BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 289|
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UNFINISHED BUSINESS
Bill No: SB 289
Author: Ducheny (D)
Amended: 8/24/10
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
SENATE FLOOR : 36-0, 5/11/09
AYES: Aanestad, Alquist, Ashburn, Benoit, Cogdill,
Corbett, Correa, Cox, Denham, DeSaulnier, Ducheny,
Dutton, Florez, Hancock, Harman, Hollingsworth, Huff,
Kehoe, Leno, Liu, Lowenthal, Maldonado, Negrete McLeod,
Oropeza, Padilla, Pavley, Romero, Runner, Steinberg,
Strickland, Walters, Wiggins, Wolk, Wright, Wyland, Yee
NO VOTE RECORDED: Calderon, Cedillo, Simitian, Vacancy
SENATE FLOOR : 33-2, 8/30/10 (Concurrence)
AYES: Aanestad, Alquist, Ashburn, Cedillo, Cogdill,
Corbett, Correa, Denham, DeSaulnier, Ducheny, Dutton,
Emmerson, Florez, Hancock, Harman, Hollingsworth, Huff,
Kehoe, Liu, Lowenthal, Negrete McLeod, Padilla, Pavley,
Price, Runner, Simitian, Steinberg, Strickland, Walters,
Wolk, Wright, Wyland, Yee
NOES: Leno, Romero
NO VOTE RECORDED: Blakeslee, Calderon, Oropeza, Wiggins,
Vacancy
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SUBJECT : Hospitals: seismic safety: periodic reports
SOURCE : California Hospital Association
DIGEST : This bill makes various changes to the hospital
seismic mandate for general acute care hospitals.
Assembly Amendments revise and recast issues related to
periodic reporting requirements by hospital operators and
provide extensions to the hospital seismic mandate for
general acute care hospitals that are reclassified using a
regulatory option or have encountered local planning
delays.
ANALYSIS :
Existing law :
1. Establishes and grants Office of Statewide Health
Planning and Development (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 Alquist Act, and its amendments, with
the following deadlines for seismic safety compliance:
A. After January 1, 2008, requires any GAC hospital
building that is determined to be a potential risk
for collapse or significant loss of life in a major
earthquake (i.e., designated as SPC-1) to be used
only for non-acute care purposes.
B. Authorizes OSHPD to extend the 2008 deadline by
five years, to January 1, 2013, if:
(1) The hospital demonstrates that compliance
with the 2008 deadline will result in a loss of
health care capacity that may not be provided by
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other general acute care (GAC) hospitals within a
reasonable proximity, and other conditions are
met.
(2) 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; or,
(3) The building is either retrofitted to SPC-2
and Non-Structural Performance Category (NPC-3)
standards, or not used for GAC inpatient services,
by January 1, 2013.
C. Authorizes OSHPD to extend the 2013 deadline by up
to two additional years, up to January 1, 2015, if
the hospital meets specified interim deadlines and is
making reasonable progress toward meeting its
timeline to retrofit or replace an SPC-1 building but
is delayed due to factors beyond its control.
D. Permits a hospital owner, in lieu of retrofitting
or rebuilding SPC-1 buildings by 2013, to instead
replace them by January 1, 2020, if:
(1) The hospital meets specified conditions,
including serving Medi-Cal or indigent
patients and underserved areas, and OSHPD
certifies that the hospital owner lacks the
financial capacity to meet seismic standards,
as defined.
(2) The nonconforming building is owned or
operated by a county, city, or county and city
that lacks the ability to meet the 2013
deadline but commits to replace the buildings
by January 1, 2020.
E. 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 (designated
as SPC-5), and requires owners of all acute care
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inpatient hospitals to demolish, replace, or change
to non-acute care all hospital buildings not in
substantial compliance.
3. Requires an owner of a GAC hospital building classified
as SPC-1, 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.
D. The building or buildings to be removed from acute
care service and the projected date or dates of this
action.
4. Requires owners of SPC-1 hospital buildings who have
requested an extension of the 2008 deadline to submit
similar reports by June 30, 2009, and November 1, 2010.
5. Requires OSHPD to make the information reported pursuant
to 3) and above available on its Web site within 90 days
of receipt.
