Summary: Barlow Respiratory Hospital requests entrance into the SHMPH on the basis that they have been licensed as an Acute Care General Hospital, and grandfathered on the requirement that they have all of the required services. They currently have limited surgical facilities on site and contract for surgical and anesthesiology services with neighboring institutions. One of the criteria for SHMPH eligibility is that the all of the services required by section 1250 of the State Health and Safety Code be located in the eligible hospital complex. Barlow does have surgical services appropriate to the patient profile for which the hospital is used, and the patients served do require a higher level of acute care and intensive care than those usually found in an ordinary hospital.
Issues: Must Barlow Hospital conform to the letter of the SHMPH entrance criteria, including the criteria cited in footnote #7 in section I.C of the Program Description?Is it sufficient to make a finding that these rules are satisfied by a finding that the hospital is capable of (1) providing emergency acute care services for individuals from the general population following a disaster with the facilities it does have, (2) that the normal in-patient population would be put at significant risk in the event a disaster caused the closure of the building, and (3) there is sufficient evidence that the acute care services required by the law are sufficiently available on site to justify a determination that the intentions behind the SHMPH rules are met?
Findings: That Barlow Respiratory Hospital is a singular special case where the on-site provision of limited, rather than complete, anesthesiology and surgery services, together with their nearby off-site full provision, does meet the purpose of the SHMPH and the intentions behind the entrance criteria. This finding is supported by the fact that the hospital's specialization on respiratory diseases has resulted in a concentration of patients requiring a particularly high level of constant care not provided by other area hospitals, and that the services necessary for these patients are provided on site. In addition, the absence of full surgical facilities does not prevent the facility from being used for full post disaster triage and emergency care should the need arise.
Rationale: The SHMPH Program is intended to provide immediate occupancy level upgrading only for acute care inpatient hospital facilities, not for facilities requiring a lower level of care. Barlow has established proof that it does service only severely ill patients, and is thus equally justified in being included into the SHMPH as the other hospitals in the Program.