A 1994 law mandating that California hospitals collectively spend billions to make their facilities seismically sound has for more than a decade left hospital executives quaking in their boots.
But today, a sympathetic governor and the wonders of technology will likely give many hospitals in the state a reprieve. The one catch is that the reprieve is tied up with Gov. Arnold Schwarzenegger's healthcare packagewhich is failing to get traction in the state Legislature. "At this point we are growing very concerned," says Carl Scheuerman, senior planner for facility planning and development at Sutter Health, a Sacramento-based hospital system. "We need to know: Do we have to do these upgrades now or not? We are running out of time."
After the 6.7 magnitude Northridge earthquake tore through Southern California in January 1994, suspending services at 23 hospitals and causing $3 billion in hospital-related damage, state lawmakers swiftly enacted the Hospital Facilities Seismic Safety Act. The law requires that hospitals at risk of collapse in future earthquakes be rebuilt or retrofitted by 2008 (later extended to 2013) or close their doors. By 2030, hospital structures must not only withstand a quake but also must be able to continue operating without any care disruptions, according to the law.
A staggering 2,700 buildings at 470 hospital campuses were required to meet these benchmarks by 2030. The total cost of those upgradespaid by the hospitalscould reach $110 billion, with construction costs averaging $1,000 per square foot, according to a study issued in January by the RAND Corp. and the California HealthCare Foundation. Out of the 40% of total hospitals statewide that must meet the 2013 deadline, nearly half will fail to do so, according to the study.
But in June, the California agency tasked with overseeing the hospital seismic upgrades, the Office of Statewide Health Planning & Development, announced that its hospital advisory board approved the use of a seismic software program that could result in as many as 650 of the 1,110 hospital buildings being reclassified as lower-risk and therefore not required to meet that deadline.
This miracle of reclassification came about thanks to the most unlikely of sources: the Federal Emergency Management Agency, which developed a disaster-risk modeling software called HAZUS (short for Hazards U.S.). The software, which can be used to evaluate risk on any disaster, including fire, flood and tornadoes, assesses seismic risk by crunching building site data and facility characteristics. The planning office identified 15 attributes in hospital buildings that could cause significant problems during an earthquake. These include soil quality and proximity to fault lines as well as "torsional irregularity" (which makes the building twist) and "weak stories" (the lower floors are weaker than the upper floors).
Later this fall, the planning office will complete its draft regulations on HAZUS, which then require approval by the state's Building Standards Commission. The planning office won't present at that commission's monthly meeting in November, according to the department, but may do so in December or at a special meeting on the topic. The regulations can then be implemented through legislation, or, if completed before Dec. 31, via emergency order by the governor.
The full version of this story initially appeared in this week's edition of Modern Healthcare magazine.
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