CABINET FOR HEALTH AND FAMILY SERVICES
DEPARTMENT FOR PUBLIC HEALTH

275 East Main Street. 

Andy Beshear Frankfon' KY 40621 Eric C. Friedlander

Governor

502-564-3970 Acting Secretary
FAX: 502-564-9377


Steven J. Stack, MD

Commissioner

March 30, 2020

Dear Colleagues,

On March 6, 2020, the Commonwealth of Kentucky identified its ?rst 9 positive patient. On this

same day, Governor Andy Beshear declared a state of emergency to mobilize all available resources to respond to
the COVID-19 pandemic and minimize the harm caused by it to Kentuckians. As 9 spreads throughout
our state, crisis standards of care will need to be deployed to save the largest number of lives possible. Utilize these
guiding, ethical principles for decision?making:

Duty to plan I Reciprocity

Duty to steward resources - Duty of care

Respect for human dignity 0 Consistency and fairness
Communication

When shifting from conventional standards of care to contingency standards of care and ?nally to crisis
standards of care, be mindful of these triggers:

Sustained community wide transmission
Shortage of supply/medication
Decrease in staf?ng levels

Limited or unavailability of ICU beds
Delays in access to care due to demand

When shifting to crisis standards of care, recognize the triggers and identify ways to modify current standards
to meet the needs of surges and to conserve healthcare resources. Escalating care should be based on what
resources are available and the quantity of resources required. Crisis options must be explored and implemented
at all levels.

I look forward to and anticipate the day when we can return to business as usual, but in the interim,
optimizing PPE, protecting staff and preventing transmission should be at the forefront of decision?making.

As

am Kentuc we re here to support you!

Steven J. Stac MD
Commissioner

Kentuckygov

TEAM A.
KENTUCKY An