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Colorado raises transfer center to highest level due to hospital capacity concerns

Patients can be transferred to any hospital in the state without consent after Tier 3 of the Combined Hospital Transfer Center was activated.

DENVER — For the first time since the COVID-19 pandemic began, Colorado patients can be transferred to any hospital in the state without their consent if deemed necessary by the Combined Hospital Transfer Center (CHTC).

Colorado Hospital Association (CHA) said Wednesday that CHTC is being raised to Tier 3, its highest level of operation, by the state's hospitals and health systems due to capacity concerns. 

The move is being considered 'unprecedented.' CHA said that when they first established the idea of a transfer center, three tiers were set up but they had never imagined they would reach the highest level. 

"We haven't reached this type of capacity level for this sustained of a period ever before that," said Cara Welch with the Colorado Hospital Association. "This is something that you know, they're dealing with every hour of every day. Hospitals are pulling every lever available to make sure that they are able to accept patients and provide care for the people that come to them." 

CHTC will now operate as a single, statewide point of contact for any hospital in Colorado that needs to transfer patients due to capacity issues.

Transfers made through CHTC are completed through a data-driven process to ensure patients have access the level of care they require, while also ensuring the most efficient use of the health care system, according to the CHA.

CHTC has the ability to transfer both COVID and non-COVID patients if a hospital doesn't have the capacity or needs to move patients for a different level of care. From transfer to treatment, this process does not mean patients are responsible for out-of-network costs if they are taken to an out-of-network facility, according to CHA. They cite the state's emergency rules, which state: “A covered person receiving care in a hospital or freestanding emergency department who is transferred to another hospital or facility in order to ensure or preserve adequate capacity due to the ongoing COVID-19 situation is deemed to have an emergency medical condition, and all services for the transfer and treatment at the receiving facility are considered to be emergency services for purposes of C.R.S. § 10-16-704(5.5), including the in network cost sharing benefits and consumer protections against balance billing.”

Gov. Jared Polis (D-Colo.) issued Executive Order D 2021-135 last week, allowing CHTC to direct the transfer of patients without first obtaining their consent under Tier 3. It also requires facilities to accept any transfer deemed necessary by CHTC.

RELATED: Polis signs executive order to help full hospitals

CTHC increases the ability for hospitals to send sicker patients to medical centers with more specialized care resources and move recovering patients to hospitals with available staff and space.

“This is an extraordinary step taken by the state’s hospitals and health systems,” said CHA Vice President of Clinical Affairs Darlene Tad-y, MD. “Even when under immense pressure, the state’s health care system continues to work collaboratively with each other and our partners at the state to ensure the best care possible is available to every Coloradan that needs it. However, activating Tier 3 of the CHTC should send a clear message to Coloradans: our health care system is in jeopardy of being overwhelmed."

CHA represents more than 100 member hospitals and health systems throughout the state.

If things continue to worsen and progress, there may be a rationing of care in the future. In some cases that is already happening. Cosmetic surgeries are currently being postponed or canceled due to one of Gov. Polis' recent executive order. 

RELATED: Colorado has 5th-highest COVID-19 rate in the country

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