Unready in the Capital
Washington Hospital Center has a plan to handle a medical catastrophe -- but not the federal funds it needs.

Friday, May 9, 2008; A26

A REPORT from Congress warns that the Washington area is ill-prepared to deal with the medical consequences of a catastrophic event. What's scary -- and maddening -- about this grim reminder of the region's vulnerability is that one possible solution is at hand but has languished because of government inaction. Instead of just sounding the alarm, Congress needs to find the money for a project that would go a long way toward improving disaster preparedness for the high-risk Washington region.

The ER One project of the Washington Hospital Center directly addresses the concerns raised by a recent report from House Democrats on the Committee on Oversight and Government Reform. Committee members surveyed trauma centers in the country's top cities and found them all lacking the capability to deal with the aftermath of "predictable surprises" such as terrorist attacks. The District was found to be woefully lacking in capacity. Indeed, Washington Hospital Center, the region's biggest provider of acute care, was the single most crowded facility of the 34 hospitals surveyed.

Officials at Washington Hospital Center were not surprised by the findings. For almost a decade they have been aware of the issues and have been developing better ways to deal with the mass casualties that would result from natural disasters or epidemics. The awful reality of Sept. 11, 2001, and the subsequent anthrax attacks made the officials' work in designing a new type of emergency-care facility all the more relevant -- and urgent. The beauty of ER One is that it could deal with casualties resulting from an event such as a biological attack or a natural pandemic but would also provide day-to-day care.

Some progress -- what hospital officials call baby steps -- has occurred over the past seven years in the effort to bring the project to life. The Bush administration supported its planning and design with federal funds, and just last month the hospital unveiled the use of innovative technologies it had developed for ER One. But an estimated $100 million to $125 million is needed for construction. The hospital is prepared to pay about $25 million and hopes the bulk of the rest will be federal money. Washington is home to the federal government, and so the importance of this facility -- and the appropriateness of federal funding -- is evident. Then, too, the project is being developed as a national pilot with plans to share innovations and ideas with other health-care facilities.

Since the Bush administration has supported this public-private partnership, it was troubling that this week, Health and Human Services Secretary Mike Leavitt told D.C. Del. Eleanor Holmes Norton (D) that he had heard of ER One but knew nothing more of it. In its remaining months, this administration could boost a project that would help make the nation's capital and its environs safer for those who live, work and govern here.

Chertoff, Leavitt Admit 'Deficiencies' in Hospitals' Abilities

By Spencer S. Hsu
Washington Post Staff Writer
Thursday, May 8, 2008; A04

Two Bush administration Cabinet members yesterday acknowledged gaps in the capability of U.S. hospitals to deal with a mass-casualty terrorist attack or other disaster, but they said a congressional effort to block pending Medicaid cuts will not fix the problem.

Testifying before the House Committee on Oversight and Government Reform, Homeland Security Secretary Michael Chertoff and Health and Human Services Secretary Michael Leavitt said lawmakers could target funds at the shortcomings more directly, such as by financing the stockpiling of hospital beds, ventilator units or medicines, if needed.

Stopping a White House plan to tighten Medicaid would not necessarily improve the nation's "surge capacity" to handle an attack on the scale of the 2004 train bombings in Madrid, they said. "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," Leavitt testified.