ASTORIA, Ore. — Residents of this small coastal metropolis within the Pacific Northwest know what to do when there’s a tsunami warning: Flee to greater floor.
For these in or close to Columbia Memorial, the town’s solely hospital, there’ll quickly be a distinct plan: Shelter in place. The hospital is constructing a brand new facility subsequent door with an on-site tsunami shelter — an elevated refuge atop columns deeply anchored within the floor, the place almost 2,000 folks can safely wait out a flood.
Oregon wants extra shelters just like the one which Columbia Memorial is constructing, emergency managers say. Hospitals within the area are more likely to incur critical injury, if not break, and will take greater than three years to totally get well within the occasion of a significant earthquake and tsunami, in response to a state report.
Columbia Memorial’s present facility is a single-story constructing, fabricated from wooden a half-century in the past, that may possible collapse and sink into the bottom or be swallowed by a landslide after a significant earthquake or a tsunami, mentioned Erik Thorsen, the hospital’s chief government.
“It is just not built to survive either one of those natural disaster events,” Thorsen mentioned.
Not less than 10 different hospitals alongside the Oregon coast are in peril as nicely. So Columbia Memorial leaders proposed constructing a hospital able to withstanding an earthquake and landslide, with a tsunami shelter, as an alternative of relocating the power to greater floor. Residents and state officers supported the plans, and the federal authorities awarded a $14 million grant from the Federal Emergency Administration Company to assist pay for the tsunami shelter.
The venture broke floor in October 2024. Inside six months, the Trump administration had canceled the grant program, often called Constructing Resilient Infrastructure and Communities, or BRIC, calling it “yet another example of a wasteful and ineffective FEMA program … more concerned with political agendas than helping Americans affected by natural disasters.”
Molly Wing, director of the enlargement venture, mentioned dropping the BRIC grant felt like “a punch to the gut.”
“We really didn’t see that coming,” she mentioned.
This summer season, Oregon and 19 different states sued to revive the FEMA grants. On Dec. 11, a choose dominated that the Trump administration had unlawfully ended this system with out congressional approval.
The administration didn’t instantly point out it will attraction the choice, however Division of Homeland Safety spokesperson Tricia McLaughlin mentioned by e-mail: “DHS has not terminated BRIC. Any suggestion to the contrary is a lie. The Biden Administration abandoned true mitigation and used BRIC as a green new deal slush fund. It’s unfortunate that an activist judge either didn’t understand that or didn’t care.” FEMA is a subdivision of DHS.
Columbia Memorial was one of many few hospitals slated to obtain grants from the BRIC program, which had introduced greater than $4.5 billion for almost 2,000 constructing tasks since 2022.
Hospital leaders have determined to maintain constructing — with unsure funding — as a result of they are saying ready is simply too harmful. With the Trump administration reversing course on BRIC, fewer communities will obtain assist from FEMA to scale back their catastrophe threat, even locations the place catastrophes are possible.
Greater than three centuries have handed since a significant earthquake brought on the Pacific Northwest’s shoreline to drop a number of toes and unleashed a tsunami that crashed onto the land in January 1700, in response to scientists who research the evolution of the Oregon coast.
The best hazard is an underwater fault line often called the Cascadia Subduction Zone, which lies 70 to 100 miles off the coast, from Northern California to British Columbia.
The Cascadia zone can produce a megathrust earthquake, with a magnitude of 9 or greater — the kind able to triggering a catastrophic tsunami — each 500 years, in response to the U.S. Geological Survey. Scientists predict a ten% to fifteen% probability of such an earthquake alongside the fault zone within the subsequent 50 years.
“We can’t wait any longer,” Thorsen mentioned. “The risk is high.”

