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EDMUND G. BROWN JR.
Governor

State of Californiaā€”Health and Human Services Agency
California Department of Public Health


AFL 20-34.7
June 30, 2022


TO:
Adult Day Health Care Centers (ADHCs)

SUBJECT:
Suspension of Regulatory Enforcement of Specified ADHC Requirements
(This AFL supersedes AFL 20-34.6)


ā€‹AUTHORITY:     Executive Order N-35-20 (PDF), N-08-21 (PDF), N-17-21 (PDF), N-21-21 (PDF), N-04-22 (PDF), and N-11-22 (PDF)


All Facilities Letter (AFL) Summary

  • This AFL notifies ADHCs of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.
  • In accordance with Executive Order N-11-22 (PDF), issued June 17, 2022, this AFL extends the temporary waiver of specified regulatory requirements until September 30, 2022.
  • Effective October 1, 2022, ADHCs must be open and providing all basic services in the center.

Pursuant to the Governor's Executive Orders N-35-20 (PDF), N-17-21 (PDF), and N-21-21 (PDF) related to COVID-19, the Director of the California Department of Public Health (CDPH) may waive any of the licensing and staffing requirements of Chapter 3.3 of Division 2 of the Health and Safety Code (HSC) and accompanying regulations with respect to any ADHC identified in HSC section 1575.

Due to the need for time to transition back to in center services and to ensure quality and continuity of services with appropriate safety protocols, CDPH is temporarily waiving specified ADHC licensing requirements and suspending regulatory enforcement to provide ADHCs with flexibility in how they provide basic services using remote methods and allow ADHCs to continue to serve as many participants as possible while maintaining physical distancing in the center.

In compliance with Executive Order N-04-22 (PDF), the temporary waiver of specified regulatory requirements contained in this AFL have been extended until September 30, 2022. ADHCs should start planning for transitioning into regular operations. Please refer to AFL 21-35 for guidance on how to operate and safely return to in-center services during the COVID-19 pandemic.

CDPH is temporarily waiving specified licensing requirements and suspending regulatory enforcement for the following requirements:

Services

Title 22 CCR sections 78301: ADHCs shall not be required to provide all services at the center and will have flexibility in how they provide basic services to participants. Basic services include: occupational therapy, physical therapy, speech therapy, medical services, nursing services, nutrition services, psychiatric or psychological services, social services, and recreation or planned social activities. Services may be provided via telehealth or other remote methods. This will allow for, but is not limited to, check-in calls, health screening calls, video conferencing, and meal delivery. ADHCs that provide in-person services should follow the mitigation guidance.

This waiver is approved under the following conditions ā€“ ADHCs shall:

  • Report any substantial staffing or supply shortages that jeopardize patient care or disrupt operations.
  • Follow their disaster response plan.
  • Follow infection control guidelines from the Centers for Medicare and Medicaid Services (CMS) and from the Centers for Disease Control and Prevention (CDC) related to COVID-19.
  • Comply with directives from their local public health department, to the extent that there is no conflict with federal or state laws or directives or CDPH AFLs.

 This waiver is valid until September 30, 2022.

 If you have any questions about this AFL, please contact your local district office.

 

Sincerely,

Original Signed by Cassie Dunham

Cassie Dunham

Deputy Director


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