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OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENTPRESENTATION TO THE LITTLE HOOVER COMMISSION
CALIFORNIA’S PUBLIC HEALTH INFRASTRUCTURE IN TIMES OF CRISIS(Hearing date June 27, 2002)
Presenter: David M. Carlisle, M.D., Ph.D.Director, Office of Statewide Health Planning and Development
Purpose: To address the Commission’s expressed concerns regarding 1) “capacityconcerns related to serving the public health needs of Californians” and 2) “Theperspective of the Office of Statewide Health Planning and Development relatedto the public health preparedness of our state.”
Overview: OSHPD works toward equitable healthcare accessibility for California throughmany different avenues. OSHPD is responsible for a variety of programs thataddress healthcare workforce needs, improve healthcare quality, provideaccurate and timely data and information products for healthcare planning andanalysis, and support safe healthcare facilities.
Capacity of Public Health Infrastructure
A. Facilities
1. General Acute Care Hospital Capacity (by state, region & county)a. Number of available general acute care bedsb. Number of available general acute care beds per 1,000 populationc. Occupancy rates
2. Hospital Emergency Department Capacity (by state, region & county)a. Location of hospitalsb. Location of emergency departments
• Level of service• Location of trauma centers• Location of hospitals with helicopters• Location of hospitals with burn units
c. Number of ED treatment stationsd. Number of ED treatment stations per 1,000 pop
3. Hospital Seismic considerationsa. Location of SPC 1 buildingsb. Emergency response team for natural or manmade calamity
B. Capacity of Healthcare Workforce (by state, region & county)
1. Designation process for medical underservedness2. Location of Health Professional Shortage Areas3. Location of Medically Underserved Areas4. Location of Medically Underserved Populations
California’s PublicHealth Infrastructure in
Times of Crisis
byDavid M. Carlisle, M.D., Ph.D.
Presentation to
Little HooverCommission
June 27, 2002
1
The Office of StatewideHealth Planning &
Development:• Develops data and
information products forhealthcare planning;
• Supports thedevelopment of safehealthcare facilities;
• Administers programsthat address healthcareworkforce needs.
2
California’s Public HealthInfrastructure in Times of
Crisis:Capacity of
General AcuteCare Hospitals
3
South East
North
Central East
Central Coast
Bay Area
Central Valley
Fresno - Madera
San Diego
Sacramento
Los Angeles - Orange
California Healthcare Infrastructure:General Acute Care Hospitals and Emergency Departments
0 100 20050 Miles
Hospital Offering Emergency Medical Services
Other General Acute Care Hospital
California Regions
Source: California Office of Statewide Health Planning and Development
4
South Eas t
North
Ce ntral Eas t
Ce ntral Coas t
Bay Are a
Ce ntral Valle y
Fre s no - Made ra
San Die g o
Sac rame nto
Los Ang e le s - Orang e
California Regions
0 100 20050 Miles
5
Available Beds per Capita by Region
0 100 20050 Miles
Available Beds per 1,000 Population1.8 to 2.1 Beds per 1,000 Population
2.1 to 2.4 Beds per 1,000 Population
2.4 to 2.6 Beds per 1,000 Population
2.6 to 2.8 Beds per 1,000 PopulationNorth
SacramentoCentral Valley
Bay Area
Fresno - Madera
Central East
Central Coast
Los Angeles - Orange
South East
San Diego
6
53%
59%
62%
57%
62%
55%
58%
63%
58%
64%
Regional Occupancy Rates
0 100 20050 Miles
Available Beds per 1,000 Population1.8 to 2.1 Beds per 1,000 Population
2.1 to 2.4 Beds per 1,000 Population
2.4 to 2.6 Beds per 1,000 Population
2.6 to 2.8 Beds per 1,000 Population
Occupancy rate for available beds in each region
North
Sacramento Central Valley
Bay Area
Fresno - Madera
Central East
Central Coast
Los Angeles - Orange
South East
San Diego
7
California’s Public HealthInfrastructure in Times of
Crisis:Hospital
EmergencyDepartment
Capacity
8
9
Los Ang e le s - Orang e
Sac rame nto
San Die g o
Fre s no - Made ra
Ce ntral Valle y
Bay Are a
Ce ntral Co as t
Ce ntral Eas t
North
South Eas t
Medical Service Status
0 100 20050 Miles
Medically Underserved Area
