Council Connect Articles

Hospital Council Responds To Proposed Policy On ‘Hard Offloads’ And Hospital Billing From Falck Ambulance


  • Alameda County Hospitals
  • Falck Ambulance
  • Hospital Council


In January, Falck Ambulance — the 911 ambulance provider for Alameda County — informed hospitals that it would be implementing a new policy in response to extended ambulance patient offload times (APOT). Under the new policy, Falck intends to leave patients in the emergency department on cots or in chairs once 60 minutes has passed (a practice known as a “hard offload”). Falck will also bill hospitals its standby rate for any ambulance held at a hospital with a patient beyond 30 minutes, which is the expected patient transfer of care time in county Emergency Medical Services (EMS) Agency policy.

In response, Hospital Council sent a letter to Falck Ambulance detailing significant concerns with “hard offloads,” including that it is not in the best interest of patients and could result in patient harm. The letter also responded to Falck’s legal justification for hospital billing, stating that it is not supported by fact or law.

Takeaway/Next Steps

Falck Ambulance agreed to postpone implementation of the policy for one month, until March 1. APOT discussions are ongoing with Falck Ambulance, Alameda County hospitals, and the Alameda County EMS Agency.


Rebecca Rozen at