text:
(a) By December 31, 1996, the California Building Standards Commission shall review, revise as necessary and adopt earthquake performance categories, seismic evaluation procedures, and standards and timeframes for upgrading the most critical nonstructural systems as developed by the department. By June 30, 1997, the California Building Standards Commission shall review, revise as necessary, and adopt seismic retrofit building standards and procedures for reviewing requests and granting delays to hospitals that demonstrate a need for more time to comply with Section 130060.

(b) For purposes of this section all submittals made by the department pursuant to subdivisions (i) and (j) of Section 130005 shall be deemed as emergency regulations and adopted as such.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 325. (AB 133) Effective July 27, 2021.)


kind: section

code: HSC

text:
(a) In the event of a seismic event, or other natural or manmade calamity that the department believes is of a magnitude so that it may have compromised the structural integrity of a hospital building, or any major system of a hospital building, the department shall send one or more authorized representatives to examine the structure or system. “System” for these purposes shall include, but not be limited to, the electrical, mechanical, plumbing, and fire and life safety system of the hospital building. If, in the opinion of the department, the structural integrity of the hospital building or any system has been compromised and damaged to a degree that the hospital building has been made unsafe to occupy, the department may cause to be placed on the hospital building either a red tag, a yellow tag, or a green tag.

(b) A “red” tag shall mean the hospital building is unsafe and shall be evacuated immediately. Access to red-tagged buildings shall be restricted to persons authorized by the department to enter.

(c) A “yellow” tag shall mean that the hospital building has been authorized for limited occupancy, and the authorized representative of the department shall write directly on the yellow tag that portion of the hospital building that may be entered with or without restriction and those portions that may not.

(d) A “green” tag shall mean the hospital building and all of its systems have been inspected by an authorized agent of the department, and have been found to be safe for use and occupancy.

(e) Any law enforcement or other public safety agency of this state shall grant access to hospital buildings by authorized representatives of the department upon the showing of appropriate credentials.

(f) For purposes of this section, “hospital building” includes the buildings referred to in paragraphs (2) and (3) of subdivision (b) of Section 129725.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 326. (AB 133) Effective July 27, 2021.)

division: 107. HEALTH CARE ACCESS AND INFORMATION

chapter: 1. Health Facilities

path: 107. HEALTH CARE ACCESS AND INFORMATION > 7. FACILITIES DESIGN REVIEW AND CONSTRUCTION > 1. Health Facilities > 8. New State Responsibilities For Seismic Safety in Hospitals


text:
(a) Within three years after the adoption of the standards described in Section 130020, owners of all general acute care hospitals shall:

(1) Conduct seismic evaluations in accordance with procedures developed by the department pursuant to subdivision (e) of Section 130005 and submit evaluations to the department for its review and approval.

(2) Identify the most critical nonstructural systems that represent the greatest risk of failure during an earthquake and submit the timetables for upgrading those systems pursuant to subdivision (f) of Section 130005 to the department for its review and approval.

(3) With respect to the nonstructural performance evaluation required by this subdivision, the evaluation need not exceed those required by the nonstructural performance category the hospital owner has elected. Additional evaluations shall be obtained if the hospital owner elects to obtain a higher nonstructural performance category at a future date. A hospital owner shall report to the department all deficiencies that are pertinent to the nonstructural performance category the hospital owner has elected to attain. A complete nonstructural evaluation and list of nonstructural deficiencies shall be submitted to the department prior to the hospital owner selling or leasing the hospital to another party.

(b) Within three years after the adoption of standards described in Section 130020, owners of all general acute care hospitals shall prepare a plan and compliance schedule for each building under the department’s jurisdiction that indicates the steps by which the hospital intends to bring their hospital buildings into substantial compliance with the regulations and standards developed by the department pursuant to the Alfred E. Alquist Hospital Facilities Seismic Safety Act and this act, identifies the phasing out of or retrofit of noncomplying structures and systems, or outlines steps for relocation of acute care services to facilities that comply with the regulations and standards developed by the department pursuant to the Alfred E. Alquist Hospital Facilities Seismic Safety Act and this act, and presents comprehensive plans and compliance schedules to the department for its review and approval, and integrates this schedule into the facility’s master plan.

(c) Owners of all general acute care hospitals may be granted a one year allowance from the requirements of subdivision (b) by the department if they demonstrate a need for more time to prepare plans and compliance schedules for their buildings.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 327. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities

path: 107. HEALTH CARE ACCESS AND INFORMATION > 7. FACILITIES DESIGN REVIEW AND CONSTRUCTION > 1. Health Facilities > 9. Hospital Owner Responsibilities


text:
On and after July 1, 2023, general acute hospital building owners shall do both of the following annually until each of the hospital buildings owned by that hospital building owner is compliant with Section 130065.

(a) Include all pertinent information regarding the building’s expected earthquake performance in emergency training, response, and recovery plans.

(b) Include all pertinent information regarding the building’s expected earthquake performance in capital outlay plans.

history: (History: Amended by Stats. 2022, Ch. 584, Sec. 3. (AB 1882) Effective January 1, 2023.)

part: 7. FACILITIES DESIGN REVIEW AND CONSTRUCTION

article: 9. Hospital Owner Responsibilities


text:
(a) (1) After January 1, 2008, a general acute care hospital building that is determined to be a potential risk of collapse or pose significant loss of life shall only be used for nonacute care hospital purposes, unless an extension of this deadline has been granted and either of the following occurs before the end of the extension:

(A) A replacement building has been constructed and a certificate of occupancy has been granted by the department for the replacement building.

(B) A retrofit has been performed on the building and a construction final has been obtained by the department.

(2) An extension of the deadline may be granted by the department upon a demonstration by the owner that compliance will result in a loss of health care capacity that may not be provided by other general acute care hospitals within a reasonable proximity. In its request for an extension of the deadline, a hospital shall state why the hospital is unable to comply with the January 1, 2008, deadline requirement.

(3) Prior to granting an extension of the January 1, 2008, deadline pursuant to this section, the department shall do all of the following:

(A) Provide public notice of a hospital’s request for an extension of the deadline. The notice, at a minimum, shall be posted on the department’s internet website, and shall include the facility’s name and identification number, the status of the request, and the beginning and ending dates of the comment period, and shall advise the public of the opportunity to submit public comments pursuant to subparagraph (C). The department shall also provide notice of all requests for the deadline extension directly to interested parties upon request of the interested parties.

(B) Provide copies of extension requests to interested parties within 10 working days to allow interested parties to review and provide comment within the 45-day comment period. The copies shall include those records that are available to the public pursuant to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).

(C) Allow the public to submit written comments on the extension proposal for a period of not less than 45 days from the date of the public notice.

(b) (1) It is the intent of the Legislature, in enacting this subdivision, to facilitate the process of having more hospital buildings in substantial compliance with this chapter and to take nonconforming general acute care hospital inpatient buildings out of service more quickly.

(2) The functional contiguous grouping of hospital buildings of a general acute care hospital, each of which provides, as the primary source, one or more of the hospital’s eight basic services as specified in subdivision (a) of Section 1250, may receive a five-year extension of the January 1, 2008, deadline specified in subdivision (a) of this section pursuant to this subdivision for both structural and nonstructural requirements. A functional contiguous grouping refers to buildings containing one or more basic hospital services that are either attached or connected in a way that is acceptable to the State Department of Health Care Services. These buildings may be either on the existing site or a new site.

(3) To receive the five-year extension, a single building containing all of the basic services or at least one building within the contiguous grouping of hospital buildings shall have obtained a building permit prior to 1973 and this building shall be evaluated and classified as a nonconforming, Structural Performance Category-1 (SPC-1) building. The classification shall be submitted to and accepted by the Department of Health Care Access and Information. The identified hospital building shall be exempt from the requirement in subdivision (a) until January 1, 2013, if the hospital agrees that the basic service or services that were provided in that building shall be provided, on or before January 1, 2013, as follows:

(A) Moved into an existing conforming Structural Performance Category-3 (SPC-3), Structural Performance Category-4 (SPC-4), or Structural Performance Category-5 (SPC-5) and Non-Structural Performance Category-4 (NPC-4) or Non-Structural Performance Category-5 (NPC-5) building.

(B) Relocated to a newly built compliant SPC-5 and NPC-4 or NPC-5 building.

(C) Continued in the building if the building is retrofitted to an SPC-5 and NPC-4 or NPC-5 building.

(4) A five-year extension is also provided to a post-1973 building if the hospital owner informs the Department of Health Care Access and Information that the building is classified as SPC-1, SPC-3, or SPC-4 and will be closed to general acute care inpatient service use by January 1, 2013. The basic services in the building shall be relocated into an SPC-5 and NPC-4 or NPC-5 building by January 1, 2013.

(5) SPC-1 buildings, other than the building identified in paragraph (3) or (4), in the contiguous grouping of hospital buildings shall also be exempt from the requirement in subdivision (a) until January 1, 2013. However, on or before January 1, 2013, at a minimum, each of these buildings shall be retrofitted to an SPC-2 and NPC-3 building, or no longer be used for general acute care hospital inpatient services.

