March 26,2018-
Last week the Kaweah Delta district board heard what amounts to a seismic shocker – the state may allow the hospital to retain their 1969-built Mineral King wing beyond 2030 for acute-care. But it will require structural testing with a high degree of uncertainty as to the outcome.
“Our engineers say for the first time there is a ray of hope” to save the four-story wing although they are “not optimistic” it will pass the test, cautions CEO Gary Herbst.
Herbst says the news is particularly significant for the future of the hospital after the failure in 2016 of local bond measure – Measure H that sought to raise $327 million of the $550 million to replace the loss of hospital beds due to the state’s tough seismic rules.
“The failure of Measure H was a teaching moment for us” admits Herbst who has since organized three community advisory groups, 20 member each, to look at how the district keeps caring for patients without a future capital funding source. The community, in a shock to the board, turned down the bond measure that required two-thirds approval but got the support of just 43% of the local voters.
While the plan to fund the replacement of existing beds fell short – demand certainly has not.
With the closure of nearby Tulare Regional Medical Center last year and no sign it will reopen soon and the spike in flu cases, demand for care has famously soared. A few months ago flu cases rose for two weeks solid with 550 cases. The district had to pitch tents to handle the case load.
“The flu is finally easing” advises Herbst, to about 125 cases a week, still above the average in other years
Something else has eased, remarks Herbst. ”The state now realizes how many hospitals could close if there is no flexibility in their seismic rules.”
Enter the structural engineers who advise the hospital. A firm called KPFF who carried out a study of the Mineral King building in 2016 even as the politics in Sacramento became more favorable to the district’s plight.
Key to any decision by the state agency overseeing seismic regulation, OSHPD (Office of Statewide Health Planning and Development) is that Visalia’s earthquake vulnerability is not like most of California. Visalia is at least 10 miles from any fault and ground motion is much lower in a quake in these parts than say Northridge.
As it is, several big LA area and Bay Area hospitals are closing. The seismic activity laws were bolstered in 1994 after the Northridge earthquake damaged and closed 10 hospitals. Pressure on rural hospitals with less funding is acute as healthcare laws change the financial picture even without the seismic issue.The closure of Tulare was preceded by an unfinished tower to meet these earthquake rules, a project that ran out of money that helped push the district deep in the red.
But the picture is brighter in Visalia.
Huge model planned
Beyond the extent of of the earthquake danger, the KPFF engineers found the concrete-built arch frame wing and its several additions – only one of two buildings like it in California – was well-built and it was possible that even without much structural retrofit, could potentially withstand an expected earthquake – as it is!
Only tests will confirm this possibility. “The big news that for the first time the state is willing to listen” says Herbst.
To convince OSHPD, Herbst says the engineers propose the construction of a large model of the building that will be given a good shake to see what happens.
This week the board heard at a study session that the model would actually be huge, about half as big as the 4-story Mineral King wing itself and built with some of the very materials used in the Visalia building. Herbst was told it will take 2 years to build, test and confer with OPSPHD on the results. The model’s cost will $1.3 million.
Herbst says since this week’s meeting was a study session, the action item to fund the $1.3 million model project is on the agenda Monday, March 26 for approval.
“I am recommending we move forward on the what amounts to a window of opportunity that OSPHD has offered us.” KPFF engineers say they are not optimistic” it will survive that good shaking but “agree it is worth a try.”
The Kaweah district board will make the decision.
Plan B
KPFF has a plan B even if the model does not withstand the shake. They propose reinforcement of the Mineral King wing with sheer walls at an estimated cost of $167 million.
“We would face a logistics problem since it would require us to close some part of the hospital as we work on it in phases.” adds Herbst.
”Even then we would end up with a 61 year-old building.“
Of course, OSHPD would have to approve any of these new plans, not a guarantee.
Even if either one of these two options pans out – the Mineral King wing will face major interior renovations to bring it up to code, adds Herbst, a cost that has yet to be estimated but could ring up around $100 million.
The benefits of these options to save the wing are significant, concludes Herbst, since the improvements could be carried out to the building incrementally, buying time and easing financing pressure to do the work using more traditional funding method.
Traditional financing is at work this month expanding the super-busy emergency room into the existing parking lot, just given the green light by the state this week.