Bioterrorism's Hefty Price Tag Before Officials.

Faced with preliminary data that area hospitals are unprepared for any large-scale chemical or biological terrorist attack -- and that the cost of readying them would be sky high -- local hospital industry and county officials are scrambling to come up with a plan in response.

An urgent survey sent by the county's Emergency Medical Services Agency to the 81 county hospitals with emergency rooms found that the hospitals could treat only a minute fraction of the county's 10 million residents during the critical, initial 24-hour period before federal help would be expected to arrive.

The 76 hospitals that responded to the survey only have enough antidote on hand to treat 230 severely poisoned victims of a chemical attack, and the capacity to decontaminate just 845 victims per hour, according to an analysis prepared by the county.

The hospitals are better prepared to treat victims of a bioterrorist attack, with enough pharmaceutical supplies on hand to give initial doses to 46,000 victims, but then have only 1,252 beds where victims of diseases like anthrax or the plague could be isolated from other patients.

Task farce formed

The results prompted the Healthcare Association of Southern California, the industry's regional trade group, to form a task force, at the request of Virginia Hastings, director of the emergency medical services agency.

That group, composed of four industry officials and county support staff, is closely reviewing the data and trying to come up with recommendations within 30 days on how to improve the hospitals' response - especially in light of the industry's financial straits and the potential multi-million cost of any fix.

"It's like having an army in full dress waiting for the war to start," said Jim Lott, executive vice president of the hospital association. "That's a very expensive proposition."

The task force also will try to get a better handle on the costs, but if a preliminary estimate by the American Hospital Association is any measure, getting the hospitals in a post-Sept. 11 state of readiness could cost upwards of $300 million.

The national trade group, in a report sent to Congress this month, estimated that it would cost hospitals $11.3 billion nationwide to get them adequately prepared to handle a chemical, biological or nuclear attack. The funding would pay for, among other items, testing labs, protective gear for medical personnel, additional medical supplies and more training.

Under a commonly used rule of thumb, that would mean California's cost would be about $1 billion and L.A. County's perhaps a third of that, according to industry officials.

But county task force member Frank Maas said he believes the industry would be capable of handling a smaller scale terrorist attack - a more likely scenario - by simply sharing resources and better tracking victims.

"I don't think we will see the day where we will walk out and see 500 people with smallpox," said Maas, administrative director of UCLA's emergency medicine center. "What you will see is a case pop up here or there, but we need to know that"

Even so, any resources pumped into disaster preparedness would come at a time when the hospital industry, and in particular its emergency services sector, can barely handle the daily demands of patient care.

A report last week by the California Medical Association concluded that more than 82 percent of the state's emergency rooms lost money in the 2000 fiscal year - a total of $325 million statewide, with L.A. County hospitals accounting for $98 million, or 30 percent, of it.

The fiscal crunch, which has stretched over a decade, has caused 60 emergency rooms to close statewide since 1990, including 10 alone since 1999, according to the report.

Data released by Hastings last week backed that up, showing that emergency rooms at-five county hospitals were so busy in October that they were closed more than half the time to paramedic calls, forcing new patients to be diverted elsewhere.

"We know they already are very, very busy and don't even have the capacity to expand during the flu season' Hastings said.

Moreover, state hospital industry officials have testified before members of the Legislature holding special out-of-session hearings that hospitals can't be expected to pick up the tab while also being asked to spend billions to seismically retrofit buildings prior to a 2008 state deadline.

The funding crunch has prompted some groups, including labor and health activists, to call for a sales tax measure. Meanwhile, Gov. Gray Davis is considering calling the Legislature into special session to consider a broad range of funding requests prompted by the terrorist attacks and souring economy.