BILL ANALYSIS Ó
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Date of Hearing: April 7, 2015
ASSEMBLY COMMITTEE ON HEALTH
Bonta, Chair
AB
81 (Wood) - As Introduced January 5, 2015
SUBJECT: Hospitals: seismic safety.
SUMMARY: Authorizes a hospital in the City of Willits, that has
already received an extension of the January 1, 2008, seismic
safety deadline from the Office of Statewide Health Planning and
Development (OSHPD), to request an additional extension of the
deadline until September 1, 2015. Makes findings and
declarations as to the necessity of a special statute for the
City of Willits and contains an urgency clause to ensure that
the provisions of this bill go into immediate effect upon
enactment.
EXISTING LAW:
1)Establishes the Alfred E. Alquist Hospital Facilities Seismic
Safety Act of 1983, to ensure that hospital buildings be
designed and constructed to resist the forces generated by
earthquakes and requires OSHPD to propose building standards
for earthquake resistance and to provide independent review of
the design and construction of hospital buildings.
2)Creates a 16-member Hospital Building Safety Board appointed
by the Director of OSHPD to act as a board of appeals in all
matters relating to the administration and enforcement of
seismic safety requirements.
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3)Provides the ability for hospitals to request and receive a
delay in their January 1, 2008 seismic compliance deadline if
the hospital can demonstrate that compliance will result in a
loss of health care capacity that may not be provided by
another hospital within a reasonable distance. Requires the
requesting hospital to state why it cannot comply with the
deadline.
4)Requires OSHPD, prior to granting an extension of the 2008
deadline, to:
a) Provide public notice of a hospital's request for an
extension which includes the facility's name,
identification number, the status of the request, and the
beginning and ending dates of the public comment period, as
well as provide copies of extension requests to interested
parties within 10 working days; and,
b) Allow the public to submit written comments on the
extension proposal for at least 45 days from the date of
the public notice.
5)Requires OSHPD to notify the Department of Public Health
(DPH), of the hospital owners that have received a written
notice of violation for failure to comply with the 2008
requirements. Requires DPH to suspend or refuse to renew the
license of a hospital that has received a notice of violation
from OSHPD because of its failure to comply, unless the
hospital places its license in voluntary suspense.
FISCAL EFFECT: This bill has not been analyzed by a fiscal
committee.
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COMMENTS:
1)PURPOSE OF THIS
BILL. According to the author, this bill seeks to extend the
seismic safety deadline to provide time to complete
construction on a new hospital building that is already 90%
complete, and if the deadline for Frank R. Howard Memorial
Hospital (HMH) in the city of Willits is not extended, they
could lose their license and jeopardize their ability to
participate in Medicare and Medicaid, which is about 80% of
their inpatient payer mix. The author notes that key services
that make HMH unique compared to other hospitals in the
surrounding area (around 100 miles or an hour drive away)
include a 24-hour emergency department, intensive care,
laboratory, imaging, orthopedics, physical rehabilitation, and
surgery.
2)BACKGROUND. Existing law establishes a seismic safety
building standards program under OSHPD's jurisdiction for
hospitals built on or after March 7, 1973. These provisions
were initiated because of the loss of life incurred due to the
collapse of hospitals during the Sylmar earthquake of 1971.
Approximately 470 general acute care hospital facilities
comprised of 2,673 hospital buildings are impacted by existing
seismic safety law. Hospitals built in accordance with the
standards resisted the January 1994 Northridge earthquake with
minimal structural damage, while several facilities built
prior to the enforcement of the new standards experienced
major structural damage and had to be evacuated.
One of the main provisions in existing law was the development,
via regulation, of earthquake or seismic performance
categories, specifically the Structural Performance Categories
(SPC) and Nonstructural Performance Categories. These include
seismic performance categories, or life safety levels, for new
and existing general acute care hospital facilities at various
levels, i.e., from those capable of providing services to the
public after a seismic event to those at significant risk of
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collapse and that represent a danger to the public. The goal
of these regulations is to develop retrofit and repair designs
for existing hospital buildings to yield predictable seismic
performance, whether at the essential life safety level or
post-earthquake continued operations level.
Each general acute care hospital facility must be at certain SPC
levels by specified timeframes. At one time all general acute
care hospital facility buildings were required to be at the
SPC-2 life safety level by January 1, 2008, to be in
compliance with the regulations, however, provisions were made
to allow this deadline to be extended to January 1, 2013, if
compliance with the 2008 deadline would result in a diminished
capacity of healthcare services to the community. In
addition, timeframes for submittal of seismic evaluations,
compliance plans, and other SPC levels are cited in the
seismic evaluation procedure regulations.
