Austin hospital safety law’s full impact could be years away

KXAN (AUSTIN) -- Despite the hum of new construction, the full impact of Austin's new hospital safety law is likely years away.

Three months ago this week, Austin passed an ordinance requiring barriers, called bollards, to improve security at new hospitals. While some facilities are already making updates, without a state-level change, a KXAN investigation found the new safety mandate could take months, if not years, to be felt.

New builds, old plans

In a city used to new construction, health care is booming. A future state-of-the-art hospital and MD Anderson Cancer Center, for instance, are coming to the University of Texas at Austin. Since those projects are still in the early stages, they will have to install crash-rated bollards under the new city rule.

But KXAN found millions of dollars of ongoing medical facility expansions -- at St. David's and Ascension Seton, among others -- exempt from doing the same.

Both hospital systems did not respond to KXAN's request for comment regarding whether bollards will voluntarily be added.

St. David's, however, previously said it had installed bollards at all of its locations.

“St. David's HealthCare installed bollards at all of our hospitals prior to the Austin City Council approving the ordinance,” the hospital system previously told KXAN.

"[A]nd we will work with policymakers to ensure compliance with any new legal or regulatory requirement," the hospital said.

Under the ordinance, which unanimously passed on Dec. 12 and took effect Dec. 23, new Austin hospitals -- and existing ones that expand -- have to install crash-rated bollards.

It's a direct response to KXAN's investigation into the deadly crash at St. David's North Austin Medical Center more than a year ago.

Our reporting previously revealed more than 400 similar crashes across the country over the past decade.

On the date it passed, its author, former Council Member Mackenzie Kelly, said the measure "will absolutely save lives."

KXAN wanted to see how the new hospital security law is working. Digging through city building permits, we found at least nine applications listed on the city's portal as being filed since the ordinance took effect -- but that bollard requirement doesn't apply to any of them.

That's because "bollard installation compliance" is actually "triggered by the Site Plan application, not the Building Permit," according to Austin Transportation and Public Works spokesman Brad Cesak.

"Bollards are reviewed and approved as part of the site," Cesak said, "and that is where they are inspected for compliance."

"Any site plan submitted on [Dec. 23] or after will have to comply," he said.

Hospitals 'put on notice'

KXAN found nearly 50 building permits issued after the ordinance took effect -- but with site plans filed before that date. Some, like St. David's new Mental Health and Wellness Center behavioral hospital, were filed years ago. In that case, in October of 2022. So, the new rule doesn't apply.

We did not find any site plans filed after the ordinance took effect.

There are "currently no site plans that have been submitted that fall under the new ordinance," Cesak confirmed.

"To me, what kicks these things off is a side show to: Why wouldn't people put them in anyway?" asked Rob Reiter, a bollard expert and co-founder of the non-profit Storefront Safety Council, which tracks vehicle crashes.

Reiter said even if hospitals don't yet have to install bollards, they should.

"From a liability standpoint, if there's a vehicle incursion at that location, and they come back with the defense of, 'Well, they weren't required,' they've been put on notice," Reiter said.

'Voluntary compliance'

Since the ordinance went into effect, "many" hospitals in the city "are already coming into voluntary compliance," Cesak said.

Austin Regional Clinic told KXAN its new 63,000 square foot Surgery Center South on Ben White Boulevard, which is currently under construction and set to open early next year, "will have bollards with lights for the entrance in compliance with the Ordinance."

After KXAN reached out, ARC said even though the ordinance only "specifies" bollards for new medical facilities, it will review its other locations.

"We have not yet added bollards to the existing entrances at ARC South 1^st or ARC South 1^st Specialty, the existing clinics adjacent to the new facility, as the Ordinance specifies the addition for new medical facilities, urgent care clinics, and stand-alone emergency rooms, which these clinics are not," said ARC Chief Administrative Officer Katherine Flynn Henry.

"ARC plans to review other existing Austin locations for potential safety issues and will address those in the most appropriate way, including the addition of bollards," Henry added in a statement. "ARC does not have any Site Plan applications in the City of Austin in the near future, but bollards will be included with all future sites."

Austin city staff are providing "construction and placement standards" to applicants so they "understand" the bollard requirements, Cesak said, adding the city is available to offer support.

"We also plan to reach out to existing facilities to make them aware of the new ordinance and provide permitting guidance should they wish to voluntarily comply," Cesak said.

A bill filed this legislative session and gaining bipartisan support would require bollards at most hospitals across the state.

"Safety has always been the standard of care," said Reiter, who wants to see hospital safety improved to prevent future disasters. "Why wouldn't you want to make it safe?"