Shake, Rattle and Roll: Is Hospital Earthquake Safety Being Rocked by a Dismal Economy?

The catastrophic 6.3 magnitude earthquake in Italy, the recent 4.3 temblor near San Jose and a rash of small quakes in Southern California made me wonder about something I haven't thought about in quite a while: What's going on with hospital seismic safety in quake-prone California? We're already overdue for "the big one."

A 1994 state law, passed after the 6.7 Northridge quake in California's San Fernando Valley, toughened up 1973 legislation requiring hospitals in danger of collapse or significant damage after an earthquake to make repairs, rebuild - or face closure. The new deadline was set for 2008. But the state's powerful hospital lobby, citing high construction costs, successfully delayed many of the retrofitting requirements from 2013 to as late as 2030. Critics argued that the extensions could compromise public safety in a disaster.

The stakes couldn't be higher. In 1994, the Northridge quake killed 61 people and injured 8,700 more. At the time, 11 area hospitals sustained enough damage that they had to either completely or partly close, requiring the evacuation of their existing patients and imperiling treatment for quake victims. In 1971, two hospitals collapsed during the 1971 Sylmar quake in Southern California, killing 50 patients.

Earlier assessments of the state's hospital buildings found that 40 percent were at the highest level of risk for collapse or major damage after an earthquake. But risk assessment technology has improved, and in 2008, state health planning officials started to let hospitals know whether their risk had changed after analysis with a sophisticated software program called HAZUS. (HAZUS, short for "Hazards U.S.," was developed by the Federal Emergency Management Administration.)

More hospitals are expected to request HAZUS analyses, hoping to push back mandatory deadlines to retrofit their buildings, according to a Modern Healthcare story by Rebecca Vesely, one of the few I've seen recently on this topic. Still, only one-third of high-risk buildings are undergoing the voluntary HAZUS testing, according to one of Vesely's later stories. As many as half of California's at-risk hospital buildings won't be able to comply with seismic safety requirements because of the economy and other issues, according to a January 2009 report from the nonpartisan California HealthCare Foundation.

So, with public attention focused on the earthquake in Italy, now is an excellent time to check in with the California Office of Statewide Health Planning and Development (OSHPD), and ask about the status of hospitals in your area. Then talk with hospitals' leaders. If they're trying to get an extension for seismic retrofitting work they've had 15 years or more to plan for, why? How is the economic downturn affecting retrofitting or rebuilding plans? A nice news peg is the July 1, 2009 application deadline for a HAZUS analysis. Is your hospital applying for a HAZUS analysis? Why or why not?

This San Diego Union-Tribune story highlights how a local hospital tower got an extension for seismic retrofits while another did not. Californians, particularly those near major faults, deserve to know more about the safety of their local hospitals in a serious earthquake. I have to tell you, the 4.3 quake in San Jose in March gave me quite a jolt. And that was only a "modest" shaker. What could happen to your hospital when "the big one" strikes?