(c) On or before March 1, 2001, the department shall establish a schedule of interim work progress deadlines that hospitals shall be required to meet to be eligible for the extension specified in subdivision (b). To receive this extension, the hospital building or buildings shall meet the year 2002 nonstructural requirements.

(d) A hospital building that is eligible for an extension pursuant to this section shall meet the January 1, 2030, nonstructural and structural deadline requirements if the building is to be used for general acute care inpatient services after January 1, 2030.

(e) Upon compliance with subdivision (b), the hospital shall be issued a written notice of compliance by the department. The department shall send a written notice of violation to hospital owners that fail to comply with this section. The department shall make copies of these notices available on its internet website.

(f) (1) A hospital that has received an extension of the January 1, 2008, deadline pursuant to subdivision (a) or (b) may request an additional extension of up to two years for a hospital building that it owns or operates and that meets the criteria specified in paragraph (2), (3), or (5).

(2) The department may grant the additional extension if the hospital building subject to the extension meets all of the following criteria:

(A) The hospital building is under construction at the time of the request for extension under this subdivision and the purpose of the construction is to meet the requirements of subdivision (a) to allow the use of the building as a general acute care hospital building after the extension deadline granted by the department pursuant to subdivision (a) or (b).

(B) The hospital building plans were submitted to the department and were deemed ready for review by the department at least four years prior to the applicable deadline for the building. The hospital shall indicate, upon submission of its plans, the SPC-1 building or buildings that will be retrofitted or replaced to meet the requirements of this section as a result of the project.

(C) The hospital received a building permit for the construction described in subparagraph (A) at least two years prior to the applicable deadline for the building.

(D) The hospital submitted a construction timeline at least two years prior to the applicable deadline for the building demonstrating the hospital’s intent to meet the applicable deadline. The timeline shall include all of the following:

(i) The projected construction start date.

(ii) The projected construction completion date.

(iii) Identification of the contractor.

(E) The hospital is making reasonable progress toward meeting the timeline set forth in subparagraph (D), but factors beyond the hospital’s control make it impossible for the hospital to meet the deadline.

(3) The department may grant the additional extension if the hospital building subject to the extension meets all of the following criteria:

(A) The hospital building is owned by a health care district that has, as owner, received the extension of the January 1, 2008, deadline, but where the hospital is operated by an unaffiliated third-party lessee pursuant to a facility lease that extends at least through December 31, 2009. The district shall file a declaration with the department with a request for an extension stating that, as of the date of the filing, the district has lacked, and continues to lack, unrestricted access to the subject hospital building for seismic planning purposes during the term of the lease, and that the district is under contract with the county to maintain hospital services when the hospital comes under district control. The department shall not grant the extension if an unaffiliated third-party lessee will operate the hospital beyond December 31, 2010.

(B) The hospital building plans were submitted to the department and were deemed ready for review by the department at least four years prior to the applicable deadline for the building. The hospital shall indicate, upon submission of its plans, the SPC-1 building or buildings that will be retrofitted or replaced to meet the requirements of this section as a result of the project.

(C) The hospital received a building permit for the construction described in subparagraph (B) by December 31, 2011.

(D) The hospital submitted, by December 31, 2011, a construction timeline for the building demonstrating the hospital’s intent and ability to meet the deadline of December 31, 2014. The timeline shall include all of the following:

(i) The projected construction start date.

(ii) The projected construction completion date.

(iii) Identification of the contractor.

(E) The hospital building is under construction at the time of the request for the extension, the purpose of the construction is to meet the requirements of subdivision (a) to allow the use of the building as a general acute care hospital building after the extension deadline granted by the office pursuant to subdivision (a) or (b), and the hospital is making reasonable progress toward meeting the timeline set forth in subparagraph (D).

(F) The hospital granted an extension pursuant to this paragraph shall submit an additional status report to the department, equivalent to that required by subdivision (c) of Section 130061, no later than June 30, 2013.

(4) An extension granted pursuant to paragraph (3) shall be applicable only to the health care district applicant and its affiliated hospital while the hospital is operated by the district or an entity under the control of the district.

(5) The department may grant the additional extension if the hospital building subject to the extension meets all of the following criteria:

(A) The hospital owner submitted to the department, prior to June 30, 2009, a request for review using current computer modeling utilized by the department and based upon software developed by the Federal Emergency Management Agency (FEMA), referred to as Hazards US, and the building was deemed SPC-1 after that review.

(B) The hospital building plans for the building are submitted to the department and deemed ready for review by the department prior to July 1, 2010. The hospital shall indicate, upon submission of its plans, the SPC-1 building or buildings that shall be retrofitted or replaced to meet the requirements of this section as a result of the project.

(C) The hospital receives a building permit from the department for the construction described in subparagraph (B) prior to January 1, 2012.

(D) The hospital submits, prior to January 1, 2012, a construction timeline for the building demonstrating the hospital’s intent and ability to meet the applicable deadline. The timeline shall include all of the following:

(i) The projected construction start date.

(ii) The projected construction completion date.

(iii) Identification of the contractor.

(E) The hospital building is under construction at the time of the request for the extension, the purpose of the construction is to meet the requirements of subdivision (a) to allow the use of the building as a general acute care hospital building after the extension deadline granted by the department pursuant to subdivision (a) or (b), and the hospital is making reasonable progress toward meeting the timeline set forth in subparagraph (D).

(F) The hospital owner completes construction such that the hospital meets all criteria to enable the department to issue a certificate of occupancy by the applicable deadline for the building.

(6) A hospital located in the County of Sacramento, San Mateo, or Santa Barbara or the City of San Jose or the City of Willits that has received an additional extension pursuant to paragraph (2) or (5) may request an additional extension until September 1, 2015, to obtain either a certificate of occupancy from the department for a replacement building, or a construction final from the department for a building on which a retrofit has been performed.

(7) A hospital denied an extension pursuant to this subdivision may appeal the denial to the Hospital Building Safety Board.

(8) The department may revoke an extension granted pursuant to this subdivision for any hospital building where the work of construction is abandoned or suspended for a period of at least one year, unless the hospital demonstrates in a public document that the abandonment or suspension was caused by factors beyond its control.

(g) (1) Notwithstanding subdivisions (a), (b), (c), and (f), and Sections 130061.5 and 130064, a hospital that has received an extension of the January 1, 2008, deadline pursuant to subdivision (a) or (b) also may request an additional extension of up to seven years for a hospital building that it owns or operates. The department may grant the extension subject to the hospital meeting the milestones set forth in paragraph (2).

(2) The hospital building subject to the extension shall meet all of the following milestones, unless the hospital building is reclassified as SPC-2 or higher as a result of its Hazards US score:

(A) The hospital owner submits to the department, no later than September 30, 2012, a letter of intent stating whether it intends to rebuild, replace, or retrofit the building, or remove all general acute care beds and services from the building, and the amount of time necessary to complete the construction.

(B) The hospital owner submits to the department, no later than September 30, 2012, a schedule detailing why the requested extension is necessary, and specifically how the hospital intends to meet the requested deadline.

(C) The hospital owner submits to the department, no later than September 30, 2012, an application ready for review seeking structural reassessment of each of its SPC-1 buildings using current computer modeling based upon software developed by FEMA, referred to as Hazards US.

(D) The hospital owner submits to the department, no later than January 1, 2015, plans ready for review consistent with the letter of intent submitted pursuant to subparagraph (A) and the schedule submitted pursuant to subparagraph (B).

(E) The hospital owner submits a financial report to the department at the time the plans are submitted pursuant to subparagraph (D). The report shall demonstrate the hospital owner’s financial capacity to implement the construction plans submitted pursuant to subparagraph (D).

(F) The hospital owner receives a building permit consistent with the letter of intent submitted pursuant to subparagraph (A) and the schedule submitted pursuant to subparagraph (B), no later than July 1, 2018.

(3) To evaluate public safety and determine whether to grant an extension of the deadline, the department shall consider the structural integrity of the hospital’s SPC-1 buildings based on its Hazards US scores, community access to essential hospital services, and the hospital owner’s financial capacity to meet the deadline as determined by either a bond rating of BBB or below or the financial report on the hospital owner’s financial capacity submitted pursuant to subparagraph (E) of paragraph (2). The criteria contained in this paragraph shall be considered by the department in its determination of the length of an extension or whether an extension should be granted.

(4) The extension or subsequent adjustments granted pursuant to this subdivision may not exceed the amount of time that is reasonably necessary to complete the construction specified in paragraph (2).

(5) If the circumstances underlying the request for extension submitted to the department pursuant to paragraph (2) change, the hospital owner shall notify the department as soon as practicable, but in no event later than six months after the hospital owner discovered the change of circumstances. The department may adjust the length of the extension granted pursuant to paragraphs (2) and (3) as necessary, but in no event longer than the period specified in paragraph (1).

(6) A hospital denied an extension pursuant to this subdivision may appeal the denial to the Hospital Building Safety Board.

(7) The department may revoke an extension granted pursuant to this subdivision for any hospital building when it is determined that any information submitted pursuant to this section was falsified, or if the hospital failed to meet a milestone set forth in paragraph (2), or where the work of construction is abandoned or suspended for a period of at least six months, unless the hospital demonstrates in a publicly available document that the abandonment or suspension was caused by factors beyond its control.

