Hospitals throughout Los Angeles County and the state were dealt a blow earlier this month when Gov. Gavin Newsom vetoed legislation that would have extended by five years a 2030 deadline for hospitals to upgrade their facilities to be able to remain in operation following a major earthquake.
The bill, SB 1432, would have granted any hospital that asked an extension until Jan. 1, 2035, to come into compliance with a 1994 law that requires all hospitals to certify that all their major facilities would be fully functional during and after a major quake. The bill had five authors, led by State Sen. Anna Caballero, D-Salinas.
The original 1994 legislation was one of a series of laws enacted following two devastating earthquakes in Los Angeles County: the 1971 Sylmar quake in which two hospitals had collapsed buildings and the 1994 Northridge earthquake, after which eight hospitals had to evacuate patients because of lack of power, water or other key life-safety components.
Hospitals have long sought to extend the compliance deadlines for the seismic upgrade mandates, arguing that their often precarious finances make the huge capital investments needed to comply very difficult.
According to information in 2022 from the California Hospitals Association, roughly 73 of the L.A. County’s 93 hospital campuses had one or more buildings that hadn’t yet met the 2030 requirements to remain operational following a quake.
Back in 2016, Santa Monica-based Rand Corp. estimated the total cost to upgrade/replace these L.A. County facilities could range from a low of $9 billion to a high of $39 billion; that study was conducted before recent spikes in inflation and construction costs.
In late 2022, a major seismic upgrade was completed with the opening of a $644 million new patient tower at Providence Cedars-Sinai Tarzana Medical Center. Also, a $1.7 billion hospital replacement project is under way at Harbor-UCLA Medical Center in West Carson.
But lots of work remains at hospitals throughout Los Angeles County to meet the deadline. And most hospitals are not financially prepared to tackle the work: As of the end of 2022, according to Business Journal research, 47 of the 75 largest hospitals in the county had negative operating margins, meaning nearly two-thirds of those hospitals were losing money.
The California Hospital Association has repeatedly pushed legislation to extend the 2030 deadline, succeeding this year in passing SB 1432 out of the Legislature.
But Newsom vetoed the bill; in his veto message, he said hospitals have had 30 years to prepare for this mandate and urged “any hospitals at risk of non-compliance with the 2030 deadline to prioritize remaining work.”
Newsom also said that any extensions should be granted on a case-by-case basis and should be balanced with the pressing need to maintain adequate hospital operations in the aftermath of a major quake.
In a statement put out after Newsom’s veto, the California Hospital Association’s chief executive, Carmela Coyle, said hospitals that do not have the ability to meet the deadline could be forced to close.
The veto, Coyle said, “places communities across California at risk of losing access to vital emergency and acute health care services.”
A spokeswoman added that the association has not yet determined any future steps to attempt to extend the mandate.
One local hospital, Children’s Hospital Los Angeles in East Hollywood, sought an extension of the mandate through separate legislation; that bill, SB 1447, was still on Newsom’s desk as of Sept. 26.