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State of California—Health and Human Services Agency
California Department of Public Health

AFL 21-12
April 16, 2021

General Acute Care Hospitals

Temporary Waiver of Practitioner’s Order for Administration of the Coronavirus Disease 2019 (COVID-19) Vaccine

​AUTHORITY:     Proclamation of Emergency (PDF), Executive Order N-27-20, Executive Order N-39-20

All Facilities Letter (AFL) Summary

  • This AFL notifies hospitals of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.
  • This AFL temporarily waives Title 22 California Code of Regulations (CCR) section 70263(g) for administration of COVID-19 vaccinations. Under the waiver, hospitals may administer any COVID-19 vaccine, authorized under a Food and Drug Administration (FDA) Emergency Use Authorization without an individual clinician order.

Pursuant to the Governor's declaration of a state of emergency related to COVID-19, the Director of the California Department of Public Health (CDPH) may waive any of the licensing requirements of Chapter 2 of Division 2 of the Health and Safety Code (HSC) and accompanying regulations with respect to any hospital or health facility identified in HSC section 1250. CDPH is temporarily waiving specified hospital licensing requirements and suspending regulatory enforcement of the following requirements as specified below:

  1. Title 22 CCR section 70263(g) related to the requirement for a practitioner's order for the administration of the COVID-19 vaccine, is temporarily waived. Hospitals may administer any COVID-19 vaccine, authorized under an FDA Emergency Use Authorization without an individual clinician order. Other vaccines administered in a hospital setting will still require a practitioner's order.

This statewide waiver is approved under the following conditions:

  • Hospitals shall continue to comply with adverse event and unusual occurrence reporting requirements specified in HSC section 1279.1 and Title 22 CCR section 70737(a).
  • Hospitals shall continue to provide necessary care in accordance with patient needs and make all reasonable efforts to act in the best interest of patients.
  • Hospitals shall follow their disaster response plan.
  • Hospitals shall follow infection control guidelines from the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) related to COVID-19.
  • Hospitals shall comply with directives from their local public health department, to the extent that there is no conflict with federal or state law or directives or CDPH AFLs.

This AFL will remain in effect until the end of the public health emergency.

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



Original signed by Cassie Dunham

Cassie Dunham

Acting Deputy Director



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