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1946
The Hill-Burton Act, also known as The Federal
Hospital Survey and Construction Act, provided
financial assistance to public and nonprofit
hospitals for renovations, additions and
new construction. In return for funding,
hospitals were committed to providing health
care to their entire communities, including
free or discounted services for those unable
to pay. A boom of construction took place,
and as a result, many hospital buildings
in California from that post-World War II
era are outdated and seismically unsafe.
1973
The Alfred E. Alquist Hospital Seismic Safety
Act was enacted in 1973 in response to the
moderate 6.6 magnitude San Fernando (Sylmar)
earthquake in 1971, when four major hospital
campuses were severely damaged and evacuated.
Two hospital buildings collapsed, killing
47 people and three more were killed in
a building that nearly collapsed. The Alquist
Act established a seismic safety building
standards program under OSHPD’s jurisdiction
for hospitals built on or after March 7,
1973. The Alquist Act emphasized that essential
facilities such as hospitals should remain
operational after an earthquake.
1994
The Northridge earthquake triggered a major
amendment to the Alquist Act in SB 1953.
While hospitals built after the Alquist
Act got through the 6.7 magnitude quake
with minimum structural damage, several
older structures sustained extensive damage
and were evacuated. Nonstructural damage
was extensive in buildings regardless of
age. SB 1953 set deadlines for seismic standards
to ensure hospitals can withstand a moderate
quake without collapsing. By 2008, all general
acute care inpatient buildings at risk of
collapsing during a strong earthquake must
be rebuilt, retrofitted or closed. Nonstructural
mechanical, electrical and plumbing systems,
including fire sprinkler branch lines, must
be braced and anchored in critical care
areas such as surgery, intensive care, pharmacy,
central supply, emergency department and
radiology. (Extensions to 2013 are being
granted.) By 2030, all hospital buildings
in the state must be operational after a
major earthquake. |
To ease the pressure on hospitals, extensions
of up to five years for the 2008 deadline can
be granted by the state planning office. So far,
about 150 hospitals have applied for extensions
under the “diminished capacity” category
and most of the requests are being granted. To
qualify, the hospital must demonstrate that:
“Compliance [to the Jan. 1, 2008 deadline]
will result in diminished health care capacity
which cannot be provided by other general acute
care hospitals within a reasonable proximity.”
At the 156-bed St. Rose Hospital, about two miles
from the active Hayward fault on the east side
of the San Francisco Bay, CEO Mike Mahoney has
been granted an extension to the 2008 deadline
and said the extra time will enable him to figure
out ways to fund about $25 million in upgrades
and new construction. He said St. Rose’s
situation was unique because it has a lot of land
that will allow the hospital to expand horizontally
instead of vertically.
“I’m very confident we’ll be
able to finance the project with retained earnings
and some borrowing,” said Mahoney, who was
chief operating officer at Dominican Hospital
in Santa Cruz during the magnitude-7.1 Loma Prieta
quake in 1989. Although no structural problems
were found at Dominican Hospital, about $1 million
in damage occurred because equipment and fixtures
such as filing cabinets, bookcases and water coolers
weren’t bolted to the walls.
Predictions that a major earthquake could occur
along the Hayward fault don’t worry Mahoney,
who drives across the zone every day going to
and from work and to meetings. “I think
about meeting the seismic standards requirements,”
he said. “I don’t think about the
fault next door.”
Time and money
Mahoney and other hospital officials are worried,
however, about long delays in getting inspections,
permits and approvals from the state planning
office and other agencies that could deter them
from meeting compliance deadlines. If the deadlines
aren’t met, the State Department of Health
Services could shut them down.
Emerson said the CHA is spearheading efforts
to fill 44 staff vacancies at the state office
that would clear the approval logjam without costing
the state extra money because hospitals pay 1.6
percent of the estimated cost of each seismic
upgrade project to support the agency.
The problem, she said, has been a hiring freeze
imposed on all state agencies because of the state
budget crisis, regardless of how they’re
funded. A CHA-sponsored bill to exempt the office
from the freeze failed to make its way through
the Legislature last year. This year’s proposed
budget includes an item supported by the hospital
industry to add the 44 positions.
“A hospital can’t move one piece
of dirt without approval by OSHPD,” said
Emerson, adding that delays usually result in
additional expenses.
Earthquakes are also a danger in other parts
of the United States, including the Western coast
states, the mid-Central region and New York. A
magnitude-5.0 quake rolled through Indiana a couple
years ago and fault zones crisscross several Eastern
states. However, California is the only state
to mandate tough seismic standards specifically
for hospitals.
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