HEALTH CARE FACILITIES ARE A CRITICAL COMPONENT TO A COMMUNITY’S RECOVERY DURING A DISASTER, AN ACCIDENT OR AN ACT OF TERRORISM. THE WATER SUPPLY FOR A FACILITY COULD BE INTERRUPTED FOR ANY OF THESE INCIDENTS. HEALTH CARE FACILITIES NEED TO BE PREPARED FOR A POTENTIAL LOSS OF THEIR WATER SUPPLY IN ADDITION TO ELECTRICAL POWER AND OTHER INFRASTRUCTURE.

ISSUE

There is no one set of national standards which establishes requirements for emergency water supplies of health care facilities. However, on June 12, 2002, President Bush signed into law the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. The act requires community water systems, serving populations greater than 3,300, to either prepare or revise an emergency response plan. In developing the plan, community water systems are encouraged to include hospitals.

The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), an independent non-profit national accreditation organization, has established the standard EM.02.02.09 requiring hospital emergency operation plans to identify procedures if the hospital cannot be supported by a local community for at least 96 hours relative to water, wastewater disposal, power and heating fuels. Although JCAHO is not a governmental agency, for health care facilities to maintain their accreditation, they must comply with the standard.

The Center for Medicare and Medicaid Services Conditions for Participation/Conditions for Coverage (42 CFR 482.41) requires that health care facilities must include emergency gas and water supply. This requirement has bearing on those health care facilities that treat Medicare and Medicaid recipients.

States and local municipalities may include requirements within their building and/or plumbing codes.

For example: California has addressed the issue through their building and plumbing codes. SB 1953 (1994), an amendment to the Alfred E. Alquist Hospital Facilities Seismic Safety Act (SB 519 HSSA) of 1973, established five nonstructural performance categories for acute care hospital facilities. These categories include expiration dates with the goal to have all acute care hospital facilities meeting NPC-5, the most stringent category, by 2030. NPC- 5 requires an on-site water supply, holding tanks for wastewater, and fuel supply for 72 hours of emergency operations. Compliance is mandated by 2030, or the facility will be removed from acute care service.

California Plumbing Code Section 614.4.1 states: “For acute care hospital facilities required to meet NPC-5, an on-site water supply of 150 gallons (based on 50 gallons/day/bed for 72 hours) of potable water per licensed bed shall be provided. The emergency supply shall have fittings to allow for replenishment of the water supply from transportable sources.”