Modern Healthcare

Trump’s easing of building regulation­s could backfire during severe flooding

- By Alex Kacik

Hurricane Harvey last week ravaged southeast Texas on an unpreceden­ted scale and put disaster preparedne­ss back in the forefront. Yet, experts say an executive order that President Donald Trump recently signed easing infrastruc­ture regulation­s would put hospitals in a vulnerable position during any future natural disasters.

Harvey brought historic levels of rain to the area and claimed dozens of lives, sparked a public health emergency, shuttered hospitals and upended Houston and the surroundin­g area—“beyond anything experience­d,” according to the National Weather Service.

The city’s largest safety-net provider, Ben Taub Hospital, was evacuated as the basement storing pharmacy supplies, food and medical equipment took on water. The University of Texas MD Anderson Cancer Center in Houston and Citizens Medical Center in Victoria closed.

Still, many Texas hospitals were well-prepared, having installed submarine doors and elevated power supplies after Tropical Storm Allison hit in 2001.

But on Aug. 15, Trump signed an executive order that immediatel­y rolled back a previous order aimed at helping floodprone communitie­s prepare for the impact of climate change and rising sea levels. The Obama-era order required that new critical buildings such as federally funded hospitals and medical facilities be built at least 3 feet above the national 100-year flood elevation standards or to at least the 500-year flood plain.

The Obama administra­tion said mandating more stringent building regulation­s in areas vulnerable to floods could increase constructi­on costs but save taxpayer money over the long term.

Trump, who says he does not believe in climate change and whose administra­tion has stripped language and mentions of climate change from federal websites, wants to bolster infrastruc­ture spending and streamline the “painfully slow, costly and time-consuming process for getting permits and approvals to build,” as he described.

With the new order in place, cities, counties, states and individual healthcare systems must evaluate their situation and build appropriat­ely, according to the architectu­re firm NBBJ, which has designed hospitals for the Cleveland Clinic, the University of California at Los Angeles and NYU Langone systems in New York City. The firm is concerned that the tighter restrictio­ns were revoked without adding any new protection­s or considerat­ions, said Mackenzie Skene, healthcare partner at NBBJ.

The White House did not respond to a request for comment on the order.

“Every foot counts,” Skene said. “Building 3 feet above flood elevation—as was suggested by former President Obama’s regulation­s— could mean the difference between full hospital functional­ity and a complete failure of electrical, plumbing and mechanical systems.”

And in fact, the Louisiana State University Hurricane Center estimated that stronger building codes would have saved around $8 billion in damage incurred by New Orleans during Hurricane Katrina in 2005.

NBBJ worked on two major hospital replacemen­t projects in New Orleans that featured an “upside-down hospital” design strategy that placed critical infrastruc­ture—typically relegated to the basement—well above flood stage, in some cases seven floors up. At University Medical Center, the first “mission critical” floor is 21 feet above base flood elevation, Skene said.

“Even after Hurricane Katrina and Superstorm Sandy—which killed at least 1,400 people and caused $179 billion in damage (combined)—there are relatively few protection­s in place that safeguard healthcare facilities from storms,” Skene said. Among the few requiremen­ts are floodwall systems with passive floodgates.

Cleveland Clinic officials say easing the Obama-era regulation­s would not affect how it builds facilities going forward. At one of its constructi­on projects in Florida, the clinic raised a surgery center’s floor level above code requiremen­ts and installed impact-resistant glass, resulting in “minimal, if any” added costs, said Frank Aucremanne, Cleveland Clinic executive director of buildings and properties.

“Our resilience to withstand extreme weather is critical,” he said. “We will go beyond code in many ways to make our buildings healthier and more affordable to operate.”

 ?? FEMA/EARL ARMSTRONG PHOTO ?? Bert Gumeringer, left, director of facilities and security at Texas Children’s Hospital, shows FEMA Deputy Administra­tor Rich Serino the operations of a “submarine door”—one of many designed to halt flooding in the tunnel system under the Texas Medical...
FEMA/EARL ARMSTRONG PHOTO Bert Gumeringer, left, director of facilities and security at Texas Children’s Hospital, shows FEMA Deputy Administra­tor Rich Serino the operations of a “submarine door”—one of many designed to halt flooding in the tunnel system under the Texas Medical...
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