Council Connect Articles

Contra Costa Fire Protection District to Implement New APOT Policy in March  


  • Contra Costa Fire Protection District  
  • American Medical Response (AMR) 


The Contra Costa County Fire Protection District and its ambulance subcontractor, AMR, plan to implement a new ambulance patient offload time (APOT) policy in March. Under the new policy, ambulance personnel who have been waiting for 60 minutes to transfer patients in need of hospital emergency department (ED) services may “immediately mov[e] the patient off the gurney by any means available while ensuring patient safety.”

Contra Costa County is the second county in the East Bay to have a so-called “hard offload” policy. Last year, the Alameda County Emergency Medical Services Agency revised its APOT policy and began allowing hard offloads effective Dec. 1, 2023. Since then, Alameda County has recorded 24 instances of hard offloads.  

Takeaway / Next Steps

Hospital Council will convene leaders from Contra Costa County hospital EDs and the fire district regarding this new policy before it goes into effect. Hospitals’ experience in Alameda County demonstrated the importance of communication between ambulance providers and hospitals to connect and agree on how the procedure will work. Our mutual goal is a collaborative offload process that puts patients’ health and safety first.