BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 499|
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UNFINISHED BUSINESS
Bill No: SB 499
Author: Ducheny (D)
Amended: 9/4/09 in Assembly
Vote: 21
PRIOR VOTES NOT RELEVANT
ASSEMBLY FLOOR : Not available
SUBJECT : Hospitals: seismic safety
SOURCE : Author
DIGEST : The provisions of this bill dealing with the
California Major Risk Medical Insurance Program were
deleted in the Assembly. The bill now revises and extends,
under specified conditions, hospital seismic safety
construction and reporting requirements.
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
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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 (Alquist Act), and its
amendments, with the following deadlines for seismic
safety compliance:
A. After January 1, 2008, requires any general
acute care (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: the hospital
demonstrates that compliance with the 2008 deadline
will result in a loss of health care capacity that
may not be provided by other GAC hospitals within a
reasonable proximity; or 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.
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: 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; or the nonconforming
building is owned or operated by a county, city, or
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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 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. The report must
identify each building subject to the deadline; the
project number or numbers for retrofit or replacement of
each building; the projected construction start and
completion date or dates; and, 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 June 30, 2011.
5. Requires OSHPD to make the information reported pursuant
to 3) and 4) above available on its Web site within 90
days of receipt.
This bill:
1. Authorizes, through January 1, 2013, the OSHPD to use
current computer modeling based on federally-developed
software (known as Hazards US, or HAZUS) to determine
the structural performance category (SPC) of GAC
hospital buildings. 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
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life in a major earthquake.
2. Deems as emergency regulations, until January 1, 2013,
regulatory submissions from OSHPD to the California
Building Standards Commission to implement either 1)
above or conforming changes in deadlines for compliance
with any nonstructural performance category (NPC)
requirements.
3. Authorizes OSHPD to extend, by up to two years, the
January 1, 2013 deadline for a SPC-1 hospital building
to be either retrofitted to SPC-2 and NPC-3 seismic
safety standards, or removed from GAC inpatient
services, if all of the following conditions are met:
A. The hospital owner submitted a request to OSHPD
prior to June 30, 2009, for HAZUS review, and the
building was deemed SPC-1 after the review.
B. Hospital building plans are submitted to OSHPD
and deemed ready for review prior to July 1, 2010,
with an indication of the SPC-1 building or
buildings that will be retrofitted or replaced as a
result of the project.
C. The hospital receives a building permit from
OSHPD prior to January 1, 2012.
D. Prior to January 1, 2012, the hospital submits a
construction timeline that demonstrates the
hospital's intent and ability to meet the
applicable deadline and that includes information
on the projected construction start and completion
dates for the project, as well as the contractor.
E. The hospital building is under construction at
the time the extension request is made, the purpose
of the construction is to allow the building to be
used as a GAC building after January 1, 2013, and
the hospital is making reasonable progress toward
meeting the construction timeline submitted to
OSHPD.
F. The hospital owner completes construction such
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that the hospital meets all criteria to enable
OSHPD to issue a certificate of occupancy by the
applicable deadline for the building.
4. Makes the following changes in current reporting
requirements applicable to owners of GAC hospital
buildings that have been classified as SPC-1 buildings:
A. Advances the due date for the next report by
hospitals to OSHPD by eight months, from June 30,
2011, to November 1, 2010, and requires annual
updates thereafter on any changes or adjustments.
B. For SPC-1 buildings planned for retrofit or
replacement, requires the report to additionally
identify whether retrofit or replacement is
intended, the intended SPC level, the applicable
deadline for retrofit or replacement, most recent
project status, and number of inpatient beds and
patient days, by type of unit and type of service
to be provided.
C. For SPC-1 buildings to be removed from acute
care services, requires the report to additionally
include: the planned uses of the building after
removal from acute care services; inpatient
services currently delivered in the building;
number of inpatient beds and patient days, by type
of unit and type of services for 2008, 2009, and
2010; and, whether the GAC services and beds will
be relocated to a new or retrofitted building and
any corresponding building sites or project
numbers.
D. For each facility where buildings will be
removed from acute care service, requires the
report to additionally include any net change in
the number of inpatient beds, by type of unit and
type of service, taking into account beds in
buildings to be taken out of service, retrofitted,
or replaced, as well as any other buildings used
for GAC inpatient services.
E. Requires the report to additionally show the
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final configuration of all buildings on a hospital
campus, showing how each building will comply with
the SPC-5/NPC 4 or 5 requirements, whether by
retrofit or replacement, and the type of services
that will be provided in each GAC hospital
building.
F. Requires OSHPD, when posting information from
these reports on its Website, to include the
hospital name, hospital owners, location of
buildings, and other specified information.
