SACRAMENTO, Calif.--While California hospitals rush to prepare for the Big One, four bills in the state Legislature could cushion the seismic blow.
The Big One in this case is the requirement that California hospitals be made earthquake-safe by 2008. All patient-care facilities must submit detailed compliance plans by Jan. 1, 2001.
Under the California Seismic Safety Act, passed after the 1994 Northridge earthquake, hospitals must have specific bracing systems in place by the end of next year. By 2008, the buildings must be strong enough to withstand a major quake and, by 2030, must have the capacity to be self-sustaining for 72 hours after a quake hits.
The deadlines affect all acute-care hospitals built before 1973, or about 1,950 buildings. The state can grant a one-year extension if a hospital proves it cannot meet the deadline and the loss of capacity cannot be made up at other local hospitals. The only other alternatives are to shut down the facility or use it for another purpose.
The problem, though, is that California hospitals will have to fork out roughly $10 billion combined to meet the new standards--and nobody has that kind of cash. More than 60% of the state's 470 hospitals, in fact, are operating in the red, according to Roger Richter, senior vice president of the California Healthcare Association.
The state has already tried to relax the requirements a bit. In February, it exempted single-story, wood-frame structures and granted more leeway in how hospitals can pass compliance evaluations after retrofit work is done.
But hospital officials worry that the amendments aren't enough.
According to preliminary cost estimates, Kaiser Permanente will still need $60 million to $100 million to make its 350-bed Sacramento Medical Center compliant. And 528-bed University of California-Davis Medical Center is looking at a potential $153 million upgrade.
In 1973, California passed a law requiring all new hospital buildings to meet specific safety requirements. But it was only after the Northridge quake severely damaged several pre-1973 buildings that the state decided to retroactively hold all patient-care facilities to the same standards.
"The intent of (the 1994 law) was to keep hospitals operational in the event of an earthquake. Ironically, it may force many facilities to close down even before a quake ever hits," Richter said.
"Originally, the belief was that hospitals could do incremental retrofitting," he explained. "But now they're finding it doesn't make sense to retrofit for 2008 because several buildings will still have to be completely rebuilt to meet the 2030 standards."
That's why the healthcare association and others are lobbying for relief. Four bills that offer varying degrees of assistance are now winding their way through the Legislature. They include:
* A Senate bill that would give hospitals that have to move or rebuild until 2013 to meet the 2008 requirements.
* An Assembly measure proposing that the Office of Statewide Health Planning and Development, which oversees hospital construction, come up with emergency regulations that would allow temporary facilities to be used while hospitals do construction.
* A Senate bill that would create assistance programs or tax breaks for needy hospitals that submit financial data relating to the cost of meeting the requirements of the 1994 law.
* And a Senate measure that would allow hospitals in certain seismic zones to do site-specific analyses of relative earthquake danger. Hospitals determined to be in less volatile areas would not have to conform to nonstructural requirements by 2008.
But such delays could compound an already complex process, said Chris Tokas, manager of the state health planning office's hospital seismic retrofit program.
"(The 1994 law) is a catalyst to rejuvenate the state's hospital system . . . to improve the buildings that are worth keeping and eliminate those that are too old to save," Tokas said. "So as painful as this program seems, it's going to be extremely beneficial for the healthcare industry."