The Federal Emergency Management Agency (FEMA) has promised to fund a hospital in Oregon for tsunami prevention. This money is MIA

Erik Torsen, CEO of Columbia Memorial Hospital in Astoria, Oregon, stands on the roof of the hospital overlooking construction. The project, designed to fortify the building in the event of an earthquake and provide shelter during a tsunami, continues even without money promised by the federal government.

Jay Frahm for NPR

Eight years ago, Erik Thorsen — CEO of Columbia Memorial Hospital in Astoria, Oregon — received a warning no hospital administrator wants to hear: A major earthquake could cause the hospital building to collapse. His staff and patients could die within moments.

“They basically said, 'None of you are prepared for a major natural disaster from the Cascadia subduction zone,'” Thorsen recalls.

The Cascadia Subduction Zone is an earthquake-prone area that extends about 700 miles from California to British Columbia. Torsen Hospital is located right along it, which is why a team of experts and engineers from the state came to talk to him and other leaders from coastal hospitals about earthquake risks.

Alarmed, Torsen — who grew up in this area, left for college, then returned to raise his family here — worked to fundraise and plan to fortify his hospital to withstand the earthquake and provide shelter during a tsunami.

A significant portion of the project's $300 million budget was to come from the Federal Emergency Management Agency (FEMA). The $14 million grant will help build a tsunami evacuation area at the hospital.

But in April, the Trump administration canceled the grant program that awarded the funding, called the Building Infrastructure and Resilient Communities (BRIC) program. A report by the Urban Institute estimates that this cancellation jeopardizes more than $3 billion nationally in hazard mitigation funds to protect communities from threats such as floods, wildfires, hurricanes, and tornadoes.

When news reached Astoria, construction plans had already begun.

“We went back to the design team and said, ‘What would it take to actually remove these items?’” says Mark Kujala, the Clatsop County commissioner who worked to raise money for the project. “Because he was so involved in the project, that was not possible.”

Construction of the hospital began in September. Current plan to fill the $14 million hole left by FEMA: No plan.

“Unfortunately, FEMA — even before the shutdown — was kind of silent on us,” Thorsen says. “And now with the closure… there is intense silence upon us.”

There is no worse place to locate a hospital

Columbia Memorial Hospital was established at its current location in 1977, when earthquake risks were not well understood. In addition to being built in an area prone to a major earthquake, the hospital is located in a low plain, a few blocks from the waterfront, on unstable ground.

Modeling predicted that after an earthquake, several feet of water could inundate the ground floor of a hospital during a tsunami.

Jay Frahm for NPR

“The theory is that if there was an earthquake, the ground beneath us would liquefy and the building would likely collapse,” Thorsen says. “If we stayed upright and the tsunami came our way, we would probably get 20 to 30 minutes notice to evacuate people up the hill.”

This means transporting vulnerable patients – in some cases, critically ill patients – from one environment to another, in the middle of a disaster zone, in a matter of minutes. Other earthquake-prone places such as Japan have built such structures to avoid this scenario by moving to higher ground within their buildings. But some experts say Oregon State is late to the game.

“We're sitting here – you know the overused phrase – [a] “A time bomb,” says Chris Goldfinger, who studies ancient archeology at Oregon State University.

Goldfinger says an earthquake measuring 9 on the Richter scale is a realistic possibility in the Cascadia subduction zone.

“This happens on average a little less than that [once every] “500 years. It's been 325 years since the last year,” Goldfinger says.

At least 25,000 people could die in this scenario, according to some estimates.

There are only three hospitals in Oregon in this area.

“Honestly, with this project, we can be the only hospital that can survive and serve a population of about 60,000 people,” Thorsen says. “It's a big responsibility.”

The hospital is currently a sprawling, one-story building, and modeling predicted that several feet of water could inundate the hospital's ground floor during a tsunami. When completed, the new hospital will be significantly taller, growing from one floor to four (plus a fifth floor for a helipad). The idea behind the vertical evacuation zone is that once the earthquake stops and the new building is still standing, people can gather on the top several floors, which were specially built to be able to withstand a tsunami.