This bill:
1. Requires any person, political subdivision of the state,
or governmental agency seeking licensure for a GAC, as
defined, to file with the Department of Public Health
(DPH) a statement that it has complied with the Alfred
E. Alquist Hospital Facilities Seismic Safety Act of
1983 (Alquist Act) and has received approval from OSHPD,
this bill also prohibits DPH from issuing a license
until these requirements are met.
2. Requires an individual or entity that seeks initial
approval to operate or manage a GAC, as defined, to file
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with DPH a statement that describes the plan for the GAC
to comply with the Alfred y Act. Requires the plan to
include a description of the financial capacity that the
proposed owner or operator anticipates to be sufficient
to ensure timely compliance and a projected timeline for
this compliance.
3. Requires the GAC applicant to provide the statement
described in #2) above to all of the following:
A. The Facility Development Division of OSHPD.
Requires OSHPD to post the statement on OSHPD's
Internet Web site.
B. Any investor or entity holding more than five
percent of the value of the GAC.
C. Any real estate investment trust which holds an
interest in the property on which the GAC is located.
D. The entity responsible for providing property and
casualty insurance coverage for the GAC.
E. The entity responsible for the directors and the
owner's liability insurance for the management of the
GAC.
F. The medical staff of the GAC.
G. The collective bargaining agent, if any, that has
a contract with the existing licenseholder.
H. The local planning departments within the local
jurisdiction of the GAC.
(1) Any health care service plans or health
insurers that have had contracts with the GAC
within the prior year.
(2) Any contractor that employs workers at the
GAC and, if applicable, the collective bargaining
agent representing the subcontracted workers.
4. Requires DPH to consider whether the GAC applicant has
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demonstrated a history of substantial compliance with
seismic safety requirements, based on information
provided by OSHPD regarding the record of compliance
with respect to any other facilities owned by the same
applicant.
5. Prohibits failure to comply with #2) through #4) above
from being subject to criminal penalty, as specified.
6. Adds the following additional conditions for OSHPD to
grant an extension of up to two years to eligible GACs
that have received an extension of the January 1, 2008
seismic deadline, as specified, for a hospital building
that the GAC owns or operates:
A. The GAC owner provides documentation to OSHPD by
January 20, 2011, stating the GAC owner's intent to
comply with the January 1, 2013, seismic deadline
requirements, as specified, by using computer
modeling utilized by OSHPD pursuant to regulations
adopted after June 30, 2009, but before December 30,
2010, and based upon Hazards US (HAZUS).
B. The GAC owner submits to OSHPD by July 1, 2011, a
request for review using computer modeling utilized
by OSHPD pursuant to regulations adopted after June
30, 2009, but before December 30, 2010, and based
upon Hazards US, and the GAC plans to construct a
building to meet the structural performance category
2 (SPC-2) requirement.
C. The GAC building plans for the building are
submitted to OSHPD and deemed ready for review by
OSHPD prior to January 1, 2012. Requires the GAC to
indicate, upon submission of its plans, the SPC-1
building or buildings that are required to be
retrofitted or replaced to meet the requirements of
this bill as a result of the project. Requires the
GAC to also provide a proposed construction timeframe
to complete the project once the permit is issued.
Requires the construction timeframe to be approved by
OSHPD and only include the amount of time that is
reasonably necessary to complete the construction
required to meet the SPC-2 requirement.
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D. The GAC receives a building permit from OSHPD for
the construction described in 6) b) above, prior to
January 1, 2013.
E. The GAC provides documentation upon application
stating that the purpose of the construction is to
meet seismic requirements, as specified, to allow the
use of the building as a GAC building after the
extension deadline granted by OSHPD, as specified,
and to make reasonable progress toward meeting the
timeline set forth in 6) c) above.
F. The additional extension granted by OSHPD, as
specified, may not exceed the lesser of two years or
the amount of time that is reasonably necessary to
complete the construction that is required for the
building to meet the SPC-2 requirement, as adjusted
for delays in construction that are beyond the
control of the GAC.
G. The GAC owner completes construction in order for
the GAC to meet all of the criteria to enable OSHPD
to issue a certificate of occupancy by the applicable
deadline for the building.
7. Permits OSHPD to revoke an extension granted for any GAC
building where the work of construction is abandoned or
suspended for a period of at least six months, unless
the hospital demonstrates in a public document that the
abandonment or suspension was caused by factors beyond
its control.