(8) Regulatory submissions made by the department to the California Building Standards Commission to implement this section shall be deemed to be emergency regulations and shall be adopted as emergency regulations.

(9) The hospital owner that applies for an extension pursuant to this subdivision shall pay the office an additional fee, to be determined by the department, sufficient to cover the additional reasonable costs incurred by the department for maintaining the additional reporting requirements established under this section, including, but not limited to, the costs of reviewing and verifying the extension documentation submitted pursuant to this subdivision. This additional fee shall not include any cost for review of the plans or other duties related to receiving a building or occupancy permit.

(10) This subdivision shall become operative on the date that the State Department of Health Care Services receives all necessary federal approvals for a 2011–12 fiscal year hospital quality assurance fee program that includes three hundred twenty million dollars ($320,000,000) in fee revenue to pay for health care coverage for children, which is made available as a result of the legislative enactment of a 2011–12 fiscal year hospital quality assurance fee program.

(h) A critical access hospital located in the City of Tehachapi may submit a seismic safety extension application pursuant to subdivision (g), notwithstanding deadlines in that subdivision that are earlier than the effective date of the act that added this subdivision. The submitted application shall include a timetable as required pursuant to subdivision (g).

(i) (1) A hospital located in the Tarzana neighborhood of the City of Los Angeles that has received extensions pursuant to subdivisions (b) and (g) may request an additional extension for a single building until October 1, 2022, in order to obtain a certificate of occupancy from the department for a replacement building.

(2) The hospital owner seeking the extension shall submit a written request that includes a timeline specifying how the hospital intends to meet the new deadline, including the construction document submission dates. The following timeline shall be met for construction document submissions:

(A) No later than January 1, 2018, the hospital owner shall submit construction documents, deemed ready for review, related to the first final review of the second increment with information including the building core and shell of the hospital. Failure to submit the construction documents by January 1, 2018, shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the documents are submitted.

(B) No later than March 1, 2018, the hospital owner shall submit construction documents, deemed ready for review, related to the first final review of the first increment with information including the structural foundation, frame, and underslab utilities of the hospital. Failure to submit the construction documents by March 1, 2018, shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the documents are submitted.

(C) No later than September 1, 2018, the hospital owner shall submit construction documents, deemed ready for review, related to the first final review of the third increment with information on the build-out of the hospital. Failure to submit the construction documents by September 1, 2018, shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the documents are submitted.

(D) No later than November 1, 2018, the hospital owner shall submit construction documents, deemed ready for review, related to the first final review of the fourth increment with information on the seismic support and anchorage of the hospital. Failure to submit the construction documents by November 1, 2018, shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the documents are submitted.

(E) The hospital owner may submit a written request to the department seeking an extension of the deadlines set forth in subparagraphs (A), (B), (C), and (D). The written request shall state with specificity the reason for the request and how the reason preventing compliance with the deadlines was outside of the control of the hospital owner. After review of the request for extension, the department may grant the request for a period of time not to exceed 30 calendar days. If the department grants the request for an extension, no fine shall accrue or be imposed during the extension period.

(3) Notwithstanding any other law, any fines assessed pursuant to paragraph (2) shall be deposited into the General Fund following a determination on appeal, if any. A hospital assessed a fine pursuant to this subdivision may appeal the assessment to the Hospital Building Safety Board, provided the hospital posts the funds for any fines to be held by the department pending the resolution of the appeal.

(4) The department shall not issue a certificate of occupancy for the single replacement building until all assessed fines accrued pursuant to paragraph (2) have been paid in full, or, if an appeal is pending, have been posted subject to resolution of an appeal. Fines deposited by the hospital pursuant to paragraph (3) shall be considered paid in full for purposes of issuing a certificate of occupancy pursuant to this paragraph. This paragraph is in addition to, and is not intended to supersede, any other requirements that must be met by the hospital for issuance by the department of a certificate of occupancy.

history: (History: Amended by Stats. 2022, Ch. 28, Sec. 113. (SB 1380) Effective January 1, 2023.)

article: 9. Hospital Owner Responsibilities


text:
(a) An owner of a general acute care hospital building that is classified as a nonconforming Structural Performance Category-1 (SPC-1) building, who has not requested an extension of the deadline described in subdivision (a) or (b) of Section 130060, shall submit a report to the department no later than April 15, 2007, describing the status of each building in complying with the requirements of Section 130060. The report shall identify at least all of the following:

(1) Each building that is subject to subdivision (a) of Section 130060.

(2) The project number or numbers for retrofit or replacement of each building.

(3) The projected construction start date or dates and projected construction completion date or dates.

(4) The building or buildings to be removed from acute care service and the projected date or dates of this action.

(b) An owner of a general acute care hospital building that is classified as a nonconforming, Structural Performance Category-1 (SPC-1) building, who has requested an extension of the deadline described in subdivision (a) or (b) of Section 130060, shall submit a report to the department no later than June 30, 2009, describing the status of each building in complying with the requirements of Section 130060. The report shall identify, at a minimum, all of the following:

(1) Each building that is subject to subdivision (a) of Section 130060.

(2) The project number or numbers for retrofit or replacement of each building.

(3) The projected construction start date or dates and projected construction completion date or dates.

(4) The building or buildings to be removed from acute care service and the projected date or dates of that action.

(c) An owner of a general acute care hospital building that is classified as a nonconforming, Structural Performance Category-1 (SPC-1) building, shall submit a report to the department no later than November 1, 2010, describing the status of each building in complying with the requirements of Section 130060, and annually thereafter shall update the department with any changes or adjustments. The report shall identify at least all of the following:

(1) For each building that is subject to subdivision (a) of Section 130060 that is planned for retrofit or replacement, the report shall identify:

(A) Whether the hospital owner intends to retrofit or replace the building to SPC-2, SPC-3, SPC-4, or SPC-5.

(B) The deadline, as described in Section 130060 or 130061.5, for retrofit or replacement of the building that the hospital owner intends to meet, and the applicable extension for which the hospital owner has been approved.

(C) The project number or numbers for retrofit or replacement of each building.

(D) The projected construction start date or dates and projected construction completion date or dates.

(E) The most recent project status and approvals.

(F) The number of inpatient beds and patient days, by type of unit and type of service to be provided.

(2) For the building or buildings to be removed from acute care service, the following information shall be included:

(A) The projected date or dates the building will be removed from service.

(B) The planned uses of the building or buildings to be removed from acute care service.

(C) The inpatient services currently delivered in the building or buildings.

(D) The number of inpatient beds and patient days, by type of unit and type of service, for the years 2008, 2009, and 2010.

(E) Whether the general acute care services and beds will be relocated to a new or retrofitted building and any corresponding building sites or project numbers.

(3) Each hospital owner shall also report, for each facility for which any buildings will be removed from acute care service, any net change in the number of inpatient beds, by type of unit and type of service, taking into account beds provided in buildings to be taken out of service, beds provided in buildings to be retrofitted or replaced, and beds provided in any other buildings used for general acute care inpatient services by the facility.

(4) Each hospital owner shall report any general acute care hospital inpatient service that is provided in any general acute care hospital building that is rated SPC-1.

(5) Each hospital owner shall report the final configuration of all buildings on its campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements, whether by retrofit or by replacement, and the type of services that will be provided in each general acute care hospital building.

(d) The department shall make the information required by subdivisions (a) and (b), available on its internet website within 90 days of receipt of this information.

(e) The department shall make the information required by subdivision (c) available on its internet website within 90 days of receipt of this information. The department shall include the hospital name, hospital owners, and location of the buildings included in the report, and, to the extent possible, for service areas containing buildings for which hospital owners report information pursuant to subdivision (c), include information on the number of inpatient beds, by type of unit and type of service, provided by facilities operating buildings that are classified as SPC-2, SPC-3, SPC-4, and SPC-5.

(f) Hospitals that have not reported pursuant to this section are not eligible for the extension provided in subdivision (f) of Section 130060.

(g) A hospital that has not submitted a report pursuant to this section shall be assessed a fine of ten dollars ($10) per licensed acute care bed per day, but in no case to exceed one thousand dollars ($1,000) per day for each SPC-1 building not in compliance with this section until it has complied with the provisions of this section. These fines shall be deposited into the Hospital Building Fund as specified pursuant to Section 129795. A hospital assessed a fine pursuant to this section may appeal the assessment to the Hospital Building Safety Board.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 330. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text:
(a) The Legislature finds and declares the following:

(1) By enacting this section, the Legislature reinforces its commitment to ensuring the seismic safety of hospitals in California. In order to meet that commitment, this section provides a mechanism for hospitals that lack the financial capacity to retrofit Structural Performance Category-1 (SPC-1) buildings by 2013 to, instead, redirect available capital and borrowing capacity to replace those building by 2020. The mechanism is intended to allow these hospitals to meet the seismic requirements, and provide state agencies and the public with more timely and detailed information about the progress these hospitals are making toward seismic safety compliance.

