As federal lawmakers debate a possible stimulus package, the head of the Alabama Hospital Association, Don Williamson, says the state is dependent on the outcome to get enough ventilators to fight the coronavirus.

“We can't guarantee or even assume that those dollars will be there. But on the other hand, you can't wait until you have those dollars to begin the process of acquiring the ventilators,” he said.

At roughly $50,000 a ventilator, Williamson says hospitals need outside funds to afford the price tag of upping their supply of the devices that have been critical to saving lives in areas with high infection rates.

“What you want to avoid is being in the situation that Italy and, and...Washington, Seattle, are in where you have to make very difficult decisions about ventilator use and ventilator assignment,” he said.

Williamson says the state has a supply of roughly 800 ventilators that are not currently in use, but some models for demand show a need for up to 6,000 ventilators.

The American Hospital Association has requested $100 billion in federal dollars for hospitals. Meanwhile the state’s hospitals, with ranging financial capabilities, face the difficult task of attempting to purchase new ventilators in time to prepare for possible demand while not knowing exactly where the dollars will come from.

“Obviously, for hospitals that are in financial difficulty, their ability to buy ventilators becomes more difficult,” he said adding that more than 80 percent of rural Alabama hospitals have negative operating margins.

Hospitals face supply shortages as well since their usual private suppliers are inundated with orders and unable to keep up.

Alabama requested 200 ventilators from the Strategic National Stockpile of supplies. While it received other protective gear it requested from the stockpile, the ventilators have not arrived, according to Williamson.

He says the state’s hospitals are also coordinating with the governor’s office and the Alabama Department of Health to seek out non-traditional ventilator manufacturers looking to produce the machines to meet the demands created by COVID-19.

Without that aid, Williamson fears difficult decisions may be made about who gets priority for care, and coronavirus-related uncompensated care costs may mean more Alabama hospitals shut their doors.