About Emergency Department/Trauma
California’s emergency departments (EDs) provide critical health services to those experiencing trauma, injury, or acute medical conditions. EDs offer comprehensive care, do not require previous authorization, and are open 24/7 year-round. EDs are facing unprecedented patient volume, with a 42% increase in the past seven years. By improving access to care for primary and specialty services, emergency visits can be reduced. More focused state and federal policies will be required to reduce Californians’ health care risks and ensure equitable access to appropriate care levels before people need emergency care.
A significant issue facing emergency departments (EDs) across California is ambulance patient offload time (APOT): the time it takes for a patient arriving at a hospital by ambulance to be transferred into the (ED). CHA has developed an APOT issue web page with additional information and resources.
2025 Emergency Services Forum
Join us for the 2025 Emergency Services Forum, returning to beautiful Newport Beach! This conference is dedicated to the uniqueness of hospital ED management and its intersection with emergency services and the community. We’re finalizing an exceptional lineup of speakers and engaging topics. The 2024 Emergency Services Forum sold out – this is an event you and your colleagues don’t want to miss!
Timeline Undetermined for Implementation of AB 40 Regulations
What’s happening: Due to state budget constraints, the state Office of Administrative Law (OAL) has not yet approved the Emergency Medical Services Authority’s (EMSA) Assembly Bill (AB) 40 (2023) regulations for public comment.
What else to know: AB 40 passed in 2023 with the intent of improving long ambulance patient offload times (APOTs). Despite the delay on implementation, CHA continues pursuing opportunities to collaborate with health care partners to improve long APOTs, which affect the entire health care delivery system.
CHA Symposium Focuses on New Approaches to Behavioral Health Care
What’s happening: More than 250 health care professionals and hospital leaders from across California gathered in Long Beach on Dec. 4-5 for CHA’s annual Behavioral Health Symposium.
What else to know: Attendees discussed innovative ways to connect patients to community-based care and tackle stigma, updates to California’s involuntary treatment and emergency services laws, and more.
Upcoming EMSA Commission Meeting to Discuss APOT Report
What’s happening: On Dec. 11, the Commission on Emergency Medical Services will convene in San Francisco, where it will discuss an ambulance patient offload time (APOT) report, among other topics.
What else to know: The report in the Emergency Medical Services Authority (EMSA) Commission Meeting Packet includes APOT data by hospital. More details for the in-person meeting can be found on the EMSA web page. See CHA’s APOT issue web page for additional resources.
CHA Disaster Planning Conference Focuses on Lessons Learned
What’s happening: CHA held its annual Disaster Planning Conference in Pasadena on Sept. 10 and 11. Topics included best practices for communication and collaboration in an emergency, treatment of special pathogens, enhancing health care cybersecurity, and fundamentals of radiation protection.
What else to know: More than 500 people attended the conference, including emergency preparedness directors and coordinators; members of hospital disaster planning teams; compliance, nurse, and case managers; and quality and safety executives.
CHA Develops New APOT Resource Page for Members
What’s happening: CHA has created a new web page that houses all resources related to ambulance patient offload time (APOT) to assist hospitals with Assembly Bill (AB) 40 compliance.
What else to know: CHA plans to regularly update the web page with AB 40 regulation developments, news, advocacy materials, and information on educational events like the next Emergency Services Forum on May 5, 2025.
AB 40 Requires Hospitals to Submit APOT Reduction Protocol in 2024
What’s happening: All hospitals with emergency departments must submit an ambulance patient offload time (APOT) reduction protocol to the Emergency Medical Services Authority to be compliant under Assembly Bill (AB) 40 (2023).
What else to know: CHA recommends submitting the protocol by Sept. 1 directly through email to APOT@emsa.ca.gov.
CHA to Host Webinar on Buffer Zone Approach to Hospital Crowding
What’s happening: CHA will host a members-only webinar on The Buffer Zone: A Novel Approach to Mass Casualty Incident (MCI) Surge in the Era of Hospital Crowding on Aug. 26 from 10-11 a.m. (PT). Registration is open.
What else to know: In this session, Scott Goldberg, MD, MPH, medical director of emergency preparedness at Brigham and Women’s Hospital, will highlight the hospital’s experience with developing and implementing buffer zones as part of their institution’s MCI plans and highlight the lessons learned during the operationalization of their buffer zone plan.
Ambulance Patient Offload Times
Ambulance patient offload times — how long it takes for a patient arriving at a hospital via ambulance to be transferred to an emergency department — are a challenge in many counties in California. Some factors contributing to longer offload times include the physical layout of a hospital, current unprecedented patient volume, increased acuity of patients’ illness or injury, and more. Challenges in the Emergency Department only continue to grow, further straining limited emergency services, and forcing us all to think about how to adapt to a changing world.
Hospitals Can Now Apply for Funds to Treat Patients with Behavioral Health Needs
What’s happening: Following the March 2024 passage of CHA-supported Proposition 1, applications are now open for $4.4 billion in new Behavioral Health Continuum Infrastructure Program (BHCIP) funding to support capital projects that expand the behavioral health services continuum.
What else to know: Hospitals can start the application process now for the first round of grants. Required pre-application consultation must be requested by Oct. 15, and applications are due by Dec. 13.