8. Requires all submissions to OSHPD to obtain an extension
of the January 1, 2008 seismic deadline, as specified,
to comply with the requirements for the extension to be
complete and accurate. Requires OSHPD to deny or revoke
an extension of the January 1, 2008, seismic deadline,
as specified, if OSHPD determines that the information
submitted did not meet this standard.
9. Permits OSHPD, in lieu of the extension to the January
1, 2008 seismic deadline, as specified, to grant an
extension to a GAC, in accordance with #11) and #14)
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below, if the GAC building will not be able to meet the
seismic safety standards, as specified, by January 1,
2013.
10.Requires the owner of the GAC, when applying for an
extension under the provisions of this bill, to submit
to OSHPD documentation that includes at least all of the
following:
A. The schedule of the project or projects, as had
been originally anticipated.
B. The schedule of the project or projects, as
currently projected.
C. Documentation that the timeline submitted to the
local planning authority or jurisdiction.
D. The local planning authority for the project and
for the enabling phases of the project does not
grant approvals prior to November 1, 2010, where
the GAC had filed the local application prior to
January 1, 2009.
E. A proposed construction timeframe demonstrating
the completion of the project once the permit is
issued. Requires the construction timeframe to be
approved by OSHPD and to only include the amount of
time that is reasonably necessary to complete
construction required to meet the seismic
requirements.
11.Permits OSHPD to grant an extension, in full one-year
increments, but no longer than three consecutive years,
which compensates for delays determined pursuant to #12)
below.
12.Requires OSHPD to conduct a comprehensive review of the
schedule for the project and necessary enabling phases
according to criteria specified in this bill. Requires
this review to encompass the project under jurisdiction
of OSHPD, as well as enabling project phases not under
the jurisdiction of OSHPD. Requires OSHPD to consider
the cumulative effect of local approval timelines for
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all elements of the project and necessary enabling
phases, inclusive of changes in scope or sequence of the
project or its enabling phases. Permits OSHPD to grant
extensions based on evaluation of each of the following
circumstances:
A. Where the local planning authority approvals
have delayed or will delay the construction start
date of the project, or of an enabling phase of
this project.
B. Where the local conditions of approval on a
project or on its enabling phases extend duration
beyond the originally anticipated construction
completion date.
C. Where changes in sequence or processes the GAC
deems necessary to mitigate local concerns on the
project or its enabling phases delay the
construction completion date.
D. Where the cumulative effect of delays on the
project or on enabling phases create additional
construction delays due to local seasonal weather
impacts.
E. Construction related to the seismic retrofit or
replacement project has begun by January 1, 2013.
F. The project was submitted for review by DPH no
later than January 1, 2009.
G. The project has received a building permit from
DPH no later than January 1, 2012, to complete
construction on the entire project.
13.Requires the GAC owner, every six months after the
approval of the extension, to report to OSHPD on the
status of the project, demonstrating that it is making
reasonable progress toward meeting the construction
timeline. Requires the GAC to also report any delays or
circumstances that could materially affect the estimated
completion date.
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14.Permits OSHPD to grant an additional extension of up to
two years in addition to the extension granted pursuant
to #11) and #12) above, if the project meets the
following criteria:
A. A matrix of buildings at the facility that
identifies compliance of each building to the
standards required in existing law at the
completion of the project.
B. The construction timelines submitted pursuant to
9) above were determined to go beyond three years
from the date the building permit was issued.
15.Permits OSHPD to revoke an extension granted pursuant to
the provisions of this bill for any GAC building where
the work of construction is abandoned or suspended for a
period of at least six months, unless the hospital
demonstrates in a public document that the abandonment
or suspension was caused by factors beyond its control.
16.Permits OSHPD to revoke an extension provided pursuant
to the provisions in this bill if it is determined the
documentation provided under #10) above was falsified in
any manner by the GAC.
17.Requires regulatory submissions made by OSHPD to the
California Building Standards Commission pursuant to
provisions in this bill to be deemed and to be adopted
as, emergency regulations.
18.Permits a GAC denied an extension pursuant to the
provisions in this bill to appeal the assessment to the
Hospital Building Safety Board.
19.Requires a GAC, on or before January 1, 2017, to report
all of the following to OSHPD:
A. Current configuration of all buildings on its
campus, including each structural performance
category.
B. The number of acute care beds and the basic and
supplemental services provided in each building.
