AFL 21-25 From the California Department of Public Health
July 23, 2021
TO: General Acute Care Hospitals
SUBJECT: Weekly Reporting Related to Patient Discharges with Coronavirus Disease 2019 (COVID-19)
Title 17 California Code of Regulations (CCR) section 2500
All Facilities Letter (AFL) Summary
This AFL requires that California hospitals report specified patient level information for each hospitalized person who tests positive for COVID-19 to assist the California Department of Public Health (CDPH) to monitor the effectiveness of vaccines and assess the impact of COVID-19 on the health care system. The reporting requirement is effective July 27, 2021.
The COVID-19 pandemic has been dynamic. New features have emerged that have influenced the course of the pandemic and the data needed to monitor it. In particular, the ongoing evolution of new SARS-CoV-2 variants and the development and use of COVID-19 vaccines have significantly changed the course of the pandemic. Key data elements regarding persons hospitalized with COVID-19 (a reportable communicable disease) are needed to monitor the effectiveness of vaccines over time as different variants circulate, and to inform projections of the impact of COVID-19 on the health care system.
Title 17 CCR section 2500 requires that “the administrator of each health facility, clinic or other setting where more than one health care provider may know of a case, a suspected case or an outbreak of disease within the facility shall establish and be responsible for administrative procedures to assure that reports are made to the local health officer.” Title 22 CCR section 70737(a) – Reportable Disease or Unusual Occurrences requires that “the hospital shall furnish such other pertinent information related to such occurrences as the local health officer or the Department may require.” Title 22 section 70751 – Medical Record Availability requires that “all required patient health records, either as originals or accurate reproductions of the contents of such originals, shall be maintained in such form as to be legible and readily available upon the request of: … (4) Authorized representatives of the Department.”
Further, both the Health Insurance Portability and Accountability Act (45 C.F.R. Sec. 512(b)) and the Confidentiality of Medical Information Act (Civil Code 56.10(c)(18)) permit hospitals to disclose patient-identifiable information to public health authorities. Specifically, Civil Code 56.10(c)(18)) provides that the information may be disclosed, as permitted by state and federal law or regulation, to a local health department for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of disease, injury, vital events, including, but not limited to, birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions, as authorized or required by state or federal law or regulation.
Effective July 27, 2021, in addition to the daily reporting required in AFL-20-31.3 and pursuant to Title 17 CCR section 2500, Title 22 CCR section 70737(a), and Title 22 section 70751, CDPH is requiring hospitals to report the following information for each person admitted to an inpatient hospital bed who tests positive for COVID-19. Persons who test positive during admission or for whom the hospital has confirmation of a positive test within 14 days before admission should be included.
Using the Excel template provided in the data dictionary (Excel), data should be reported each Tuesday for discharged COVID-19 positive patients whose discharge diagnosis coding was completed in the prior week. If the diagnosis codes are not available for this week’s report, the patient should not be reported until the diagnosis codes are available. Systems are encouraged to report on behalf of all hospitals within the system. Please report each individual once only per hospital admission.
- Submitting organization name
- Hospital name
- Medicare CCN
- OSHPD number
- Patient name
- Date of birth
- Patient address
- Medical record number
- Date first positive COVID-19 test was collected for this illness for which the hospital has documentation
- Type of test
- Date of admission
- Whether patient required intensive care unit (ICU) level of care during hospitalization
- Date(s) of COVID vaccination(s) (if known)
- Type(s) of COVID vaccine(s) received (if known)
- Date of discharge
- Discharge diagnosis codes
- Died during hospitalization
For persons without known vaccination status, CDPH will conduct a cross match with the COVID immunization registry.
Data reported to CDPH should be sent via Secure File Transfer Protocol (SFTP). Please complete the following steps to obtain access to the SFTP site for file submission. Including the requested elements will facilitate timely completion of account requests.
- For each reporting entity (parent organization or facility), please submit an email to the CalREDIE Help Desk (firstname.lastname@example.org) to request SFTP access.
- Subject line: COVID Hospitalization SFTP access request – Name of your organization
- For each person requiring access (accounts should not be shared), please include:
- Organization name
- Organization type (Parent organization vs. Individual facility)
- First name
- Last name
CDPH understands that some counties may have implemented additional reporting requirements to collect similar information. CDPH wants to avoid duplicate reporting to the extent possible, however there may be some period of dual reporting as we coordinate data exchange between counties and the state. To ensure consistent reporting across the state, CDPH is providing a data dictionary (Excel) that includes standardized definitions. GACHs are encouraged to review the data dictionary (Excel) in its entirety before inputting data.
Please remember to immediately report suspected and confirmed cases of COVID-19 to your local public health department (PDF) and your district office.
If you have any questions about reporting via SFTP or about data specifications, please contact email@example.com.
Original signed by Cassie Dunham
Acting Deputy Director
- Data Dictionary (Excel)