Hospitals can no longer declare routine overcrowding–based diversions and must avoid prolonged EMS diversions, though limited exceptions remain for system outages or extraordinary emergencies.

The policy prioritizes sending ambulances to the most appropriate facility quickly, rather than the nearest or already overcrowded one.

Indiana’s capital city has not used diversion for over three years, and the new statewide rule is expected to prompt nearby cities to adjust as they implement the restriction.

State Health Commissioner says diversion worsens patient outcomes by delaying care and tying up EMS on the road.

The Indiana Department of Health stresses addressing root causes of overcrowding through internal hospital improvements and better ED flow, not diverting EMS.

EMS providers expect less unnecessary travel and faster return-to-service, with patients potentially gaining quicker ED access and fewer transfer searches.

Diversions during COVID-19 reflected high volumes and staffing shortages; the change seeks to address capacity issues within hospitals rather than routing ambulances elsewhere.

Hospitals will generally continue accepting incoming emergency transports even when EDs are crowded, with limited exceptions for major disasters or critical infrastructure failures.

Indiana will end routine ambulance diversions starting in September, making it the third state to prohibit the practice.

Officials say routine diversions create a chain reaction that lengthens EMS response times and complicates regional emergency care amid staffing and resource challenges.

The policy aims to reduce ambulance delays, shorten transport times, and improve access to emergency care by avoiding unnecessary cross-hospital transports.

Under the new rule, diversions tied to crowding are restricted; routine crowding-based diversions are no longer permitted, with rare exceptions.