To prepare for impending earthquakes, California has made serious measures to improve seismic codes for all buildings, but hospitals are the only facilities that must meet these standards–or risk closure. The costs for the upgrades are primarily the responsibility of the hospitals, which is causing problems for facility managers in this sector. This NPR report by Cy Musiker of KQED examines the “Catch-22” situation in California’s hospitals.
Here is a summary of Musiker’s story.
A 1971 earthquake in Southern California (the Somar Quake) killed 46 patients and staff members in the Veterans Hospital and prompted lawmakers to set a deadline, 2008, for seismic standard requirements in the state’s hospitals. Extensions have been granted until 2013 for nearly half of the facilities, but an even tougher standard will roll into action in 2030. The 2030 standards will require all hospitals to be fully operational after a major quake.
Right now, nearly one third of California’s hospitals are “seismically unsafe.” But administrators say they can’t afford expensive upgrades without going broke or cutting services. Boards won’t finance improvements in older facilities (their argument being, “why pour resources into a ‘money pit?’), but building new facilities are also cost prohibitive. Most hospitals can not afford the upgrades without some financial assistance from the state, which is only being given to children’s hospitals in the state. In 2001, cost estimates by the Rand corporation put the price tag at approximately $41 billion for the rest of the non-compliant health care facilities in California.
The health care industry in California is lobbying hard to extend deadlines once again, but the state’s nursing union is arguing against the extensions, claiming that the hospitals are big money makers and should be able to afford the upgrades. Either way, an extension will only translate into higher costs for retrofits in most cases, and a delay could cost many lives, should another major earthquake hit the state.
While larger, for profit hospitals may be able to foot the bill of seismic upgrades, smaller non profit or rural hospitals will struggle and many may be forced to close. Oftentimes, when money does become available in these facilities, it is spent on new equipment instead of infrastructure. Generally, administrators are too busy dealing with day to day operations to worry about seismic standards, a prioritization problem that could come back to haunt them–especially if hospitals are forced to close because of their failure to meet the standards.
The full piece can be found here.