BILL ANALYSIS
SB 608
Page 1
Date of Hearing: August 25, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
SB 608 (Alquist) - As Amended: August 24, 2010
SENATE VOTE : 37-0
SUBJECT : Hospitals: seismic safety.
SUMMARY : Permits the Office of Statewide Health Planning and
Development (OSHPD) to grant two separate extensions to a
general acute care hospital (GAC) for a total of five years,
under specified circumstances related to local planning delays,
for compliance with existing state seismic safety requirements.
Specifically, this bill :
1)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 3) and 6) below, if the GAC building
will not be able to meet the existing seismic safety
standards, as specified, by January 1, 2013, due to a local
planning delay.
2)Requires the owner of the GAC, when applying for an extension,
to submit to OSHPD documentation that includes at least all of
the following:
a) The original schedule of the project or projects as had
been originally anticipated;
b) The schedule of the project or projects as currently
projected;
c) A timeline for the submission of documents to the local
planning authority or jurisdiction;
d) Documentation that 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 originally filed the local application prior to January
1, 2008; and,
e) A proposed construction timeframe demonstrating the
completion of the project once the permit is issued.
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Requires the construction timeframe to be approved by OSHPD
and to only include the amount of time that is reasonably
necessary to complete the construction required to meet the
seismic requirements.
3)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 4) below.
4)Requires OSHPD to conduct a comprehensive review of the
schedule for the project or projects according to criteria
specified in this bill. Requires this review to encompass the
project or projects under jurisdiction of OSHPD, as well as
other project phases not under the jurisdiction of OSHPD.
Requires OSHPD to consider the cumulative effect of local
approval timelines for all elements of the project or
projects, inclusive of changes in scope or sequence of the
project or projects required by the local planning process.
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 projects;
b) Where the local conditions of approval on a project or
projects extend the duration beyond the originally
anticipated construction completion date;
c) Where the cumulative effect of delays on the project or
projects create additional construction delays due to local
seasonal weather impact requirements of the local planning
authority;
d) Construction related to the seismic retrofit or
replacement project has begun by January 1, 2013;
e) The project or projects were submitted for review by DPH
no later than January 1, 2009; and,
f) The project or projects have received a building permit
from DPH no later than January 1, 2012.
5)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
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toward meeting the construction timeline.
6)Permits OSHPD to grant an additional extension of up to two
years in addition to the extension granted pursuant to 3) and
4) above, if and only if, the projects meet all of 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 1)
above were determined to go beyond three years from the
date the building permit was issued;
c) Acute care services will not be provided in any
structural performance category (SPC)-1 building at any
time during the extension;
d) The GAC demonstrates that it has, and maintains
throughout the extension, life safety systems in all acute
care patient care areas that do not depend on, and are not
routed through, an SPC-1 building; and,
e) The GAC either demonstrates that the SPC-1 building does
not pose a structural risk to an adjoining hospital
building that is used for acute care services or mitigates
the risk in accordance with a deadline described in the
January 1, 2008 seismic deadline, as specified, that OSHPD
determines will best protect patients' safety.
7)Permits OSHPD to revoke an extension for any GAC building
where the work of construction is abandoned or suspended for a
period of at least six months, unless the GAC demonstrates in
a public document that the abandonment or suspension was
caused by factors beyond its control.
8)Permits OSHPD to revoke an extension granted if it is
determined that any information submitted was falsified in any
manner by the GAC or if the GAC fails to meet any criteria or
conditions, as specified.
9)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.
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10)Requires the GAC owner that applies for an extension to pay
to OSHPD an additional fee, to be determined by OSHPD,
sufficient to cover the additional cost incurred by OSHPD for
maintaining all reporting requirements established pursuant to
the provision of this bill, including, but not limited to, the
costs of reviewing and verifying the extension documentation
submitted. Prohibits the additional fee from including any
cost for review of the plans or other duties related to
receiving a building or occupancy permit.
11)Permits a GAC denied an extension to appeal the assessment to
the Hospital Building Safety Board.
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 (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:
i) 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, and other conditions are
met;
ii) The hospital agrees that by January 1, 2013,
designated services will be provided by moving into an
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existing conforming building, relocating to a newly-built
building, or continuing in the retrofitted building, as
specified; or,
iii) The building is either retrofitted to SPC-2 and
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:
i) 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,
ii) 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 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;
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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)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 4) above available on its Web site within 90 days of
receipt.
