Emergency Response Operations

HCAI COVID-19 and RSV Resources

General COVID-19 Information

General RSV Information

Suspension and Restoration of Temporary Conditions (COVID-19)

February 6, 2023
 
To: All Licensed Healthcare Facilities
Subject: Suspension and Restoration of Temporary Conditions (revised)

Pursuant to All Facilities Letter (AFL) 20-26.13 from California Department of Public Health (CDPH), issued on June 30, 2022, stating that CDPH is temporarily waiving specified regulatory requirements until the end of the declared COVID-19 emergency. Facilities that have a continued need for flexibility may submit a program flex application through the RSS platform Risk & Safety Solutions (riskandsafety.com). A username and password are needed in order to log in. For first time waiver applicants, providers may go to RSS Registration Page to register for an account. Facilities may reference AFL 22-01 (ca.gov).  This AFL supersedes AFL 20-26.12 issued on March 16, 2022.

Per subsequent announcement that the declared COVID-19 emergency will end on February 28,2023, all other temporary changes of use or modification to the physical environment must be restored to original condition by April 11, 2023, (six weeks after expiration of the waiver) in compliance with the code it was constructed under. Restoration to original conditions must be reported to HCAI so that confirmation may be made. Where such temporary changes are to be made permanent, projects must be submitted to the Department of Health Care Access and Information (HCAI) for review and approval immediately whether the changes involve construction or not. Projects intended to be made permanent must meet all current California Building Standards Code requirements and brought into full compliance. Non-compliant conditions cannot remain in use beyond February 28, 2023, without approval by CDPH per the Program Flexibility procedure above.

If air pressure adjustments were made to specific rooms or areas in response to COVID-19, these areas will require documentation to show what the rooms were prior to the alteration and plans to return them to previous compliant conditions. If no pre-balance report was completed, or they cannot be substantiated, pressures must be adjusted to comply with current code requirements.

If you have any questions about this notice, please contact your region’s Plan Review Supervisor or Regional Compliance Officer (RCO).
Sincerely,

Chris Tokas, S.E., F.SEAOC, C.B.O.
Deputy Director
HCAI – OSHPD

For reference, see the Governor’s executive order.

Suspension and Restoration of Temporary Conditions (RSV)

November 17, 2022

To: All Licensed Healthcare Facilities
Subject: Resources on the HCAI site for RSV patient surge needs

An early wave of Respiratory Syncytial Virus Infection (RSV) activity has recently hit levels similar to seasonal peaks in prior years. RSV, in addition to circulation of other respiratory viruses has led to increased hospitalizations among infants and young children. This has contributed to stresses in the pediatric healthcare delivery system in California and across the US.

Multiple respiratory viruses, including influenza and COVID-19, are expected to increase in the coming months further stretching California hospital resources for both adults and children.

Pursuant to All Facilities Letter (AFL) 22-23 from California Department of Public Health (CDPH), issued on November 11, 2022, stating that CDPH is temporarily waiving specified regulatory requirements, facilities that have a need for flexibility can request a program flexibility. Please refer to AFL 22-23 for specific guidance and instructions.

Hospitals may reconfigure space as needed to accommodate observed or predicted patient surge, patient cohorting, modified infection and source control procedures, and other mitigation strategies.

Please note that most of this type of emergency work does not require the issuance of a building permit by HCAI. However, hospitals shall notify the HCAI Compliance Officer (RCO) assigned to their facility for any temporary changes of use or modification to their physical environment under AFL 22-23.

Chris Tokas
Deputy Director, Facilities Development Division
Department of Health Care Access and Information

California Department of Public Health Guidance (COVID-19)

AFL 18-09 Requesting Increased Patient Accommodations Including Medical Surge Tent Use.

AFL 20-26 Suspension of Regulatory Enforcement of Hospital Requirements re-issued June 30, 2022   (originally issued 3/20/2020 and revised on 7/3/2020, 2/1/2021, 4/28/2021, 7/16/2021, 11/12/2021 and 3/16/2022).

