Following a major earthquake, one with a magnitude of 5.5 and above, serious injuries are likely, which requires hospitals to be fully operational and free of structural and nonstructural damage. To ensure this, California hospitals are required to comply with Senate Bill 1953, which following the 1994 Northridge earthquake amended previous hospital safety acts.
Currently, SB 1953 requires hospitals to evaluate and rate all their general acute care hospital buildings for seismic resistance using standards developed by the California Office of Statewide Health Planning and Development (OSHPD).
Those hospital facilities that do not exceed maximum allowable seismic risk have a final compliance deadline of 2020 (previously 2008) to meet 2030 seismic safety standards if the hospital sends a resolution to the department of health services by July 1, 2006 stating the hospital has plans in place to meet the requirements and deadline.
According to the U.S. Geological Survey Earthquake Hazards Program, San Diego has not experienced a major earthquake with an epicenter relatively close to the city since a 1991 Imperial Valley quake, which had a magnitude of 6.5.
"Earthquake safety is something we have to be prepared for," said Lou Smith, vice president of facilities for Sharp Healthcare.
As a result of the required safety requirements and questions about when the next big quake will be, hospitals in San Diego have already begun or are in the process of seismic improvements.
One example is the Veterans Affairs Medical Center, which on Tuesday awarded a $52.2 million contract to Clark Construction for seismic corrections to an 855,000-square-foot building. The project will include new stair towers and creation of a braced-frame system for the building. According to Clark, which provided seismic improvements for another VA medical center in Palo Alto, there is currently no official start date. Although the San Diego center does not fall under SB 1953, it must meet similar and sometimes more stringent federal requirements.
Unlike the VA hospital, all nonfederal, general acute care hospitals in San Diego must meet the seismic safety requirements. This includes five Scripps hospitals, some of which are new enough that no structural improvements will be needed. According to Bruce Rainey, director of construction for Scripps Healthcare, Green, Encinitas Memorial and Mercy Chula Vista hospitals all fall into this category, as only nonstructural improvements such as ceiling work and piping need to be done.
Mercy Hospital needs major structural improvements, but those improvements are not in the tower that houses patients. Scripps is currently in the process of soliciting for designers.
In some cases, such as Memorial Hospital La Jolla, the cost to make seismic improvements almost equals that of building a replacement facility. This fact prompted Scripps to design a replacement facility for the patient care part of the hospital campus. Design for the facility is currently in its first phase, and the new facility is expected to be complete by 2030, Rainey said.
The overall price tag for both structural and nonstructural improvements to the five hospitals is still unknown because of the continued increase in construction materials and the lengthy approval process OSHPD must complete before a project can begin. Scripps, like other private nonprofit hospitals, does not receive government funding, thus it must borrow money or rely on private funding for projects to reach completion.
Other hospitals that have made or will need to make structural or nonstructural improvements to their facilities include five Sharp hospitals, the UCSD Hillcrest Medical Center, and the Pomerado and Palomar hospitals.
As part of a $753 million major expansion project, Palomar Pomerado Health will construct a new hospital and make seismic improvements to both the Palomar and Pomerado hospitals. The UCSD Hillcrest Medical Center, at an estimated cost of more than $43.4 million, will upgrade all nonstructural performance category systems to meet with seismic safety requirements, according to the University of California Non-State Capital Program.
According to Smith, Sharp Memorial, which is more than 50 years old, is 20 percent complete on its construction of a new seven-story tower hospital, which is estimated to reach completion by 2007. The total cost will be $130 million, and the new facility would be the first hospital built in San Diego since 1993.
Grossmont Hospital has completed a new emergency room and critical care unit, while Sharp Coronado is in the process of completing more upgrades. The Chula Vista center is currently in the planning phases for the building of an additional tower. Lastly, the Mary Birch hospital for women, built in 1991, is already in compliance with the seismic safety requirements.
"It's good to know that we're prepared," Smith said, adding that Children's Hospital is also planning to construct a new tower.
Despite the state safety requirement deadline, it is important that hospitals meet 2030 seismic requirements as soon as possible. According to an OSHPD publication, "California's Hospital Seismic Safety Law 2005," the average age of the riskiest hospitals is nearly 50 years, and in 2008 the average age of affected hospital buildings will be between 45 to 49 years.