Constructing for the Future
The BRIC program began in 2020, through the first Trump administration, to supply communities and establishments with funding and technical help to fortify their constructions in opposition to pure disasters.
Joel Scata, a senior lawyer with the environmental advocacy group Pure Sources Protection Council, mentioned this system helped communities higher put together so they may cut back the price of rebuilding after a flood, twister, wildfire, or excessive climate occasion.
To qualify for a grant, a hospital needed to present that the venture’s advantages have been larger than the long run hazard and price. In some instances, that profit won’t be readily obvious.
“It prevents bad disasters from happening, and so you don’t necessarily see it in action,” Scata mentioned.
Scata famous that the Trump administration has additionally stopped awarding grants by FEMA’s Hazard Mitigation Grant Program, which predates BRIC.
“There really is no money going out the door from the federal government to help communities reduce their disaster risk,” he mentioned.
A current KFF Well being Information investigation utilizing proprietary information from Fathom, a world chief in flood modeling, discovered that at the least 170 U.S. hospitals are in danger of serious and doubtlessly harmful flooding from extra intense and frequent storms. That rely didn’t embody Columbia Memorial, as Fathom’s information didn’t account for tsunamis. It fashions flooding from rivers, sea degree rise, and excessive rainfall.
In current days, an atmospheric river — a slender storm band carrying vital quantities of moisture — dumped greater than 15 inches of rain on components of Oregon and Washington, inflicting catastrophic flooding alongside rivers and the coast. Within the Washington city of Sedro-Woolley, which sits alongside the Skagit River, the PeaceHealth United Normal Medical Middle evacuated nonemergency sufferers.
Excessive winds battered Astoria, leaving the town with some minor landslides, in response to information stories. However flooding on the street to the close by seaside city of Seaside made the drive almost impassable.
The Trump administration is leaning on states to take larger duty for recovering from pure disasters, Scata mentioned, however most states should not financially ready to take action.
“The disasters are just going to keep on piling up,” he mentioned, “and the federal government’s going to have to keep stepping in.”

A Hospital at Danger
Columbia Memorial is blocks from the southern shore of the Columbia River, close to the Washington border, the place the space’s pure hazards embody earthquakes, tsunamis, landslides, and floods. A important entry hospital with 25 beds, it opened in 1977 — earlier than state constructing codes addressed tsunami protections.
Thorsen mentioned the brand new facility and shelter can be a “model design” for different hospitals. Design plans present a five-level hospital constructed atop a basis anchored to the bedrock and surrounded by concrete columns to defend it from tsunami particles.
The shelter can be on the roof of the second flooring, above the projected most tsunami inundation. Will probably be accessible through an outside staircase and inside staircases and elevators, with sufficient room for as much as 1,900 folks, plus meals, water, tents, and different provides to maintain them for 5 days.


With most affected person care offered on the second and third ranges, turbines on the fourth degree, and utility traces underground, the hospital is anticipated to stay operational after a pure catastrophe.
Thorsen mentioned an earthquake and tsunami threaten not solely huge flooding but additionally liquefaction, during which the bottom loosens and causes constructions above it to break down. Deep foundations, thick slabs, and different structural helps are anticipated to guard the brand new hospital and tsunami construction in opposition to such failure.
By way of the years, hospital directors and civic leaders in Astoria have sought different places for Columbia Memorial. However relocation wasn’t economical. Columbia Memorial dedicated to put money into a brand new hospital and tsunami shelter to guard not solely sufferers and workers but additionally close by residents.
“Your community should count on your hospital to be a safe haven in a natural disaster,” Thorsen mentioned.

Preventing To Restore Funds
The estimated development finances for Columbia Memorial’s enlargement is $300 million, principally financed by new debt from the hospital. The tsunami shelter is budgeted at about $20 million, for which FEMA’s BRIC program awarded almost $14 million, with a $6 million matching grant from the state, which has maintained its help.
The shelter and the constructing’s structural protections — that includes strengthened metal, deeper foundations, and thicker slabs — are integral to the design and can’t be eliminated with out compromising the remainder of the construction, mentioned Michelle Checkis, the venture architect.
“We can’t pull the TVERS [tsunami vertical evacuation refuge structure] out without pulling the hospital back apart again,” she mentioned. “It’s kind of like, if I was going to stack it up with Legos, I would have to take all those Legos apart and stack it up completely differently.”