3)STATUS OF WAIVERS AND COMPLIANCE. Subsequent legislation has
provided for additional seismic compliance extensions.
Statewide, many hospitals are on different timelines based on
the specific extension. HMH has what is commonly known as an
SB 1661 waiver.
SB 1661 (Cox), Chapter 679, Statutes of 2006, requires all
general acute care hospitals that have non-seismically safe
buildings to report to OSHPD by June 30, 2009, on the status
of their compliance with the seismic safety deadlines. SPC-1
buildings are buildings posing significant risk of collapse
and danger to the public. Buildings with an approved
extension are permitted to provide acute care service only up
to the length of extension granted, the maximum extension that
may be granted per statute is January 1, 2020, beyond which
the building can no longer provide general acute care
services. In order to grant an extension to the hospital,
OSHPD must consider the structural integrity of the building,
the loss of essential healthcare services to the community
should the hospital be closed, and the financial hardship that
the hospital may have experienced. The extension granted to
HMH was until January 1, 2015, and the hospital complied with
the SB 1661 reporting requirements, which state:
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a) The hospital building was under construction at the time
of the request for extension;
b) The hospital building plans were submitted to OSHPD and
were deemed ready for review by OSHPD at least four years
prior to the applicable deadline for the building;
c) The hospital received a building permit at least two
years prior to the applicable deadline for the building;
d) The hospital submitted a construction timeline at least
two years prior to the applicable deadline for the building
demonstrating the hospital's intent to meet the applicable
deadline. Requires the timeline to include all of the
following:
i) The projected construction start date;
ii) The projected construction completion date;
iii) Identification of the contractor; and,
iv) The hospital is making reasonable progress toward
meeting the timeline set forth in d) above, but factors
beyond the hospital's control make it impossible for the
hospital to meet the deadline.
3)SUPPORT. HMH (located in northern Mendocino County) is the sponsor of
this bill and states that they are central to the maintenance
of access to care in the communities they serve. HMH contends
that since 2009 they have been working closely with their
contractor to make sure that the new facility under
construction was seismically compliant and would be ready for
occupancy on or before the January 1, 2015 deadline. However,
in mid-September 2014, citing unanticipated construction
delays, the contractor provided HMH with a new schedule
reflecting completion of construction in the spring of 2015.
HMH notes that the circumstances they encountered appear to be
much like those experienced by the five hospital projects that
were the subject of AB 2557 (Pan), Chapter 821, Statutes of
2014 that extended the deadline to September 1, 2015.
Adventist Health, the operator of the hospital, writes that as
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part of their hospital system in California, HMH has been
designated by the federal government as a Critical Access
hospital, which means it is a vitally important link in
maintaining access to care in rural areas where hospital
services are scarce.
4)PREVIOUS
LEGISLATION.
a) AB 2557authorized OSHPD to grant five hospitals, who had
already received an extension of the January 1, 2008,
seismic safety deadline, an additional extension until
September 1, 2015.
b) SB 90 (Steinberg), Chapter 19, Statutes of 2011, allowed
a hospital to seek an extension for seismic compliance for
its SPC-1 buildings of up to seven years based on the
following elements: the structural integrity of the
building; the loss of essential hospital services to the
community if the hospital closed; and, financial hardship.
c) SB 499 (Ducheny), Chapter 601, Statutes of 2009,
required all general acute care hospitals that have SPC-1
buildings to report to OSHPD by November 1, 2010, and
annually thereafter, on the status of their compliance with
the seismic safety deadlines.
d) SB 306 (Ducheny), Chapter 642, Statues of 2007, amended
the Alfred E. Alquist Hospital Facilities Seismic Safety
Act to permit hospitals to delay compliance with the July
1, 2008 seismic retro deadline, and the 2013 extension, to
the year 2020, by filing a declaration with OSHPD that the
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owner lacks financial capacity to comply with the law.
e) SB 1661 (Cox), Chapter 679, Statutes of 2006, authorized
an extension of up to an additional two years for hospitals
that had already received extensions of the January 1, 2008
seismic safety compliance deadline if specified criteria
were met, and required specified hospital reports to be
posted on the OSHPD Website.
REGISTERED SUPPORT /
OPPOSITION:
Support
Frank R. Howard Memorial Hospital (sponsor)
Adventist Health
California Hospital Association
Loma Linda University Medical Center
Opposition
None on file.
Analysis Prepared
by: Lara Flynn / HEALTH /
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