Referral Team Covid Algorithm

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by  QI Medical Shelters/County of Los Angeles

COVID TRIAGE ALGORITHM
for QI/DPH CALL
CENTER Los Angeles
(updated January 27, 2022)
draft
New DHS IQ Prioritization Tool for COVID SURGE: effective 1/27/2022
PEH or non-PEH really sickwithCOVID >any hospitalized PEHCOVID positive >
PEH or non-PEH COVID positive -not too sick but medically/behaviorally challenged >
PEHquarantine =non-PEH quarantine (depends ondegree of comorbidity)
Group A: PEH
1. PEHwho are COVID+from congregatesheltersor sober living/LT treatment centerWITH MODERATE TO HIGH COVID-RELATED SYMPTOMS.*
2. PEH who are COVID+from HOSPITALS/ERsand needstep-down caredue to lack of capacity in hospitals/ERS with no appropriate shelter destination. (NOTES: DHS hospitals take
precedence over private hospitals. Symptomatic/medically vulnerable individuals take precedent over asymptomatic and less vulnerable individuals.)*
3. PEH who are COVID+OR PUI with high index of suspicion of COVID from any shelter**or encampment AND have one or more of the following:*
1. a. > 65yo
b. Havesignificant medical vulnerabilities placing them at riskfor COVIDdeath
c. Are unable to 'self-isolate' or adhere to masking guidance dueto behavioral issues
4. PEH who are COVID positive who are in a shelter that does not have a safe isolation space (as indicated by CRT or CFS team)
Group B:Community Members
1. Non-PEH COVID+ from Hospital/ERwith MODERATE TO HIGH COVID-RELATED SYMPTOMSwho cannot home-isolate (due to crowded living conditions or lack of caregiving support) and are
a. > 65yo
b. Havesignificant medical vulnerabilities placing them at risk for COVIDdeath
c. Are unable to 'self-isolate' or adhere to masking guidance due to behavioral issues
2. Non-PEH COVID+ OR PUI with high index of suspicion of COVID who have MODERATE COVID-RELATED SYMPTOMS AND have one or more
of the following:
a. > 65yo
b. Havesignificant medical vulnerabilities placing them at risk for COVIDdeath
3. Non-PEH COVID+ from any location with MODERATE TO HIGH COVID-RELATED SYMPTOMS* or PUI with high index of suspicionwho cannot home-isolate (due to crowded
living conditions or lack of caregiving support) and have extenuating circumstances such as cognitive/behavioral challenges or other disability.
Group C: Quarantine
1. PEH COVID-exposed with high degree of medical vulnerability: unvaccinated take precedence over unvaccinated.
2. PEH COVID-exposedwith behavioral issues from congregate facility and unable to shelter-in-place: unvaccinated take precedence over unvaccinated.
3. Non-PEH COVID-exposedwith behavioral issues and unable to quarantine due to crowded living conditions or lack of caregiving support: unvaccinated take precedence over unvaccinated.
