CHA News

CHA Shares Information for Hospitals on Winter Surge Program Flexibility

What’s Happening: Hospitals are preparing for patient surges due to the increase of respiratory infections this winter and may need to request flexibility from licensing regulations. 

What Else to Know: There are important things for hospitals to keep in mind when sending program flexibility applications to the California Department of Public Health (CDPH).  

In 2022, CDPH centralized all state licensing and federal certification application processes with the Centralized Applications Branch (CAB). The goal was to ensure standardization and consistency of the state licensing and federal certification application process. As such, all applications that were previously processed by CDPH District Offices are now reviewed and evaluated by the CAB. 

As your hospital considers space conversion or other program flexibility applications, it is important to remember the following as you submit your online application: 

  1. Include complete descriptions of the hospital’s plan to implement its alternate concept — CDPH expects that applications include detailed descriptions of how hospitals intend to comply with the law with the modification requested and explains how the facility plans to meet the intent of the regulation. For example, if a hospital is applying for a space conversion, a map of the space, census data, equipment availability, and other supply needs (i.e. medical gas equipment), must be included in the application to comply with regulations. CDPH has noted that some submissions have lacked detail on alternative concepts. 
  1. On your application, ensure that the correct regulation your hospital is requesting a program flex from is used in the application. 
  1. CDPH recommends that hospitals attach a document to their application versus entering information in the box provided. 
  1. For space program flexes, the Department of Health Care Access and Information (HCAI) may need to approve the application. CDPH recommends working with your engineering colleagues and HCAI district staff to understand if HCAI approval is needed. 
  1. Fill out the Justification section with the rationale for the requested plan provided in the alternative concept. 
  1. Provide direct phone numbers for the point of contact for the request to facilitate communication with CDPH. 

CDPH also encourages facilities to apply for program flexibility prospectively and in anticipation of surges. Lastly, if a facility is facing an immediate challenge, a hospital can request an urgent, 24-hour review of the application. 

If you have any questions, please contact Trina Gonzalez, vice president, policy, at or Lois Richardson, vice president, policy, at