BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   SB 289|
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                                 THIRD READING


          Bill No:  SB 289
          Author:   Ducheny (D)
          Amended:  4/23/09
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  11-0, 4/15/09
          AYES:  Alquist, Strickland, Aanestad, Cedillo, Cox,  
            DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8


           SUBJECT  :    Hospitals:  seismic safety:  periodic reports

           SOURCE  :     California Hospital Association


           DIGEST  :    This bill requires owners of hospital buildings  
          that do not meet existing requirements to be retrofitted or  
          rebuilt by 2008 or 2013 to avoid risk of collapse in an  
          earthquake, and who have requested extensions of the 2008  
          and 2013 deadlines, to include additional information in  
          the reports they are required to file with the Office of  
          Statewide Health Planning and Development by June 30, 2011,  
          regarding buildings they intend to remove from acute care  
          service.

           ANALYSIS  :    

          Existing law:

          1. Gives responsibility to the Office of Statewide Health  
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             Planning and Development (OSHPD) for reviewing and  
             approving all plans relating to construction, additions  
             to, reconstruction, or alteration of, hospital  
             buildings, as defined.  Before adopting any such plans,  
             hospitals must submit the plans to OSHPD for approval  
             and pay an application filing fee that is determined by  
             the office and that is based on the project's estimated  
             construction cost.

          2. Establishes timelines for hospital compliance with  
             seismic safety standards. By January 1, 2008, buildings  
             posing a significant risk of collapse and a danger to  
             the public must be rebuilt or retrofitted to be capable  
             of withstanding an earthquake, or be removed from acute  
             care service.  By January 1, 2030, hospital buildings  
             must be capable of remaining intact after an earthquake,  
             and must also be capable of continued operation and  
             provision of acute care medical services, or else be  
             changed to non-acute care use.

          3. Allows OSHPD to grant delays of up to five years beyond  
             the 2008 deadline under certain circumstances, including  
             upon a demonstration that compliance will result in a  
             loss of health care capacity that may not be provided by  
             other general acute care hospitals within a reasonable  
             proximity.  Existing law also authorizes an extension of  
             up to an additional two years beyond this for hospitals  
             that have already received extensions of the January 1,  
             2008, seismic safety compliance deadline, if specified  
             criteria are met, including that the hospital building  
             is under construction at the time of the request for  
             extension, and that the hospital submitted a  
             construction timeline at least two years prior to the  
             applicable deadline and is making reasonable progress  
             toward meeting the deadline, but factors beyond the  
             hospital's control make it impossible for the hospital  
             to meet the deadline.  

          4. Permits a hospital owner, in lieu of retrofitting or  
             rebuilding hospital buildings at risk of collapse by  
             2013, to instead replace them by January 1, 2020, if the  
             hospital owner meets several conditions and OSHPD  
             certifies that the hospital owner lacks the financial  
             capacity to meet seismic standards, as defined.  Among  







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             the conditions the hospital must meet to be eligible for  
             this extension is that the hospital:

             (1)   Maintains a Medi-Cal contract with the  
                California Medical Assistance Commission (CMAC),  
                with exceptions.

             (2)   Maintains basic emergency medical services if  
                the hospital provided such services as of July 1,  
                2007.

             (3)   Meets one of the following:

               (A)     The hospital is located within a Medically  
                  Underserved Area or a Health Professions  
                  Shortage Area, as specified.

               (B)     OSHPD determines, by means of a health  
                  impact assessment, that removal of the building  
                  or buildings from service may diminish  
                  significantly the availability or accessibility  
                  of health care services to an underserved  
                  community.

               (C)     CMAC determines that the hospital is an  
                  essential provider of Medi-Cal services in the  
                  hospital's service area.

               (D)     The hospital demonstrates that, based on  
                  annual utilization data submitted to the office  
                  for 2006 or later, the hospital had in one year  
                  over 30 percent of all discharges for either  
                  Medi-Cal or indigent patients in the county in  
                  which the hospital is located.

