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EDMUND G. BROWN JR.
Governor

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


April 6, 2020


TO:
All Californians

SUBJECT:
Alternate Care Sites FAQ


ALTERNATE CARE SITES FAQ

 

What is an "alternate care site?"

An alternate care site helps provide care for less sick patients to allow hospitals to focus their resources on those with the greatest needs.  An alternate care site receives patients who have been discharged from hospitals and, if needed, from emergency departments, but still need some care and medical monitoring.  With local and state approval, they may also accept patients directly from the 911 system.

 

An alternate care site may be designated as COVID-19 only or may also be used for non-COVID-19 patients depending on the type of facility and the needs of the community.

 

Who will receive care in an alternate care site?

An alternate care site provides general, low‐level care for mildly to moderately symptomatic COVID‐19 patients, including those who have not yet tested positive but are presumed to be.  This includes patients who may need oxygen, but who do not require extensive nursing care, and who can generally move about on their own.  If the layout of the facility allows for clear separation of patients, alternate care sites may also be used for non-COVID-19 patients.  

 

Hospitals will transfer patients who have stabilized and have lower-level needs, but who still require medical monitoring, to make room for those with higher needs related to COVID-19 or other illnesses (like strokes and emergency surgeries). 

 

How are patients placed in an alternate care site?

The decision-making process may vary depending on the prevalence of COVID-19 in the surrounding community, as well as local hospital capacity.  Considerations when determining whether an alternate care site is appropriate include whether a hospitalized patient is stable for transfer, and meets all relevant criteria.

 

Alternate care sites will not offer the same breadth of services as a hospital.  If a patient's condition worsens (such as a decline in respiratory status) to a level that requires medical care beyond the level available at the alternate care site, the patient will be transferred to a hospital.   These transfers will generally occur through ambulances and the usual emergency response system.


How is it determined which alternate care site a patient will be placed in?

Patients will be transferred to the nearest appropriate alternate care site, based on their needs and the site's capacity.

 

Can patients receive visitors at these sites?

To prevent the spread of COVID-19, visitors will not be allowed at alternate care sites.

 

Who will be staffing the alternate care sites?

Alternate care sites will be staffed using a number of resources, including the newly established California Health Corps.  The Health Corps is made up of health care providers, behavioral health professionals, and health care administrators who sign up to work at alternate care sites.  The intent of Health Corps is to supplement the existing state health care workforce with underutilized and underemployed professionals, and with qualified student, retiree, and out-of-state health care providers.  It is the intent of the Health Corps program to keep people in their local areas.  While this is not a guarantee, because the program works to match participant skills and experience with community need, the goal is that participants will work locally.

 

Additional staff to support the functions of the site will be identified from among a number of sources, including personnel from surrounding health care organizations.

 

When utilized, Health Corps members will be hired as state employees for the duration of their service. The State will cover all professional liability (such as for malpractice claims) for members of the California Health Corps. This is standard practice for state-employed health care providers. Additionally, state law provides broad immunity from liability for providers who render services during proclaimed emergencies.

 

What types of services are provided at these sites?

Lower level health care services are provided at alternate care sites, including basic medicine, oxygen, supportive care, IV fluids, and laboratory services.  Medical and nursing providers will staff all alternate care sites.


Will there be security at these sites?

Yes, each alternate care site will be staffed with its own security personnel.


How long will these sites be in operation?

Alternate care sites are intended to reduce the burden on health care systems caused by the COVID-19 pandemic, and can help state, local, and tribal entities address potential capacity and capability gaps in health care systems during the pandemic. Decisions about the continued need for these sites will be made at the state, local, and tribal level.


How are these sites being paid for?

The state is funding alternate care sites and working with our federal partners for reimbursement through the FEMA Public Assistance program.


How are these sites chosen?

Sites are chosen based on the projected need for additional health care resources in an area. After a site has been initially identified, a site assessment is conducted, including physical, logistical, operational, and infection prevention and control considerations.

 

Examples of alternate care site locations include hotels, National Guard armories, civic sports centers, convention centers, community centers, and the like, within close proximity to hospital systems.


Who is responsible for operating the sites and ensuring proper oversight?

Alternate care sites come in various forms, including state-sponsored sites and locally-sponsored sites. 


What should individuals and households do if an alternate care site is placed in their neighborhood/community?

As these additional health care resources are brought into communities, residents do not need to do anything beyond the steps they are already taking to stop the spread of COVID-19.  These include staying at home, maintaining physical distance of at least six feet from other people when they need to leave their homes, and most importantly, washing their hands frequently and avoiding touching their faces.  People may consider covering their faces when they leave home, but this is no substitute for physical distancing and hand hygiene.  The state will take the utmost precautions to protect alternate care site workers and the surrounding communities.

 

Where can I find a list of these sites?

There is not a public listing of alternate care sites.  Development of these sites will depend on the local and regional needs for additional health care services.  

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