Infra Insight Blog

On January 17, 1994, a 6.7 magnitude earthquake struck Northridge, California, resulting in thousands of casualties and approximately $60 billion in damages and economic loss. Hospitals within the impacted area suffered severe structural damage and many became inoperable. Recognizing the insufficiency of the existing seismic safety standards for hospitals, the state of California signed Senate Bill 1953 (SB 1953) into law in September 1994.

SB 1953, also known as the Hospital Seismic Retrofit Program, established the following deadlines by which all California general acute care hospitals must meet certain structural and nonstructural seismic strengthening requirements:

• By January 1, 2008, all general acute care hospitals were required to be retrofitted or replaced to prevent collapse after an earthquake. This deadline has since been extended to 2025.
• By January 1, 2030, all general acute care hospitals are required to be capable of remaining operational after an earthquake.

Under the law, the Office of Statewide Health Planning and Development (OSHPD) established the following earthquake performance categories for hospitals:

Structural Performance Categories (SPC) measure the probable seismic performance of building structural systems (such as columns and beams). SPC ratings range from 1 to 5. SPC 1 buildings may be at risk for collapse during an earthquake. SPC 5 buildings are reasonably capable of remaining operational after an earthquake.

Non-Structural Performance Categories (NPC) measure the probable seismic performance of equipment and systems critical to patient care. NPC ratings also range from 1 to 5.  NPC 1 is assigned to buildings where equipment and systems critical to patient care may be completely non-operational after an earthquake. NPC 5 is assigned to buildings where such equipment and systems are reasonably capable of remaining operational after an earthquake.

By 2030, all general acute care hospital buildings are required to be SPC 3 (at a minimum) and NPC 5.  Absent an exemption, hospitals that fail to meet these requirements must cease operations.

While a number of hospitals in Los Angeles County have initiated large-scale construction projects in response to these requirements, approximately two-thirds of hospitals across the state are still in need of major seismic upgrades in order to meet the impending deadline.  Many of these hospitals are small hospitals in rural or suburban areas.

Getting all hospitals across the finish line will not be an easy task. According to a 2019 study by the RAND Corporation, the seismic upgrades needed to bring all hospitals in compliance with the 2030 requirements may cost as much as $143 billion. 

The financial hurdles are particularly challenging for smaller and rural hospitals.  To address these challenges, the Small and Rural Hospital Relief Program, established by Senate Bill 395, provides funding and technical assistance for small, rural, and critical access hospitals in the state to meet the 2030 seismic safety standards. The program budget is currently $2-3 million but, per the state budget, $50 million in tax funds will be used to expand the program in 2024.

More information about the Small and Rural Hospital Relief Program can be found here.