​Pursuant to the Governor's Executive ​Order N-2-25 (PDF) related to the Los Angeles and Ventura counties fires and windstorm conditions state of emergency, the Director of the California Department of Public Health (CDPH) may waive any of the licensing requirements of Chapters 1, 2, 8, and 8.5 of Division 2 of the Health and Safety Code (HSC) and accompanying regulations with respect to any hospital, clinic, other health facility, home health agency, or hospice agency identified in HSC sections 1200, 1250, 1727 or 1746. CDPH is temporarily waiving specified hospital licensing requirements and suspending regulatory enforcement of the following requirements:​

Licensure

Title 22 California Code of Regulations (CCR) sections ​70105

A GACH that has submitted an application to CDPH for any of the following may begin providing care prior to obtaining approval and licensure by CDPH:

• Change of Beds
• Change of Service

For capacity tracking purposes during the fires and windstorms, GACHs must submit an application when changing beds or services listed on their license. This shall not require approval of the application before the GACH may provide care, however the facility needs to notify CDPH, as soon as reasonably feasible, of their plan for services and staffing to ensure patient safety and quality of care.

Space

Title 22 CCR section ​​70805
GACHs may convert the use of existing space and use additional space, including surge tents, to allow additional patients access to care. Any beds added for temporary use shall ensure patient privacy. ​

Staffing

Only those GACHs experiencing a fire and/or windstorm related surge of patients or staffing shortages resulting from fire and/or windstorm impacts, including, school closures, or an emergency such as a fire or public safety power shutoff, may request a staffing waiver. A GACH seeking a staffing waiver must submit a program flexibility and supporting documentation on the Risk and Safety Solutions (RSS) website. GACHs with staffing waivers must maintain sufficient staffing levels for patient safety and must have a plan in place to resume mandatory staffing levels as soon as feasible. If approved, temporary staffing waivers will only be for a two-week period. Prior approval is required.​

Federal Waivers

In addition to the blanket waivers provided in this AFL, the Centers for Medicare and Medicaid Services have approved federal waivers for facilities impacted by the fires and windstorms in Los Angeles and Ventura counties. These waivers include the following:

1. GACHs may use non-hospital building/space for patient care provided sufficient safety and comfort are provided for patients and staff.​
2. GACHs may provide care in temporary expansion sites or in beds not typically authorized for acute care.
3. GACHs may house acute care inpatients in excluded distinct-part units, such as excluded distinct-part unit inpatient rehabilitation facilities (IRFs) or inpatient psychiatric facilities (IPFs) where the distinct-part unit's beds are appropriate for acute care inpatients.
4. GACHs may allow physicians whose privileges will expire during the emergency period and new physicians to practice at GACHs before full medical staff/governing body review and approval.
   

Individual facilities may also submit 1135 waiver requests directly to CMS if there are additional needs beyond what is included in the federal blanket waivers.

This statewide waiver is approved under the following conditions:

• Hospitals shall continue to comply with adverse event and unusual occurrence reporting requirements specified in HSC section 1279.1 and Title 22 California Code of Regulations section 70737(a).
• Hospitals shall report any substantial staffing or supply shortages that jeopardize patient care or disrupt operations.
• Hospitals shall continue to provide necessary care in accordance with patient needs and make all reasonable efforts to act in the best interest of patients.
• Hospitals shall follow their disaster response plan.
• Hospitals shall 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.
  

Program Flexibilities

If facilities need flexibility for requirements not addressed in this AFL, they must submit an individual request. Requests for program flexibility must include justification for the program flexibility request and adequate supporting documentation that the proposed alternative does not compromise patient care. Facilities can request a program flexibility on the Risk and Safety Solutions (RSS) website.

This waiver is valid until March 31, 2025, and may be extended based on any updated Executive Orders.

CDPH will continue to investigate and conduct enforcement activities, pursuant to Executive Order ​N-2-25 (PDF).

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

Sincerely,

Original signed by Chelsea Driscoll

Chelsea Driscoll

Acting Deputy Director

Resources:

• Proclamation of State of Emergency (PDF)
• Executive Order ​N-2-25 (PDF)
• Blanket Federal Waivers for 2025 Southern CA Wildfires (PDF)​