(2) This section requires hospitals seeking this assistance to demonstrate that their financial condition does not allow them to retrofit these buildings by 2013, and requires them to meet specified benchmarks in order to be eligible for the extended timelines set forth in this section. Failure to meet any of these benchmarks shall result in the hospital being noncompliant and subject the hospital to loss of licensure.

(3) It is the intent of the Legislature to ensure the continuation of services in medically underserved communities in which the closure of the hospital would have significant negative impacts on access to health care services in the community.

(4) It is also the intent of the Legislature that this section be implemented very narrowly to target only facilities that are essential providers in underserved communities and that lack the financial capacity to retrofit SPC-1 buildings by 2013.

(b) A hospital owner may meet the requirements of subdivision (a) of Section 130060 by replacing all of its buildings subject to that subdivision by January 1, 2020, if it meets all of the following conditions:

(1) The hospital owner has requested an extension of the deadline described in subdivision (a) or (b) of Section 130060.

(2) (A) The department certifies that the hospital owner lacks the financial capacity to meet the requirements of subdivision (a) of Section 130060 for that building. In order to receive the certification, the hospital owner shall file with the department by January 1, 2009, financial information as required by the department. This information shall include a schedule demonstrating that, as of the end of the hospital owner’s most recent fiscal year for which the hospital owner has filed its annual financial data with the department by July 1, 2007, the hospital owner’s annual financial data for that fiscal year show that the hospital owner meets all of the following financial conditions:

(i) The owner’s net long-term debt to capitalization ratio, as measured by the ratio of net long-term debt to net long-term debt plus equity, was above 60 percent.

(ii) The owner’s debt service coverage, as measured by the ratio of net income plus depreciation expense plus interest expense to current maturities on long-term debt plus interest expense, was below 4.5.

(iii) The owner’s cash-to-debt ratio, as measured by the ratio of cash plus marketable securities plus limited use cash plus limited use investments to current maturities on long-term debt plus net long-term debt, was below 90 percent.

(B) The department shall certify that a hospital owner applying for relief under this subdivision meets each of these financial conditions. For the purposes of this subdivision, a hospital owner shall be eligible for certification only if the annual financial data required by this paragraph for the hospital owners and all of its hospital affiliates, considered in total, meets all of these financial conditions. For purposes of this section, “hospital affiliate” means any hospital owned by an entity that controls, is controlled by, or is under the common control of, directly or through intermediate entity, the entity that owns the specified hospital. The applicant hospital owner shall bear all costs for review, but not to exceed the costs of review, of its financial information.

(3) The hospital owner files with the department, by January 1, 2009, a declaration that the hospital for which the hospital owner is seeking relief under this subdivision shall satisfy all of the following conditions:

(A) The hospital shall maintain a contract with the California Medical Assistance Commission (CMAC) under the selective provider contracting program, unless in an open area as established by CMAC.

(B) The hospital shall maintain at least basic emergency medical services if the hospital provided emergency medical services at the basic or higher level as of July 1, 2007.

(C) The hospital meets any of the following criteria:

(i) The hospital is located within a Medically Underserved Area or a Health Professions Shortage Area designated by the federal government pursuant to Sections 330 and 332 of the federal Public Health Service Act (42 U.S.C. Secs. 254b and 254e).

(ii) The department determines, by means of a health impact assessment, that removal of the building or buildings from service may diminish significantly the availability or accessibility of health care services to an underserved community.

(iii) The CMAC determines that the hospital is essential to providing and maintaining Medi-Cal services in the hospital’s service area.

(iv) The hospital demonstrates that, based on annual utilization data submitted to the office for 2006 or later, the hospital had in one year over 30 percent of all discharges for either Medi-Cal or indigent patients in the county in which the hospital is located.

(4) The hospital owner submits, by January 1, 2010, a facility master plan for all the buildings that are subject to subdivision (a) of Section 130060 that the hospital intends to replace by January 1, 2020. The facility master plan shall identify at least all of the following:

(A) Each building that is subject to subdivision (a) of Section 130060.

(B) The plan to replace each building with buildings that would be in compliance with subdivision (a) of Section 130065.

(C) The building or buildings to be removed from acute care service and the projected date or dates of that action.

(D) The location for any new building or buildings, including, but not limited to, whether the owner has received a permit for that location. The replacement buildings shall be planned within the same service area as the buildings to be removed from service.

(E) A copy of the preliminary design for the new building or buildings.

(F) The number of beds available for acute care use in each new building.

(G) The timeline for completed plan submission.

(H) The proposed construction timeline.

(I) The proposed cost at the time of submission.

(J) A copy of any records indicating the hospital governing board’s approval of the facility plan.

(5) By January 1, 2013, the hospital owner submits to the department a building plan that is deemed ready for review by the department, for each building.

(6) By January 1, 2015, the hospital owner receives a building permit to begin construction, for each building that the owner intends to replace pursuant to the master plan.

(7) Within six months of receipt of the building permit, the hospital owner submits a construction timeline that identifies at least all of the following:

(A) Each building that is subject to subdivision (a) of Section 130060.

(B) The project number or numbers for replacement of each building.

(C) The projected construction start date or dates and projected construction completion date or dates.

(D) The building or buildings to be removed from acute care.

(E) The estimated cost of construction.

(F) The name of the contractor.

(8) Every six months thereafter, the hospital owner reports to the department on the status of the project, including any delays or circumstances that could materially affect the estimated completion date.

(9) The hospital owner pays to the department an additional fee, to be determined by the department, sufficient to cover the additional cost incurred by the department for maintaining all reporting requirements established under this section, including, but not limited to, the costs of reviewing and verifying the financial information submitted pursuant to paragraph (2). This additional fee shall not include any cost for review of the plans or other duties related to receiving a building or occupancy permit.

(c) The department may also approve an extension of the deadline described in subdivision (a) or (b) of Section 130060 for a general acute care hospital building that is classified as a nonconforming SPC-1 building and is owned or operated by a county, city, or county and city that has requested an extension of this deadline by June 30, 2009, if the owner files a declaration with the department stating that as of the date of that filing the owner lacks the ability to meet the requirements of subdivision (a) of Section 130060 for that building pursuant to subdivision (b) of that section. The declaration shall state the commitment of the hospital to replace those buildings by January 1, 2020, with other buildings that meet the requirements of Section 130065 and shall meet the requirements of paragraphs (4) to (9), inclusive, of subdivision (b).

(d) A hospital filing a declaration pursuant to this section but failing to meet any of the deadlines set forth in this section shall be deemed in violation of this section and Section 130060, and shall be subject to loss of licensure.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 331. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text:
(a) For the purposes of this section, the following terms have the following meanings:

(1) “Rebuild plan” means a plan to meet seismic standards primarily by constructing a new conforming SPC-5 building for use in lieu of an SPC-1 building.

(2) “Removal plan” means a plan to meet seismic standards primarily by removing acute care services or beds from the hospital’s license.

(3) “Replacement plan” means a plan to meet seismic standards primarily by relocating acute care services or beds from nonconforming buildings into a conforming building.

(4) “Retrofit plan” means a plan to meet seismic standards primarily by modifying the building in a manner that brings the building up to SPC-2, SPC-4D, or SPC-5 standards.

(b) (1) Except as specified in paragraph (2), all hospitals seeking an extension for their SPC-1 buildings shall submit to the department an application, in a manner acceptable to the department, by April 1, 2019.

(2) If Providence Tarzana Medical Center in the City of Los Angeles or UCSF Benioff Children’s Hospital in the City of Oakland seeks an extension for its SPC-1 buildings, it shall submit to the department an application, in a manner acceptable to the department, by September 1, 2019.

(3) At a minimum, an application described in paragraph (1) or (2) shall state which of the seismic compliance methods described in subdivision (a) will be used for each SPC-1 building.

(c) A hospital owner that has been granted an extension pursuant to subdivision (g) of Section 130060 or subdivision (b) of Section 130061.5 may request, and the department shall grant, an additional extension of time as set forth in this section.

(d) (1) For a hospital that seeks an extension for compliance based on a replacement plan or retrofit plan, the owner shall submit a construction schedule, obtain a building permit, and begin construction by April 1, 2020.

(2) Using the construction schedule submitted pursuant to paragraph (1), the hospital and the department shall identify at least two major milestones relating to the compliance plan that will be used as the basis for determining whether the hospital is making adequate progress toward meeting the seismic compliance deadline.

(3) Failure to comply with the requirements described in paragraph (1) or (2), or to meet any milestone agreed to pursuant to paragraph (2), shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met.

(4) Final seismic compliance shall be achieved by July 1, 2022.

(e) (1) For a hospital that seeks an extension for compliance based on a rebuild plan, the department shall grant an extension of up to five years. The owner shall submit, in a manner acceptable to the department, no later than July 1, 2020, the rebuild plan, deemed ready for review, and shall submit a construction schedule, obtain a building permit, and begin construction no later than January 1, 2022.

(2) The hospital and the department shall identify at least two major milestones, agreed upon by the hospital and the department, that will be used as the basis for determining whether the hospital is making adequate progress toward meeting the seismic compliance deadline.

(3) Failure to comply with the requirements described in paragraph (1) or (4), or to meet any milestone agreed to pursuant to paragraph (2) or (4), shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met.

