BILL ANALYSIS
SB 289
Page 1
SENATE THIRD READING
SB 289 (Ducheny)
As Amended April 23, 2009
Majority vote
SENATE VOTE :36-0
HEALTH 18-0 APPROPRIATIONS 17-0
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|Ayes:|Jones, Fletcher, Adams, |Ayes:|De Leon, Conway, Ammiano, |
| |Ammiano, Block, Carter, | | |
| |Conway, De La Torre, De | |Charles Calderon, Coto, |
| |Leon, Emmerson, Gaines, | |Davis, Duvall, Fuentes, |
| |Hayashi, Hernandez, | |Hall, Harkey, Miller, |
| |Bonnie Lowenthal, Nava, | |John A. Perez, Skinner, |
| |V. Manuel Perez, Salas, | |Solorio, Audra |
| |Audra Strickland | |Strickland, Torlakson, |
| | | |Hill |
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SUMMARY : Requires owners of hospital buildings that are
classified as nonconforming, Structural Performance Category-1
(SPC-1) buildings for which extensions of the 2008 deadline for
seismic retrofitting or rebuilding have been requested, to
include additional information in statutorily required reports
due to the Office of Statewide Health Planning and Development
(OSHPD) by June 30, 2011. Specifically, this bill :
1)Requires owners of general acute care hospital buildings
classified as nonconforming, SPC-1 buildings (defined in
regulations as buildings at risk of collapse in an earthquake)
for which extensions of the 2008 deadlines to retrofit or
rebuild have been requested, to include the following
additional information in reports to be filed with OSHPD by
June 30, 2011:
a) For each building planned for retrofit or replacement,
the number of inpatient beds, by type of unit and type of
service to be provided;
b) For any building or buildings to be removed from acute
care service, the following information:
i) The projected due date or dates the building will be
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removed from service;
ii) The inpatient services currently delivered in the
building or buildings; and,
iii) The number of general acute care inpatient beds and
patient days, by type of unit and type of service, for
the years 2008, 2009, and 2010.
c) For each facility in which buildings will be removed
from acute care service, the net change in the facility's
number of inpatient beds, by type of unit and type of
service, provided in buildings to be taken out of service,
retrofitted or replaced, or otherwise used for general
acute care inpatient services.
2)Requires OSHPD to make the above information available on its
Internet Website within 180 days of receipt, and extends, from
90 to 180 days, the timeframe for posting currently required
information. Requires OSHPD, to the extent feasible, to
include the number of inpatient beds, by type of unit and
types of service, provided by facilities operating SPC-2,
SPC-3, SPC-4, and SPC-5 buildings.
EXISTING LAW :
1)Establishes and grants OSHPD authority and responsibility for
reviewing and approving all plans relating to construction,
additions to, reconstruction, or alteration of, health care
facilities, as defined. Before adopting any such plans,
requires hospitals to submit the plans to OSHPD for approval
and to pay an application filing fee, as determined by OSHPD,
based on the project's estimated construction cost.
2)Establishes the Alfred E. Alquist Hospital Facilities Seismic
Safety Act of 1983 (Act), and its amendments, as follows:
a) After January 1, 2008, requires any general acute care
hospital building that is determined to be a potential risk
for collapse or significant loss of life in an earthquake
to only be used for nonacute care hospital purposes.
Authorizes OSHPD to grant a delay of up to five years
beyond the 2008 deadline under specified circumstances,
including upon a demonstration by the hospital that
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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;
b) Authorizes OSHPD to grant extensions to the deadline
described in 2) a) above if the hospital agrees that by
January 1, 2013, designated services will be provided by
moving into an existing conforming building, relocating to
a newly-built building, or continuing in the retrofitted
building, as specified, and permits an additional two-year
extension for hospitals that have already received
extensions of the January 1, 2008 deadline, if specified
conditions are met;
c) 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 the conditions the hospital
must meet to be eligible for this extension are that the
hospital:
i) Maintains a Medi-Cal contract with the California
Medical Assistance Commission (CMAC), with exceptions;
ii) Maintains basic emergency medical services if the
hospital provided such services as of July 1, 2007; and,
iii) Meets one of the following:
(1) The hospital is located within a Medically
Underserved Area or a Health Professions Shortage
Area, as specified;
(2) 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;
(3) CMAC determines that the hospital is an
essential provider of Medi-Cal services in the
hospital's service area; or,
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(4) 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%
of all discharges for either Medi-Cal or indigent
patients in the county in which the hospital is
located.
d) Requires, by January 1, 2030, all hospital buildings to
be capable of remaining intact after an earthquake, and
capable of continued operation and provision of acute care
medical services, and requires owners of all acute care
inpatient hospitals to demolish, replace, or change to a
non-acute care use all hospital buildings not in
substantial compliance.
