Amy Pultz says it is not too late for organizations that don't have final plans in place for the 2030 deadline.

SACRAMENTO—Senate Bill 1953 has been on the minds of healthcare organization administrators in California since it came into law in 1994. The intent of the bill is for hospitals' structural designs to withstand major seismic events in order to protect patient and staff lives while ultimately remaining in operation to serve the community after an earthquake.

There have been several adjustments to required deadlines through the years, but the final target date remains set at January 1, 2030, says Amy Pultz, an associate and senior architect with architecture and planning firm Dahlin Group, in this exclusive. By now, critical decisions have been made by healthcare organizations providing acute care services in California and each have had to painstakingly evaluate options with millions to billions of dollars at stake.

"For organizations that do not yet have final plans in place to meet the 2030 deadline, it is not too late," Pultz tells GlobeSt.com. "With the amount of information that was required to meet past deadlines, the pieces are there. It may be time to compare new ideas with the options that have already been considered."

The first step is ensuring compliance with California Legislature AB 2190 section 2, which indicates that healthcare organizations providing acute care services in California not already in full compliance must submit a letter before January 1, 2020 stating recognition of the SB 1953 2030 deadline requirements. By doing this, it acknowledges the possibility of facing hospital closure if found in non-compliance.

"The overarching question that may still need to be faced is: rebuild or retrofit?" Pultz asks. "The easier of the two complex options is to rebuild acute care spaces and the supporting central plant. Although upfront costs of ground-up construction can be steep, the outcome will result in a building that is sure to meet SB 1953 requirements with life to carry on services well beyond 2030."

Since the bill was enacted, the need for acute care spaces has lessened due to non-acute care services previously provided in hospital environments shifting to de-centralized outpatient services. With that in mind, an option may be to strategically build new acute care spaces to allow for subsequent construction flexibility, says Pultz.

Structurally upgrading existing hospital buildings by retrofitting is a challenge to both document and implement, but still a valid option, she says. This is especially true if real estate on campus is limited or phasing is required to spread the cost of construction over time. Understanding how to work with multiple user groups for phasing is critical but can be done if the goal of minimizing impact on hospital operations is a primary concern. It is also of vital importance to explore ways of creating functional and pleasing spaces within buildings designed around old codes.

"Whatever option is best for the organization, i.e., rebuild, remove, replace or retrofit, it takes a team of architects, engineers and builders committed to providing thorough site investigations, quantifiable construction documents and solutions in a timely manner so that critical decisions can be made," Pultz tells GlobeSt.com. "With little time remaining prior to the 2030 deadline, it may be necessary to consider a design-build delivery method for even the structural and non-structural upgrades to the buildings that will remain as acute care. With financial hardship still a concern, this is a call for private developers to consider contributing to communities by collaborating with healthcare organizations so that these facilities will not have to face closure due to non-compliance for lack of sufficient capital–a noble cause that comes with risk worthy of reward."

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