Columbia Memorial has sought assist from Oregon’s congressional delegation. In a letter to Division of Homeland Safety Secretary Kristi Noem and former FEMA appearing administrator David Richardson, the lawmakers demanded that the companies restore the hospital’s grant.
The hospital’s management is looking for different grants and philanthropic donations to make up for the loss. As a final resort, Thorsen mentioned, the board will take into account eradicating “nonessential features” from the constructing, although he added that there’s little fats to trim from the venture.
The lawsuit introduced by states in July alleged that FEMA lacks the authority to cancel the BRIC program or redirect its funding for different functions.
The states argued that canceling this system ran counter to Congress’ intent and undermined tasks underway.
Of their response to the lawsuit, the Trump administration mentioned repeatedly that the defendants “deny that the BRIC program has been terminated.”
The lawsuit cites examples of tasks in danger in every state as a consequence of FEMA’s termination of the grants. Oregon’s first instance is Columbia Memorial’s tsunami shelter. “Neither the County nor the State can afford to resume the project without federal funding,” the lawsuit states.
In response to questions in regards to the impression of canceling the grant on Astoria and the encompassing group, DHS spokesperson Tricia McLaughlin mentioned BRIC had “deviated from its statutory intent.”
“BRIC was more focused on climate change initiatives like bicycle lanes, shaded bus stops, and planting trees, rather than disaster relief or mitigation,” McLaughlin mentioned. DHS and FEMA offered no additional remark about BRIC or the Astoria hospital.


Making ready for a Tsunami Catastrophe
Situated close to the tip of the Lewis & Clark Nationwide Historic Path, Astoria sits on a peninsula that juts into the Columbia River close to the Pacific Ocean.
A lot of the town will not be within the tsunami inundation space. However Astoria’s downtown business district — the place present outlets, resorts, and seafood eating places line the streets — is almost all an evacuation zone.
Two hospitals — Ocean Seaside Well being in close by Washington, and Windfall Seaside Hospital in Oregon — are about 20 miles from Columbia Memorial. Each are 25-bed hospitals, and neither is designed to face up to a tsunami.
Ocean Seaside Well being frequently conducts drills for mass-casualty and pure disasters, mentioned Brenda Sharkey, its chief nursing officer.
“We focus our planning and investments on areas where we can make a real difference for our community before, during, and after an event — such as maintaining continuity of care, ensuring rapid triage, and coordinating with regional emergency partners,” Sharkey mentioned in an e-mail.

Gary Walker, a spokesperson for Windfall Seaside, mentioned in an announcement that the hospital has a “comprehensive emergency plan for earthquakes and tsunamis, including alternative sites and mobile resources.”
Walker added that Windfall Seaside has employed “a team of consultants and experts to conduct a conceptual resilience study” that may consider the hospital’s vulnerabilities and advocate methods to deal with them.
Oregon’s emergency managers advise residents and guests in coastal communities to right away search greater floor after a significant earthquake — and to not depend on tsunami sirens, social media, or most expertise.
“There may not even be cellphone towers operating after an event like this,” mentioned Jonathan Allan, a coastal geomorphologist with the Oregon Division of Geology and Mineral Industries. “The earthquake shaking, its intensity, and particularly the length of time in which the shaking persists, is the warning message.”
The stronger the earthquake and the longer the shaking, he mentioned, the extra possible a tsunami will head to shore.
A tsunami triggered by a Cascadia zone earthquake might strike land in lower than half-hour, in response to state estimates.
Lots of Oregon’s seaside communities are close to high-enough floor to hunt security from a tsunami in a comparatively brief time, Allan mentioned. However he estimated that, to avoid wasting lives, Oregon would want a few dozen vertical tsunami evacuation shelters alongside the coast, together with in seaside cities that entice vacationers and the place the closest excessive floor is a mile or extra away.
Willis Van Dusen’s household has lived in Astoria because the mid-Nineteenth century. A former mayor of Astoria, Van Dusen harassed that tsunamis should not a hypothetical hazard. He recalled seeing one in Seaside in 1964. The wave was solely about 18 inches excessive, he mentioned, but it surely flooded a street and destroyed a bridge and a few houses. The reminiscence has stayed with him.
“It’s not like … ‘Oh, that’ll never happen,’” he mentioned. “We have to be prepared for it.”


KFF Well being Information correspondent Brett Kelman contributed to this report.