A DOWNTOWN CLINIC IS ENSURED
Hilbert Morales, EL OBSERVADOR     

The good news last week was the purchase of the land occupied by the closed down San Jose Medical Center. Purchasing that property ensures that a future medical facility, most likely a modern clinic, will be located at 725 East Santa Clara Street. It is made up of 13.39 acres bounded by Santa Clara, East St. John, and North 14th and North 17th Streets. The Santa Clara County Board of Supervisors authorized the purchase price of $24.6 million on December 2009.

With today's medical knowledge and its applied technology, it is essential that this proposed clinic with its specialty equipment and personnel be housed in a building that is engineered to withstand a Richter 7.0 earthquake. Look at what happened to hospitals and clinics during Haiti's recent earthquake to know that the inability to deliver essential medical services happened because all their facilities collapsed, destroying essential medical services infrastructure required for the delivery of medical services to survivors. In additions, the buildings collapsing also killed many essential medical personnel. And to make things worse, supplies became inaccessible when buried under rubble.

Therefore, health services planners must be authorized to ensure the buildings will withstand a Richter 7.0 earthquake such as the one that occurred in this area in 1906 and again during Loma Prieta earthquake of 1989.

Supervisor George Shirakawa representing District 2, where this site is located, expressed elation. The Health and Hospital System of the County of Santa Clara must now perform what is necessary in guiding the construction, organization and establishment of the medical facility system that can operate effectively after a major earthquake occurs. There is no doubt that such an earthquake will happen in the future, since its location is between the San Andreas and the Hayward Fault.

While existing plans call for the remodeling of an existing 37,000 square feet medical office building, it would be prudent to have seismic safety engineers assess its ability to remain operational after a Richter 7.0 quake (the structural standard at SCVMC). The necessary structural upgrades must be implemented if required. In addition, all communications and service systems much be anchored to ensure operational capability after an earthquake. This could not come at a better time because President Ken Yeager of the Board of Supervisors is totally committed to improvement of the health care status of the residents of this county. In addition, the County Executive, Dr. Jeff Smith, M.D., is knowledgeable about the scope and requirements of a modern medical clinic.

Finally, since jobs and health care are the top priorities of the Obama Administration, it would seem very possible to have adequate American Recovery and Reinvestment Act  (ARRA) funding for this medical facility.

While this proposed medical facility is being planned, it would be instructive to study clinic systems such as the Palo Alto Medical Foundation, the Mayo Clinics and the Case-Western Reserve Clinics for organizational and medical service delivery concepts. And it is not too early to begin to have preliminary discussions to establish the network of relationships with area hospitals and specialty medical services providers. And let's not overlook the need for Stanford Medical School to have access to this clinic for its primary care training programs. It takes time and due diligence to establish the optimal mosaic of relationships that make up medical services delivery capability.

The biggest danger is to remodel that existing building without looking into its ability to be of use after a major seismic incident. The challenge is to take the time to do the creative visionary planning which results in a freestanding clinic facility, which is capable of providing medical services during normal times, but most especially, after experiencing a major earthquake already predicted by the local U.S. Geologic Service. Expediting things and cutting costs now will only result in the inability of this facility to serve the community when it is needed the most. Just look at what happened in Haiti, where the earthquake exposed the inadequate construction standards accepted by authorities, contractors, and developers who looked the other way when short cuts were taken. Eventually, it was ordinary residents who paid with anguish, suffering and their lives. That may be mitigated here. So let's ensure that the proposed downtown clinic will serve the people all of the time, even after a major earthquake.