BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 608
                                                                  Page  1


          SENATE THIRD READING
          SB 608 (Alquist)
          As Amended August 24, 2010
          Majority vote 

           SENATE VOTE  :37-0  
           
           HEALTH              14-1                                        
           
           -------------------------------- 
          |Ayes:|Monning, Fletcher,        |
          |     |Carter, Conway, De La     |
          |     |Torre, De Leon, Eng,      |
          |     |Gaines, Hernandez, Bonnie |
          |     |Lowenthal, Nava, V.       |
          |     |Manuel Perez, Salas,      |
          |     |Audra Strickland          |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Ammiano                   |
          |     |                          |
           -------------------------------- 
           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  








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               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.   
               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  








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               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  
            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  








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               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.

          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:








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             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  
                 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  








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                 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;

             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  :  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,  








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          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.

          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.


           Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916)  
          319-2097 


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