9.01.2010

Will California’s Hospitals Become Earthquake-Safer Sooner?

An effort to strengthen more of California’s hospitals against earthquakes sooner is awaiting action by Gov. Arnold Schwarzenegger.

The measure is the latest in a line of legislation dating back to 1973 attempting to ensure hospitals withstand the jolt of a major quake.

Nearly 40 years later, 721 hospital buildings out of 2,670 buildings at 416 facilities across the state are judged to be at risk of collapse or significant loss of life in a major earthquake, according to data from the Office of Statewide Planning and Development, which oversees hospital seismic safety.

“(This bill) attempts to balance acute care with seismic safety in our hospitals and the need to keep hospitals open in our communities,” said Sen. Denise Ducheny, a San Diego Democrat who carried the bill, in convincing her fellow senators to vote for the measure.

The 40-member Senate sent her bill, SB 289, to the GOP governor on August 30 with a bipartisan 33-2 vote.

Hospitals were placed on what was intended to be a strict timetable to strengthen themselves – at their own expense – against future earthquakes after the 1994 Northridge earthquake in Los Angeles when 11 hospitals were damaged – two severely — or became unusable after the temblor.

That law, SB 1953, required acute care hospitals to reinforce themselves by 2008 or stop being acute care hospitals. A 2000 bill granted some qualifying hospitals a five-year extension to 2013. Six years later, another bill allowed hospitals that made substantial progress in seismically strengthening their buildings or were involved in major construction an additional two-year extension.

County or city hospitals were given until 2020 to comply if they can’t meet the 2013 deadline. But in order to get the extension the local government must replace the existing structures.

By 2030, all hospital buildings must be able to withstand a major earthquake or be demolished, replaced or no longer offer acute care.

The state notes that there is a 62 percent probability of at least one 6.7 magnitude or greater quake striking the San Francisco Bay Area before 2032. Southern California has a 60 percent probability of a major quake during the same period.

Hospitals have long complained about this “unfunded mandate,” citing a 2007 RAND study that calculated the costs of meeting the requirement as ranging from $45 billion to $110 billion.

Opponents of Ducheny’s bill argue that it simply is another postponement of the day of reckoning, imperiling both patients and hospital personnel.

“Nurses and other health care workers are at the front lines when devastation occurs,” wrote Zenei Cortez, co-president of the California Nurses Association in a March 22 post at californiahealthline.org.

“As Haiti, Chile and the earthquakes in California should signal, the one building that Californians will most need standing following a serious earthquake is their community’s acute care hospital.”

Hospitals have made progress.

Their evaluation in 2001 showed that 40 percent of the state’s hospital buildings were at risk of collapse in a major quake.

The 721 buildings on the state’s list represent 27 percent of the state’s hospital buildings.

Buildings in need of strengthening are in 41 of the state’s 58 counties, the greatest number of at risk buildings – 270 – in Los Angeles County. Some hospitals have multiple buildings in need of reinforcement. The state shows the Kaiser Foundation Hospital Oakland Campus with 12 buildings at risk of collapse. The Ronald Reagan University of California at Los Angeles Medical Center has 15.

Among the provisions in Ducheny’s bill is allowing the state to grant one-year extensions – no more than three years total – for individual projects if the delays stem from the local planning process.

Prior to 2020, hospitals must submit a master plan for the buildings they intend to rebuild or replace by 2030.

California hospitals acknowledge the measure postpones their date of compliance but say it does so in order to allow them to keep their doors open to patients.

Ducheny’s bill also requires hospitals that do not meet the state’s seismic standards to post a sign at all public entrances saying this:

“The State of California has determined that this hospital has buildings that are at risk of collapse in a major earthquake.”

Given the bipartisan support, it’s probable Schwarzenegger will sign the measure although he has taken no public position on it.

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