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CDPH Issues AFL on Crisis Standards of Care
The California Department of Public Health (CDPH) has issued All Facilities Letter (AFL) 20-91, which addresses the need for all health facilities to have crisis care continuum guidelines and to implement those guidelines if they are experiencing surge as a result of the current increase in COVID-19 cases. The AFL outlines new expectations for hospitals during the current surge and includes links to the CDPH Crisis Care Continuum Guidelines and its new Crisis Care Guidelines Pre-Implementation Checklist.
Notably, the AFL states that, by Jan. 6, 2021, all facilities must notify their local CDPH district office and local public health department via email that they have adopted and publicly posted (including a link to the posting) their own crisis care continuum guidelines, another facility’s guidelines, or the state’s California Crisis Care Continuum Guidelines. According to the AFL, hospitals are expected to have plans that best fit their facility and regional needs and processes, while following ethical principles, health equity goals, and civil rights laws. Additionally, hospitals 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.
Facilities that do not have current guidelines should consult with their Medical Health Operational Area Coordinators for technical assistance.
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
Update on State COVID-19 Supplemental Paid Sick Leave
Earlier this week, the President signed a bill that partially extends the paid leave provisions in the Families First Coronavirus Response Act (FFCRA). While the federal bill does not extend the mandatory leave entitlement, it does allow private employers covered by the FFCRA that voluntarily provide the leave to receive payroll tax credits until March 31, 2021.
California’s COVID-19 Supplemental Paid Sick Leave is set to expire on Dec. 31, unless the FFCRA was extended. It is unclear whether the partial extension of the FFCRA is sufficient to trigger an extension — to March 31, 2021 — of California’s COVID-19 Supplemental Paid Sick Leave. CHA is seeking clarification on this from the California Labor & Workforce Development Agency and will share updates in Coronavirus Response.
As of last week, there were no certain plans to extend California’s COVID-19 Supplemental Paid Sick Leave if the FFCRA was not extended, but this is an evolving situation. If the agency determines that the partial extension does not extend it, the Legislature or the governor could step in and extend the COVID-19 Supplemental Paid Sick Leave or wait to see whether the Biden administration takes any action. CHA will continue to provide updates as they develop.
FAQs to Assist with New PPE Law
With California’s general acute care hospital personal protective equipment stockpile bill (Assembly Bill 2537) taking effect on Jan. 1, 2021, CHA has developed these frequently asked questions to assist hospitals with implementation. There remains much ambiguity with this law; CHA will continue to provide updates as they develop. Questions can be directed to Gail Blanchard-Saiger.
Summary of Dec. 22 CDPH Call
CDPH has provided a summary of its recent weekly call with health care facilities.