G. For a hospital that does not submit the required
reports, establishes a fine of $10 per licensed
acute care bed per day, up to a maximum of $1,000
per day for each SPC-1 building for which a report
has not been submitted, and permits a hospital to
appeal a fine assessment to the Hospital Building
Safety Board. Requires revenues from fines to be
deposited into the Hospital Building Fund.
5. Adds provisions to avoid chaptering out AB 523
(Huffman), which authorizes OSHPD to allow up to January
1, 2015, for Marin General Hospital to be retrofitted or
replaced.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Assembly Appropriations Committee,
absorbable workload to OSHPD to review hospitals for
eligibility for the two-year extension added by this bill.
If half of the 239 buildings with a pending HAZUS review
remain at the SPC-1 level, about 120 would become eligible
for an extension. Current law and regulations require
OSHPD to level a user fee of up to two percent of a
hospital project's estimated construction costs to support
the workload of review and technical assistance. The
current fee is 1.64 percent 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 in special funds will be
generated. Additional unknown revenues into the Hospital
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Building Fund, to the extent hospitals pay fines for
failure to submit mandated reports ($10 per licensed bed
per day, up to $1,000 per day for each SPC-1 building for
which a report has not been submitted).
SUPPORT : (Verified 9/11/09)
California Hospital Association
Catholic Health Care West
Lakewood Regional Medical Center
OPPOSITION : (Verified 9/11/09)
California Nurses Association/National Nurses Organizing
Committee
ARGUMENTS IN SUPPORT : According to the author's office,
this bill provides short-term relief for hospitals while
maintaining current statutory deadlines for seismic safety
compliance. The author's office states that this bill
represents a compromise on a larger on-going discussion
related to hospital seismic safety compliance. The
author's office further states that this bill improves
state monitoring of hospital compliance and assists
hospitals in achieving compliance while addressing
barriers, such as access to capital, that hinder or prevent
compliance. The author's office states that she intends to
continue working with hospitals, labor groups, the
Administration, and other major stakeholders on how best to
achieve compliance so that communities can continue to have
access to their hospital providers.
ARGUMENTS IN OPPOSITION : The California Nurses
Association (CAN)/National Nurses Organizing Committee
states that, "CNA has been on record on numerous occasions
opposing seismic extensions. WE have seen many extensions
pass through the legislature including, AB's 1046 and 1275
(Frommer) 2005, AB 1978 (Walters) 2006, SB 491 (Ducheny),
2006 and SB 167 (Speier), 2006 and most recently SB 306
(Ducheny) 2007, we opposed these bills because they
extended seismic retrofit deadlines without adequate
information and despite the health and safety risk to
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patients and health care workers.
"Most notably, CAN opposed SB 1661 (Cox) Chapter 693,
Statutes of 2006, which authorized the Office of Statewide
planning and Development (OSHPD) to grant an additional
two-year extension of the January 1, 2013, deadline if the
hospital building subject to the extension is under
construction at the time of the request for this extension
and the hospital has made a good faith effort to comply
with the January 1, 2013, deadline.
"CAN opposes SB 499 because of the following:
SB 499 grants hospitals who fall HAZUS reclassification, an
SB 1661 extension. Although we understand that this is not
a NEW extension, this provision allows hospitals additional
two-years to comply, even though hospitals made the
conscious choice to be re-classed by HAZU. Hospitals now
know that because one method has failed to yield a
satisfactory result, they can take advantage of this
legislation to buy more time. There are roughly 239
hospitals that are PENDING HAZUS review. It is believed
that half of those hospitals will be re-classed to a lower
category, and perhaps the other half may fail. It would be
premature to grant extensions when the data hasn't been
finalized.
"SB 499 also allows OSHPD to promulgate Emergency
Regulations to adjust the HAZUS methodology for rating
hospitals. How many hospitals does this provision effect,
and who?
"We find it unsettling that legislation is used to tweak
and manipulate existing laws and regulations when hospitals
have known of their obligation to comply with seismic
safety since the 70's. The industry understands that
buildings that predate 1973 would not be in use in 30-40
years due to construction shelf life.
"CAN appreciate the Senator's willingness to have the
conversation with stakeholders on this most critical issue
of public safety. We welcome the broader conversation next
year but unfortunately at this time, we must remain in an
oppose position.
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"We cannot stand by and allow for a system of continued
non-compliance. Our patients and caregivers are put at
continued risk. It's good public policy to have a
seismically sound hospital should the next seismic event
occur. We respectfully ask for an "NO" vote when this bill
comes before you on the Senate Floor."
RJG:do 9/11/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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