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In response to CHA’s advocacy efforts, the California Department of Public Health (CDPH) this afternoon issued All Facilities Letter (AFL) 21-31 to clarify the Aug. 5 state public health officer order regarding hospital visitors (see earlier CHA summary of the order). That order requires general acute care hospitals (GACHs), skilled-nursing facilities, and intermediate care facilities to verify that visitors entering the facility for indoor visitation with a patient are fully vaccinated or have had a recent negative COVID-19 test.
The AFL clarifies that outpatient settings on a GACH license are not included. Specifically, it states that a person who accompanies a patient to an outpatient visit is not considered to be a “visitor in acute health care” and therefore is not subject to the vaccination or testing requirement outlined in the public health officer order.
The order contained only one exemption from the vaccination or testing requirement — for visitors of a patient in critical condition, when death may be imminent. CHA had expressed concern to CDPH about hospitals being required to refuse entry to parents or guardians of pediatric patients, support persons for labor and delivery patients, and support persons for patients with physical, intellectual, or developmental disabilities or cognitive impairment.
Today’s AFL states that these visitors have a limited exemption from the vaccination or testing requirement:
• Parent or guardian visitors of pediatric patients
• A support person for a labor and delivery patient
• Support persons for a patient with physical, intellectual, developmental disability, or cognitive impairment are considered visitors who are visiting a patient in critical condition.
It is limited in that it states that for subsequent visits following the emergent situation, and as soon as reasonably possible, these visitors must comply with the vaccine verification or applicable testing requirements within 72 hours. In addition, they must still comply with other infection control and prevention requirements that apply to indoor visits (e.g., masking and social distancing).
The AFL requires hospitals to retain documentation of their verification of visitors’ vaccination status or test results for one year following the end of the public health emergency. CHA will clarify but assumes that this is the end of the state of California’s COVID-19 state of emergency.
CHA will continue to provide more information about the hospital visitation order as it becomes available.