking of what an earthquake could do to hospitals here in Los Angeles.

In storm-stricken New York, other hospitals scrambled to find space for patients. National Guard troops carried many of them down hundreds of stairs in a behemoth 828-bed public hospital building crippled by power outages and flooding.

In Los Angeles, the “Big One” is the most likely local version of Hurricane Sandy, a massive earthquake that could damage or close most hospitals in our fault-crossed megalopolis. Many of us remember how the 6.7-magnitude Northridge earthquake in 1994 damaged or shuttered 11 hospitals in the Los Angeles area.

That’s why three giant “hospitals-in-a-box” are stored in undisclosed spots in California -- and why state officials have tried to find resources to keep them.

But the state may not have the money to keep those three mobile field hospitals in working order after summer 2013. 

California spent $18 million in 2006 to purchase the mobile hospitals. Each one can hold 222 beds and comes equipped with surgical suites and pharmacies stocked with drugs of all kinds. 

More than 20 semi-tractor-trailers would move a single hospital to a quake-damaged area of the state. Constructed to be fully functional after a quake, each hospital would take up space the size of two football fields.

I only learned about the “hospitals-in-a-box” a year ago while writing “Fault Lines,” a series on the shortcomings of hospital seismic safety. That series was a partnership with the San Bernardino Sun, located just a few miles from the San Andreas Fault, considered the most dangerous fault in the United States.

After a 7.8 magnitude quake on the San Andreas, only one hospital in San Bernardino County would be completely functional, according to a UCLA analysis. It’s a 25-bed rural desert hospital, 212 miles east of downtown San Bernardino.

That’s the sort of disaster scenario that the mobile hospitals were meant to address.

During the Bellevue evacuation yesterday, I talked with Dr. Howard Backer, director of the California Emergency Medical Services Authority, the agency that oversees the mobile hospitals.

Experts say that a massive earthquake could injure many more people than massive flooding.

“It does what Sandy did on the East Coast, undercutting the resources for hospitals,” Backer said.

The mobile hospitals would provide a “flexible asset to move very quickly,” he said. “This would allow us to disperse services at a time when the despair is highest, the need is highest.”

But amid its economic troubles, California decided it could no longer afford the $1.7 million bill to store and maintain the hospitals.

So the state stitched together a “Band-Aid” solution. The hospitals’ vendor, BLU Med Response  Systems, agreed to maintain the hospitals for $400,000 temporarily this year, and officials found funds elsewhere in the state budget to pay that bill this year.

Next year is a big question mark.

“The chance of cobbling together another deal is very low,” Backer said. The last best hope, he said, is funding from the private sector, nonprofits or, less likely, government.

Could images of National Guard troops evacuating Bellevue rekindle support in Sacramento for California’s “hospitals-in-a-box?” 

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