CHA Resources on Planning for Crisis Standards of Care
In June, the California Department of Public Health (CDPH) issued its California SARS-CoV-2 Pandemic Crisis Care Guidelines: Concept of Operations/Health Care Facility Surge Operations and Crisis Care, providing a framework to help health care facilities plan for an overwhelming medical surge due to the pandemic. The guidelines include an overview of surge capacity and crisis care operational considerations, as well as a decision-making framework for allocating ventilators and pandemic patient care strategies for scarce resource situations.
Importantly, while the Guidelines provide information to support individual health care facilities or health system operations, CDPH makes clear that the Guidelines do not replace the judgment of operational management, medical directors, legal advisors, or clinical staff or consideration of other relevant variables and options. To assist hospitals as the winter surge continues to grow, CHA has prepared several resources that highlight the guidelines’ key concepts and planning considerations for allocating scarce medical resources during surge operations. These include:
- A checklist for preparing for the possibility of moving to crisis standards of care
- A step-by-step guide for implementing crisis standards of care
- FAQs about crisis standards of care
- Key messages for use or customization with the media or public
CHA recommends that when hospitals implement the crisis care guidelines they notify the local CDPH district office as a way of communicating the change in operations at the hospital.
Updated Vaccination Primer Includes New Information for Hospitals
CHA has updated its COVID-19: Vaccination Primer for California Hospitals with new information released by the state on additional doses being distributed statewide, who may issue vaccine orders and who may administer vaccines, provider enrollment approval considerations, and more.
FAQs Answer Key Questions About Nurse Staffing Shortages, Link to Helpful Resources
To assist with hospitals’ nurse staffing shortages during the current surge – particularly in critical care environments – CHA has compiled a quick-reference set of FAQs that address the expedited option for nurse staffing ratio flexes recently issued by CDPH; how to request a program flex for nursing documentation; samples of team nursing models currently in use by other hospitals; how to use nursing students to supplement care and for administering vaccines; and available critical care training specific to COVID-19 ICU patients.
Congress Passes Year-End Legislation That Includes COVID-19 Relief
The House and Senate leadership reached an agreement Dec. 21 on a year-end legislative package that extends funding for the federal government through the end of the federal fiscal year, provides additional relief for small businesses, workers and health care providers suffering from the COVID-19 pandemic, and addresses the issue of surprise medical bills.
CHA worked closely with the California congressional delegation and the leadership to help shape this legislation. While all our priority issues were not completely addressed, the bill includes important provisions on relief from Medicare and Medicaid cuts and adjustments to Provider Relief Fund reporting. CHA will continue to work with the next Congress and the Biden administration to secure additional funds for hospitals and their front-line workers. Details of the stimulus package are available on the CHA website.
DHCS Seeks Federal Approval for No-Cost COVID-19 Vaccines for Medi-Cal Beneficiaries
With the recent Food and Drug Administration approval of COVID-19 vaccines, the Department of Health Care Services (DHCS) is seeking federal approval to help support delivery of the vaccine to all Medi-Cal beneficiaries.
DHCS will follow CDPH’s California’s COVID-19 vaccination plans. They call for implementation in several phases: pre-vaccine; limited doses available; larger number of doses available; and sufficient supply of doses available for the entire population. DHCS expects to issue initial guidance on COVID-19 vaccine administration and reimbursement policy by Dec. 25.
CMS Issues Guidance on Infection Control in Psychiatric, Intermediate Care Facilities
The Centers for Medicare & Medicaid Services (CMS) has issued guidance to psychiatric hospitals, psychiatric residential treatment facilities, and intermediate care facilities for individuals with intellectual disabilities that aims to improve infection control practices and help prevent the transmission of COVID-19. The guidance also seeks to avoid the need for use of seclusion and restraint, specifically as an infection control intervention.
The guidance includes a set of FAQs in the following areas:
- Promising practices, measurement, and mitigation strategies for infection control during the public health emergency (PHE)
- Use of isolation, cohorting, and personal protective equipment
- Intervention, mitigation, and training strategies
- Transition and discharge during the PHE
- Engaging family, caregiver, support personnel, and community resources
- Available local, state, and federal resource guides and web links
Toolkit Offers Help Complying with COVID-19 Workplace Notice Requirements
CHA has released a toolkit to help hospitals comply with the COVID-19 workplace notice requirements in a new California law — Assembly Bill 685 — that takes effect Jan. 1, 2021. The law, which is enforced by Cal/OSHA, requires employers to notify employees that they may have been exposed to COVID-19 in the workplace. The toolkit covers key provisions of the law and includes a sample notice for employees.
While CHA convened a member workgroup to develop the toolkit to address the law’s most relevant components and issues, it is not legal advice and hospitals are encouraged to consult with counsel on any questions or concerns. CHA has also developed an on-demand educational video that provides a summary of the law.
CHA Board Honors Health Care Workers With Award of Merit
At its Dec. 15 meeting, the CHA Board of Trustees gave the organization’s highest honor – the Award of Merit – to California’s COVID-19 caregivers. The award, which recognizes outstanding contributions to the health care community, recognizes the 500,000 men and women of California’s hospitals who wake up every day, selflessly leave their families, and arrive at our hospitals to care for patients during the pandemic. This short tribute video from CHA recognizes hospital workers’ selfless contributions over the past year.
Hospitals Have a Message for the Public: Don’t Share Your Air
During a statewide, virtual press conference on Dec. 22, leaders, physicians, and front-line workers from three hospital systems — stretched to their limits by the COVID-19 surge — pleaded with Californians to take stringent, common-sense precautions in the coming weeks to avoid getting or spreading the virus.
In conjunction with California Health and Human Services Secretary Mark Ghaly, MD, they issued a “prescription” for Californians to avoid spreading the virus during the Christmas, Kwanzaa, and New Year’s holidays: Don’t share your air. This includes keeping your face covered with a mask, keeping the air flowing (turn on fans and open windows if indoors), and keeping your in-person interactions with others short.
Next CDPH Office Hours: Dec. 29
CDPH will hold a COVID-19 Vaccination Office Hours for hospitals on Dec. 29 from 9 to 10 a.m. (PT). The link to participate at the time of the event is here. Webinar dates will resume on Jan. 8.
Coronavirus Response Returns Jan. 5
Coronavirus Response will not be published on Dec. 29. The next issue will be Jan. 5, 2021.