National Nurses United

LLOYD CLUFF/CORBIS Damage to Olive View Medical Center after the 1971 Sylmar earthquake in Los Angeles. that he, his coworkers, and his patients stand the best possible chance of staying safe when the next big earthquake shakes California. But the same can't be said of nurses and other healthcare providers, patients, and communities depending on hospitals across California. Despite requirements on the books for more than 30 years for hospitals to meet seismic safety deadlines, some 1123 buildings at 323 acutecare hospital campuses around the state—representing about half of California's hospital infrastructure—are still currently in danger of collapsing during the next Big One. While some hospitals and systems have already upgraded or are well into the construction process, the hospital industry as a whole has pled difficulty and poverty in meeting the requirements. While some rural and public hospitals have legitimate limitations on their finances and organizational capacity that have prevented them from making progress, other hospitals do not. These hospital owners have instead preferred to spend their resources on revenue-generating construction and squeeze as much money as they can out of their existing buildings. At the same time, they have aggressively lobbied the California Legislature to extend the deadlines, angled for public money to rebuild their hospitals, and pushed to redefine which structures count as collapse risks. And they've been successful. Due to legislative amendments, original deadlines of 2008 for retrofitting or rebuilding have been pushed back up to 12 years, to 2020. All structures are supposed to be rebuilt by 2030, but one study estimates that many hospitals will not even meet that timeline. In addition, the state is now preparing to reclassify which buildings are most in danger of falling down, a process that's expected to shift about half of the riskiest structures to a lesser category. In all this wrangling between hospitals and the state over seismic safety deadlines, however, the main policy goal of protecting patient safety, worker safety, and public safety seems to have been largely forDECEMBER 2007 gotten or, at the least, seriously compromised. Meanwhile, geologists claim that we are due any moment for a major magnitude quake. Critics of extending the seismic deadlines argue that instead of focusing on what hospitals need, California should be focusing on what communities need. "Based on our experience so far, granting extensions simply communicates the wrong message," said Donna Gerber, director of government relations for CNA/NNOC. "In the interest of the public's health, we believe the Legislature needs to be firm on deadlines and make it clear when you say that you expect to make facilities safe for the public that in fact you do so." From an RN's perspective, Thomas noted that he sure would hate to be working or be a patient in one of the buildings on the state's fall-down list. "I wouldn't be very happy about it at all," he said. "After an earthquake, any hospital might be the only hospital available. That may be the only structure that is actually functional. The idea that we couldn't provide care in a medical emergency is very disturbing." L egislation requiring hospitals to meet seismic safety requirements always seems to surface soon after a big earthquake. The Legislature in 1983 approved the Alfred E. Alquist Hospital Seismic Safety Act after the San Fernando, or Sylmar, earthquake destroyed some hospitals. That law required new hospital construction to meet new stringent safety codes. Then after the 1994 Northridge earthquake severely damaged 11 area hospitals, the Legislature passed SB 1953, which mandated that hospitals retrofit their existing buildings to withstand earthquakes by 2008, and rebuild all infrastructure by 2030. Under the intent of the law, all general acute-care hospitals by 2030 should be able to operate continuously if an earthquake should strike. If hospitals could not meet the deadlines, they would be shut down or could not be used for acute-care service. Hospital structures were divided into various "seismic performance categories" (SPCs) based on how well they could withstand a major earthquake. An SPC-1 label indicates that a structure poses a significant risk of collapse and danger to the public after a strong earthquake. SPC-2s may not jeopardize lives, but may suffer serious damage and be irreparable or unusable after an earthquake. SPCs-3s, 4s, and 5s continue down the scale of danger. In 2000, SB 1801 amended the original law to allow hospitals a five-year extension of the 2008 deadline to 2013. Then in 2006, SB W W W. C A L N U R S E S . O R G REGISTERED NURSE 11

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