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Finally, Long Overdue Progress In Hospital Seismic Safety

In 2010, St. Jude Medical Center in Fullerton had three buildings that were assigned California's highest-danger designation for earthquake damage, according to a report prepared for the California Senate. The hospital has retrofit buildings before and since to counter the danger. (Omar Bárcena via Flickr)

After years of delay, retrofitting and rebuilding, more than 90 percent of California’s acute care hospital buildings are no longer at risk of collapse during an earthquake, according to the most recent available data from the state’s Office of Statewide Health Planning and Development (OSHPD).

But the remaining hospitals still need to meet the state’s tough seismic safety requirements, or close buildings that are not up to standard by 2030. Buildings at six rural “critical access” hospitals remain on the state’s list of structures most likely to collapse in an earthquake, and their administrators face challenges keeping them open.

“I am very pleased with the progress that has been made,” said Robert David, director of OSHPD, which oversees hospital earthquake safety. “Based on information and schedules provided by the hospitals … the remaining acute care buildings appear to be on track to meet the state deadline to withstand a major earthquake or be removed from service.”

An estimated 251 buildings are still rated “SPC-1,” the highest risk category — down from more than 1,000 in 2001, according to OSHPD spokesman David Byrnes.

Another 629 buildings are rated “SPC-2,” the second highest risk. Not all of those buildings house patients; some may hold administrative offices, for example. But state law requires all buildings in the top two risk categories to close by 2030 unless they have been repaired or replaced. In addition, all SPC-1 buildings must be retrofitted to meet at least SPC-2 requirements by 2020 unless a hospital has received a specific deadline extension from OSPHD.

It has taken years for hospitals to get this far.

After the magnitude 6.7 Northridge earthquake crippled local hospitals in 1994, state lawmakers toughened up 1973 legislation that required hospitals in danger of collapse or significant damage in an earthquake to make repairs or rebuild — or face closure.

At the time, the new deadline was set for 2008. But the state’s hospital industry group, citing high construction costs, successfully pushed back many of the retrofitting requirements from 2013 to as late as 2030. Critics argued that the extensions could compromise public safety in a disaster.

There’s a 93 percent chance that a 7.0 magnitude earthquake could strike the Bay Area in the next 30 years, according to the most recent estimate by the U.S. Geological Survey.

While many hospitals around the state have spent millions on retrofitting or replacing unsafe buildings, some have chosen to shut down non-compliant facilities before the final 2030 deadline. Sutter-owned Alta Bates Hospital announced this week that it plans to close acute care and emergency services in Berkeley between 2018 and 2030 because of the earthquake safety requirements. Some critics say Sutter is using those requirements as an excuse to consolidate some of its services.

A number of hospitals still face difficulty getting the money they need to replace aging buildings, and they’re hoping to get the needed capital through bond measures, tax hikes and other means.

In Fort Bragg, the Mendocino Coast District Hospital is trying to figure how best to keep its main hospital open. It’s got the second highest risk rating and would need to close by 2030 unless improved or replaced. But the 25-bed critical access hospital declared bankruptcy in 2012, and amid staff turmoil, its financing options are limited.

The hospital’s board is considering a parcel tax, and its CEO has floated the idea of converting the public hospital to private nonprofit status to draw more funds.

Wade Sturgeon, the hospital district’s chief financial officer, said that reports of the hospital’s potential demise have been exaggerated. “We’ve been able to improve a lot of things. We are having conversations about what do we do going forward,” Sturgeon said. He added that new state building regulations taking effect in 2017 may allow his hospital to stay open past 2030 with some retrofits.

While hospitals are finally making progress since the tighter earthquake safety regulations took effect more than 20 years ago, the delays haven’t been good for patients or hospital staff, said Stephanie Roberson, legislative advocate for the California Nurses Association. The association is a persistent critic of what it has seen as hospital foot-dragging.

“We need to make sure these hospitals are held accountable,” Roberson said. “We saw what happened in Northridge – the loss of life and property to the tune of billions of dollars. Hospitals are supposed to be that beacon of light in the community, and if we have a seismic catastrophe they are centers for the public to take refuge.”

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