CHA News

CDPH Publishes Resources for Hospital Response to Patient Surges 

CHA remains in close contact with state officials during the current surge of patients that is challenging the health care delivery system. The California Department of Public Health (CDPH) has published several All Facilities Letters (AFLs) that hospitals may find useful during the current patient surges.  

The AFLs are: 

AFL 22-33: Guidance for Response to Surge in Respiratory Viruses Among Adult Patients  

This AFL, released Dec. 16, provides guidance to hospitals on planning for and responding to surges due to increases in COVID-19, influenza, and other respiratory viruses. The AFL: 

  • Explains the current waiver of specific regulations and statutes during the COVID-19 state of emergency related to use of space and bed classification 
  • Provides guidance to facilities on planning for and responding to patient surges 
  • Reminds hospitals of the August 2021 state public health officer hospital and health care surge order,which is still in effect. It requires general acute care hospitals to report to the medical health operational area coordinator (MHOAC), local public health officer, and CDPH district office when they have less than 20% ICU capacity, are using alternative space, or are using a team nursing program flex for three consecutive days. This also requires hospitals to accept patients when clinically appropriate and directed by the MHOAC when a CDPH public health officer region has less than 10% of staffed ICU beds for three consecutive days. CDPH has resumed posting the data on regional capacity, so hospitals can know when this trigger has been hit by a region within the state. 

AFL 22-23.1: Guidance for Response to Surge in Respiratory Viruses Among Pediatric Patients  

This AFL, which was updated on Dec. 15: 

  • Explains the current waiver of specific regulations and statutes during the COVID-19 state of emergency related to use of space and bed classification 
  • Explains the program flexibility process that allows flexibility from regulatory requirements 
  • Provides guidance to facilities on planning for and responding to pediatric surges related to respiratory syncytial virus and other respiratory viruses 
  • Contains a link to template/sample requests for program flexibility to assist hospitals in submitting program flexibility requests for team nursing and for adding a pediatric supplemental service to a hospital’s license 

AFL 21-08.9: Guidance on Quarantine and Isolation for Health Care Personnel (HCP) Exposed to SARS-CoV-2 and Return to Work for HCP with COVID-19  

This AFL, which was updated on Dec. 2, provides hospitals and skilled-nursing facilities (SNFs) with updated guidance on: 

AFL 20-91: California Crisis Care Continuum Guidelines: Implementing During the Surge of Coronavirus Disease 2019 (COVID-19) Cases  

As a reminder, under this AFL released Dec. 28, 2020: 

  • Facilities that need to implement crisis care, including triage of critical care resources, must notify their local public health department and local CDPH district office via email and phone call immediately when initiating crisis care to ensure the state is aware of conditions at the facility. 

Hospitals with questions or concerns on these AFLs, program flexibility requests, and assistance with SNFs, can contact their CDPH district office. Hospitals with resource requests should contact their MHOAC. At this time, the state is not contracting with temporary staff; however, hospitals should submit requests for staffing to the state so that it understands the resource needs and can take appropriate action as needed. For urgent matters, hospitals may contact the CDPH duty officer at (916) 328-3605.  

In addition, CHA has put together these FAQs on Hospitals Facing Critical Staffing Shortages, which may be helpful during this surge.