*Unvaccinated/un-boosted clients always take precedence over vaccinated
New DHS IQ Prioritization Tool for COVID SURGE: effective 1/27/2022
PEH or non-PEHreally sickwithCOVID> any hospitalized PEHCOVIDpositive >
PEH or non-PEHCOVIDpositive-not too sick but medically/behaviorally challenged >
PEHquarantine=non-PEH quarantine(depends ondegreeof comorbidity)
Group A: PEH
1. PEHwho are COVID+fromcongregatesheltersor sober living/LT treatmentcenterWITH MODERATE TO HIGH COVID-RELATED SYMPTOMS.*
2. PEHwho are COVID+from HOSPITALS/ERsand needstep-down caredue to lack of capacity in hospitals/ERS with no appropriate shelter destination. (NOTES: DHS hospitals takeprecedence over
private hospitals. Symptomatic/medically vulnerable individuals take precedent over asymptomatic and less vulnerable individuals.)*
3. PEH who are COVID+OR PUIwithhigh index of suspicion of COVID from any shelter**or encampment AND have one or more of thefollowing:*
a. > 65 yo
b. Havesignificant medical vulnerabilities placing them at riskforCOVIDdeath
c. Areunable to 'self-isolate' or adhere to masking guidance duetobehavioral issues
4. PEH who are COVID positive who are in a shelter that does not have a safeisolation space (as indicated by CRT or CFS team)
Group B:Community Members
1. Non-PEH COVID+ from Hospital/ERwith MODERATE TO HIGH COVID-RELATED SYMPTOMSwho cannot home-isolate (due to crowded living conditions or lack of caregiving support)and are
a. > 65yo
b. Havesignificant medical vulnerabilities placing them at risk for COVIDdeath
c. Areunable to 'self-isolate' or adhere to masking guidance due to behavioral issues
2. Non-PEH COVID+ OR PUI with high index of suspicion of COVID who have MODERATE COVID-RELATED SYMPTOMS AND have one or more
of the following:
a. > 65 yo
b. Havesignificant medical vulnerabilities placing them at riskforCOVIDdeath
3. Non-PEH COVID+ from any location with MODERATE TO HIGHCOVID-RELATED SYMPTOMS*or PUI with high index of suspicionwhocannot home-isolate (due to crowdedliving conditions or lack of
caregiving support)and have extenuating circumstances such as cognitive/behavioral challenges or other disability.
Group C: Quarantine
1. PEH COVID-exposed with high degree of medical vulnerability: unvaccinated take precedence over unvaccinated.
2. PEH COVID-exposedwith behavioral issues from congregate facility and unable to shelter-in-place: unvaccinated take precedence over unvaccinated.
3. Non-PEH COVID-exposedwith behavioral issues and unable to quarantine due to crowded living conditions or lack of caregiving support: unvaccinated take precedence over unvaccinated.
*Unvaccinated/un-boosted clients always take precedence over vaccinated
MASTER QI/DPH LIST AND CONTACT NUMBERS FOR
DPH CALL CENTER ONLY
CONFIRMED SITES TYPE UNITS REFERRAL PATHWAY SERVICES OFFERED DPH CONTACT
Vagabond Non-congregate 71 DPH Call Centerdirectsto Medium-High medical, PEH,
3101 S. Figueroa St. HFH QI Teamwhich then DMH Support DHS/DPH DAILY INTAKE RN: 213-436-6821
LA 90007 triages to
Vagabond, Sherman or MLK
Sherman Non-congregate 70 DPH Call Centerdirectsto Medium-High medical,PEH, DHS/DPH DAILY INTAKE RN: 213-436-6821
15485 Ventura Blvd, HFH QI Teamas above minimal DMH support
Sherman Oaks, CA
91403
MLK Congregate 72 DPH Call Low-Medium medical, PEH DPH liaisons:
1680 E 120th St, Los Centerdirectsto both HFH QI Ruth Sepulveda-909-682-0786
Angeles, CA 90059 Team [email protected]
AND to AND
Site Maria [email protected]
323-303-6254
Exodus/ Congregate 52 DPH Call Centerdirectsto Site Low-Medium medical, PEH Hilary Aquino:
David L. Murphy [email protected]
640Maple Avenue · Exodus: 213-395-7700
Los Angeles, CA 90014
Olive View RCC and Congregate 16 DHS SW to Low-Medium medical, PEH For concerns:
Rancho RCC HFH IH Teamvia CHAMP JuatuanMark: 213-317-6034 or
