CALIFORNIA CALLED UNPREPARED PUBLIC HEALTH SYSTEM GETS POOR RATING.

Byline: Staff and Wire Services

California's public health system is ill-prepared to handle threats from infectious disease, bioterrorism or environmental hazards, according to a report released Thursday by a state watchdog commission.

The Little Hoover Commission launched its review after the Sept. 11, 2001, terrorist attacks and concluded the public health system is the state's biggest weakness.

But the commission's conclusions may not apply much to Los Angeles County, which with nearly one-third of the state's population has its own comprehensive public-health bureaucracy, said Dr. Jonathan Fielding, director of public health for the Los Angeles County Department of Health Services.

``I think some of the points they make are very important, but we have a lot more resources and capabilities than other places,'' Fielding said. ``We're being viewed nationally as a model of (bioterrorism) preparedness.''

Fielding's comments were echoed by Los Angeles Fire Department Battalion Chief Robert Franco, who said the department is ``probably 10 times'' more prepared for a bioterrorism attack than it was before September 2001. For example, he said, the department now is capable of decontaminating 200 bioterrorism victims an hour.

The 13-member commission appointed by the governor said the public health system has slowly eroded since its reorganization in 1970, becoming so fragmented that its response to a bioterrorism attack would be slowed by bureaucracy. It also concluded that the system was underfunded.

Diana Bonta, director of the state Department of Health Services, said the authors ``completely missed the mark.''

The commission, she said, invited testimony only from people who supported its preconceived conclusions.

``The report is asking for reactive, they're not asking for proactive work that needs to be done,'' Bonta said.

Assemblyman Keith Richman, R-Granada Hills, said he introduced legislation last year that would have mandated many of the things the Hoover Commission is now recommending. Richman's bill, which died in committee last April, would have authorized the governor to declare a public health emergency and conscript doctors, nurses and pharmacists from throughout the state to respond.

Richman, a physician, said the administration of Gov. Gray Davis has not done enough to prepare for health threats, whether from bioterrorism or epidemics.

``The issue of putting in place a chain of command clearly delineating responsibilities at the local, state and federal level is very important,'' Richman said. ``All the (crisis simulation) exercises that have been run, whether they have been state or federal exercises, there is routinely chaos and confusion.''

In addition to the threat of bioterrorism, the commission said the system is not equipped to detect and track more routine, but still dangerous, threats such as hospital-acquired infections.

The Centers for Disease Control estimated those infections annually kill as many as 80,000 people and sicken up to 2 million. Hospitals are not required to report those cases, so the estimates are based on information volunteered by hospitals.

The commission estimated about 8,400 of deaths from hospital-acquired infections are in California. An improved public health system could track those cases as they emerge and better educate health workers to prevent many of the deaths, the report said.

Bonta said infection control is handled by workers at hospitals and nursing homes.

``Should we have enough staff to be in every hospital to check if they're doing infection control? That would not be a good use of resources,'' she said.