Note to state officials: Save retrofitting for a sunnier day

Note to state officials: Save retrofitting for a sunnier day

Note to state officials: Save retrofitting for a sunnier day

With a growing number of the region’s hospitals suffering from depleted profits — or operating in the red outright — it may be time to rethink the 2013 seismic retrofitting deadlines.And it wouldn’t be the first time state officials have revisited the decree.State legislators originally passed the SB 1953 amendment to the Alquist Act after the 1994 Northridge earthquake, when more than 9,000 in the San Fernando Valley were injured, two hospitals suffered major structural damage and 23 hospitals suspended their service.

The law was quite straightforward: all of the state’s general acute care facilities must be evaluated for their compliance with standards developed by the California Office of Statewide Health Planning and Development.Basically, the standards state that structures must be able to withstand an earthquake of 6.0 magnitude, a number determined in part by the fact that a quake of that magnitude or higher occurs in the state every two to three years, according to data collected by the California Geological Survey.Hospitals classified as SPC-1 — meaning that the facility posed a significant risk of collapse and a danger to the public — had to be retrofitted, replaced or removed by January 2008.Seemed simple enough, except that the law offered no financial assistance for the retrofitting, and nearly 40 percent of the state’s 442 acute care hospitals fell into the SPC-1 category.According to the California Healthcare Association, the estimated total cost for the updates to all of the state’s hospitals was $24 billion — a number that was equivalent to the total, undepreciated value of all of the buildings and the assets inside at the time.By 2006, it had become painfully clear to state officials that far too many of the hospitals had not secured the resources to meet the impending deadline. Closing all of those that didn’t meet the standards was clearly not an option, so the deadline was quietly extended from 2008 to 2013.And this was in 2006, when the economy was stable.Unfortunately, an identifying characteristic of our capitalistic model is the menstrual-like cycle of boom and bust. Welcome to the bust. Fortunately, we’ve been here before.But even a first-year med student can explain that in lean periods, sacrifices must be made. As much as you desperately need to attend that seminar in Chicago on evidence-based management of cancer-related mucositis, you still need to pay your practice’s electric bill. And when push comes to shove, keeping the lights on takes priority.In much the same way, state legislators must recognize that in a year of the worst state budget crisis since the Great Depression, with the stock market in duress and an increased burden on heath care providers, retrofitting structures — important though it may be — just does not take priority.Look around the region at hospitals like O’Connor in San Jose, Marin General in Greenbrae and The Community Hospital of Los Gatos. All were considered profitable — or at least financially stable — at this time last year. One falling into an operational deficit could be blamed on poor management; two perhaps could be a fluke. The problem is clearly not in the hospitals themselves, but rather in their economic environments, and many are well on their way to being casualties of the downturn.Bear in mind that the entire purpose of the seismic laws is to ensure that after a massive tremor, our hospitals will survive to serve our communities. Perhaps more dire is our hospitals’ survival through this economic crisis and ability to continue serving our communities now.The last thing our state needs is to lose the jobs and stability that a hospital provides. And the last thing our communities need is to lose the hospitals on which they depend, especially to their inability to survive an earthquake that has yet to strike.The burden of retrofitting — especially in a time when large donors have all but disappeared, the number of uninsured Californians has surpassed 7 million, the state budget is facing $42 billion in cuts and taxpayers are rightfully wary of assuming more bond debt as the feds pass a $787 billion stimulus package — has become just that: a burden.Doesn’t putting our hospitals out of business defeat the purpose?

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