An illustration of the project shows how the new construction will allow vertical evacuation during a tsunami. “This will be a safe place not only for patients or hospital staff, but for the community as well,” says Democratic Congresswoman Susan Bonamici. “They can't outrun a tsunami.”

ZGF Architects

To help mitigate this potential disaster, engineers designed a plan to stabilize the hospital at a depth of 65 feet. “The building is 97 feet high, and there is a helipad on the roof,” says Thorsen, pointing at the hospital and describing its new design. The 100-foot drill bit—essentially a massive version of the type of drill bit one might find in a household tool box—actually makes deep holes to secure piles.

Although the Pacific Northwest has begun building this type of structure, Goldfinger says, it is difficult to finance it without federal support. “The federal government is the only entity that is well-equipped to treat this as a national-level problem,” he says. “It's way beyond anything the states can do on their own.”

“It's very frustrating”

Although Torsen and his staff say they have gotten some indication that existing grants to BRIC countries will continue to be distributed, they have not received any money yet.

The BRIC program was created under the first Trump administration to immunize communities against natural disasters. After its cancellation, a lawsuit challenged the program's termination and a federal judge issued an injunction.

The aforementioned construction project is still moving forward without federal grant money. Hospital leadership says they are thinking “creatively” about other funding sources, though they haven't found anything close to the $14 million the federal government promised them.

Jay Frahm for NPR

“It's very frustrating,” says Democratic Congresswoman Susan Bonamisi, who represents the district. Bonamisi says she and her staff are appealing to anyone who will listen to help get the money.

“I lost count of the number of calls I made, trying to get someone from FEMA on the phone,” Bonamisi says.

FEMA did not respond to a request for comment for this story.

Bonamisi says plans for a new hospital have given her peace of mind about a potential disaster in her area. Some forecasts predict that a 9.0-magnitude earthquake here could be the worst natural disaster the United States has ever seen.

“This will be a safe place not only for patients or staff at the hospital, but for the community as well,” Bonamisi says. “They can't outrun a tsunami.”

She says that in addition to saving lives, the project will save property and money. “It's very important — now that they're starting construction — that this funding comes through.”

Waste, fraud and abuse vary at the local level

When Trump officials started talking about cutting “waste, fraud and abuse,” Willis Van Dusen got excited. A registered Republican, Van Dusen was mayor of Astoria for more than two decades. He says eliminating waste is what he and his fellow Republicans wanted.

“This is what Trump ran on,” he says.

But when Trump's campaign of “waste, fraud and abuse” reached his city, Van Dusen says he felt differently. “What is more important than a hospital in a rural community like Astoria?” he asks.

Astoria has a history as a fishing and logging town, but more recently it has given way to big-city retirees and craft breweries. It's a rare, politically moderate area — a place, Van Dusen says, where neighborhoods are socially and economically mixed and where people are usually more concerned with questions of practical issues like trash pickup than with identity politics.

There are few issues more practical than having a trusted hospital nearby, Van Dusen says. When he had a heart attack several years ago, it was doctors at Columbia Memorial Hospital who brought him back. “I'm already dead,” he says, pointing to an EKG reading he keeps in his office.

Willis Van Dusen, who was mayor of Astoria for more than two decades, credits doctors at Columbia Memorial Hospital with bringing him back to life after his heart attack. Here, Van Dusen holds up a framed EKG from that event.

Jay Frahm for NPR

He says ensuring this hospital can continue to provide care during an earthquake and tsunami is the opposite of waste, fraud and abuse.

“Just having this money taken away from us makes me angry,” he says.

Van Dusen says he's not the only one in this city struggling with insanity, regardless of his political party. He adds: “Every Republican I spoke to is angry about what is happening.”

Hospital CEO Eric Thorsen says they won't give up — even without federal money. Construction continues. They were thinking of other ways to finance it.

Thorsen feels a responsibility to protect this community where he has spent most of his life. “We have this obligation to ensure the safety of our patients, our residents and our citizens,” he says.

But without the federal government, the path ahead is unclear.

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