This AFL notifies APHs that the California Department of Public Health (CDPH) has amended Title 22 CCR sections 71213 and 71215 and adopted sections 71213.1 and 71215.1. These regulations are effective June 1, 2026. APHs should update any facility policies and procedures as appropriate.
Licensed Nurse-to-Patient Minimum Ratio
The regulations establish a minimum nurse-to-patient ratio of one licensed nurse to six adult patients in freestanding APHs and one licensed nurse to five patients under the age of eighteen in freestanding APHs. The regulations define “licensed nurses" as psychiatric technicians, licensed vocational nurses, and registered nurses. Psychiatric technicians and licensed vocational nurses cannot exceed 50 percent of the licensed nurses on the unit.
Determining Staffing Based on Patient Acuity and Care Needs
The regulations also require freestanding APHs to consider the following when determining staffing levels above the minimum ratios:
- Patient acuity;
- Skill level and skill mix of personnel required for patient care and risk mitigation, including licensed personnel and unlicensed mental health workers;
- Requirements for special nursing activities;
- Placement of the patient in the nursing unit; and
- Time required to conduct assessments, care planning, and discharge planning.
Questions
For any additional questions or comments, please email the CHCQ Regulation Development Section at: CHCQRegulations@cdph.ca.gov.
Sincerely,
Original signed by Mandi Posner
Mandi Posner
Deputy Director