The LSU official in charge of the state's charity hospital system says it would cost $258 million to repair Charity Hospital and $395 million to replace it.

WWL-TV

Smithburg believes it would cost $395 million to replace both Charity Hospital with a new facility.

Don Smithburg, chief executive officer of the Louisiana State University Health Care Systems Division, told the LSU Board of Supervisors on Friday that federal guidelines call for replacing a building if repair costs would be more than half replacement costs.

For Charity, south Louisiana's only trauma center which was shut down by Hurricane Katrina, repairs would cost 65 percent of the replacement costs.

It would be an even higher percentage -- 68 percent -- for University Hospital: $172 million to replace it and $117.5 million to fix, he said.

At Charity, which held the trauma center, the basement -- holding the morgue, electric systems and pumps -- filled during the floods. Administrators say it is no longer fit for hospital use.

The Navy hospital shop Comfort left New Orleans two weeks ago. An Army trauma unit set up at the convention center will leave in two weeks.

The only fully operating hospitals in the area hit by Katrina are in suburban Jefferson Parish: East and West Jefferson hospitals and Ochsner Clinic Foundation Hospital. And, though they have a good few empty beds, they don't have the staff to use them. Many doctors haven't returned because their homes are gone and their children don't have schools, he said.

Smithburg said that officials talked to Ochsner about leasing the Elmwood Medical Center as a trauma center. In addition, Smithburg said, officials are negotiating with owners of St. Charles General Hospital in New Orleans itself as a clinic or primary care hospital.

In the meantime he said officials are trying to find another federal unit to replace the MASH unit that will close at the Convention Center.

His comments added dollar signs to the warnings made a day

earlier by Dr. Patrick C. Breaux, president of the Orleans Parish

Medical Society.

"The available hospital services are strained to their limits.

We are one bus crash, major fire, or flu epidemic from disaster,"

Breaux said. The state must set up a new Level I Trauma Center in

the area, he said.

"When you look at their available beds, staffed beds, they are

almost always full," Breaux said.

Touro Infirmary's emergency room is the only one working in New

Orleans itself. "It has 30 beds available. In a couple of weeks it

will have 80 beds, plus the emergency room and operating rooms to

provide some trauma care," Breaux said.

A second, 15-bed MASH-type unit will remain after the convention

center unit leaves, but it's in a tent and more suitable for

triage, short-term care and minor trauma or illness than major

trauma care, Breaux said.

"It is not suitable for any major trauma," Breaux said. "It

would be something that could be used in a combat zone. But for an

urban area with regular hospital facilities available, it's not

desirable to do anything other than triage and walk-in Band-Aid

type things."

Although the hospital at Elmwood has been used as a specialty

hospital, it has the facilities needed for a trauma center, and

could be used as one "until a permanent facility which replaces

Charity can be built. I use the word 'can' because that's going to

be the big issue to deal with," Breaux said.

It's not at all clear where the money would come from, he said.

"That negotiation is at a level way beyond my pay grade."

Smithburg was in Washington on Thursday, where he warned the

public hospital system, which had 1.2 million patients a year

before the storm, will collapse next month without fast federal

help.

"We're out of money, roughly after Thanksgiving," Smithburg

said.

Smithburg said the system will have to furlough 2,900 of its

8,000 employees next week, the first step toward permanent layoffs

on Dec. 17.

Two of the system's nine hospitals, Charity and University in

New Orleans, have been closed since they were severely damaged in

the storm. They are the system's two biggest hospitals and include

the state's only accredited trauma care unit -- though it was on

probation, according to the Louisiana Hospital Association.

The state's other trauma center, at LSU's Shreveport campus, is

working to regain accreditation after failing to send in required

paperwork last year, according to the LHA.

Hospital system engineers have declared both Charity and

University a total loss.

Smithburg said the system is awaiting the Federal Emergency

Management Agency's final decision on whether they could get

federal disaster coverage for the entire replacement cost.

The more immediate problem, he said, is the system's need for

$15 million a month for the next six months to meet its payroll,

and $200 million in interim financial support for the other seven

system hospitals that have taken on additional patients because of

the closures of Charity and University.

Because those seven were not directly damaged by either Katrina

or Hurricane Rita, they are not eligible for FEMA grants.

Smithburg said he's hoping both the payroll aid and the interim

support will be included in a new hurricane relief spending bill

being prepared by the Bush administration. He said he has pressed

the issue with Louisiana's congressional delegation but has had

little chance to plead his case with administration officials.

(Copyright 2005 by The Associated Press. All Rights Reserved.)