On November 14, the California Building Standards Commission (CBSC) approved plans to amend the requirements for hospital seismic safety measures in order to delay billions in premature spending. The new requirements will allow significant savings in the state's healthcare costs over the next 15 years.

At issue is the implementation of Senate Bill 1953 (SB 1953), legislation originally passed in 1994. Drafted by Senator Alfred E. Alquist in response to the magnitude 6.7 earthquake that hit Northridge in 1994 and halted emergency services at 23 hospitals in the Los Angeles area, SB 1953 was intended to ensure that by 2030, all of California's hospitals would not close or suspend critical care services following a major natural disaster.

As part of SB 1953, legislators set three intermediate deadlines, the third of which was the subject of the Commission's vote last year. It required all general acute-care inpatient buildings at risk of collapsing during a 500-year earthquake—classified as Structural Performance Category-1 (SPC-1) buildings—be rebuilt, retrofitted, or closed by January 2008. All others could wait to upgrade to the fully operational level until 2030.

Following the 1994 decision, 40% of California's hospital buildings were categorized and reported as SPC-1 rated. Though the percentage seemed unusually high, policy makers trusted the available evaluation methodology. The criteria used to deem a building as high-risk was that its construction pre-dated 1973, prior to the Alfred E. Alquist Hospital Facilities Seismic Safety Act, and that it had the same characteristics as buildings that had collapsed in previous earthquakes. While this rapid assessment procedure may have been the most accurate for the time, it created an overly broad definition of what constituted a high-risk building, thereby wrongly categorizing hundreds of buildings that were actually usable until the 2030 deadline.

As the 2008 deadline approached, hospitals across the state with buildings that were rated SPC-1 clamored for relief from the high cost of compliance. One solution emerged that allowed a reassessment of the affected facilities using newer and more accurate evaluation procedures. The Commission's November vote accepted a series of code amendments that permitted the use of HAZARDS U.S. (HAZUS) Loss Estimation Methodology—the latest software program developed by the Federal Emergency Management Administration (FEMA)—to assess the risk facing hospital buildings.

The decision to rely on new and superior technology to identify facilities that are most at risk rather than continue to umbrella a large number of buildings under the old standards was a sound policy judgment. Because the improved earthquake risk assessment tool directly predicts the probability of collapse, it is perfectly suited for use in determining which hospitals need to comply with the 2008 deadline. HAZUS is more accurate and scientifically defendable than the methods employed back in 1994; it is also more consistent with Senator Alquist's original projections related to the number of buildings that would have to meet the earlier 2008 compliance deadlines.

HAZUS was developed as a loss estimation tool by FEMA for use after natural disasters and is continually being improved. Using mathematical formulae and information about building stock, local geology, and the location and size of earthquakes, OSHPD's application of HAZUS screens out hospital buildings unlikely to collapse following a 500-year earthquake. Building upon the screening tools used when the original legislation was passed, HAZUS processes zoning map data from the U.S. Geological Survey and uses ArcGIS to track and display more precise ground motion estimates. The simple fact is that the HAZUS technology and data processing skill set was not available to structural engineers and legislators back in 1994 when the original regulations were written. Its availability today is due to deliberate planning and forward thinking at FEMA.

As SB 1953's January 2008 deadline drew closer, concern grew within the healthcare industry over the unnecessary closure of numerous California hospital buildings. Prior to the CBSC's November vote, of the nearly 2,700 general acute-care inpatient hospital buildings in California, just over 1,000 buildings would have been forced to rebuild, retrofit, or close, leaving a significant number of Californians without accessible service. The latest HAZUS evaluation is expected to reduce the number of SPC-1 classified hospital buildings from 40% to 20% or less. This drop in the number of SPC-1 rated buildings is not a matter of lowering safety assessment standards or an arbitrary move by policy makers to reduce costs or extend the schedule for compliance. It is the direct result of updated technology and more accurate assessment tools. No changes occurred in the SPC-1 rating system; the HAZUS methodology recharacterizes many buildings originally labeled as unsafe that should never have been assigned as such.

The current projection (formulated from a much more comprehensive data source) of a 10 to 20% closure rate appears compatible with the expected rate as foreseen by Senator Alquist when he composed SB 1953. Initially Alquist, the head of the California Seismic Safety Commission, expected 8 to 10% of California's hospital buildings would be classified as SPC-1.

The decreased estimate in the number of unsafe hospital buildings does not equate to an increased safety risk for Californians but rather a halt in premature, unnecessary spending of precious healthcare dollars that should be funneled toward more urgent needs. Not only does the new assessment methodology adhere to the rigid safety standards set forth by FEMA, it also allows California's hospitals to delay spending $24 billion on retrofitting buildings that are at minimal risk of collapse and will not need to be rebuilt until 2030. When 66% of California's hospitals are currently losing money from operations, funds should be spent only when needed to achieve the state's seismic safety goals.

It was sound public policy and safe seismic engineering for the CBSC to implement the latest HAZUS software to assess buildings truly at risk before untimely structural requirements were enforced. Application of the HAZUS methodology is consistent with California's commitment to the goal of SB 1953, which is to prevent the interruption of patient services in times of crisis. HD

Chris Poland, SE, is Chairman and CEO of Degenkolb Engineers, based in San Francisco.

For further information, phone 415.392.6952, e-mail aodell@degenkolb.com, or visit http://www.degenkolb.com.

Sidebar

Want to express your opinion? To comment on this article, visit http://www.healthcaredesignmagazine.com and click on Current Issue.