For temporary changes of use or modifications to the physical environment for COVID-19, an HCAI permit is not required until the end of the waiver date in AFL 20-26.  HCAI compliance officer or other HCAI field staff should be informed of these temporary changes. To determine the HCAI field staff responsible for a facility, select the appropriate facility in HCAI Facility Detail.  Notify CDPH as required by AFL 20-26.  

AFL 20-48 Transfers to Low Acuity Alternate Care Sites During Coronavirus Disease 2019 (COVID-19) Pandemic.

AFL 21-09 Additional Temporary Waivers Tied to the Hospital Surge Public Health Order

See list of COVID-19 Facility Waivers granted by CDPH.

California Department of Public Health Guidance (RSV)

AFL 22-23 Guidance for Response to Surge in Respiratory Viruses among Pediatric Patients, dated November 11, 2022.

For temporary changes of use or modifications to the physical environment for RSV, an HCAI permit is not required until the end of the RSV emergency.  HCAI compliance officer or other HCAI field staff should be informed of these temporary changes. To determine the HCAI field staff responsible for a facility, select the appropriate facility in HCAI Facility Detail.  Notify CDPH as required by AFL 22-23.

Surge Tents

See guidance provide by California Department of Public Health in AFL-18-09 and HCAI’s CAN 2-108 (See Page 6).

Where surge tents do not meet State Fire Marshal requirements, HCAI recommends providing a fire watch per Policy Intent Notice 14.

Negative Pressure Room

See Policy Intent Notice 4.  Even though this was written for tuberculosis (TB) cases, this applies for the current COVID-19 and RSV Emergency.


Interim guidance for Ventilation, Filtration, and Air Quality in Indoor Environments

See CDPH’s Interim guidance for Ventilation, Filtration, and Air Quality in Indoor Environments. This Guidance is intended to be used for buildings for which the state or local health department is permitting business, assembly, or other occupancy or use to occur indoors.

Vaccine Freezer Permit Checklist

See checklist (v6, dated 12/17/2020)

This is intended to be used for the expedited review and installation of Ultra Low Temperature Freezers used for the storage of COVID vaccines in California healthcare facilities. The checklist summarizes and references the applicable requirements from the Department of Health Care Access and Information (HCAI) as adopted and amended to the California Building Standards Code.

Applicants should verify compliance of the plans submitted for building permit with all referenced requirements from HCAI when completing this checklist. The checklist should be completed by the project architect or engineer based on the design actually reflected in the plans at the time of completion of the checklist. This checklist only references HCAI requirements associated with the
installation of these freezers. Upon receipt of the project with this checklist, the project will be expedited.  If all items with an * comply, no permit or anchorage is required. Coordinate with Compliance Officer.

Buildup of Frost or Ice on Vaporizers and Pipes due to High Flow Medical Oxygen

For the frost or ice buildup issue on vaporizer and pipes, see advisory/guide put out by KLM Industries and Matheson.

(Alt Link: Advisory/guide put out by KLM Industries and Matheson)

HCAI Medical Oxygen Systems best practices during COVID-19 Pandemic (Dated 1/8/2021)

Recommended COVID-19 Essential built environment elements for medical quarantine

See the recommended essential elements in this document (revised 3/23/2020).

See example of recommended bed/cot layout.

See CDC Guidelines for Alternate Care Sites and Isolation Sites.

Recommended Guidelines for Re-population for COVID-19 for vacant/closed hospital or Skilled Nursing buildings

See the Recommended Guidelines for Re-population for COVID-19.

Use of Plastic Barriers Used for Separation of COVID Positive Areas in Healthcare Facilities

See letter issued on use of plastic barriers used for separation of COVID positive areas in healthcare facilities.

HCAI Emergency Operation Events

Log of events in HCAI Emergency Operations:

These documents are subject to frequent changes as new information is received.

Contact Information

For questions or comments related to this website, please email HCAI COVID19 Emergency Operations at EOC@hcai.ca.gov