LEGISLATION
Cracking Down
on Wall Time
Governor Signs Landmark Law Sponsored by CPF
Ever-longer ambulance patient offload times (APOT) have become a public safety crisis that can’t wait any longer. Times spent by paramedics “on the wall” in hospital emergency rooms were before the pandemic, got longer during the pandemic and have reached crisis levels.
California took a groundbreaking step toward reducing dangerously long wall times. Assembly Bill 40, sponsored by CPF and signed by Gov. Gavin Newsom, sets a new 30 minute standard in law for hospitals to accept patients from ambulance crews. The new law also establishes data collection to ensure accountability and creates an accountability process for hospitals that don’t meet the standard.
“Extended wall times are a drain on taxpayer resources and a life-threatening risk to patients,” said CPF President Brian Rice. “We introduced AB 40 to say enough is enough – it’s time to set a standard and hold hospitals accountable.”
Few outside the hospital industry dispute the problem of excessive APOT. Wall times of 60 to 70 minutes or longer are common. In many places, that’s the average. Still, despite clear evidence and a trove of horror stories, hospitals – especially for-profit hospitals – lobbied hard and spent big to kill AB 40. They were met, however, with a united fire service – labor and management – as well as strong support from local governments and private ambulance providers.
“When paramedics are stuck on the wall providing care while they wait, they are, in effect, padding hospital profits at taxpayer expense,” said President Rice. ”They fought to keep hidden subsidy, but the fire service came together as a united front.”
Despite the hospitals’ heavy lobbying effort, the vote in support of AB 40 was extraordinary and bipartisan. The governor followed suit by signing it into law, putting a measurable APOT standard into law for the first time.
“The battle isn’t over,” said President Rice, “but AB 40 is a breakthrough for ambulance response and patient safety.”