SB 1953 Background Information

California’s hospitals are on the front lines–operating around-the-clock emergency rooms and providing critical trauma care to all patients regardless of their ability to pay. 

But California’s hospitals face an unprecedented state mandate to meet sweeping new earthquake safety standards–an unfunded requirement so enormous that it dwarfs the ability of even the most financially sound hospitals to pay for it. 

California’s hospital seismic safety law, SB 1953, was passed in 1994 and requires every hospital building to comply with two deadlines. By Jan. 1, 2008 (or no later than Jan. 1, 2013 if an extension has been granted), every hospital building must meet specific construction standards established to keep these structures standing after a major earthquake. By Jan. 1, 2030, the law requires all hospital buildings to comply with standards intended to keep these buildings operational following a severe quake.

The costs of meeting this unfunded mandate continue to skyrocket. Many factors–including inflation, the limited number of qualified engineers and contractors, and the soaring costs of building materials – have pushed those costs up by as much as 20 percent annually. Since 2001, the estimated costs for hospital construction have more than doubled from $1 million to up to $2.5 million per bed.

Most hospitals in California–even those with strong finances–cannot afford to sustain up to 20 percent annual increases in facility construction. And the majority of California hospitals do not have strong financial bottom-lines. 

In the midst of these difficult times, policymakers and the public increasingly expect hospitals to invest in new, expensive technologies (such as those aimed at reducing medical errors and adding electronic medical records) that will improve the quality of care provided to patients. Again, these are worthy goals–but hospitals cannot do it all.

The state’s health care system is already facing extreme economic and operational pressures. Sixty-six percent of California’s hospitals – two out of every three – are currently losing money from operations. Hospitals are reeling from the impacts of reductions in reimbursement and delayed or denied payments from health plans, a statewide nursing shortage, increasing numbers of uninsured patients and surging growth in the state’s population.

SB 1953 At A Glance

• Seismic-safety legislation SB 1953 (Chapter 740, Statutes of 1994) was passed by the
• California Legislature in 1994 following the Northridge earthquake (which occurred on Jan. 17, 1994.) The Northridge earthquake caused 23 hospitals to suspend some or all of their services and resulted in more than $3 billion in hospital-related damages.
• SB 1953 requires hospitals to comply with three seismic safety deadlines – 1) by 2002, major non-structural systems such as backup generators, exit lighting, etc. must be braced; 2) by 2008, all general acute-care inpatient buildings at risk of collapsing during a strong earthquake must be rebuilt, retrofitted or closed; and 3) by 2030, all hospital buildings in the state must be operational following a major earthquake.
• All general acute-care inpatient hospital buildings must meet at least SPC-2 and NPC-3 requirements so as not to pose a risk of collapsing in a major earthquake. Meeting these requirements will allow hospital buildings to remain operational until 2030. A significant number of buildings that have to be retrofitted by 2008 (up to 2013) will ultimately have to be replaced in order to meet the more stringent 2030 requirements.
• There are approximately 2,700 general acute-care inpatient hospital buildings (approximately 470 hospitals) which are required to meet the mandates of SB 1953.