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SAN JOAQUIN COUNTY EMS SYSTEM PERFORMANCE UPDATE: AMBULANCE PATIENT OFFLOAD TIME (APOT) AND MEDICAL PATIENT DESTINATION POLICY
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RECOMMENDATION
It is recommended that the City Council receive and file this informational report regarding the implementation of San Joaquin County Emergency Medical Services Agency (SJCEMSA) EMS Policy No. 4985, Transfer of Patient Care in the Emergency Department, and EMS Policy No. 5201, Medical Patient Destination. These policies became effective May 1, 2026, and represent coordinated regional initiatives to improve ambulance availability, enhance patient access to appropriate specialty care, and strengthen collaboration among hospitals, emergency medical service providers, and regional fire agencies.
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DISCUSSION
Background
Emergency Medical Services (EMS) within San Joaquin County are coordinated through the San Joaquin County Emergency Medical Services Agency (SJCEMSA), which is responsible for establishing policies that promote consistent, high-quality emergency medical care throughout the region. As part of its ongoing commitment to improving patient outcomes and strengthening system performance, SJCEMSA implemented EMS Policy No. 4985, Transfer of Patient Care in the Emergency Department, and EMS Policy No. 5201, Medical Patient Destination, effective May 1, 2026. These complementary policies provide standardized guidance for ambulance patient offload, hospital destination decisions, and coordination among hospitals, ambulance providers, and regional fire agencies.
Together, these policies support a more efficient and integrated emergency medical system by improving ambulance availability, ensuring patients are transported to the most appropriate receiving facility based on their clinical needs, and enhancing coordination among regional healthcare and public safety partners. This report provides an overview of these initiatives and their collective role in strengthening emergency medical services throughout Stockton and San Joaquin County.
Present Situation
Effective May 1, 2026, SJCEMSA implemented EMS Policy No. 4985, Transfer of Patient Care in the Emergency Department, and EMS Policy No. 5201, Medical Patient Destination, as part of a coordinated effort to improve emergency medical services throughout San Joaquin County (Attachments A-C). EMS Policy No. 4985 establishes standardized expectations for the timely transfer of patient care from ambulance personnel to hospital staff upon arrival at an emergency department, reducing ambulance patient offload delays and returning ambulances to service more quickly for the next emergency response. EMS Policy No. 5201 establishes consistent countywide patient destination criteria that ensure patients are transported to the most appropriate receiving hospital based on their medical condition, specialty care needs, hospital capabilities, and patient preference when clinically appropriate. Together, these policies improve operational consistency while supporting timely access to definitive medical care across the regional EMS system.
Implementation of these policies has strengthened collaboration among SJCEMSA, CENCAL Fire & EMS Authority, American Medical Response (AMR), local hospitals, and regional fire agencies through ongoing performance monitoring, operational coordination, and continuous quality improvement. Weekly performance reporting and quarterly stakeholder meetings provide opportunities to evaluate system performance, identify improvement initiatives, and maintain a coordinated regional approach to emergency medical services. By reducing ambulance patient offload delays while ensuring patients receive care at the most appropriate hospital, these policies improve ambulance availability, enhance emergency response capability, preserve patient choice when appropriate, and support a more efficient, reliable, and patient-centered EMS system for the residents and visitors of Stockton and San Joaquin County.
EMS Policies No. 4985, Transfer of Patient Care in the Emergency Department, and No. 5201, Medical Patient Destination, establish a coordinated countywide framework that strengthens emergency medical services by improving ambulance availability, standardizing patient destination practices, enhancing access to specialty care, and promoting collaboration among hospitals, EMS providers, and regional fire agencies. Collectively, these initiatives support improved patient outcomes, increased system efficiency, and a resilient emergency medical services system capable of meeting the healthcare and public safety needs of the Stockton community and San Joaquin County.
FINANCIAL SUMMARY
This report is informational only and has no direct fiscal impact. Implementation of EMS Policies No. 4985 and No. 5201 is being accomplished through existing regional partnerships, operational resources, ongoing education, and established performance monitoring processes.
Attachment A - 2025 SJCEMSA - APOD Table
Attachment B - SJCEMSA EMS Policy No. 4985 - Transfer of Patient Care in the Emergency Department
Attachment C - SJCEMSA EMS Policy No. 5201 - Medical Patient Destination