3)Requires an owner of a general acute care hospital building
that is classified as a SPC-1 building, (who has not requested
an extension of the 2008 deadline), to submit a report to
OSHPD no later than April 15, 2007, describing the status of
each building in complying with the deadline, and to identify
the following:
a) Each building that is subject to the deadline;
b) The project number or numbers for retrofit or
replacement of each building;
c) The projected construction start date or dates and
projected construction completion date or dates; and,
d) The building or buildings to be removed from acute care
service and the projected date or dates of this action.
4)Existing law 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.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, no direct fiscal impact to OSHPD to continue
oversight of hospital seismic safety and post additional data
items from hospitals requesting an extension of seismic safety
deadlines.
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COMMENTS : According to the author, this bill will enable the
state to better assess the scope and impact of hospital closures
that may result from enforcement of the state's hospital seismic
safety deadlines, by requiring hospital owners to provide more
specific information concerning the types of services and
numbers of patients served by buildings that will be removed
from acute care service, rather than retrofitted, by the 2013
deadlines. This additional information will supplement
information hospitals are required to file with OSHPD in June of
this year and June 2011 about new buildings under construction,
as well as buildings to be removed from service, and will form
the basis for discussions about the impact of the 2013 seismic
deadlines on hospital services and capacity. The author states
that the reports, along with more information about which
hospital buildings may be reclassified to higher status based on
newer, more sophisticated modeling tools, are likely to raise
difficult questions about the impacts of hospital seismic safety
mandates and state budget-related fiscal pressures on access and
quality of care, particularly in underserved communities. The
author notes that recent reports indicate that several regions
of the state will need additional hospital beds to meet the
needs of the growing elderly population, which additionally
needs to be factored into the assessment of the net impact of
the 2013 deadlines.
California's hospital seismic safety law, SB 1953 (Alquist),
Chapter 740, Statutes of 1994, was passed by the Legislature a
few months after the Northridge earthquake. SB 1953 establishes
seismic standards for hospital buildings, as well as deadlines
for compliance with those standards, and requires every hospital
building to comply with two deadlines. By January 1, 2008 (or
no later than January 1, 2013, if an extension has been
granted), every hospital building must meet specific
construction standards established to keep these structures
standing after a major earthquake. By January 1, 2030, the law
requires all hospital buildings to comply with standards
intended to keep these buildings operational following a severe
quake.
Due to the major strides in earthquake risk engineering that
have occurred in the years since SB 1953 passed, on November 14,
2007 the California Building Standards Commission approved the
implementation of a state-of-the-art risk technology, HAZUS
(Hazards U.S. Multi-Hazard), to reexamine the seismic risk of
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SPC-1 hospital buildings. This reassessment allows OSHPD to
reprioritize SPC-1 hospital buildings based on their level of
seismic risk and if they meet specified criteria, move the
building to SPC-2 category. If reclassified, these hospital
buildings would move from a 2008 and 2013 seismic deadline to a
2030 deadline.
The deadline for hospitals to apply for a HAZUS reclassification
was June 30, 2009. According to OSHPD, requests for
reclassification were submitted for 549 SPC-1 buildings, of
which 214 (39%) had been reclassified to SPC-2 status as of
mid-August 2009. OSHPD review of HAZUS requests is still
pending for a little less than half of requests received.
Based on its latest assessment of seismic risk, including
reclassifications to date per HAZUS, as of mid-August 2009,
OSHPD has classified 875 (32%) of California's hospital
buildings as 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 have received extensions). Another 288
buildings (11%) 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, about 1,560
buildings (57%) 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. The
number of SPC-1 buildings will be further reduced when OSHPD
completes its review of HAZUS requests.
Most of the current reporting requirements for hospital seismic
safety compliance were enacted in SB 1661 (Cox), Chapter 679,
Statutes of 2006. SB 1661 authorizes OSHPD to grant SPC-1
hospitals an additional two-year extension until 2015, and
requires all hospitals with SPC-1 buildings to report to OSHPD
on their progress with seismic safety compliance, regardless of
whether those buildings were planned for acute care, outpatient
or other purposes. Specifically, SB 1661 requires hospitals
that will not meet retrofit or rebuilding deadlines to report to
the state on the building or buildings to be removed from acute
care service and the projected dates of those actions. The most
recent of the reports required under SB 1661 was due to OSHPD on
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June 30, 2009 and OSHPD is required to make the information
received available on its Web site within 90 days of the
deadline. The next reporting requirement of SB 1661 is due June
30, 2011 and is the reporting requirement proposed for expansion
in this bill.
