(TNS) — California’s hospitals are scrambling to retrofit their buildings before “The Big One” hits, an effort that will cost tens of billions dollars and could jeopardize health-care access, according to a newly released study.

The state’s 418 hospitals have a deadline from the state, too. They’re racing to meet seismic safety standards set by a California law that was inspired by the deadly 1994 Northridge earthquake, which damaged 11 hospitals and forced evacuations at eight of them.

By 2020, hospitals must reduce the risk of collapse. By 2030, they must be able to remain in operation after a major earthquake.

That could cost hospitals between $34 billion and $143 billion, according to a new report from Rand Corp.

The report, funded by the California Hospital Association, examined whether the state’s hospitals will be able to comply with the law, particularly the 2030 deadline.

About a third of the hospitals in the state are in financial distress, and that number could rise to more than 50 percent as hospitals seek seismic compliance, the study found.

Read more