FISCAL EFFECT : This bill as amended has not been analyzed by a
fiscal committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill
provides a narrow set of circumstances that permit GACs to
request from OSHPD two separate extensions for a total of five
years to comply with state seismic safety requirements. The
author maintains that, currently, there are instances where
the local planning review and approval process for GAC
construction projects have taken longer than originally
anticipated. In addition, the author asserts that local
approving agencies can require that the phases of a hospital
construction project be done in a specific sequence which can
lengthen the total amount of time needed to finish the
project, forcing some GACs to adjust their construction
schedules. The author argues that due to these factors, a few
GACs will be unable to meet the state seismic deadline of
2015. This bill attempts to address the issue of local
planning delays and timing by providing an opportunity for a
limited number of hospitals that are structurally rated as not
having any patients or employees in a building at risk of
collapse or significant loss of life in a major earthquake to
achieve full seismic compliance.
2)BACKGROUND . Stanford Hospitals and Clinics (SHC), located in
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the City of Palo Alto (the City) is one of four Level 1 trauma
centers in Northern California that provides tertiary clinical
services and trains and supports over 1,000 medical residents.
Since 1959, SHC and the Stanford School of Medicine have been
collocated in the same building. According SHC, there is
limited space to replace and renew SHC to meet seismic
standards and that over two years of preperatory work, such as
relocating existing staff and functions, moving utility lines,
and replacing parking structures is required before
construction can begin on a new SHC facility.
The City is currently reviewing an application submitted by SHC
in August of 2007 for the construction of a new SHC facility
that will be seismically compliant. According to the City,
upon receipt of the application, it commenced the
environmental review, preliminary design review, and analysis
of the requested entitlements. The City maintains that the
new SHC facility represents the largest private development
request within the City in recent memory and, as such, the
project's complexity and the need for a thorough environmental
review has extended the timeline beyond what was originally
envisioned. To date, the Draft Environmental Impact Report
for the new SHC facility has been released for public review,
preliminary design reviews are nearing completion and City
leadership is estimating the final approval of the new SHC
facility project by the end of this year.
3)SUPPORT . According to supporters, this legislation recognizes
that some hospitals have faced unforeseen issues that have
slowed their ability to meet the seismic standards, despite
working intently to comply. Supporters maintain that this
bill provides OSHPD the necessary authority to grant an
extension based on a hospital's ability to meet specific
criteria that guarantee safety of patients, visitors, and
staff during the extension periods.
4)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,
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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.
5)PREVIOUS AND RELATED LEGISLATION .
a) SB 289 (Ducheny) introduced in 2009 revises and extends,
under specified conditions, hospital seismic safety
construction and reporting requirements. SB 289 (Ducheny)
will be heard in the Assembly Health Committee on August
25, 2010.
b) AB 303 (Beall), Chapter 428, Statutes of 2009, allows
specified county and UC disproportionate share hospitals
that serve Medi-Cal patients to receive supplemental
Medi-Cal reimbursement from the Construction and Renovation
Reimbursement Program for debt service on new capital
projects to meet seismic safety deadlines if plans are
submitted to the state after January 1, 2007 and before
December 31, 2011.
c) AB 523 (Huffman), Chapter 243, Statutes of 2009, allows
OSHPD to grant a two-year extension of the 2013 seismic
deadline for a hospital building that is owned by Marin
Healthcare District. Establishes interim deadlines and
requirements the hospital must meet in order to qualify for
the extension, as specified.
d) SB 306 (Ducheny), Chapter 642, Statutes of 2008, amends
the Act to permit a hospital that has received an extension
of the 2008 seismic retrofit deadline to January 1, 2013,
to instead replace a SPC-1 building by January 1, 2020, if
the hospital demonstrates it lacks financial capacity to
retrofit by 2013 and meets other specified conditions.
e) SB 1661 (Cox), Chapter 693, Statutes of 2006, authorizes
up to two additional two years for hospitals that have
already received an extension to January 1, 2013 of the
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2008 seismic safety compliance deadline if specified
criteria are met, and requires hospitals with SPC-1
buildings to submit reports with specified information, to
be posted on the Website of OSHPD.
f) SB 167 (Speier), of 2005, would have permitted 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.
g) AB 1978 (Walters), of 2005, would have extended, from
January 1, 2008 to January 1, 2015, the deadline for any
SPC-1 building 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.
h) AB 1673 (Nation and Richman), of 2005, would have
repealed provisions of the Alquist 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.
i) 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.
6)CHAPTERING OUT . This bill and SB 289 (Ducheny) both amend the
same code sections. Language has been included in this bill
to avoid chaptering out the other, should both bills be
enacted.
REGISTERED SUPPORT / OPPOSITION :
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Support
Stanford Hospital and Clinics (cosponsor)
Stanford University (cosponsor)
Lucille Salter Packard Children's Hospital
City of Pal Alto
Opposition
California Nurses Association
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097