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Biosecurity Briefing
House Committee Discusses Hospital Surge Capacity for Mass Casualty Events By Kunal Rambhia, May 9, 2008 On May 5, 2008, the House Committee on Oversight and Government Reform held the first of a two part hearing to assess the impact of “Medicaid regulations on hospital emergency surge capacity and the ability of hospitals to respond to a mass casualty event.”1 The first day of hearings included testimony from five stakeholders representing various backgrounds and involvement in emergency preparedness. Day two of the hearing took place on May 7 and included testimony from Secretary of Homeland Security Michael Chertoff and Secretary of Health and Human Services Michael Leavitt. The hearing was held to address the issue of hospital surge capacity in the context of several proposed Medicaid regulations. The Washington Post reported on May 6, 2008, that the changes to Medicaid would “eliminate reimbursements for residents and interns at teaching hospitals and payments to public hospitals,” which over five years would cut federal expenditures by approximately $17.8 billion.2 The Medicaid changes in question would go into effect on May 26, but an initiative approved by the House is waiting Senate and ultimately Presidential approval to stop the changes from being implemented “until their true impacts can be understood.”1 Critics of the proposed regulations have suggested that the cuts in federal funding will further weaken hospital preparedness and surge capacity and force states to bear the burden of funding. The Washington Post reported on May 8 that Secretary Leavitt testified that “there are deficiencies in our surge capacity. I just don't believe Medicaid dollars is the source of funds that ought to be directed or looked to link to that solution.”3 As part of the preparation for the hearing, a survey of 34 Level 1 trauma centers was conducted on March 25, 2008. The survey examined “emergency room capacity in” Washington, DC, New York, Los Angeles, Chicago, and Houston, which are “considered at greatest risk of a terrorist attack.”1 In addition, Denver and Minneapolis, which will host the upcoming Democratic and Republican conventions, participated in the survey. Results of the survey determined that none of the participating hospitals would have the capacity to deal with a surge of patients after a terrorist bombing on the scale of the 2004 Madrid bombings, which sent 270 patients to a single hospital within the first few hours. The survey indicated that some Washington, DC, and Los Angeles hospitals are already working over capacity, and many would have to go on diversion if a terrorist attack were to take place. More information, including witnesses’ testimonies, can be found at: http://oversight.house.gov/story.asp?ID=1929. References
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