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.
