1. Chris Tokas S.E. Manager, Hospital Seismic Retrofit Program Office of Statewide Health Planning and Development Status of the California Hospital Seismic Retrofit Program (SB 1953) ABAG RPC Workshop on Post-Disaster Hospital & Public Health Systems June 3, 2009

2. Earthquakes as a Catalyst for Change Major advances in the structural engineering art are associated with damaging earthquakes. –1933 Long Beach –1964 Alaska –1971 San Fernando –1989 Loma Prieta –1994 Northridge –1995 Kobe

3. 1971 San Fernando Earthquake Olive View Medical Center Godden Collection, Earthquake Engineering Research Center, University of California, Berkeley

4. Lessons Learned in the San- Fernando Earthquake The Earthquake demonstrated Deficiencies in: –Building Design Codes –Code enforcement process Plan review Construction inspection

5. CODES & STANDARDS DETAILEDPLANREVIEW MATERIALS QUALITY CONTROL FIELD INSPECTION The Foundation Pillars for Achieving the Targeted Seismic Performance Level

6. The 1972 Hospital Seismic Safety Act (HSSA) The HSSA Establishes Hospitals as essential facilities and defines explicitly their expected performance.

7. The 1st Ever Definition of Functionality that hospitals, that house patients who have less than the capacity of normally healthy persons to protect themselves, and that must be reasonably capable of providing services to the public after a disaster, …. that hospitals, that house patients who have less than the capacity of normally healthy persons to protect themselves, and that must be reasonably capable of providing services to the public after a disaster, shall be designed and constructed to resist, insofar as practical the forces generated by earthquakes, gravity, and winds.

8. The Need for a Statewide Enforcement Agency Laws and regulations w/o rigorous enforcement are ineffective. OSHPD/FDD is the enforcement agency of the HSSA. –Primary Responsibilities Design Plan Review Construction Oversight

9. Northridge Performance Performance of all Buildings at 23 Hospital Sites with One or More Yellow or Red Tagged Buildings Number (%) of Buildings Type of DamagePre ActPost Act Structural Damage Red tagged12 (24%)0 (0%) Yellow tagged17 (33%)1 (3%) Green tagged22 (43%)30 (97%) Nonstructural Damage Major31 (61%)7 (23%) Minor20 (39%)24 (77%) Total Buildings5131

10. Quantification of Seismic Resilience of GAC Facilities as Patients/Day Treatment Capacity of the Total Available Hospital Infrastructure. Patients/Day 100% t 1 Earthquake Effects (Damaged, Collapsed or Closed Hospitals) t 0 Δt = Rapidity Rebuilding of Capacity (Repair, Retrofit, Replacement) Parking lot palliative interim measures until weather inclement or National Guard withdraws Time 0 Significant Seismic Event Occurs Robustness Pre-EQ Level = Hospital Infrastructure Recovers Without the Earthquake

11. Why SB 1953? 1994 Northridge quake critically damaged major hospitals - SB 1953 enacted –Protect life and property –Provide for treatment of injured –Protect investment –Reduce demand on post-earthquake resources

12. What is SB 1953? Evaluation –SB 1953 classifies buildings by risk (1=worst, 5-best) Structural (SPC-1 to SPC-5) Nonstructural (NPC-1 to NPC-5) Database of Hospital Building Stock Retrofit to prevent collapse and loss of life Retrofit to provide continued operation after an earthquake

13. SB 1953 Major Milestones 1998 1999 2000 2002 2008 2030 2001 Seismic evaluations and plans for compliance submitted to OSHPD Improvements to allow evacuation 1.1.2002 Improvements to allow evacuation 1.1.2002 Prevent collapse and loss of life 1.1.2008 Prevent collapse and loss of life 1.1.2008 All buildings capable of continued operation By 1.1.2030 All buildings capable of continued operation By 1.1.2030 2013 Possible Extension

14. Hospital Building Seismic Performance Ratings Structural Performance Ratings Total No. of Hospital Buildings Reported = 2719 435 Hospitals Reported SPC-1 = significant risk of collapse SPC-2 = pre-HSSA, no collapse SPC-3 to 5 = post-HSSA

15. Hospital Building Seismic Performance Ratings Non-Structural Performance Ratings 435 Hospitals Reported Non-Structural Performance Ratings Total No. of Hospital Buildings Reported = 2719

16. Bay Area Counties (9)

17. SPC Rating - ABAG vs Overall 9 ABAG Counties 435 Hospitals 19% 22% 29% 11% 20%

18. NPC Rating - ABAG Vs Overall 19% 17% 38% 19% 50% 3% 9 ABAG Counties 435 Hospitals

19. What Should Hospitals Be Doing Today? Mitigation Strategies –Conversion –Seismic Retrofit –Replacement

20. Delays in Compliance Diminished Capacity –Request by 01-01-07 SB 1801 (no longer Available) SB 2006 –2030/NPC 3/Zone 3 SB 1661 –2015 Compliance/Under Circumstances beyond hospital’s control SB 306 –2020/Fully Compliant Hospital Buildings Sooner

21. The Next Compliance Milestone 2013 SPC-2 –Advanced Analysis/Seismic Retrofit/HAZUS Reassessment NPC-3 –NPC-3 Specific Areas Critical Care Areas, Clinical laboratory service spaces, Pharmaceutical service spaces, Radiological service spaces; and Central and sterile supply areas.

22. Parting Thoughts SB 1953 Stimulates realistic long-term planning. When in doubt call us “Do nothing alternative” is not a solution –Phased but Continuous Mitigation over time will achieve compliance in the end