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C. Identification of each building that needs to
meet the structural and nonstructural requirements
established in existing law.
20.Requires a GAC, before January 1, 2020, to submit a
master plan for all the buildings that the GAC intends
to rebuild or replace by January 1, 2030. Requires the
master plan to identify at least all of the following:
A. Each building that is subject to be demolished,
replaced or changed to nonacute care use because it
is not in compliance with existing seismic law.
B. The current plan to rebuild or replace each
building with buildings that would be in compliance
with existing seismic law, including all structural
and nonstructural requirements.
C. The building or buildings to be removed from acute
care service and the projected date or dates of that
action.
D. The location for any new building or buildings,
including, but not limited to, whether the owner has
received a permit for that location.
E. A copy of the preliminary design for the new
building or buildings.
F. The number of beds available for acute care use in
each new building.
G. The timeline for completed plan submission.
H. The proposed construction timeline.
I. The proposed cost at the time of submission.
J. A copy of any records indicating the hospital
governing board's approval of the hospital master
plan.
21.Requires on or before January 1, 2023, the GAC owner to
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submit to OSHPD a building plan for each building that
is deemed ready for review by OSHPD.
22.Requires, on or before January 1, 2025, the GAC owner to
receive a building permit to begin construction for each
building that the owner intends to replace or retrofit
pursuant to the master plan.
23.Requires, within six months of receipt of the building
permit, the GAC owner to submit a construction timeline
that identifies at least all of the following:
A. Each building that is subject to be demolished,
replaced or changed to nonacute care use because it
is not in compliance with existing seismic law.
B. The project number or numbers for replacement of
each building.
C. The projected construction start date or dates
and projected construction completion date or
dates.
D. The building or buildings to be removed from
acute care.
E. The estimated cost of construction. and,
F. The name of the contractor.
24.Requires the GAC owner, every six months thereafter, to
report to OSHPD on the status of the project, including
any delays or circumstances that could materially affect
the estimated completion date.
25.Requires a hospital that has not submitted a report to
be assessed a civil penalty of $10 per licensed acute
care bed per day, but in no case to exceed $1,000 per
day for each SPC-1 building not in compliance until it
has complied. Requires these civil penalties to be
deposited into the Facilities Penalties Account
established #32) below. Permits a GAC assessed a civil
penalty to appeal the assessment to the Hospital
Building Safety Board.
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26.Requires OSHPD to make the information required by #19)
and #20) above, available on its Internet Web site
within 90 days of receipt of this information.
27.Permits a GAC that complies with seismic safety law to
post a sign at all public entrances to the GAC building
that states: "THE STATE OF CALIFORNIA HAS DETERMINED
THAT THIS HOSPITAL FACILITY HAS COMPLIED WITH APPLICABLE
STATE SEISMIC SAFETY LAWS FOR HOSPITALS."
28.Requires that a GAC that has a SPC-1 building to post a
sign at all public entrances to the building that
states: "THE STATE OF CALIFORNIA HAS DETERMINED THAT
THIS HOSPITAL HAS BUILDING(S) THAT ARE AT RISK OF
COLLAPSE IN A MAJOR EARTHQUAKE. The plan of compliance
for this hospital is available for your review at the
hospital's Internet Web site (insert Web site address).
To receive additional information regarding hospital
seismic safety, go to www.oshpd.ca.gov."
29.Requires all signs posted pursuant to #27) or #28) above
to be posted in a conspicuous place at all public
entrances of the building, and not to be less than five
inches by seven inches in size and be printed in no less
than 30-point bold-type.
30 Clarifies that the plan of compliance to be publicly
available in #28) above is the November 1, 2010
reporting requirement, in existing law, for SPC-1
buildings.
31.Requires, by February 1, 2011, each GAC that has an
SPC-1 building to certify in writing to OSHPD that it
has complied with subdivision #28), #29), and #30)
above. Requires failure to post the sign required in
subdivision #29) to result in the GAC being assessed a
civil penalty of $10 per licensed acute care bed per
each day that the GAC fails to post the sign, but in no
case to exceed $1,000 per day for each SPC-1 building.
32.Requires these fines to be deposited into the Facilities
Penalties Account which is hereby established within the
Hospital Building Fund established pursuant to existing
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law.
33.Permits a GAC assessed a civil penalty to appeal the
assessment to the Hospital Building Safety Board.
