Idaho activates crisis standards of care in three health districts in southern Idaho

The Idaho Department of Health and Welfare (DHW) activated Crisis Standards of Care (CSC) Monday morning in accordance with IDAPA 16.02.09 - Crisis Standards of Care For Healthcare Entities in three local public health districts -- Southwest District Health, Central District Health, and South Central District Health - due to severe staffing and blood shortages.

The high number of both clinical and non-clinical staff unable to work due to the impacts of COVID-19 infections coupled with a nation-wide staffing shortage limiting access to contracted traveling staff is impacting current hospital operations. It is also limiting the ability of hospitals to maintain capacity for things like intensive care beds due to inadequate staffing. Additionally, a nation-wide shortage of blood and blood products is significantly impacting healthcare systems, and most have implemented blood conservation strategies.

This action was taken after Saint Alphonsus Health System requested CSC activation. DHW Director Dave Jeppesen convened the CSC Activation Advisory Committee virtually on Jan. 21. The committee recommended that CSC be activated statewide. Jeppesen made the decision to activate only in southern Idaho after reviewing current hospital capacity regionally. Other regions of the state are likely to move into CSC if current COVID-19 trends continue.

"The highly contagious Omicron variant has thrown us a curve ball," said Jeppesen. "Once again, the situation in our hospitals and health systems is dire - we don't have enough resources to adequately treat patients. Please get vaccinated and boosted if you can and wear a high-quality protective mask in public places. Omicron is so much more contagious than previous variants, and even though a lower percentage of cases are ending up in the hospital, the record number of cases is still putting strain on our healthcare system."

To see more about the Crisis Standards of Care view at the DHW's weekly media briefing https://www.youtube.com/watch?v=4dNO4FnmK10.

Although DHW has activated CSC, hospitals will implement as needed and according to their own CSC policies. However, not all hospitals will move to that standard of care. If they are managing under their current circumstances, they can continue to do so.

The process to initiate crisis standards of care began when resources were limited to the point of affecting medical care. Jeppesen convened the Crisis Standards of Care Activation Advisory Committee on Jan. 21, to review all the measures that were taken to adequately staff hospitals and health systems. The committee determined that the ability of all Idaho hospitals and healthcare systems to deliver the usual standard of care has been severely affected by the severe staffing shortage and the nation-wide shortage of blood. The committee recommended to the director that crisis standards of care be activated statewide. Jeppesen issued his decision to activate in three health districts in southern Idaho on Jan. 24, under the authority vested in him through the temporary rule.

Efforts will continue in earnest to alleviate the resource constraints in the state caused by the massive increase in the number of COVID-19 cases. The crisis standards of care will remain in effect until there are sufficient resources to provide the usual standard of care to all patients.

CSC timeline

• Jan. 24, 2022: CSC activated in Southwest District Health, Central District Health, and South Central District Health in southern Idaho.
• Dec. 20, 2021: CSC deactivated in the Panhandle Health District.
• Nov. 22, 2021: CSC deactivated in all but the Panhandle Health District.
• Sept. 16, 2021: CSC expanded to the entire state.
• Sept. 6, 2021: CSC activated in the Panhandle Health District in northern Idaho.

CSC background

Crisis standards of care are guidelines that help healthcare providers and systems decide how to deliver the best care possible under the extraordinary circumstances of an overwhelming disaster or public health emergency. The guidelines may be used when there are not enough healthcare resources to provide the usual standard of care to people who need it. The goal of crisis standards of care is to extend care to as many patients as possible and save as many lives as possible.

When crisis standards of care are in effect, people may get medical care that is different from what they expect. For example, patients admitted to the hospital may find that hospital beds are not available or are in repurposed rooms (such as a conference room) or that needed equipment or supplies are not available. They may have to wait for a bed to open, or be moved to another hospital in or out of state that has the resources they need.

Learn more about crisis standards of care and see an FAQ at https://coronavirus.idaho.gov/idaho-resources/.