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Title: Section 360.2 - Surge and Flex Health Care Coordination System Requirements

Effective Date


Section 360.2. Surge and Flex Health Care Coordination System Requirements.

(a) In the event of a declared State disaster emergency, the Commissioner shall have all necessary authority and procedures to activate the Surge and Flex Health Care Coordination System (hereinafter “Surge and Flex System”), including the following:

(1) Increase Bed Capacity. At the Commissioner’s direction, which shall be incremental and geographically targeted, health care facilities shall increase by up to 50% the number of acute care beds and/or change the service categories of beds certified or otherwise approved in any entity regulated by the Department. At the Commissioner’s direction, health care facilities shall postpone up to 100% of non-essential elective procedures or allow such procedures only pursuant to such conditions as the Commissioner may determine. The Department shall establish procedures to approve temporary changes at regulated health care facilities to physical plants, to facilitate the increased capacity and shall expedite review of construction applications related to temporary locations, provided that schematics are filed with the Department and patient safety is maintained.

(2) Enhanced Staffing Capacity. Health care facilities shall establish plans to meet enhanced staffing levels sufficient to ensure that the increased bed capacity has adequate staffing. The Commissioner may further expand or modify criteria for staffing. Health care facilities shall have access to a State-run portal for staffing needs identifying both volunteers and available staff; whether licensed or registered in New York State, or authorized or licensed to practice in any other state or Canada.                                                                                             

(3) Availability of Supplies and PPE. Health care facilities shall maintain and actively manage a supply of personal protective equipment (PPE) appropriate for use during a declared health emergency that could last at least 60-days pursuant to Section 405.11(g) of this Title. The Commissioner shall have all necessary authority to re-distribute the resources of a regulated entity if there is a determination that such resources are limited and in order to preserve the health and safety of New Yorkers, including:

(i) Requiring that any medical or other equipment that is held in inventory by any entity in the State, or otherwise located in the State, be reported to the Department, in a form and with such frequency as the Commissioner may determine.

(ii) Requiring that the patient census be reported to the Department, in a form and with such frequency as the Commissioner may determine.

(iii) For any infectious and communicable disease, ensuring that testing results are reported immediately if positive, and as determined by the Commissioner if such testing results are negative, via the electronic clinical laboratory reporting system or as the Commissioner may determine.

(iv) Suspending or restricting visitation, in accordance with the need to conserve PPE, and subject to such conditions or limitations as the Commissioner may determine.

(4) Statewide Coordination.

(i) Discharging, transfer, and receiving of patients. Health care facilities regulated by the Department shall, if directed to do so by the Commissioner, rapidly discharge, transfer, or receive patients, while protecting the health and safety of such patients and residents, and consistent with the Emergency Medical Treatment and Active Labor Act (EMTALA). The Department shall coordinate with health care facilities to balance individual facility patient load, and may promulgate further directives to specify the method and manner of transfer or discharge.

(ii) Designating Health Care Facilities as Trauma Centers. The Department is authorized to designate an entity as a trauma center; extend or modify the period for which an entity may be designated as a trauma center; or modify the review team for assessment of a trauma center; or change the level of acuity designation or health services of a facility or other determination about patient care as appropriate, including restricting admission or treatment to patients with a particular diagnosis.

(iii) Maintaining a Statewide Health Care Data Management System. Health care facilities or health systems shall report as directed by the Department any information necessary to implement the Surge and Flex System (e.g. available hospital beds, equipment available and in use) and the Department shall use that health facility or health system data in order to monitor, coordinate, and manage during the emergency.

Statutory Authority

Public Health Law, Sections 225, 576, 2800, 2803 and 4662 & Social Services Law, Section 461


VOLUME C (Title 10)