CSAC Bulletin Article

State Issues Immediate Hospital Capacity Order

January 7, 2021

The California Department of Public Health issued an immediate hospital surge order on January 5 to compel the transfer of patients from hospitals in crisis and acceptance of those patients by other hospitals with available capacity. Children’s Hospitals are not included in the order.

The order applies to counties in a region under the Regional Stay at Home Order that have zero percent ICU availability and the ICU availability for an individual county is ten percent or less. As of today, hospitals in the following counties fall under the order:

San Joaquin Valley Region: Fresno, Kern, Kings, Madera, Merced, San Benito, San Joaquin, Stanislaus

Southern California Region: Imperial, Los Angeles, Orange, Riverside, San Bernardino, San Diego.

The order, which remains for at least three weeks and perhaps longer based on the above metrics, includes the following requirements:

  • Delay Non-Urgent Procedures: All hospitals and ambulatory surgery centers operating under a hospital license or hospital-based clinic shall categorize all elective procedures and delay non-urgent surgical procedures for the duration of the order
  • Process: A hospital in the county that has reached crisis care and does not have the ability to examine and treat patients shall notify the proper chain of command (MHOAC, Local Health Officer, CDPH Licensing & Certification District Office, Regional DMHS, EMSA).
  • Patient Transfers: As directed by the above chain of command, a hospital in crisis care shall transfer patients to another facility when clinically appropriate and regardless of a patient’s ability to pay. 
  • Transfer Acceptance: All hospitals in the state must accept patients from hospitals in crisis care transferred pursuant to this order when they are capable and when such transfers are clinically appropriate. Hospitals directed to accept patients under the order must acknowledge their acceptance of the patient within 60 minutes of the request.
  • Load Balancing: The MHOAC, RDMHS and EMSA Director or designee should take all measures to ensure balanced distribution of patients across the hospital system and shall immediately notify the MHOAC and RDMHS in the receiving county if it is different than the sending county.

The order does not include additional administrative flexibility for hospitals in crisis, such as relaxing requirements for updating patient records, but the state may allow these changes via regulation. We will update counties on any new developments related to this order.

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