AFL 22-34.5 From the California Department of Public Health
February 8, 2022
TO: Adult Day Health Care Centers (ADHCs)
SUBJECT: Suspension of Regulatory Enforcement of Specified ADHC Requirements (This AFL supersedes AFL 20-34.4)
All Facilities Letter (AFL) Summary
- This AFL notifies ADHCs 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 extends the temporary waiver of specified regulatory requirements in this AFL until March 31, 2022.
Pursuant to the Governor’s Executive Order N-35-20 and Executive Orders N-17-21 (PDF) and N-21-21 (PDF) related to COVID-19, the Director of the California Department of Public Health (CDPH) may waive any of the licensing and staffing requirements of Chapter 3.3 of Division 2 of the Health and Safety Code (HSC) and accompanying regulations with respect to any ADHC identified in HSC section 1575.
Due to the need for time to transition back to in center services, to ensure quality and continuity of services with appropriate safety protocols, and to avoid an abrupt transition during winter, when risks are greater, CDPH is temporarily waiving specified ADHC licensing requirements and suspending regulatory enforcement to provide ADHCs with flexibility in how they provide basic services using remote methods and allow ADHCs to continue to service as many participants as possible while maintaining physical distancing in the center.
In compliance with Executive Order N-21-21 (PDF), the temporary waivers of specified regulatory requirements in this AFL will expire on March 31, 2022 and this AFL will be rescinded. ADHCs should start planning for transitioning into regular operations. Please refer to AFL 21-35 for guidance on how to operate and safely return to in-center services during the COVID-19 pandemic.
CDPH is temporarily waiving specified licensing requirements and suspending regulatory enforcement for the following requirements:
Title 22 CCR sections 78301, 78305, 78307, 78309, 78311, 78313, 78319, 78337, 78339, 78341: ADHCs shall not be required to provide all services at the center and will have flexibility in how they provide basic services to participants. Basic services include: occupational therapy, physical therapy, speech therapy, medical services, nursing services, nutrition services, psychiatric or psychological services, social services, and recreation or planned social activities. Services may be provided via telehealth or other remote methods. This will allow for, but is not limited to, check-in calls, health screening calls, video conferencing, and meal delivery. ADHCs that provide in-person services should follow the mitigation guidance.
This waiver is approved under the following conditions – ADHCs 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 laws or directives or CDPH AFLs.
This waiver is valid until March 31, 2022. CDPH will not take enforcement action on ADHCs that were operating under waivers authorized in AFL 20-34.4 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.
Original signed by Cassie Dunham
Acting Deputy Director