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EDMUND G. BROWN JR.
Governor

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


AFL 23-20
June 28, 2023


TO:
All Facilities

SUBJECT:
Hot Summer Weather Advisory

​​​



​Al​l Facilities Letter (AFL) Summary

  • This AFL reminds health care facilities to implement recommended precautionary measures to keep individuals safe and comfortable during extremely hot weather.
  • Facilities must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications.
  • Facilities must report extreme heat conditions that compromise patient health and safety and/or require an evacuation, transfer, or discharge of patients.

​​The summer season, along with its potential for fluctuating high temperatures, is approaching. The California Department of Public Health (CDPH), Center for Health Care Quality (CHCQ), reminds all health care facilities that the elderly and other health compromised individuals are more susceptible to temperature extremes and possible dehydration. Facility administrators should monitor weather predictions for fluctuations in extreme temperatures and take extra precautions to be sure appropriate air conditioning equipment is well maintained and operating effectively.

CDPH recommends the following to prepare for high summer temperatures:​​​

1. ​​Ensure a comfortable climate for staff, visitors, patients, and residents:

​​​(a) Engage facilities management to deliver a comfortable ambient environment and safe storage conditions: for example, ensure climate control, adequate ventilation, and proper PPE usage; preserve power infrastructure through power management and partnerships; and procure/service critical cooling equipment.

(b) Contingency planning: facilities must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications. Facilities should use portable fans and other temporary cooling devices when indicated.

(i) Ensure fans are used properly:

1. Ceiling fans: setting fan to rotate counterclockwise will push air down. Check to see if your ceiling fan can do this.
2. REMINDER: While electric fans might provide some comfort, when temperatures are really hot, they won't prevent heat-related illness.
3. Avoid the use of high-speed settings on fans. 
4. Orient fans to promote airflow from clean-to-less-clean direction, for example, from other parts of a facility towards locations with known or suspected COVID-19 cases, and then to the outside. 
5. Mount fans in open windows or place them near open windows to direct indoor air to flow outside.  
6. Position fans so that air does not blow from one person to another.  
7. Do not have residents congregate in outside areas where window fans are located. 

​​​2. Be prepared for heat- and summer-related illness:​​

(a) Heat-related illness: heat-related illnesses include heat stroke, heat exhaustion, heat cramps, sunburn, and heat rash, with varying susceptibilities across population segments.  Health care facilities should be prepared to care for heat-related illnesses, particularly to identify population groups disproportionately affected by heat-related illnesses.

(b) Summer-related illnesses: the risk for mosquito-borne illnesses like West Nile Virus increases in the summer.  Although relatively uncommon, health care providers should remain vigilant to detect new cases.​

3. Take precautions to maintain adequate hydration among patients, residents, staff, and visitors, particularly in vulnerable populations.

CHCQ recommends facilities review CDPH's Fast Facts: Preventing Summer Heat Injuries and implement the following measures to keep residents and clients comfortable during extremely hot weather:

  • Dress in lightweight, loose-fitting clothing
  • Keep residents well hydrated with particular attention to dependent residents
  • Minimize physical activities during the hottest parts of the day
  • Stay indoors and out of the sun during the hottest parts of the day
  • Use fans as indicated in the “Fast Facts" page on preventing summer heat injuries
  • Open windows where feasible if screens are intact, to allow fresh air to circulate
  • Use cool compresses, misting, showers, and baths to promote cooling
  • Avoid hot and heavy meals
  • Encourage frozen treats such as “popsicles" between meals
  • Keep a hydration station readily available to residents, family, and staff
  • Be alert to adverse changes in patient and resident conditions that may be heat related
  • Develop and implement a system to monitor hydration status and be prepared to take appropriate interventions.
  • Pay special attention to patients with medications that make the patient susceptible to high temperatures, e.g., psychotropic medications.​

Licensing regulations require facilities to report all emergency and/or disaster-related occurrences that threaten the welfare, safety, or health of patients to the CHCQ. If the extreme heat conditions affect your facility by compromising patient health and safety and/or require an evacuation, transfer, or discharge of patients, you must contact your CHCQ district office. Please follow these guidelines for reporting such occurrences:

 

TimeRequirement
During normal business hours (8:00 a.m. – 5:00 p.m.)Contact the local CHCQ district office you customarily work with for your geographical location.
For after-hour reporting or if the local CHCQ district office is non-operational due to an emergency and/or disaster
  • For facilities outside Los Angeles County, contact the State Office of Emergency Services Warning Center at (916) 845-8911. Ask that they notify the CDPH duty officer.
  • For facilities in Los Angeles County contact the Los Angeles County Operator at (213) 974-1234. Ask that they notify the on-call Health Facilities Inspection Division supervisor.

 

If you have any questions regarding the content of this AFL, please contact your respective district office.

 

Sincerely,

Original signed by Cassie Dunham

Cassie Dunham

Deputy Director

 

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