          5. Requires an owner of a general acute care hospital  
             building that is classified as a nonconforming  
             Structural Performance Category-1 (SPC-1) building  
             (defined in regulations as a building that is at risk of  
             collapse in an earthquake) who has not requested an  
             extension of the 2008 deadline, to submit a report to  
             the office no later than April 15, 2007, describing the  
             status of each building in complying with the deadline.   








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          6. Requires the report to identify the following:

             (1)   Each building that is subject to the deadline.

             (2)   The project number or numbers for retrofit or  
                replacement of each building.

             (3)   The projected construction start date or dates  
                and projected construction completion date or  
                dates.

             (4)   The building or buildings to be removed from  
                acute care service and the projected date or dates  
                of this action.

          7. Requires owners of general acute care hospital buildings  
             classified as nonconforming SPC-1 buildings who have  
             requested an extension of the 2008 deadline to submit  
             similar reports by June 30, 2009, and June 30, 2011.

          8. Requires OSHPD to adopt regulations and standards to  
             administer its responsibilities, and to submit building  
             standards relating to seismic safety for hospital  
             buildings and relating to requests for extensions of  
             deadlines for seismic compliance to the California  
             Building Standards Commission for adoption and approval.

          This bill:

          1. Requires owners of hospital buildings that are  
             classified as nonconforming, SPC-1 buildings, who have  
             requested extensions of the 2008 deadlines for  
             retrofitting or rebuilding, to include additional  
             information in the reports they are required to file  
             with OSHPD by June 30, 2011, regarding buildings they  
             intend to remove from acute care service.  The  
             additional information would include: 

             (1)   The inpatient services currently delivered in  
                the buildings to be removed from acute care  
                service.

             (2)   The number of inpatient beds and patient beds  







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                and patient days, by unit and type of service in  
                2008, 2009, and 2010.

             (3)   Request hospitals report to OSHPD regarding and  
                net change in the number of inpatient beds, by type  
                of unit and type of service, taking into account  
                buildings to be taken out of service, retrofitting  
                or replacement of those buildings, and beds  
                provided in any other buildings used for general  
                acute care inpatient services by the facility.

           Background
           
           Hospital Seismic Safety Requirements  .  In response to the  
          6.7 magnitude Northridge earthquake in January 1994, the  
          Legislature passed, and then-Governor Wilson signed into  
          law, SB 1953 (Alquist), Chapter 740, Statutes of 1994,  
          establishing seismic standards for hospital buildings as  
          well as deadlines for compliance with those standards.

          Based on its latest assessment of seismic risk, OSHPD has  
          classified 948 (35 percent) of California's hospital  
          buildings as Structural Performance Category-1 (SPC-1)  
          buildings, meaning that they are at risk for collapse in an  
          earthquake.  These buildings must be retrofitted, replaced,  
          or removed from acute care services by January 1, 2008 (or  
          2013 if they receive extensions).  Another 231 buildings  
          (roughly nine percent) are categorized as SPC-2 buildings,  
          meaning that they are not at risk of collapse, but may not  
          be reparable or functional following a strong quake.  These  
          buildings must be brought into compliance with the  
          requirements of SB 1953 by 2030 or be removed from acute  
          care service.  Finally, over 1,536 buildings (56 percent)  
          are SPC-3, SPC- 4, and SPC- 5, meaning that they are  
          considered capable of providing services following a strong  
          quake and may be used without restriction beyond 2030.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  5/5/09)

          California Hospital Association (source)
          Hospital Corporation of America







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           ARGUMENTS IN SUPPORT  :    The California Hospital  
          Association, the sponsor of this bill, states that this  
          bill will add important information to the reports  
          hospitals must report to the state concerning buildings  
          they intend to remove from service by 2013, rather than  
          retrofit.  Specifically, the information will include the  
          types of services provided by the buildings to be removed  
          from service and number of patient visits by type of  
          service.  CHA believes this information will give the state  
          a more complete picture of the effect of hospital closures  
          that result from hospital seismic mandates.


          CTW:do  5/5/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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