BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 499
                                                                  Page  1

          Date of Hearing:   September 9, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  SB 499 (Ducheny) - As Amended:  September 4, 2009 

          Policy Committee:                             Health Vote:17-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill modifies oversight of and deadlines associated with  
          California hospital seismic safety requirements. Specifically,  
          this bill: 

          1)Authorizes, until January 1, 2013, the Office of Statewide  
            Health Planning and Development (OSHPD) to extend deadlines by  
            two years subject to criteria established by SB 1661 (Cox),  
            Chapter 679, Statutes of 2006 and adds new criteria to the SB  
            1661 requirements.  

           2)Authorizes, until January 1, 2013, OSHPD to use federal  
            Hazards US (HAZUS) (computer modeling used to estimate  
            structural earthquake losses), and deems submissions as  
            emergency regulations if related to HAZUS or compliance with  
            nonstructural performance category (NPC) requirements.  
           
          3)Expands hospital reporting requirements for Structural  
            Performance Category (SPC)-1 buildings.  SPC-1 buildings are  
            those at greatest risk for collapse during an earthquake.  
            Establishes a penalty for failure to report of $10 per  
            licensed bed up to $1,000 per day per SPC-1 building, to be  
            deposited in the Hospital Building Fund. New reporting  
            requirements include: 

             a)   The number and service type of inpatient beds for  
               building planned for retrofit or replacement. 
             b)   The dates a building will be removed from service and  
               the services currently provided. 
             c)   The number of inpatient beds and patient days by type of  
               service for 2008, 2009, and 2010. 
             d)   The net change in number of beds due to retrofit,  
               replacement, and removal from service







                                                                  SB 499
                                                                  Page  2

           FISCAL EFFECT  

          1)Absorbable workload to OSHPD to review hospitals for  
            eligibility for a two-year extension. According to OSHPD, 240  
            SPC-1 buildings owned by 85 hospitals have requested HAZUS  
            review, but have not reported any active construction projects  
            approved by OSHPD. Estimates indicate approximately 120, or  
            half, of these buildings may be eligible for an extension per  
            requirements of this bill. 

          2)Current law and regulations require OSHPD to levy a user fee  
            of up to 2% of a hospital project's estimated construction  
            costs to support the workload of review and technical  
            assistance. The current fee is 1.64% of construction costs and  
            is deposited in the Hospital Building Fund.  Assuming the  
            owners of each of the 120 buildings reclassified pursuant to  
            this bill pay a fee on a $20 million seismic project,  
            approximately $40 million special funds will be generated.  
            These funds are used to support OSHPD throughout the building  
            cycle, which can last 5 years or more. For example, OSHPD  
            provides plan review, technical assistance, and inspection  
            support. 

          3)Additional unknown revenues deposited into the Hospital  
            Building Fund to the extent hospitals are required to pay  
            penalties of $10 per licensed bed up to $1,000 per day per  
            SPC-1 building for failure to report to OSHPD. 

           COMMENTS  

           1)Rationale  . This bill is author sponsored to create alternative  
            pathways for hospitals having trouble meeting current law  
            deadlines regarding rebuilding or retrofitting hospital  
            buildings at risk for collapse during an earthquake. The bill  
            builds on criteria established by SB 1661 by adjusting interim  
            benchmarks to allow more hospitals to qualify for the  
            extension. In addition, this bill provides specificity to  
            OSHPD authority around the use of federal HAZUS data, expands  
            hospital reporting requirements, and establishes penalties to  
            increase the number of hospitals that comply with hospital  
            reporting requirements. 
           
           2)Seismic Safety Landscape  . Hospitals throughout California are  
            subject to statutory seismic requirements and face billions of  
            dollars of unfunded construction needs. According to OSHPD,  
            there is $10 billion in hospital planning and construction  
            currently underway statewide. According to a 2007 study by  






                                                                  SB 499
                                                                  Page  3

            RAND, total construction costs for California may range from  
            $45 billion to $110 billion in 2006 dollars. The actual costs  
            will depend on project size and duration, future inflation,  
            and construction costs. 

           3)Hospital Earthquake Risk  . Structural Performance Category-1  
            (SPC-1) hospital buildings pose a significant risk of collapse  
            and a danger to the public after a strong earthquake. The  
            lowest risk structure is a SPC-5. Under current law, SPC-1  
            buildings must have been retrofitted, replaced, or removed  
            from acute-care service by January 1, 2008, unless a hospital  
            has been granted an extension to 2013 or 2020. SB 1661  
            established eligibility for certain hospitals to receive an  
            extension to 2013 and SB 306 (Ducheny), Chapter 642, Statutes  
            of 2007 established processes for hospitals to receive the  
            extension to 2020.  

           4)Recent Risk Assessments  . OSHPD has classified about 900 of  
            2,700 hospital buildings statewide as SPC-1. These SPC-1  
            buildings are owned by 274 hospitals.  The deadline for  
            hospitals to apply for a HAZUS reclassification was June 30,  
            2009 and 550 requests for HAZUS review were submitted. Of the  
            300 HAZUS reviews that OSHPD has completed, about 70% of  
            buildings have been reclassified to SPC-2 or a lower risk  
            level. It is expected that of the remaining hospitals subject  
            to HAZUS review, the reclassification rate will be less than  
            70% due to incomplete or inadequate hospital submissions.  
            Based on mandated reports submitted by hospitals, OSHPD  
            indicates about 40% of hospitals with SPC-1 buildings are on  
            track to meet respective statutory timelines while 60% have  
            status that is either unknown or not likely to result in  
            timely rebuilding or retrofitting. 

           5)Concerns  . The California Nurses Association (CNA) opposes this  
            bill due to the extension of seismic safety deadlines  
            contained in this bill. CNA is concerned about patient health  
            and safety following an earthquake. CNA indicates they have  
            opposed numerous other bills, including SB 1661, which  
            proposed extending seismic safety deadlines.

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081