The California Department of Health has issued an All Facilities Letter (AFL) outlining temporary waivers and program flexibility for healthcare facilities in response to the surge in respiratory viruses among pediatric patients. The AFL allows facilities to reconfigure space and adjust bed classifications without requesting individual waivers or program flexibility during the COVID-19 State of Emergency. It also provides guidance on planning for and responding to pediatric surges related to respiratory syncytial virus (RSV) and other respiratory viruses. Healthcare facilities, including those without existing pediatric services, are encouraged to explore short-term measures to expand capacity for evaluation and treatment of pediatric patients. Facilities must submit requests for program flexibility, including justification and supporting documentation, through the CDPH Flex Waiver Webpage. Non-compliance may result in regulatory enforcement. The AFL aims to help facilities manage the increasing demand for pediatric care due to the rise in respiratory viruses and the potential increase in COVID-19 cases and hospitalizations.

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