Seismic Retrofit of California Hospitals: Implementing Regulatory Policy in a Complex and Dynamic Context

Implementing public policy rarely flows either automatically or smoothly following enactment. This paper is a midstream analysis of a study of the implementation of seismic safety legislation in California aimed at strengthening or eliminating older acute-care hospitals. SB 1953, as it has become known, is legislation requiring that owners of acute-care hospitals built before 1973 strengthen those structures to meet contemporary seismic safety standards. Implementing the Act has been troublesome for both health-care administrators and regulators in large part because of the complex, dynamic, and unpredictable environment within which health-care organizations found themselves in the years following enactment of the policy.