(4) For a hospital that has previously submitted to the department a rebuild project under construction, the department may accept certification from the hospital that it has obtained appropriate building permits consistent with an approved incremental plan review and that construction thereunder has commenced and is continuing. The previously approved construction schedule shall be amended to reflect the extension being requested, and at least two new major milestones shall be identified. The owner shall not be required to resubmit construction plans previously submitted to the department, and the department may not impose new or different requirements for any increment already approved or building permit already issued by the department as a condition for granting an extension.

(5) Final seismic compliance shall be achieved, and a certificate of occupancy shall be obtained, by January 1, 2025.

(f) The department may grant an adjustment to the requirements described in paragraph (1) or (2) of subdivision (d) or paragraph (1) or (4) of subdivision (e), or the milestones agreed to pursuant to paragraph (2) of subdivision (d) or paragraph (2) or (4) of subdivision (e), as necessary to deal with contractor, labor, or material delays, or with acts of God, or with governmental entitlements, experienced by the hospital. If that adjustment is granted, the hospital shall submit a revised construction schedule, and the hospital and the department shall identify at least two new major milestones consistent with the adjustment. Failure to comply with the revised construction schedule or meet any of the major milestones shall result in penalties as specified in paragraph (3) of subdivision (d) and paragraph (3) of subdivision (e). The adjustment shall not exceed the corresponding final seismic compliance date specified in paragraph (4) of subdivision (d) or paragraph (5) of subdivision (e).

(g) The duration of an extension granted by the department pursuant to this section shall not exceed the maximums permitted by this section. Moreover, within that limit, the department shall not grant an extension that exceeds the amount of time needed by the owner to come into compliance. The determination by the department regarding the length of the extension to be granted shall be based upon a showing by the owner of the facts necessitating the additional time. It shall include a review of the plan and all the documentation submitted in the application for the extension, and shall permit only that additional time necessary to allow the owner to deal with compliance plan issues that cannot be fully met without the extension.

(h) No extension shall be granted pursuant to this section for SPC-1 buildings unless the owner has submitted to the department, by January 1, 2018, a seismic compliance plan.

(i) An extension shall not be granted pursuant to this section for seismic compliance based upon a removal plan.

(j) (1) Except as specified in paragraph (2), in lieu of the reporting requirements described in Section 130061, a hospital granted an extension pursuant to this section shall provide a quarterly status report to the department, with the first report due on July 1, 2019, and every October 1, January 1, April 1, and July 1 thereafter, until seismic compliance is achieved.

(2) In lieu of the reporting requirements described in Section 130061, if Providence Tarzana Medical Center in the City of Los Angeles or UCSF Benioff Children’s Hospital in the City of Oakland is granted an extension pursuant to this section based on an application submitted on or after April 1, 2019, the first quarterly status report shall be due on October 1, 2019, and every January 1, April 1, July 1, and October 1 thereafter, until seismic compliance is achieved.

(3) The office shall post the status reports described in paragraphs (1) and (2) on its internet website.

(k) Before June 1, 2019, the office shall provide the Legislature with an inventory of the SPC category of each hospital building. A report submitted to the Legislature pursuant to this subdivision shall be submitted in compliance with Section 9795 of the Government Code.

(l) (1) The office may revoke an extension granted pursuant to this section for a hospital building where the assessment for a penalty exceeds 60 days.

(2) Notwithstanding any other law, any penalties assessed pursuant to this section shall be deposited into the General Fund within 45 days of assessment or within 45 days following a determination on appeal, if any. A hospital assessed a penalty pursuant to this section may appeal the assessment to the Hospital Building Safety Board, provided the hospital posts the funds for any penalties with the department, to be held pending the resolution of the appeal.

(3) The department shall not issue a construction final or certificate of occupancy for the building until all assessed penalties accrued pursuant to this section have been paid in full or, if an appeal is pending, have been posted subject to resolution of the appeal. Penalties deposited by the hospital pursuant to paragraph (2) shall be considered paid in full for purposes of issuing a construction final or certificate of occupancy. This paragraph is in addition to, and is not intended to supersede, any other requirements that must be met by the hospital for issuance of a construction final or certificate of occupancy.

(m) The department may promulgate emergency regulations as necessary to implement this section.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 332. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text:
(a) With regard to a general acute care hospital building located in Seismic Zone 3 as indicated in the 1995 edition of the California Building Standards Code, any hospital may request an exemption from Non-Structural Performance Category-3 requirements in Title 24 of the California Code of Regulations if the hospital building complies with the year 2002 nonstructural requirements.

(b) The department shall determine the maximum allowable level of earthquake ground shaking potential for purposes of this section.

(c) To qualify for an exemption under this section, a hospital shall provide a site-specific engineering geologic report that demonstrates an earthquake ground shaking potential below the maximum allowable level of earthquake ground shaking potential determined by the department pursuant to subdivision (b).

(d) (1) To demonstrate an earthquake ground shaking potential as provided in subdivision (c), a hospital shall submit a site-specific engineering geologic report to the department.

(2) The department shall forward the report received from a hospital to the Division of Mines and Geology in the Department of Conservation for purposes of a review.

(3) If, after review of the analysis, the Division of Mines and Geology concurs with the findings of the report, it shall return the report with a statement of concurrence to the office. Upon the receipt of the statement, if the ground shaking potential is below that established pursuant to subdivision (b), the department shall grant the exemption requested.

(e) A hospital building that is eligible for an exemption under this section shall meet the January 1, 2030, nonstructural requirement deadline if the building is to be used for general acute care inpatient services after January 1, 2030.

(f) A hospital requesting an exemption pursuant to this section shall pay the actual expenses incurred by the department and the Division of Mines and Geology.

(g) All regulatory submissions to the California Building Standards Commission made by the department for purposes of this section shall be deemed to be emergency regulations and shall be adopted as emergency regulations. This emergency regulation authority shall remain in effect until January 1, 2004.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 333. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text:
Notwithstanding Section 130063, a county-owned general acute care hospital building is allowed an extension of the Non-structural Performance Category-2 requirements of Title 24 of the California Code of Regulations if all of the following conditions are met:

(a) The county submitted the compliance plan on or before January 1, 2001.

(b) The county submitted the Non-structural Performance Category-2 building plans to the Department of Health Care Access and Information on or before September 1, 2001.

(c) The county complies with the year 2002 nonstructural requirements established by regulation 12 months after receipt of the building permit approval letter from the Department of Health Care Access and Information.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 334. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text:
Notwithstanding Section 130063, an existing county-owned general acute care hospital building may receive a one-year extension of the January 1, 2002, deadline for the Non-structural Performance Category-2 requirements in Title 24 of the California Code of Regulations if all of the following conditions are met:

(a) The existing hospital building is removed from general acute care service on or before January 1, 2003.

(b) Construction of the replacement building that will meet the 2030 nonstructural and structural deadline requirements, which commenced before January 1, 2001, is completed by January 1, 2003.

history: (History: Added by Stats. 2001, Ch. 247, Sec. 2. Effective January 1, 2002.)

article: 9. Hospital Owner Responsibilities


text:
(a) In lieu of the extension described in subdivision (f) of Section 130060, the department may grant an extension to a general acute care hospital pursuant to either subdivision (c) or (f) if the hospital building will not meet the seismic safety standards of that section by January 1, 2013, due to a local planning delay.

(b) When applying for an extension under this section, the owner of the general acute care hospital shall submit to the department documentation that includes at least all of the following:

(1) The original schedule of the project or projects as had been originally anticipated.

(2) The schedule of the project or projects as currently projected.

(3) A timeline for the submission of documents to the local planning authority or jurisdiction.

(4) Documentation that the local planning authority for the project and for the enabling phases of the project does not grant approvals prior to November 1, 2010, where the hospital had originally filed the local application prior to January 1, 2008.

(5) A proposed construction timeframe demonstrating the completion of the project once the permit is issued. The construction timeframe shall be approved by the department and shall only include the amount of time that is reasonably necessary to complete the construction required to meet the seismic safety requirements.

(c) The department may grant an extension, in full one-year increments, but no longer than three consecutive years, that compensates for delays determined pursuant to subdivision (d).

(d) The department shall conduct a comprehensive review of the schedule for the project or projects according to criteria specified in this section. This review shall encompass the project or projects under the jurisdiction of the department, as well as other project phases not under the jurisdiction of the department. The department shall consider the cumulative effect of local approval timelines for all elements of the project or projects, inclusive of changes in scope or sequence of the project or projects required by the local planning process. The department may grant extensions based on an evaluation of each of the following circumstances:

(1) Where the local planning authority approvals have delayed or will delay the construction start date of the project or projects.

(2) Where the local conditions of approval on a project or projects extend the duration beyond the originally anticipated construction completion date.

(3) Where the cumulative effect of delays on the project or projects creates additional construction delays due to local seasonal weather impact requirements of the local planning authority.

(4) Construction related to the seismic retrofit or replacement project has begun by January 1, 2013.

(5) The project or projects were submitted for review by the department no later than January 1, 2009.

(6) The project or projects have received a building permit from the department no later than January 1, 2012.

