On Aug. 16, the California Department of Public Health (CDPH) issued a state public health officer order on hospital surge. This requires hospitals to give notice when certain triggers are met and to accept patients under specific conditions.
Specifically, it requires a general acute care hospital to provide notice when:
- Less than 20% of staffed adult intensive care unit beds (ICU) are available for three consecutive days
- It is utilizing alternative spaces for inpatient surge capacity, including but not limited to cafeterias, hallways, or conference rooms
- It is utilizing tents or other outside structures for inpatient surge capacity
- It utilizes a team nursing model for three consecutive days
When that occurs, the hospital shall immediately notify, in writing, its Medical and Health Operational Area Coordinator (MHOAC), local public health officer, and CDPH Licensing and Certification District Office.
Second, when a mutual aid region (area led by Regional Disaster Medical Health Coordinators and Specialists) has less than 10% of staffed adult ICU beds available for a period of three consecutive days or when an individual general acute care hospital has zero ICU capacity, the following transfers must be accepted must be accepted for seven days:
- Transfers that are clinically appropriate and directed by the MHOAC, RDMHS, or the Emergency Medical Services Authority (EMSA) or its designee (such as the All Access Transfer Center, a division of which is the California Emergency Command and Transfer Center referenced in the order)
- Transfers that the hospital has the capability to accept, as determined by the hospital’s leadership and MHOAC
- Transfers to other hospitals first within the county; then, if exhausted, within the region; and then, if exhausted, within the state
CDPH is developing a public-facing dashboard to indicate when a region has less than 10% of staffed adult ICU beds available for three consecutive days.
CDPH has stated that it does not intend to issue an All Facilities Letter. The effective date of the health order is tomorrow, Aug. 18.