Governor Considerations Regarding Crisis Standards of Care

As part of state public health emergency preparedness initiatives, many states have developed guidelines or frameworks to address crisis standards of care (CSC). CSC are intended to help health systems and providers implement standardized and consistent approaches to allocate scarce resources throughout a region or state for triaging and treating patients impacted by a given emergency. Standardization is critical to ensure fairness in access to care throughout the affected area and to help limit the extent to which patients “hospital shop” if there is perceived or actual differentiation in protocols for prioritizing care. Absent state guidance, hospitals will develop and follow their own policies. However, hospitals can incorporate guidance into their own operating procedures, decide when to activate, and decide when to deactivate.

The rapid spread of COVID-19 has led several states to update their CSC frameworks to address issues unique to the pandemic (e.g., allocation of ventilators, use of intensive care unit beds, reduced use or dosage of certain drugs or use of alternative therapies due to inadequate drug supply, and insufficient personal protective equipment limiting the number of treating providers). Governors are well-positioned to facilitate coordination of framework development, solicit stakeholder input to achieve buy-in, ensure the appropriate legal protections for health care professionals, and communicate with the public about the plan.

All NGA COVID-19 memos can be found here, or visit COVID-19: What You Need To Know for current information on actions States/Territories are taking to address the COVID-19 pandemic; as well as advocacy, policy, and guidance documents for protecting public health and the economy.