Nov. 30—Administrators at Kern Valley Hospital are scrambling to meet a 2030 deadline that requires their hospital to be entirely quake-proof.
The Kern County Board of Supervisors approved its application Tuesday to the Governor's Office of Emergency Services for a $34.5 million federal grant that will pay for most of the seismic upgrades needed at Kern Valley Healthcare District.
"It's a big need, but it's very expensive to do," said James Zervis, chief operations officer for Kern County.
An early estimate put the overall costs of retrofitting the hospital, which was built in 1964 and houses 24 beds, at around $43 million. If the grant is approved, it would provide 70 percent of the total project funds. The district will match the remaining 30 percent.
"Our systems are worn out," said Bob Easterday, plant operations officer for KVHD. "The requirements are not just to the physical structure but also includes (things) like our water pipes, gas piping, heating and cooling and AC systems. All those have to be replaced to meet seismic requirements."
Existing law requires that by 2030, all acute-care facilities, which includes the hospital, must be "reasonably capable" of providing services following an earthquake.
"The problem is, this Senate bill was passed without funding to make it happen," Easterday said.
The mandate is part of the Hospital Seismic Retrofit Program, which passed in 1994, after a regional quake that shut down numerous hospitals, killed scores of people and caused billions of dollars in damages.
Ninety-five percent of hospital buildings, according to the California Department of Health Care Access and Information, meet the original seismic standards under the 1994 law, including Kern Valley Hospital.
But in the years since, tougher rules have been tacked on. Hospitals today are required to not only be capable of withstanding a quake, but to stay in near-full operation if one happens.
The retrofits necessary for the new standard, hospital officials say, are costly.
Many hospitals are struggling to pool together the money and instead are asking state officials to reconsider the deadlines around the rule.
"Everyone is struggling with this," Easterday said. "Mercy, Memorial, (Adventist Health Bakersfield) — they're all working on this."
According to the California Hospital Association, a Sacramento-based industry advocacy group, several hospitals in Kern County have not met the 2030 requirements.
In a 2022 letter to state legislators, the association claimed that, due to deficits afflicted by COVID-19, federal aid alone will not be enough to improve California hospitals by 2030.
"This extension will give hospitals time to begin recovering from the financial devastation of the pandemic without sacrificing patient care, especially in our most challenged communities," Carmela Coyle, president & CEO of the association, wrote in the letter.
In a 2021 study by the RAND Corp., a Santa Monica-based research group, statewide improvements would cost upward of $143 billion, depending on whether hospitals decide to either retrofit or build anew.
"Legislators need to understand that hospital losses, massive inflation in construction costs, and rising interest rates are all impacts of the pandemic that will continue to take a toll on California's hospitals," Coyle said.
Originally, KVHD offered to pay 25 percent of the project. The hospital district bumped it to 30 percent to better its chances of receiving a federal grant.
"The larger the percentage the hospital agrees to pay, the more likely it is you'll be funded," Easterday said. "There's still absolutely no guarantee the hospital will get that money. But like the lottery, you can't win if you don't play."
KVHD's acute-care hospital is small. With only 24 beds, it doesn't compare to others in the county. Its three ICU beds are currently suspended, and its CT scanner is in a trailer.
But its nearly 18,000 residents near Wofford Heights, Kernville, Lake Isabella and Bodfish — many of whom are on Medi-Cal or Medicare — it is their only option for emergency care. If the KVHD is unable to secure the funding, it will lose its license to operate.
Without the hospital, ambulance response times will triple. Residents would be forced to trek west to Bakersfield or east to Ridgecrest.
A shutdown would be a major blow not only to the area's health care access, but also to the nearly 300 workers the hospital employs.
In 2018, officials tried to pass Measure Q, a property tax estimated to rake in $1.1 million annually that would cost property owners $82 a year. Voters rejected it overwhelmingly, and Easterday doesn't blame them.
"We are a disadvantaged community here," Easterday said. "A lot of people here are retired or on Medicaid. When they see measures like that come through — there's no way they can pay an increased tax rate."
Measure Q was the fourth attempt since 2006 to pay for the seismic retrofits.
The hospital was shut down and sustained structural damage in 2019 when consecutive quakes — at magnitudes of 6.4 and 7.1 — shook Ridgecrest. While earthquakes are not common, a major fault does run within a quarter-mile of the facility, through the neighboring Searles Lake.
"It could produce a 7.0 quake, which would shut the hospital down," Easterday said.
"It is a lot of money for this hospital because we don't make a lot of money," Easterday said. "We do not have enough to fund this project and that's the same for a lot of hospitals."
Officials are unsure whether they will get the money. They applied for a federal grant in 2020 and were rejected. This round of funds, while administered by the state, originates from the Federal Emergency Management Agency, which restricts the district as an applicant. It instead had to apply vicariously through the county.
"KVHD asked the county to apply since they can't on their own," Zervis said. "So we applied on their behalf, but they handle all the work, they wrote grants and will provide the matching funds ... they're responsible for it."
The application must be submitted by Friday. Zervis said it may take up to nine months to hear a response. In the event that the application is rejected, hospital officials may need to come up with another plan.
"We're going to have to take a long hard look at whether we undergo a construction project we cannot fund to complete," Easterday said.