(e) Every six months after the approval of the extension, the hospital owner shall report to the department on the status of the project or projects, demonstrating that it is making reasonable progress toward meeting the construction timeline.

(f) The department may grant an additional extension of up to two years in addition to the extension granted pursuant to subdivisions (c) and (d) only if the project or projects meet all of the following criteria:

(1) A matrix of buildings at the hospital that identifies compliance of each building to the standards required by Section 130065 at the completion of the project or projects.

(2) The construction timelines submitted pursuant to subdivision (a) were determined to go beyond three years from the date the building permit was issued.

(3) Acute care services will not be provided in any SPC-1 building at any time during the extension.

(4) The hospital demonstrates that it has, and maintains throughout the extension, life safety systems in all acute care patient care areas that do not depend on, and are not routed through, an SPC-1 building.

(5) The hospital either demonstrates that the SPC-1 building does not pose a structural risk to an adjoining hospital building that is used for acute care services or mitigates the risk in accordance with a deadline described in subdivision (f) of Section 130060 that the department determines will best protect patient safety.

(g) The department may revoke an extension granted pursuant to this section for any hospital building where the work of construction is abandoned or suspended for a period of at least six months, unless the hospital demonstrates that the abandonment or suspension was caused by factors beyond its control.

(h) The department may revoke an extension granted pursuant to this section if it is determined that any information submitted pursuant to this section was falsified in any manner by the hospital or if the hospital fails to meet any of the criteria or conditions specified in this section.

(i) Regulatory submissions made by the department to the California Building Standards Commission pursuant to this section shall be deemed, and shall be adopted as, emergency regulations.

(j) The hospital owner that applies for an extension pursuant to this section shall pay to the department an additional fee, to be determined by the department, sufficient to cover the additional cost incurred by the office for maintaining all reporting requirements established under this section, including, but not limited to, the costs of reviewing and verifying the extension documentation submitted pursuant to this section. This additional fee shall not include any cost for review of the plans or other duties related to receiving a building or occupancy permit.

(k) A hospital denied an extension pursuant to this section may appeal the denial to the Hospital Building Safety Board.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 335. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text:
(a) In accordance with the compliance schedule approved by the department, but in any case no later than January 1, 2030, owners of all acute care inpatient hospitals shall either:

(1) Demolish, replace, or change to nonacute care use all hospital buildings not in substantial compliance with the regulations and standards developed by the department pursuant to the Alfred E. Alquist Hospital Facilities Seismic Safety Act and this act.

(2) Seismically retrofit all acute care inpatient hospital buildings so that they are in substantial compliance with the regulations and standards developed by the department pursuant to the Alfred E. Alquist Hospital Facilities Seismic Safety Act and this act.

(b) Notwithstanding subdivision (a), if a hospital’s seismic compliance plan, developed pursuant to subdivisions (b) and (d) of Section 130065.1, or pursuant to Section 130069.1, and approved by the department, substantiates the need for a delay of up to three years or, at most, five years beyond January 1, 2030, the owner of that general acute care hospital shall, by the deadline authorized in the approved extension, do either of the following:

(1) Demolish, replace, or change to nonacute care use all hospital buildings not in substantial compliance with the regulations and standards developed by the department pursuant to the Alfred E. Alquist Hospital Facilities Seismic Safety Act of 1983 and this act.

(2) Seismically retrofit all acute care inpatient hospital buildings so that they are in substantial compliance with the regulations and standards developed by the department pursuant to the Alfred E. Alquist Hospital Facilities Seismic Safety Act of 1983 and this act.

(c) Upon compliance with this section, the hospital shall be issued a written notice of compliance by the department. The department shall send a written notice of violation to hospital owners that fail to comply with this section.

history: (History: Amended by Stats. 2024, Ch. 896, Sec. 2. (SB 1447) Effective January 1, 2025.)

article: 9. Hospital Owner Responsibilities


text:
(a) For purposes of this article, the following definitions shall apply:

(1) “Critical access hospital” means a hospital designated by the State Department of Public Health as a critical access hospital, and certified as such by the Secretary of the United States Department of Health and Human Services under the federal Medicare Rural Hospital Flexibility Program.

(2) “Distressed Hospital Loan Program recipient” is a hospital that received a loan pursuant to Chapter 4 (commencing with Section 129380) of Part 6. This may also include a future program recipient, should the Legislature appropriate additional state funding to the program and extend the date identified in Section 129387.

(3) “Health care district hospital” is a hospital authorized pursuant to Division 23.

(4) “Rural hospital” means a “rural general acute care hospital” as set forth in subdivision (a) of Section 1250 or a hospital located in a rural or frontier medical study service area, as defined by the California Healthcare Workforce Policy Commission.

(5) “Small hospital” is a hospital with 50 beds or fewer.

(b) Notwithstanding the January 1, 2030, seismic compliance deadline outlined in Section 130065, a Distressed Hospital Loan Program recipient, a small hospital, a rural hospital, a critical access hospital, or a health care district hospital, except as otherwise provided in this section, may seek approval from the department for a delay to the compliance deadline by up to three years with the submission and departmental approval of a seismic compliance plan, as described in subdivision (d), and, if necessary, a Nonstructural Performance Category-5 evaluation report.

(c) (1) Hospitals that belong to integrated health care systems with two or more separately licensed hospital facilities shall be ineligible for a delay under this section, including a health care district hospital that has a contractual agreement with a health system that imposes upon the health system any financial responsibility for the health care district’s infrastructure costs for compliance with Section 130065, unless the entire integrated health care system is determined by the department to be in financial distress.

(2) Paragraph (1) shall not apply to any of the following:

(A) A rural hospital with fewer than 80 general acute care beds and general acute care hospital revenue of seventy-five million dollars ($75,000,000) or less, as reported to the department pursuant to Section 128740 in 2020.

(B) A hospital that is part of an integrated health care system that is operated by a health care district or a nonprofit corporation that is affiliated with the health care district hospital owner by means of the district’s status as the nonprofit corporation’s sole corporate member.

(C) A health care district hospital that does not have a contractual, management, lease, or operating agreement with a health system that imposes upon the health system any financial responsibility for the health care district’s infrastructure cost for compliance with Section 130065.

(d) A Distressed Hospital Loan Program recipient, a small hospital, a rural hospital, a critical access hospital, or a health care district hospital, except as otherwise specified, with a building that is not anticipated to be in full compliance with the seismic safety regulations or standards described in Section 130065 when this section becomes operative shall provide all of the following to the department:

(1) A Nonstructural Performance Category-5 evaluation report in compliance with Article 11 of Chapter 6 of Title 24 of the California Administrative Code for each noncompliant building, if necessary, by no later than January 1, 2025.

(2) The hospital’s seismic compliance plan in accordance with Section 1.4 of Article 1 of Chapter 6 of Title 24 of the California Administrative Code and related regulations, by no later than January 1, 2026. The seismic compliance plan shall outline steps, including milestones, to achieve compliance with seismic safety standards at the earliest reasonable date, but by no later than January 1, 2033.

(3) The subject hospital and the department shall identify at least two major milestones relating to the seismic compliance plan that will be used as the basis for determining whether the hospital is making adequate progress toward meeting the subject hospital’s seismic compliance deadline. The seismic compliance plan is subject to departmental review for reasonableness.

(A) If the seismic compliance plan includes a compliance schedule that is delayed beyond the 2030 seismic compliance deadline described in Section 130065, the hospital shall submit any documentation requested by the department to assist the department in its review of the reasonableness of the compliance schedule.

(B) The department shall have 120 days to approve or deny the hospital’s seismic compliance plan and any delay to the seismic compliance deadline. If the department determines the compliance schedule is unreasonable based on the information submitted, the department shall notify the hospital and provide the department’s rationale for its determination. The hospital shall be given the opportunity to address the identified concerns or to provide additional information to substantiate the compliance schedule.

(e) (1) The department shall have the discretion to additionally delay the amount of time by which a Distressed Hospital Loan Program recipient, a small hospital, a rural hospital, a critical access hospital, or a health care district hospital shall comply with Section 130065 by two years, up to a maximum of January 1, 2035. This delay may be authorized as necessary for hospitals that continue to experience financial distress or that need to deal with contractor, labor, or material delays, acts of God, governmental entitlements, or other circumstances beyond the hospital’s control. If up to an additional two-year delay is granted, the hospital shall submit a revised construction schedule and associated milestones to the department.

(2) A Distressed Hospital Loan Program recipient, a small hospital, a rural hospital, a critical access hospital, or a health care district hospital, except as otherwise specified, that is granted a delay in compliance with the requirements of Section 130065 pursuant to this subdivision shall provide the department with any information that the department deems necessary, including, but not limited to, information to assess whether the hospital is in financial distress or continues to be in financial distress.

(3) For eligible hospitals requesting an additional delay under this subdivision due to financial distress, the department shall make a determination of financial distress using financial criteria, including, but not limited to, days cash on hand, current ratio, access to working capital, operating margin, cash burn rate, the financial impact of mandatory seismic compliance costs on the hospital or integrated health care system, and other methodologies developed pursuant to Chapter 4 (commencing with Section 129380) of Part 6.

