Regional ICU Capacity

It is critical to ensure that Californians have access to the care they need in our hospitals. As COVID-19 hospitalizations increase, the state has issued a Public Health Order governing health care system protocols and surge capacity.

During last winter's surge in COVID cases, hospital capacity was ensured because of the combined effects of the State's general public health measures and critical efforts to coordinate hospital response on a local, regional, and statewide level.

Monitoring and Reporting Health Care System Capacity

Hospitals must notify local public health officials and the Medical and Health Operational Area Coordinator (MHOAC) if they experience the following conditions:

Have less than 20% of staffed adult Intensive Care Unit (ICU) beds available for three consecutive days;
Are utilizing alternative spaces for in-patient surge capacity, including but not limited to cafeteria, hallways, and/or conference rooms;
Are utilizing tents or other outside structures for in-patient surge capacity for three consecutive days; or
Are utilizing a team nursing model for three consecutive days.

Regional Surge Orders Go into Effect When Needed

California’s health care system is divided into six regions. When hospitals within a region have less than 10% of staffed adult ICU beds available for a period of three consecutive days, or when an individual general acute care hospital has zero ICU capacity, then the following surge orders will apply for seven days:

All general acute care hospitals in the county who do have ICU bed capacity must accept transfer patients when clinically appropriate and directed by the Medical and Health Operational Area Coordinator (MHOAC).
All general acute care hospitals in the region who do have ICU bed capacity must accept transfer patients when clinically appropriate and directed by the Regional Disaster Medical Health Specialist (RDMHS).
If there is no ICU bed capacity within the region, then all general acute care hospitals in the State of California must accept transfer patients when clinically appropriate and directed by the California Emergency Medical Services Authority (EMSA) Director or designee.