Financial pressure for California hospitals: Seismic safety upgrades must be implemented

According to a new study, a large amount of money that will range between $34 billion and $143 billion will be invested to improve seismic response of hospital structures in California.

The state law obliges hospital structures to improve their performance under seismic loads. In particular, buildings have to make improvements in order to:

1. Highly mitigate the risk of collapse by 2020 and
2. Be operational after a seismic shock by 2030

According to the California state law, hospitals must pay the whole cost that is needed for the upgrades. This task is going to be challenging as, currently, about 34% of hospitals experience an economic distress and the structural improvements need a large amount of money. It is expected that independent private hospitals, public health care district hospitals and critical access hospitals that serve rural areas will, among others, face severe difficulties to accomplish the construction works.

The report analyzes the financial consequences of the upgrades on the hospitals but it does not suggest whether this policy should be implemented. On the contrary, it recommends some extra alternatives that could prove to be beneficial to ensure both seismic safety and the economic prosperity of the hospitals. 

"There is little question that it is in the public interest to have seismically resilient hospitals. But given that hospitals most at risk of collapse will be upgraded by 2020, there is an opportunity for analysis and discussion for how to most effectively and efficiently enhance resilience in health service delivery in the future," Benjamin Preston, a senior policy researcher and director of RAND's Community Health and Environmental Policy Program and the lead author of the study, stated.

During the 1994 Northridge Earthquake, 11 hospitals in California suffered critical and were rendered unusable. Not only they couldn't serve injured victims, but people who were already hospitalized had to be transferred to nearby hospitals that were highly crowed. Since that incident, the state adopted SB1953 (Chapter 740, Statutes of 1994. Seismic Mandate) which establishes a seismic safety building standard for California hospitals.