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Idaho Uses HPP Funding to Develop a Robust Crisis Standards of Care Plan in Preparation for COVID-19 Case Surge

June 2020

Preparedness Activities1:

In June 2020, the Idaho Department of Health and Welfare (DHW) published the Idaho Crisis Standards of Care (CSC) Plan, which is a product of collaboration among a variety of public health, emergency management, health care partners, and other stakeholders throughout the state. The Idaho DHW facilitated several discussions on the health care delivery challenges that often accompany emergencies and disasters, and how these impacts could be mitigated through certain response strategies and CSC. The Idaho DHW and its partners based the plan on the Institute of Medicine’s (IOM) Crisis Standards of Care, A Systems Framework for Catastrophic Disaster Response guidance, which covers CSC planning in five areas: Emergency Management and Public Safety, Emergency Medical Services (EMS), Hospital, Public Health, and Out of Hospital Care.

The Idaho DHW used Hospital Preparedness Program (HPP) funding to secure a contract with an external consultant who supported the Idaho DHW in the development of the CSC Plan. The combination of collaboration among Idaho DHW physicians and public health staff and the expertise provided from external partners— including the external consultant, hospital systems, hospice, and public safety— was critical in ensuring the development of an inclusive, comprehensive CSC Plan.

Response Activities:

Idaho convened the State of Idaho Medical Advisory Committee (SIDMAC) to develop guidance for response activities regarding the implementation of CSC. The SIDMAC included representation from across the state including critical care intensivists, health care facilities, EMS, and legal and special needs populations. The SIDMAC developed incident-specific priorities and guidance for health care organizations to reference when delivering patient care and prioritizing scarce medical resources. In anticipation of the need to possibly implement CSC strategies during the COVID-19 pandemic, SIDMAC met multiple times between April and December 2020 to develop Patient Care: Strategies for Scarce Resource Situations guidance, which contains potential resource allocation and utilization strategies for facilities in conventional, contingency, and crisis care. This document will continue to be updated as needed to address resource strains on the health care system during disasters.


As of late January 2021, over 161,000 Idaho residents have been infected with COVID-19, and at least 1,700 of these residents have died (Idaho COVID-19 website). To date, Idaho has not needed to activate CSC; however, the process for activating CSC has been developed, and this planning has strengthened relationships among key stakeholders that would be involved in activating and implementing CSC. While the DHW reserves the authority to implement CSC2, if needed, the DHW Director would coordinate closely with the CSC Activation Advisory Committee, who would meet to advise on implementation actions.

More Information:​

The Idaho DHW released a CSC C​hecklist which allows a facility to assess and report the need to activate CSC. Find this resource and more on the Idaho DHW website.