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.
EMSA Releases AB 40 Emergency Regulations
What’s happening: On April 1, the Emergency Medical Services Authority (EMSA) released emergency regulations to implement Assembly Bill (AB) 40 (2023).
What else to know: Because these are emergency regulations, there will only be a five-day comment period. Comments are due to the Office of Administrative Law (OAL) by Saturday, April 5.
2025 Emergency Services Forum Takes Place May 5 in Newport Beach
What’s happening: This year’s Emergency Services Forum is happening in Newport Beach on May 5 from 8 a.m. to 4 p.m. (PT). Attendees can expect dynamic sessions covering industry topics, insights into the evolving behavioral health landscape, an interactive Q&A forum, and more. Registration is open, and early bird pricing ends April 8.
What else to know: The forum kicks off with a keynote address by Liz Basnett, director of the California Emergency Medical Services Authority (EMSA), who will provide transparency on EMSA’s requirements, as well as share efforts to modernize and update regulations to meet emergency services’ increasing needs.
2025 Emergency Services Forum Returns to Newport Beach
What’s happening: In just over six weeks, the Emergency Services Forum returns to Newport Beach, where emergency services professionals will gather for a day of learning, discussion, and networking.
What else to know: The forum, held May 5 from 8 a.m. to 4 p.m., is open for registration. The deadline for booking at the discounted hotel room rate is April 14.
Comments on Proposed EMSA Critical, Specialty Care Program Regulations Due April 3
What’s happening: The Emergency Medical Services Authority (EMSA) is proposing to update a chapter of the California Code of Regulations (CCR) that covers critical and specialty care programs, including as trauma, ST-elevation myocardial infarction (STEMI), stroke, and emergency medical services for children (EMSC) systems. Written comments on the proposed regulations are due April 3.
What else to know: The proposed revisions — to CCR Title 22, Division 9, Chapter 6 on Specialty Programs — were developed in collaboration with the California state technical advisory committees for trauma, STEMI, stroke, and EMSC. Each committee included CHA representatives.
2025 Behavioral Health Care Symposium
The 2025 Behavioral Health Care Symposium returns to Sacramento!
2025 Disaster Planning Conference
The 2025 Disaster Planning Conference will be in Sacramento this year. It’s sure to be as spectacular as ever.
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.
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.
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.