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EDMUND G. BROWN JR.
Governor

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


AFL 20-30.6
October 5, 2021


TO:
Primary Care Clinics (PCCs)
Mobile Health Care Units (MHCUs)

SUBJECT:
Suspension of Regulatory Enforcement of Specified PCC and MHCU Requirements
(This AFL supersedes AFL 20-30.5)

AUTHORITY:     Executive Orders N-35-20 (PDF), N-08-21 (PDF), and N-17-21 (PDF)


All Facilities Letter (AFL) Summary

  • This AFL notifies PCCs and MHCUs of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.
  • This revision clarifies that for any clinics conducting COVID-19 vaccinations, treatment, and/or testing, the waiver is extended until December 31, 2021.


Pursuant to the Governor's Executive Order (EO) N-35-20 (PDF), the Director of the California Department of Public Health (CDPH) may waive any of the licensing and staffing requirements of Chapters 1 and 9 of Division 2 of the Health and Safety Code (HSC) and accompanying regulations with respect to any PCC identified in HSC section 1200 and MHCU identified in HSC section 1765.105.

In accordance with EO N-17-21 (PDF), after December 31, 2021, the temporary waivers of specified regulatory requirements contained in this AFL will expire and this AFL will be rescinded.

Due to increasing circulation of more transmissible variants of the SARS-CoV-2 virus and the rapid rise of COVID-19 incidence in California, CDPH is temporarily waiving specified clinic licensing requirements and suspending regulatory enforcement for clinics conducting COVID-19 vaccinations, treatment, and/or testing for the following requirements.

Licensure

1.    HSC sections 1765.135(a) and 1765.140 
An MHCU operated by a PCC is subject to all applicable suspensions of PCC statutes and regulations specified in this AFL.

Administration

2.    HSC section 1206(h)
An intermittent clinic operated by a PCC may extend operating hours beyond 40 hours a week. 

3.    HSC section 1226.1(a)(2)
The tuberculosis test requirement for PCC personnel at the time of employment may be delayed for up to 60 days from hire to allow for COVID-19 vaccination.

Space Conversion

4.    HSC section 1231(a) and Title 22 California Code of Regulations section 75072
A PCC seeking to convert space to provide additional patient care or triage areas may do so without obtaining prior approval from CDPH provided any space conversions are implemented to ensure safe and adequate patient care and follow recommended COVID-19 mitigation strategies. Mitigation strategies are detailed in the COVID-19 Health Care System Mitigation Playbook (PDF) and include:

  • Extension of clinic hours
  • Use of non-patient areas for patient care
  •  Creation of overflow space for screening, triage, isolation, and transfer/discharge
  • Establishment of separate screening areas on the facility property (e.g., room to cohort patients, tents erected in the parking lot, "Drive By" testing locations)
  • Establishment of safety checkpoints at portals of entry

This waiver is approved under the following conditions – PCCs and MHCUs 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 law or directives or CDPH AFLs

This waiver is valid until December 31, 2021, for any clinics conducting COVID-19 vaccinations, treatment, and/or testing. CDPH will not take enforcement action on clinics that were operating under waivers authorized in AFL 20-30.5 between October 1, 2021, and the date of publication of this AFL.

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

 

Sincerely,

Original signed by Cassie Dunham

Cassie Dunham

Acting Deputy Director


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