About Emergency Department/Trauma
California’s emergency departments (EDs) are filled to the brim (some 15 million people visit EDs every year) — often so packed that patients are forced to wait hours to be treated and ambulances are delayed in transferring patients to hospitals. Several things are behind this crisis:
- A lack of primary care clinicians that accept Medi-Cal
- A lack of post-hospital care sites (nursing homes, rehab facilities, mental health and addiction facilities, etc.) for patients and challenges with commercial insurance companies approving post-hospital care
- Workforce shortages
- Massive increases in the need for mental health and substance use disorder treatment
- Growing hospital financial distress, in part due to government payer shortfalls
- A dearth of alternative community care sites, like clinics or home settings
Without change, EDs — which accept all patients 24/7 year-round — will struggle to provide critical care to those experiencing trauma, injury, or acute medical conditions. Addressing this problem will take commitment and innovation from insurance companies, state policymakers, providers, and others to deliver better access to primary and specialty services, improved funding for ED care, and more.
CHA Urges Continued Collaboration, Improvements to Audit Tool in Comments on AB 40 Regulations
What’s happening: Last week, CHA submitted comments to the Emergency Medical Services Authority on the proposed Chapter 1.2 Ambulance Patient Offload Time Emergency Medical Services Authority regulations, which implement provisions of Assembly Bill 40 (2023).
EMSA Releases Updated AB 40 Regulations; Comments Due March 4
What’s happening: The Emergency Medical Services Authority (EMSA) has released updated Assembly Bill (AB) 40 regulations for final rulemaking related to ambulance patient offload times (APOT), with comments due on March 4.
EMSA Approves Specialty Designation Regulations, Highlights Continued APOT Reduction Challenges
What’s happening: At its quarterly meeting last week, the Commission on Emergency Medical Services reviewed ongoing implementation challenges related to Assembly Bill (AB) 40’s ambulance patient offload time (APOT) requirements, under which hospitals must submit APOT reduction protocols annually.
Comments on Trauma/Specialty Care Regulations Due Next Week
What’s happening: Last week, the Emergency Medical Services Authority (EMSA) released updated critical care and specialty program regulations.
HCAI Finds Increase in Alcohol-Related ED Visits
What’s happening: Alcohol-related emergency department (ED) visits and admissions have increased steadily over recent years, from roughly 603,000 in 2020 to more than 636,000 in 2023, according to recent findings from the California Department of Health Care Access and Information (HCAI).
Hospitals Must Submit 2025 APOT Reduction Protocols to EMSA, Audit Tool Tutorial Now Available
What’s happening: Under Assembly Bill (AB) 40 (2023), hospitals must submit an ambulance patient offload time (APOT) reduction protocol to the Emergency Medical Services Authority (EMSA) annually on or before June 30. CHA recommends that hospitals submit their protocols as soon as possible. EMSA’s APOT Audit Tool aims to reduce APOTs — as required under...
Hospitals Should Increase Participation in APOT Audit Tool
This post has been archived and contains information that may be out of date.
What’s happening: To increase data confidence and reliability, more hospitals must register for the Emergency Medical Services Authority’s (EMSA’s) “APOT Audit Tool” and begin conducting monthly audits. To be compliant with Assembly Bill (AB) 40 requirements, hospitals must also submit their APOT reduction protocols to EMSA.
Ambulance Patient Offload Times
When patients arrive at hospitals via ambulance, the goal is to transfer them to hospital care as quickly as possible. But that process can be slowed by several factors: the physical layout of a hospital, current unprecedented patient volume, increased acuity of patients’ illness or injury, and more.
Assembly Bill 40 (2023) – APOT Reduction Protocol Requirements
As mandated by Assembly Bill 40 (2023), California hospitals must submit Ambulance Patient Offload Time (APOT) Reduction Protocols by September 1, 2024. This Educational Brief will provide you with some best practices from your peers. This presentation reviews key deadlines and requirements and shares Sutter Health’s approach to incorporating APOT protocols into existing procedures.
New Demands on Emergency Departments in 2024 — Participant Information
Actions taken by Governor Newsom during the 2023 legislative season will significantly impact California’s emergency departments. Many bills signed into law affect hospitals for years to come.
Hear from CHA experts as they focus on the implications of ambulance patient offload time requirements, behavioral health care laws, and discharge challenges.