Ambulance patient offload time.

Existing law requires the Emergency Medical Services Authority to develop, using input from stakeholders and after approval by the Commission on Emergency Medical Services, and adopt a statewide standard methodology for the calculation and reporting by a local emergency medical services (EMS) agency of ambulance patient offload time (APOT) . Existing law defines APOT as the interval between the arrival of an ambulance patient at an emergency department and the time that the patient is transferred to an emergency department gurney, bed, chair, or other acceptable location and the emergency department assumes responsibility for care of the patient. Existing law requires the authority to report twice per year to the commission the APOT by local EMS agency jurisdiction and by each facility in that jurisdiction. This bill would instead require the authority to report the APOT data to the commission every 6 months. The bill would, subject to an appropriation, require the authority to take certain actions in collaboration with the Office of Emergency Services and the State Department of Public Health, for the purpose of reducing ambulance patient offload delays, protecting patients from unnecessary and life-threatening impacts to their overall health outcomes, and preparing for surges in demand for emergency medical services. Under the bill, those actions would include, among others, implementing a public education campaign, supporting staffing of EMS providers and additional resources for physical assets, issuing clear guidelines relating to triage and care, creating an expedited mechanism for a local EMS agency to obtain approval from the authority to implement alternate destination policies, designating urgent care overflow facilities that could serve as surge capacity for hospitals, and establishing policies relating to use of available fire department resources, telehealth, EMS-initiated refusal, assessment, and referral, as specified. The bill would also require the authority to develop policies to allow for the safe and efficient transfer of patients from emergency departments to nonhospital facilities, and would require the State Department of Public Health and the State Department of Health Care Services to engage local health departments with skilled nursing facilities and community behavioral health providers, at the election of those local health departments. The bill would require the authority to implement a specified set of those actions on or before July 1, 2023.