(4) If the department determines that an eligible hospital or integrated health care system is no longer in financial distress and is not likely to return to financial distress due to complying with seismic safety standards, the hospital or integrated health care system shall submit a revised seismic compliance plan to the department for review and approval one month after being informed of the department’s determination that the hospital or integrated health care system is no longer in financial distress. Notwithstanding any delay of the January 1, 2030, seismic requirements granted to the hospital or integrated health care system pursuant to subdivision (b), the department may adjust compliance deadlines to reflect the fact that the hospital or integrated system is no longer in financial distress.

(f) Notwithstanding any other provisions in this chapter, a hospital seeking a delay under this section shall comply with requirements for a seismic compliance plan in accordance with Section 1.4 of Article 1 of Chapter 6 of Title 24 of the California Administrative Code and related regulations.

(g) All hospitals determined eligible to delay compliance with Section 130065 pursuant to this section shall comply with Section 130065 no later than January 1, 2035. Failure to comply with the revised construction schedule or meet any major milestones established by the department and the hospital shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met.

(h) The department shall provide support to a Distressed Hospital Loan Program recipient, a small hospital, a rural hospital, a critical access hospital, or a health care district hospital requesting a delay under this section to explore the opportunities under the Small and Rural Hospital Relief Program to assist with seismic compliance.

(i) Hospitals that fail to meet any milestone or seismic compliance deadline approved in its compliance plan shall not be issued a building permit for any building in the facility except those required for seismic compliance, maintenance, and emergency repairs until the milestone is met and the hospital is adequately progressing toward meeting the subject hospital’s seismic compliance, as determined by the department.

(j) This section shall not extend any deadlines for Structural Performance Category-1 buildings to achieve structural integrity to no longer pose a potential risk of collapse or a significant risk of loss of life.

(k) Notwithstanding any other law, any information used by the department to determine a hospital’s financial status for purposes of this section is confidential and shall not be subject to disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).

(l) The department shall adopt regulations and standards, or revise existing regulations and standards, or both, to implement the provisions of this section. Regulatory submissions made by the department to the California Building Standards Commission pursuant to this section shall be deemed to be emergency regulations and shall be adopted as such. The adoption of these regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, and general welfare.

history: (History: Amended by Stats. 2025, Ch. 67, Sec. 131. (AB 1170) Effective January 1, 2026.)

article: 9. Hospital Owner Responsibilities


text: The department shall annually post a list of hospitals that have been granted a delay of the January 1, 2030, deadline described in Section 130065 pursuant to Section 130065.1 on its internet website. The list shall include the name and location of each hospital and the projected final compliance date approved by the department.

history: (History: Added by Stats. 2024, Ch. 801, Sec. 3. (AB 869) Effective January 1, 2025.)

article: 9. Hospital Owner Responsibilities


text: Before January 1, 2020, the owner of an acute care inpatient hospital whose building does not substantially comply with the seismic safety regulations or standards described in Section 130065 shall submit to the department an attestation that the board of directors of that hospital is aware that the hospital building is required to meet the January 1, 2030, deadline for substantial compliance with those regulations and standards.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 337. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text:
(a) Before January 1, 2024, the owner of an acute care inpatient hospital that includes a building that does not substantially comply with the seismic safety regulations or standards described in Section 130065 shall post in any lobby or waiting area generally accessible to patients or the public a notice provided by the department that the hospital is not in compliance with the seismic safety requirements that the hospital is required to meet by January 1, 2030. The notice shall be posted until the time the owner receives notification from the department that it meets the requirements described in Section 130065.

(b) On or before January 1, 2024, and annually thereafter, the owner of an acute care inpatient hospital that includes a building that does not substantially comply with the seismic safety regulations or standards described in Section 130065 shall provide an annual status update on the Structural Performance Category ratings of the buildings and the services provided in each hospital building on the hospital campus to all of the following entities until each of the hospital buildings owned by that hospital building owner is compliant with Section 130065:

(1) The county board of supervisors in whose jurisdiction the hospital building is located.

(2) The city council in whose jurisdiction the hospital building is located, if applicable.

(3) Any labor union representing workers who work in a building that does not substantially comply with the seismic safety regulations or standards described in Section 130065.

(4) The board of directors of the special district or joint powers agency that provides fire and emergency medical services in the jurisdiction in which the hospital building is located, if applicable.

(5) The department.

(6) The board of directors of the hospital.

(7) The local office of emergency services or the equivalent agency.

(8) The Office of Emergency Services.

(9) The medical health operational area coordinator.

(c) Before July 1, 2023, the department shall develop the notice required in subdivision (a) with the intent that the notice will clearly convey to patients and the public that the hospital building does not meet seismic safety standards intended to ensure that the hospital will be capable of continued operation following an earthquake. For SPC-2 buildings, the notice shall clearly state, “The State of California has determined that this building does not significantly jeopardize life, but may not be repairable or functional following an earthquake.” For other buildings that are not compliant with the seismic safety regulations or standards described in Section 130065, the notice shall state, “The State of California has determined that the hospital building is at risk of not being functional to provide care to its patients or the community after an earthquake.” In its discretion, the department may develop multiple notices in order to provide a more detailed description of different hospital buildings’ failure to meet the seismic safety regulations or standards described in Section 130065.

history: (History: Added by Stats. 2022, Ch. 584, Sec. 4. (AB 1882) Effective January 1, 2023.)

article: 9. Hospital Owner Responsibilities


text:
(a) Notwithstanding any other law, including, but not limited to Sections 130060 and 130061, the office may waive the requirements for the Seton Medical Center in Daly City to comply with this chapter, in whole or in part, if both of the following occur:

(1) The Seton Medical Center submits a plan to the office, on or before January 15, 2022, that proposes compliance with the applicable seismic safety standards of this chapter, and the regulations promulgated pursuant to this chapter, on or before July 1, 2023.

(2) The office accepts the plan submitted by the Seton Medical Center as feasible to complete and promoting public safety.

(b) If the office accepts the plan pursuant to subdivision (a), the Seton Medical Center shall report to the office, in the manner required by the office, on its progress to timely complete the plan, on or before all of the following dates:

(1) April 1, 2022.

(2) July 1, 2022.

(3) October 1, 2022.

(4) January 1, 2023.

(5) April 1, 2023.

(c) The office may revoke its waiver, in whole or in part, of the requirements of this chapter, if the Seton Medical Center fails to timely report progress that the office deems is sufficient to complete the plan.

history: (History: Added by Stats. 2021, Ch. 65, Sec. 1. (AB 1527) Effective January 1, 2022.)

article: 9. Hospital Owner Responsibilities


text:
(a) Notwithstanding any other law, including, but not limited to, Sections 130060 and 130061, the department may waive the requirements of this chapter, in whole or in part, for O’Connor Hospital and Santa Clara Valley Medical Center in the City of San Jose if both of the following occur:

(1) (A) The hospital or medical center submits to the department, within 30 days following the effective date of this statute, a plan for compliance with the applicable seismic safety standards of this chapter, and the regulations promulgated pursuant to this chapter.

(B) For the O’Connor Hospital seismic update, the plan shall provide for compliance on or before July 1, 2023.

(C) For the Santa Clara Valley Medical Building F (Services Building) Seismic Upgrade, the plan shall provide for compliance on or before July 1, 2025.

(D) For the Santa Clara Valley Medical Center Building N (RSC) Tier 2 Upgrades, the plan shall provide for compliance on or before December 31, 2025.

(E) For the Santa Clara Valley Medical Center Old Main Demolition and Rebuild project, the plan shall provide for compliance on or before July 1, 2026.

(2) The department accepts the plan submitted by the hospital or medical center based on it being feasible to complete and promoting public safety. The department shall not unreasonably reject the plan, unreasonably impose conditions on the acceptance of the plan, or unreasonably withhold or delay acceptance or rejection of the plan.

(b) If the department accepts the hospital’s or medical center’s plan pursuant to subdivision (a), the hospital or medical center shall report to the department, in the manner required by the department, on its progress to timely complete its plan, on or before all of the following dates:

(1) April 1, 2023.

(2) July 1, 2023.

(3) October 1, 2023.

(4) January 1, 2024.

(5) April 1, 2024.

(6) July 1, 2024.

(7) October 1, 2024.

(8) January 1, 2025.

(9) April 1, 2025.

(10) July 1, 2025.

(11) October 1, 2025.

(12) January 1, 2026.

(13) April 1, 2026.

(14) July 1, 2026.

(c) The department may revoke its waiver of the requirements of this chapter, in whole or in part, if O’Connor Hospital or Santa Clara Valley Medical Center fails to timely report progress that the department reasonably deems is sufficient to complete their respective plans if both of the following are true:

(1) The lack of timely reporting, lack of reasonable progress, or both, is not due to unforeseen circumstances outside the control of the County of Santa Clara.

(2) If the office intends to revoke the waiver, or any part of the waiver, the department provides at least 90 days’ written notice to the County of Santa Clara prior to the effective date of the revocation and, during the notice period, the department provides the County of Santa Clara a reasonable opportunity to cure the noncompliance that forms the basis of the intended revocation.

