GACH Coronavirus Disease 2019 (COVID-19) Daily Reporting (This AFL supersedes AFL 20-31.2)

AFL 20-31.3 From the California Department of Public Health TO: General Acute Care Hospitals (GACHs) SUBJECT: GACH Coronavirus Disease 2019 (COVID-19) Daily Reporting (This AFL supersedes AFL 20-31.2) ​AUTHORITY:      Proclamation of Emergency (PDF) All Facilities Letter (AFL) Summary This AFL requires GACHs to report COVID-19 data daily to the California Department of Public Health (CDPH).

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Process for Fit-testing Resource Requests

AFL 21-05 From the California Department of Public Health TO: Skilled Nursing Facilities SUBJECT: Process for Fit-testing Resource Requests ​All Facilities Letter (AFL) Summary This AFL informs Skilled Nursing Facilities (SNFs) of the process for requesting resources through Salesforce to assist in the fit-testing of respiratory protection for staff. Effective January 13, 2021, the State of California has introduced a new process for SNFs to request fit-testing assistance for staff respiratory protection.

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AB 2037 – Updated Notice Timelines for Hospital Closure, Reduction or Elimination of Emergency Medical Service, and Relocation or Elimination of Supplemental Services

AFL 21-04 From the California Department of Public Health TO: General Acute Care Hospitals Acute Psychiatric Hospitals SUBJECT: AB 2037 – Updated Notice Timelines for Hospital Closure, Reduction or Elimination of Emergency Medical Service, and Relocation or Elimination of Supplemental Services AUTHORITY:     Health and Safety Code sections 1255.1 and 1255.25 ​All Facilities Letter (AFL) Summary This AFL notifies all general acute care hospitals and acute psychiatric hospitals (hospitals) of the requirements of Assembly Bill (AB) 2037 (Chapter 95, Statutes of 2020), which increases existing timeframes for hospitals to provide advance notice of impending hospital closure, closure or reduction of emergency medical services, or relocation or elimination of supplemental services.AB 2037 also specifies required public notice methods.

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Implementation of Assembly Bill (AB) 1128 – Program of All-Inclusive Care for the Elderly (PACE): Facility Licensing Exemption

AFL 21-03 From the California Department of Public Health  TO: Primary Care Clinics (PCCs) Adult Day Health Centers (ADHCs) Home Health Agencies (HHAs) SUBJECT: Implementation of Assembly Bill (AB) 1128 – Program of All-Inclusive Care for the Elderly (PACE): Facility Licensing Exemption AUTHORITY:     Health and Safety Code sections 1206(q), 1231.5, 1580.1, 1734.5, 1738(b); Welfare and Institutions Code section 14592    All Facilities Letter (AFL) Summary This AFL notifies PCCs, ADHCs, and HHAs of the implementation of AB 1128 (Chapter 821, Statutes of 2019).

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Residential Alternate Care Site (R-ACS) Option to Increase Bed Capacity Due to Anticipated Surge in Coronavirus Disease 2019 (COVID-19)

AFL 21-02 From the California Department of Public Health TO: General Acute Care Hospitals SUBJECT: Residential Alternate Care Site (R-ACS) Option to Increase Bed Capacity Due to Anticipated Surge in Coronavirus Disease 2019 (COVID-19) ​All Facilities Letter (AFL) Summary This AFL notifies General Acute Care Hospitals (GACHs) of the availability of R-ACSs as a potential discharge option for COVID-19 positive patients needing residential level of care.

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Interdisciplinary Team (IDT) Authorized Medical Interventions for Residents Unable to Provide Informed Consent and Without a Health Care Decision Maker (This AFL supersedes AFL 20-83)

AFL 20-83.1 From the California Department of Public Health  TO: Skilled Nursing Facilities (SNFs)Intermediate Care Facilities (ICFs) SUBJECT: Interdisciplinary Team (IDT) Authorized Medical Interventions for Residents Unable to Provide Informed Consent and Without a Health Care Decision Maker(This AFL supersedes AFL 20-83) ​AUTHORITY:      Health and Safety Code (HSC) section 1418.8   All Facilities Letter (AFL) Summary This AFL notifies SNFs and ICFs of the appellate court’s decision in California Advocates for Nursing Home Reform (CANHR), et al.

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Annual Announcement: Online Application Period for Patient Needs Waiver (PNW) and Workforce Shortage Waiver (WSW)

AFL 21-01 From the California Department of Public Health TO: Skilled Nursing FacilitiesSUBJECT: Annual Announcement: Online Application Period for Patient Needs Waiver (PNW) and Workforce Shortage Waiver (WSW) AUTHORITY:     Health and Safety Code section 1276.65 and Title 22 California Code of Regulations section 72329.2 All Facilities Letter (AFL) Summary This AFL announces the opening of the application period for SNFs requesting a PNW and WSW for fiscal year 2021-2022.

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California Crisis Care Continuum Guidelines: Implementing During the Surge of Coronavirus Disease 2019 (COVID-19) Cases

AFL 20-91 From the California Department of Public Health December 28, 2020 TO: General Acute Care Hospitals SUBJECT: California Crisis Care Continuum Guidelines: Implementing During the Surge of Coronavirus Disease 2019 (COVID-19) Cases All Facilities Letter (AFL) Summary This AFL reminds facilities of the need to develop and implement Crisis Care Continuum Guidelines, as needed, in response to the current surge in COVID-19 cases.

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Program Flexibility Requirement for General Acute Care Hospitals (GACH) Before Providing Acute Hospital Care at Home Services

AFL 20-90 From the California Department of Public Health December 23, 2020 TO: General Acute Care Hospitals SUBJECT: Program Flexibility Requirement for General Acute Care Hospitals (GACH) Before Providing Acute Hospital Care at Home Services ​AUTHORITY:     Centers for Medicare and Medicaid Services (CMS) COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (PDF), Division 2 of the California Health and Safety Code and Title 22 CCR Division 5, Chapter 1 All Facilities Letter (AFL) Summary This AFL provides direction to GACHs who may be interested in providing acute hospital care at home services.CMS is offering individual waivers that allow GACHs to provide acute care to patients in their homes to help address the urgent need to increase hospital capacity to care for patients.In addition to receiving waiver approval from CMS, a GACH seeking to provide acute hospital care at home services must also meet applicable GACH licensing requirements and obtain approval for appropriate program flexibilities from the California Department of Public Health (CDPH).

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Suspension of Regulatory Enforcement of Hospice Requirements

AFL 20-47.1 From the California Department of Public Health December 21, 2020 TO: Hospice Providers SUBJECT:Suspension of Regulatory Enforcement of Hospice Requirements (This AFL supersedes AFL 20-47) ​AUTHORITY:     Executive Order N-35-20 (PDF) All Facilities Letter (AFL) Summary This AFL notifies hospice providers of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.This revision rescinds prior authorization to begin operations based solely on submission of an application and clarifies that a hospice provider seeking initial licensure must receive approval before providing care.

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