Medically Underserved Population
Area Not Designated
California Regions
Source: California Office of Statewide Health Planning and Development
Emergency Department Treatment Stationsper Capita by Region
0 100 20050 Miles
Treatment Stations per 1,000 Population0.12 to 0.15 Stations per 1,000 Population
0.16 to 0.20 Stations per 1,000 Population
0.21 to 0.26 Stations per 1,000 Population
0.27 to 0.40 Stations per 1,000 Population
North
SacramentoCentral Valley
Bay Area
Fresno - Madera
Central East
Central Coast
Los Angeles - Orange
South East
San Diego
10
California’s Public HealthInfrastructure in Times of
Crisis:Hospital SeismicConsiderations
11
12
Los Angeles - Orange
Sacramento
San Diego
Fresno - Madera
Central Valley
Bay Area
Central Coast
Central East
North
South East
Hospitals Rated Seismically Compliant until 2030
0 100 20050 Miles
Hospital with no SPC 1 Buildings
California Regions
Source: California Office of Statewide Health Planning and Development
SPC Ratings and % of Available Beds, By Region
% of Available Beds byRegion, in Hospitals with no
SPC-1 Buildings:
19San Diego21South East21LA-Orange29Central Coast18Central East39Fresno-Madera24Central Valley35Bay Area45Sacramento27North%Region
13
14
Los Angeles - Orange
Sacramento
San Diego
Fresno - Madera
Central Valley
Bay Area
Central Coast
Central East
North
South East
Hospitals Posing a Significant Collapse RiskFollowing a Strong Earthquake
0 100 20050 Miles
Hospital with 100% SPC 1 Buildings
California Regions
Source: California Office of Statewide Health Planning and Development
SPC Ratings and % of Available Beds, By Region
% of Available Beds by Region,in Hospitals Posing a SignificantCollapse Risk Following a Strong
Earthquake (100% SPC-1Buildings):
2San Diego4South East
18LA-Orange5Central Coast0Central East1Fresno-Madera
14Central Valley16Bay Area
0Sacramento8North
%Region
15
16
Los Angeles - Orange
Sacramento
San Diego
Fresno - Madera
Central Valley
Bay Area
Central Coast
Central East
North
South East
Hospitals with Mixed Seismic Ratings
0 100 20050 Miles
Hospital with Mixed Seismic Ratings
California Regions
(Excludes any Hospital with 100% SPC 1 Buildings)
Source: California Office of Statewide Health Planning and Development
Hospitals Excluding Those atGreatest Risk of Collapse
Hospital with other than 100% SPC-1 buildings
SPC Ratings and % of Available Beds, By Region
% of Available Beds byRegion, in Hospitals
Excluding Those at GreatestRisk of Collapse
(Excludes 100% SPC-1 Hospitals):
81San Diego79South East79LA-Orange71Central Coast82Central East61Fresno-Madera76Central Valley65Bay Area55Sacramento73North%Region
17
EmergencyResponse Team
• In the event of a seismicevent, or other natural ormanmade disaster,OSHPD will send three-person teams to evaluatethe hospital structure andsystems.
• Team findings:– Red tag=Hospital building
unsafe; Evacuate immediately.– Yellow tag=Hospital building
may have limited occupancy.– Green tag=Hospital building
found safe for use andoccupancy. 18
California’s Public HealthInfrastructure in Times of
Crisis:California’sHealthcareWorkforce
19
• Health professional shortagearea (HPSA)– Identifies areas of underserved
populations for primary care, dentaland mental health services >3,500:1 population to primary carephysician (exceptions made forareas with unusually high needs)
• Medically underserved area orpopulation (MUA/MUP)– Measures the degree of
underservice by poverty rates,percentage of pop > 65, infantmortality and population to providerratios
• Note: areas must apply forthese designations
20
Health Professional Shortage Area (HPSA) Status
0 100 20050 Miles
Designated Primary Medical Care HPSA
Area Not Designated
California Regions
North
SacramentoCentral Valley
Bay Area
Fresno - Madera
Central East
Central Coast
Los Angeles - Orange
South East
San Diego
21
Medical Service Status
0 100 20050 Miles
Medically Underserved Area
Medically Underserved Population
Area Not Designated
California Regions
North
SacramentoCentral Valley
Bay Area
Fresno - Madera
Central East
Central Coast
Los Angeles - Orange
South East
San Diego
22
California’s PublicHealth Infrastructure in
Times of Crisis
23