California Hospitals Undergoing Seismic Retrofitting

California hospitals are working hard to meet 2020 and 2030 seismic retrofitting deadlines in accordance with the updated Alquist Act.

As the deadline to meet California’s strict new seismic retrofitting laws approaches, the Bay Area is experiencing a rush of new hospital construction and structural improvements. Learn more about seismic retrofitting and how Canopy Health’s affiliated hospitals are meeting state requirements.

California’s Seismic Retrofitting Laws

California is one of the United States’ most seismically active states, experiencing two-to-three magnitude 5.5 or higher earthquakes each year. Due to this ongoing threat, California has become a world leader in seismic building codes and regulation.

Images of the San Fernando VA Hospital after the 1971 Sylmar earthquake are a stark reminder of why seismic retrofitting matters. During the quake, the unreinforced walls of the hospital collapsed, killing at least 44 people. In response, the legislature passed the Alfred E. Alquist Hospital Seismic Safety Act. However, in the 1980’s, hospitals were slow to adopt seismic improvements. Concerned legislators authorized an engineering study that assessed California’s aging hospital infrastructure. The study found that 83% of the state’s hospital beds were in noncompliant facilities.

Their concern was merited. In 1994, the magnitude 6.7 Northridge quake caused billions of dollars in damage to older pre-Alquist hospitals. The legislature responded by amending the Alquist Act, requiring that all California hospital assess their seismic risk and make certain improvements by 2030. While extensions have been given in the past, the highest risk “Structural Performance Category-1 (SPC-1)” buildings must be retrofitted by 2020. Less dangerous hospital SPC-2 facilities must be retrofitted by 2030. If hospitals do not meet these requirements, they will lose their acute care licenses.

Challenges to Hospitals’ Seismic Compliance

This legislation caused California hospitals to face difficult decisions: retrofit aging facilities, replace them, or close. These decisions weren’t limited to small or financially challenged hospitals. According to one study, about 50% of California’s hospital space was within SPC-1 or SPC-2 facilities. Many of these hospitals were 50 years old or more and were either approaching or had exceeded their useful lives. Besides being at risk for seismic collapse, some communities had outgrown these older spaces. 

For many, retrofitting old hospitals didn’t make sense — especially since early retrofitting costs were comparable to those of new construction. Early estimates indicated that seismic retrofitting and construction would cost roughly $1,000 per square foot. For this and other reasons, hospitals were slow to pursue seismic retrofitting. By December 2006, only 40% of SPC-1 facilities had seismic retrofitting and reconstruction projects in the works. 

Thankfully, improvements to the design and approval processes helped speed up the hospital retrofitting and reconstruction. Currently, about 90% of California hospitals comply with the revised Alquist Act requirements. Still, there are hundreds of operational hospital buildings that are at high risk during a serious earthquake. 

Bay Area Hospitals Experience a Construction Boom

As of 2018, Canopy Health alliance members have made significant advances towards full seismic compliance. Some hospitals, including UCSF Mission Bay, John Muir Medical Center, Walnut Creek, Highland Hospital, Marin General Hospital, and Washington Hospital have either completed or are constructing new patient towers that meet or exceed the Alquist Act’s requirements. Many of these construction projects don’t simply focus on seismic safety. Canopy Health’s alliance hospitals are expanding their facilities, improving patient experiences, and implementing new technologies. 

In addition to reconstruction, other facilities are implementing braces, reinforcements, changes to mechanical and electrical systems, and other improvements. Currently, all Canopy Health affiliated hospitals appear on track to meet the 2030 deadline.

While many hospitals are pushing aggressive construction projects, a small number of California hospitals are closing instead. Notably, Berkeley will no longer have an acute care hospital or an emergency department after 2030. Rather than improve Alta Bates Hospital’s aging facilities, Sutter Health to not upgrade the only hospital in Berkeley. Because of this, acute care services will eventually have to be moved offsite. 

Canopy Health’s Affiliated Hospitals Are Dedicated to Patient Safety

Legal compliance is important, but it’s not our affiliate hospitals’ primary concern. Instead, Canopy Health’s alliance focuses on patient safety and quality medical care. They understand that after a natural disaster, operating hospitals are a vital resource. We applaud our alliance’s advances in both structural stability and improved patient experience. 


California’s hospital seismic safety law: its history, implementation, & progress. Office of Statewide Health Planning & Development. Retrieved from

Frequently asked earthquake questions (2017) State of California Department of Conservation. Retrieved from

Meade, C. and Kulick, J. (2007, January 1). SB1953 and the challenge of hospital seismic safety in California. California HealthCare Foundation. Retrieved from