When Every Minute Counts: Grand Jury Says Ambulances Are Waiting Too Long At Contra Costa Hospitals

A new Contra Costa County Civil Grand Jury report warns that ambulance patient offload delays continue to strain the county’s emergency medical system, leaving ambulances and crews waiting at hospitals instead of responding to new emergencies. The report found that while conditions have improved over the past year, delays remain widespread and continue to exceed local and state standards.

The report examines Ambulance Patient Offload Time (APOT), which measures how long it takes from an ambulance’s arrival at a hospital until the patient is officially accepted by emergency department staff. When that process takes longer than established standards, it becomes an Ambulance Patient Offload Delay (APOD). According to the Grand Jury, these delays often occur when emergency departments are operating at or near capacity and cannot immediately accept patients who are not considered critical emergencies.

Contra Costa County has adopted a goal of transferring patients within 20 minutes, 90% of the time, which is more stringent than California’s statewide standard of 30 minutes. However, the report found that no hospital in the county is consistently meeting the county’s benchmark. Statewide, more than half of California hospitals exceeded their local offload standards in January 2026.

One of the report’s major concerns is that ambulance crews often must remain with patients until hospitals formally accept them, effectively taking ambulances out of service. The Grand Jury concluded that these delays reduce the number of ambulances available for other emergencies and can contribute to longer response times throughout the county.

The report highlights several factors contributing to the problem, including growing demand for emergency services, increasing emergency room visits, and the use of ambulances and emergency departments by lower-acuity patients who may be able to receive care elsewhere. The county’s largest fire district, Contra Costa County Fire Protection District, reported ambulance transports increased from 75,046 in 2021 to 85,783 in 2025.

The county’s Psychiatric Emergency Services Unit in Martinez was identified as having the longest offload delays. Grand jurors found that the facility can only assess one patient at a time because it has a single intake room, forcing additional patients to wait in ambulances. The county has plans to expand the facility, but the estimated $30 million to $40 million project currently remains unfunded.

To address the issue, the Grand Jury recommended exploring alternatives to ambulance transport for certain behavioral health patients, expanding programs that redirect low-acuity callers to non-emergency care, funding improvements at Psychiatric Emergency Services, and hiring an outside consultant to evaluate patient flow at Contra Costa Regional Medical Center. The report also recommends that county supervisors receive regular updates on ambulance offload times and related system performance.

While county officials, hospitals and emergency responders have launched several initiatives aimed at reducing delays, the Grand Jury concluded that ambulance offload delays remain a persistent challenge that continues to affect emergency medical services throughout Contra Costa County.