The California Hospital Association (CHA) and the Hospital
Corporation of America (HCA), supporters of this bill, state
that they are concerned that the existing mandated reporting due
in 2011 focuses on only whether or not a non-conforming hospital
building is going to meet its deadline or close. CHA and HCA
believe that, if a hospital is forced to close due to the
seismic mandate, information should be collected on the effect
of the closures so plans can be made for alternative access to
care for those affected by the closure.
Previous and related legislation:
1)AB 303 (Beall) allows specified county and University of
California disproportionate share hospitals that contract with
CMAC to serve Medi-Cal patients to receive supplemental
Medi-Cal reimbursement from the Construction and Renovation
Reimbursement Program for new capital projects to meet state
seismic safety deadlines for which plans have been submitted
to the state after January 1, 2007 and before December 31,
2011. AB 303 is currently on the Assembly Appropriations
Committee suspense file.
2)AB 411 (Garrick) requires health care district hospitals which
have been denied a request for an extension of the seismic
retrofit deadlines to report to OSHPD the district's efforts
to comply with the seismic deadlines; to reassess the
structural performance of the hospital's buildings; and to
secure passage of local bond financing for seismic compliance.
Requires reporting of specified information on barriers to
passage of proposed hospital bond financing. AB 411 is
currently in the Senate Rules Committee.
3)AB 523 (Huffman), pending on the Senate floor, allows OSHPD to
grant a two-year extension of the 2013 seismic deadline for a
hospital building that is owned by a health care district, but
is operated by a third party under a lease that extends at
least through December 31, 2009, based on a declaration that
the district has lacked, and continues to lack, unrestricted
access to the hospital building for seismic planning purposes
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during the time of the lease. Establishes interim deadlines
and requirements the hospital must meet in order to qualify
for the extension, as specified. Contains an urgency clause
to ensure that the provisions of AB 523 go into immediate
effect upon enactment.
4)AB 1235 (Hayashi), pending on the Senate floor, authorizes
OSHPD to approve a specific extension for a hospital building
owned or operated by Alameda County on the Alameda County
Medical Center's Fairmont campus. Specifically, provides a
six month extension of various interim deadlines in current
law for a hospital building owned and operated by a county,
city, or city and county, to replace a SPC-1 building by
January 1, 2020.
5)SB 306 (Ducheny), Chapter 642, Statutes of 2008, amends the
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 owner
lacks financial capacity to comply with the law.
6)SB 1661 (Cox), Chapter 693, Statutes of 2006, authorizes an
extension of up to an additional two years for hospitals that
have already received extensions of the January 1, 2008
seismic safety compliance deadline if specified criteria are
met, and requires specified hospital reports to be posted on
the Web site of OSHPD.
7)SB 167 (Speier) of 2005, would have amended the Act to permit
delays of the 2008 seismic safety deadline for specified
hospitals that do not exceed maximum allowable seismic risk,
as determined by OSHPD, and expedited the final compliance
deadline to 2020 for hospitals granted the delay. SB 167
failed passage in the Assembly Health Committee.
8)AB 1978 (Walters) of 2005, would have extended, from January
1, 2008 to January 1, 2015, the deadline for any general acute
care hospital building determined to be at potential risk of
collapse, or pose significant loss of life, to only be used
for nonacute care purposes, and permitted hospitals subject to
the 2015 deadline to request additional extensions to 2020, as
specified. AB 1978 failed passage in the Assembly Health
Committee.
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9)AB 1673 (Nation and Richman) of 2005, would have repealed
provisions of the Act that require specified hospitals to meet
seismic retrofitting requirements by 2008, revised the final
2030 deadline requirement to 2020, and made the bill
contingent upon the enactment of AB 1672 (Nation) relating to
electronic medical recordkeeping. AB 1673 failed passage in
the Assembly Health Committee.
10)SB 1953 (Alquist), Chapter 740, Statutes of 1994, requires
every hospital building to comply with two deadlines. By
January 1, 2008 (or no later than January 1, 2013, if an
extension has been granted), every hospital building must meet
specific construction standards established to keep these
structures standing after a major earthquake. By January 1,
2030, the law requires all hospital buildings to comply with
standards intended to keep these buildings operational
following a severe quake.
Analysis Prepared by : Joyce Iseri / HEALTH / (916) 319-2097
FN: 0002411