{"id":"AK-031","kind":"order","level":"state","jurisdiction":"Alaska","state":"AK","metro":"","industry":"","agency":"","eco":"","issuer":"Adam Crum, Commissioner, DHSS","authority":"HB 76 secs. 4 and 13, ch. 2, SLA 2021; CMS 1135 blanket waivers","instrument":"Addendum No. 1 to the COVID-19 Public Health Emergency Order (Crisis Standards of Care)","title":"Addendum No. 1, COVID-19 Public Health Emergency Order, September 21, 2021","dateIssued":"2021-09-21","effective":"2021-09-21","end":"Open-ended (in force Sept. 30, 2021)","startDate":"2021-09-21","endDate":"2021-09-30","quarters":["2021Q3"],"types":["HC","EMER","SUPPLY"],"addressees":["hospitals, psychiatric hospitals, critical access hospitals, long-term care hospitals, skilled nursing facilities","DHSS"],"clause":"Statewide hospital capacity has been limited and has moved into the high-alert level... Hospitals within Anchorage have been on EMS divert \u003e90 percent of the time for the last seven days.... NOW, THEREFORE, I, Adam Crum, as the Commissioner of DHSS, based on the limited authorities provided in Chapter No. 2, SLA 2021, do hereby issue this ADDENDUM No. 1 to the April 30 2021 PUBLIC HEALTH EMERGENCY ORDER... I. Scope Of Practice Guidelines For Hospitals... 1. Consistent with the Centers for Medicare and Medicaid Services\u0027 (CMS) 1135 Blanket Waivers... implement all flexibilities... including... The use of alternate care sites... 2. In addition to the above flexibilities, evaluate and take necessary action as conditions warrant to: a. Postpone or reschedule medical and surgical procedures at hospitals; b. Address staffing limitations by increasing patient-to-staffing ratios, team nursing models, utilizing nurse extenders... c. Expand clinical care within the hospital campus to maximize the use of all available beds","enforcement":"Good-faith immunity for acts performed at the request of a government agency under HB 76 sec. 13 (not for gross negligence, reckless or intentional misconduct)","functions":["SX surgery and elective procedures (postponement directed)","IP inpatient and surge capacity","ED emergency department (EMTALA off-site screening)","HR staffing ratios","CB patients","SC"],"notes":"The Q3 2021 State health-care instrument; DHSS announced activation of crisis standards of care for twenty facilities (AK-092).","sourceUrl":"https://gov.alaska.gov/wp-content/uploads/sites/2/COVID-19-PUBLIC-HEALTH-EMERGENCY-ADDENDUM-NO-1-Final.pdf","snapshot":"https://web.archive.org/web/20210923081938/https://gov.alaska.gov/wp-content/uploads/sites/2/COVID-19-PUBLIC-HEALTH-EMERGENCY-ADDENDUM-NO-1-Final.pdf","fileExists":true,"fileBytes":245269,"grade":"primary","character":"","description":"","collection":"AK","url":"/library/AK-031","exhibitUrl":"/exhibit/AK-031","citation":"Adam Crum, Commissioner, DHSS, Addendum No. 1 to the COVID-19 Public Health Emergency Order (Crisis Standards of Care) (Sept. 21, 2021) (Ex. AK-031)","stateName":"Alaska","related":["AK-092","DUT-AK-021"]}