34.Prohibits moneys in the account from continuously
appropriated pursuant to this section, and are required
to be available for expenditure only upon appropriation
by the Legislature in the annual Budget Act or other
measure.
35.Makes other technical and clarifying changes.
Background
In 2008, a multidisciplinary working group of scientists
and engineers predicted that, within the next 30 years,
California has more than a 99 percent chance of having an
earthquake equal to or greater than the magnitude 6.7
Northridge earthquake of 1994. The probability of a
magnitude 6.7 or stronger earthquake striking the Los
Angeles area over the next 30 years is 67 percent, and 63
percent for the San Francisco Bay Area.
The Northridge earthquake resulted in enactment later that
year of SB 1953 (Alquist), Chapter 740, Statutes of 1994.
SB 1953 expands the 1983 Alquist Act by establishing
seismic standards for GAC buildings and requiring every GAC
building to comply with the standards and to meet specific
deadlines. By January 1, 2008 (or 2013/2015 if extensions
have been granted), every GAC hospital building must meet
specific construction standards established to keep these
structures standing after a major earthquake or be removed
from acute care. By January 1, 2030, all GAC buildings
must comply with standards intended to keep these buildings
standing and operational following a severe earthquake.
SPC classifications, ranging from SPC-1 to SPC-5, are used
to indicate the structural seismic risk of a hospital
building in the event of a major earthquake, with SPC-1
used to designate buildings at potential risk of collapse
or significant loss of life in a major earthquake. Because
SPC-1 buildings are considered hazardous and at risk of
collapse in the event of an earthquake they are required
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under current law to be retrofitted, replaced or removed
from providing acute care services by 2013.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 8/27/09)
California Hospital Association (source)
Association of California Healthcare Districts
California Children's Hospital Association
Catholic Healthcare West
Hospital Corporation of America
Providence Health & Services California
Tahoe Forest Health System
OPPOSITION : (Verified 8/27/10)
California Nurses Association
Children's Advocacy Institute
ARGUMENTS IN SUPPORT : The California Hospital
Association, Catholic Healthcare West, Tahoe Forest Health
System, Association of California Healthcare Districts and
Providence Health & Services California all write in
support that this bill will allow hospitals to continue
working toward meeting the seismic mandate, ensuring their
buildings will withstand a major earthquake, by recognizing
the limits on capital while maintaining the structural
integrity of the seismic mandates. Supporter assert that
this bill provides hospitals the time needed to meet the
seismic mandate without risk of closure preserving access
to care for communities throughout the state.
The California Children's Hospital Association (CCHA)
writes that safety is the number one concern of children's
hospitals and that all eight California hospitals are
working diligently to meet the seismic mandate and or move
services from the affected buildings. CCHA maintains that
if hospitals do not met the specified deadline, they are
required to close, and in the case of children's hospitals,
there is no other option for providing these highly
specialized tertiary and quaternary services to
California's children.
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ARGUMENTS IN OPPOSITION : According to the California
Nurses Association (CNA), California nurses know first hand
the devastation that an earthquake can bring. CNA argues
that the experience in Haiti especially proved that the one
building that Californians will most need standing
following a serious earthquake is their community's acute
care hospital. CNA maintains that for nearly four decades
California hospitals have been on notice regarding seismic
safety since the 1971 earthquake in Sylmar caused two big
hospitals to collapse, with 45 people alone dying in the
ruins of a Veteran's Hospital. CNA asserts that hospitals
have come begging to the Legislature virtually every year
seeking extension after extension which has resulted in the
deadlines being repeatedly delayed. According to CNA, in a
seismically active state such as California, the time for
compliance is now and the reward for non-compliance should
not be more extensions. CNA argues the continually moving
goal post of seismic extensions must stop.
The Children's Advocacy Institute (CAI) writes in
opposition to this bill that children are uniquely
imperiled by hospitals that remain seismically unsafe and
believe those children's hospitals can not be treated in an
identical methodological fashion as other hospitals with
regard to the urgency of a retrofitting timetable. CAI
also states that the reason for instituting legislative
deadlines in the first place is that the Legislature
sensibly believed that achieving seismic safety for
hospitals was a priority. However, the legislative
approach of setting a deadline and then offering an
extension, CAI further maintains appears to be undermining
the policy of insisting on seismic safety by a hard
accountable deadline.
CTW:do 8/31/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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