(DPH DOES NOT REFER AND andemail interimhousing Yancy Martinez
TO EITHER SITE. THESE @dhs.lacounty.gov [email protected]
ARE DIRECT REFERRALS
Subject: “SAFE ISOLATION
THROUGH THE HOSPITAL
BED”
SOCIAL WORK TEAMS)
DHS/HFH CHIEF MEDICAL OFFICER: Dr. Heidi Behforouz
QIOperationsLead: EricEspinosa, (626) [email protected]
QIMedical/Clinical Lead:[email protected]
QI PROVIDER ON CALL 24X7: 213-477-0294 MASTER QI/DPH FLOW AND CONTACT
DHS/DPH Liaisons fortrouble shooting intakes:
Angi Enriquez [phone] and
LIST WITH ALL NUMBERS
Elna Anderson [phone]
DPH CALL CENTER (FOR REFERRALS ONLY): 833-596-1009
CONFIRMED SITES TYPE UNITS REFERRAL PATHWAY SERVICES OFFERED CONTACTS (INTAKE, OPS, CLINICAL, DISPO)
Vagabond Non-congregate 71 DPH Call Centerdirectsto Medium-High medical, PEH, Operations site lead:
HFH QI Teamwhich then DMH Support Christine Merino [phone]
triages to DHS/DPH DAILY INTAKE RN: 213-436-6821
Vagabond, Sherman or MLK Principal Discharge coordinators: Bianca Martinez (862)
579-9620
Sherman Non-congregate 70 DPH Call Centerdirectsto Medium-High medical,PEH, Operations Lead:Heidi Spencer 615-618-2058
HFH QI Teamas above minimal DMH support 1. Principal clinical contacts, if any: Angi Enriquez, (213)
675-5317 and Elna Anderson [phone]
2. Principal Discharge Coordinators: John Sutton, (424)
542-2538 and Clinton Lane [phone]
(FirstToServe)
3. DMH [phone]
MLK Congregate 72 DPH Call Low-Medium medical, PEH Principal contacts:
Centerdirectsto both HFH QI Jerri Santo [email protected]
Team 323-251-6207
AND to Shalonda [email protected],
Site Shalonda 424-338-2753 or cell 323-210-9697
DPH liaisons:
Ruth Sepulveda-909-682-0786
[email protected]
Maria [email protected] 323-303-6254
Clinical contacts:
Elke Wurzbach, NP 424-338-
2782 [email protected]
Janet Bond, RN [email protected]

HOSPITALIZED
at DHS Facility
Moderately Severely
Asymptomatic Mildly Symptomatic
Symptomatic Symptomatic
No Concerning
Vulnerable
Comorbidities Stay in Hospital
Unsheltered or from
Sober Living / From Homeless Shelter DPH Call Center to
Treatment Center
refer to IQ
DHS SW refers to
Hospital coordinates
Campus Recuperative
Care via bothCHAMP DPH Call Center for return to facility's If unable to return to
AND email placement at Exodus isolation area. shelter,call DHS COVID-
at InterimHousing Sobering Center You will NEED address, 19 Support Line: 833-
@dhs.lacounty.gov (8pm-8am only) and point of contact at 900-2558
subject heading: "safe facility/shelter.
isolation bed"
HOSPITALIZED at
Private Facility
Moderately Severely
Mildly Symptomatic
Asymptomatic
Symptomatic Symptomatic
No Concerning
Vulnerable
Comorbidities Stay in Hospital
Unsheltered or from
Sober Living / From Homeless Shelter DPH Call Center to
Treatment Center
refer to IQ
Hospital coordinates
Call DPH Call Center for return to facility's If unable to return to
isolation area. shelter,call:DHS
triage to Exodus
COVID-19 Support
Sobering Center NEED address and point
Line:833-900-2558
of contact at
shelter/facility.
SHELTER OR HIGH-
RISK CONGREGATE
SETTING
Asymptomatic/Mild Symptomatic C19+ or
Symptoms C19+ PUIs
**
From red zone shelter
1. > 65 yo
Shelter-in-place if not No concerning co-
or vulnerable/ 2. Med vulnerabilities placing
from red-zone shelter morbidities
at risk for C19 death
behavioral issues**
3. Unable to follow isolation
due to behavioral issues
DPH Call Center
Moderate Symptoms Severe Symptoms
triages to Q/I
DPH Call Center
Hospital/911
triages to QI
UNSHELTERED PEH
Asymptomatic/Mild Symptomatic C19+ or
Symptoms C19+ PUIs
No concerning co-
Shelter-in-place ** Vulnerable
morbidities
If unable to "shelter-in-
place" safely, DPH Call DPH Call Center triages
Moderate Symptoms Severe Symptoms
Center triages to Exodus to Q/I
Sobering Center
DPH Call Center triages
Hospital/911
to QI