(d) (1) (A) A hospital with a waiver approved under this section shall be subject to penalties for failure to meet milestones expressed in its compliance plan or any requirement of this section.

(B) The county shall bear the responsibility of paying any penalties.

(2) If the county fails to pay the assessed penalty amount within 30 days of the initial notice of penalties from the department, the department shall collect legal interest of 10 percent and the costs associated with recovery of any arrears.

(3) Upon a failure by the county to make a payment to the department within 60 days of notice of penalties, the department shall apply Section 1.4.5.1.2.1 of the California Administrative Code and withhold any building permits except maintenance and emergency repairs.

(4) Upon a failure by the county to make a payment 90 days after the notice of penalties, the department shall collect the full amount due, including costs and interest, either under the authority of Chapter 4.3 (commencing with Section 16580) of Part 2 of Division 4 of Title 2 of the Government Code or by withholding the amount from any general fund appropriations.

(e) The provisions of this section shall be retroactively applied so that there is no period of noncompliance if the passage of the act that added this section overlaps with the reporting requirements set forth elsewhere in this article.

history: (History: Amended by Stats. 2023, Ch. 304, Sec. 1. (AB 1471) Effective October 4, 2023.)

article: 9. Hospital Owner Responsibilities


text:
(a) Notwithstanding any other law, including, but not limited to, Sections 130060 and 130061, the department may waive the requirements of this chapter, in whole or in part, for Pacifica Hospital of the Valley in the County of Los Angeles if both of the following occur:

(1) The hospital submits a plan to the department, on or before September 15, 2022, that proposes compliance with the applicable seismic safety standards of this chapter, and the regulations promulgated pursuant to this chapter, on or before January 1, 2025.

(2) The department accepts the plan submitted by the hospital based on it being feasible to complete and promoting public safety.

(b) If the department accepts the hospital’s plan pursuant to subdivision (a), the hospital shall report to the department, in the manner required by the department, on its progress to timely complete its plan, on or before the following dates:

(1) October 1, 2022.

(2) January 1, 2023.

(3) April 1, 2023.

(4) July 1, 2023.

(5) October 1, 2023.

(6) January 1, 2024.

(7) April 1, 2024.

(8) July 1, 2024.

(9) October 1, 2024.

(c) The department may revoke its waiver of the requirements of this chapter, in whole or in part, if Pacifica Hospital of the Valley fails to timely report progress that the department reasonably deems is sufficient to complete the plan.

(d) The provisions of this section shall be retroactively applied so that there is no period of noncompliance if the passage of the act that added this section overlaps with the reporting requirements in Section 130062.

history: (History: Added by Stats. 2022, Ch. 592, Sec. 1. (AB 2404) Effective September 27, 2022.)

article: 9. Hospital Owner Responsibilities


text:
(a) Notwithstanding any other law, the Children’s Hospital Los Angeles, referenced in subdivision (c) of Section 10727 of the Welfare and Institutions Code, may seek an extension to the January 1, 2030, seismic compliance deadline outlined in Section 130065, of up to three years, to no later than January 1, 2033, with the submission and department approval of a seismic compliance plan, and a Nonstructural Performance Category-5 evaluation report, if necessary. The department may authorize this extension as necessary if the hospital experiences issues with contractor, labor, or material delays; acts of God; governmental entitlements; or with other circumstances beyond the hospital’s control that prevent it from meeting the January 1, 2030, deadline.

(b) If the Children’s Hospital Los Angeles includes a building that is not anticipated to be in full compliance with the seismic safety regulations or standards described in Section 130065 on the date this section becomes effective, the hospital may submit both of the following items to the Department of Health Care Access and Information by the dates specified to seek an extension:

(1) A Nonstructural Performance Category-5 evaluation report for each noncompliant building, if necessary, as outlined in Article 11 of Chapter 6 of Title 24 of the California Code of Regulations, by no later than January 1, 2025.

(2) The hospital’s seismic compliance plan, as outlined in Section 1.4 of Article 1 of Chapter 6 of Title 24 of the California Code of Regulations and related regulations, by no later than January 1, 2026. The seismic compliance plan shall outline steps, including milestones, to achieve compliance with seismic safety standards at the earliest reasonable date, but no later than January 1, 2033. The hospital and the department shall identify at least two major milestones relating to the seismic compliance plan that will be used as the basis for determining whether the hospital is making adequate progress towards meeting the hospital’s seismic compliance deadline. The seismic compliance plan is subject to department review.

(c) The department shall approve or deny the hospital’s seismic compliance plan and any extension to the seismic compliance deadline within 120 days.

(d) If the seismic compliance plan includes a compliance schedule that is extended beyond the January 1, 2030, seismic compliance deadline established in Section 130065, the hospital shall submit any documentation requested by the department to assist the department in its review of the compliance schedule.

(e) If the department determines the compliance schedule is unreasonable based on the information submitted, the department shall notify the hospital and provide the department’s rationale for its determination. The hospital shall be given the opportunity to address the identified concerns or to provide additional information to substantiate the compliance schedule.

(f) The duration of an extension granted by the department pursuant to this section shall not exceed the maximums permitted by this section and the department shall not grant an extension that exceeds the amount of time needed by the hospital to come into compliance. The department may grant an adjustment to an extension of time approved pursuant to this section, the milestones agreed upon pursuant to this section, or both, as necessary to deal with contractor, labor, or material delays; acts of God; governmental entitlements; or other external forces beyond the hospital’s control.

(g) If the hospital fails to meet any milestone or the seismic compliance deadline approved in the compliance plan approved pursuant to this section, it shall not be issued a building permit for any building in the facility except those required for seismic compliance, maintenance, and emergency repairs until the milestone is met and the hospital is adequately progressing toward meeting the hospital’s seismic compliance, as determined by the department. On a case-by-case basis, the department may determine if a building permit unrelated to seismic compliance may be considered for approval.

(h) Failure to comply with the revised construction schedule or meet any major milestones established by the department and the hospital shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met.

(i) Notwithstanding any other provision of this chapter, the hospital shall comply with requirements for a seismic compliance plan in accordance with Section 1.4 of Article 1 of Chapter 6 of Title 24 of the California Code of Regulations and related regulations.

(j) This section does not extend any deadlines for Structural Performance Category-1 buildings to achieve the structural integrity to no longer pose a potential risk of collapse or pose a significant risk of loss of life.

(k) Pursuant to Section 130065.15, the department shall include the name and location of the hospital and the projected final compliance date approved by the department.

(l) The department shall adopt regulations and standards, or revise existing regulations and standards, or both, to extend the deadlines for meeting the structural performance and nonstructural performance requirements pursuant to Section 130065 and this section. Regulatory submissions made by the department to the California Building Standards Commission pursuant to this section shall be deemed to be emergency regulations and shall be adopted as such. The adoption of these regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, and general welfare.

history: (History: Added by Stats. 2024, Ch. 896, Sec. 3. (SB 1447) Effective January 1, 2025.)

article: 9. Hospital Owner Responsibilities


text: The department shall notify the State Department of Public Health of the hospital owners that have received a written notice of violation for failure to comply with either Section 130060 or 130065. Unless the hospital places its license in voluntary suspense, the State Department of Public Health shall suspend or refuse to renew the license of a hospital that has received a notice of violation from the department because of its failure to comply with either Section 130060 or 130065. The license shall be reinstated or renewed upon presentation to the State Department of Public Health of a written notice of compliance issued by the department.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 338. (AB 133) Effective July 27, 2021.)

article: 9. Hospital Owner Responsibilities


text: The Small and Rural Hospital Relief Program is hereby established under the administration of the Department of Health Care Access and Information for the purpose of funding seismic safety compliance with respect to small hospitals, rural hospitals, and critical access hospitals in the state.

history: (History: Added by Stats. 2021, Ch. 489, Sec. 2. (SB 395) Effective January 1, 2022.)

path: 107. HEALTH CARE ACCESS AND INFORMATION > 7. FACILITIES DESIGN REVIEW AND CONSTRUCTION > 1.5. Small and Rural Hospital Relief Program


text:
For purposes of this chapter:

(a) “Department” means the Department of Health Care Access and Information.

(b) “Fund” means the Small and Rural Hospital Relief Fund established in Section 130077.

(c) “Seismic safety compliance” means compliance with Article 9 (commencing with Section 130050) of Chapter 1.

(d) “Qualified applicant” means any of the following hospitals:

(1) A small hospital.

(2) A rural hospital.

(3) A critical access hospital.

chapter: 1.5. Small and Rural Hospital Relief Program


text:
(a) The Small and Rural Hospital Relief Fund is hereby established in the Treasury.

(b) Notwithstanding Section 13340 of the Government Code, all moneys in the fund are continuously appropriated, without regard to fiscal years, for the administration and funding of the grant program pursuant to this chapter.


text:
(a) The department shall provide a grant to a qualified applicant that meets both of the following criteria:

(1) Seismic safety compliance imposes a financial burden on the applicant that may result in hospital closure.

(2) The hospital closure described in paragraph (1) would substantially impact the accessibility to health care in the communities surrounding the hospital.

(b) A grant provided by the department pursuant to this section may be used only for funding seismic safety compliance.