ASAP
Practical Implications of California’s Proposed Revisions to Emergency Medical Services and First Aid Regulations
At a Glance
- Cal/OSHA has proposed revisions to emergency medical services and first aid regulations affecting general industry and construction employers.
- These amendments aim to clarify first-aid supply requirements, align with national voluntary consensus standards, and enhance workplace safety preparedness.
- The measure is on the September 17, 2026, agenda for the California Occupational Safety and Health Standards Board meeting, during which public comments will be accepted and a final vote may occur. If so, it could become effective within a relatively short period for employers to plan for compliance.
Nearly all California employers could be affected by proposed revisions to the state’s workplace first-aid regulations. Cal/OSHA is proposing revisions to emergency medical services and first aid regulations for general industry and construction employers under Title 8, Sections 3400 (Medical Services and First Aid-General Industry) and 1512 (Emergency Medical Services-Construction).
While the proposed amendments leave many provisions of Sections 3400 and 1512 unchanged, the amendments would, among other things, clarify minimum first-aid supply requirements, establish two methods for selecting first-aid kit contents, require additional supplies based on workplace-specific hazard assessments, and require employers to identify and communicate first-aid kit locations. Portions of the regulations would also align with ANSI/ISEA Z308.1-2021, the national voluntary consensus standard for workplace first-aid kits and supplies.1
If the revisions are adopted in their current form, California employers will need to reassess their first-aid programs, kit inventories and locations, and emergency response procedures.
Where Does the Rulemaking Stand?
The proposal is now postured for likely approval by the California Occupational Safety and Health Standards Board (“Standards Board”) at its meeting on September 17, 2026. This rulemaking stems from a series of petitions submitted over the years requesting updates to California’s workplace first-aid requirements. The Standards Board issued its notice of proposed rulemaking in November 2025, held a public hearing in January 2026, released a revised version in May 2026, and then released the latest version of the draft regulations in September 2026.
The proposal has not been finalized, and the current requirements remain in effect. Public comment will be permitted at the meeting on September 17, 2026. No proposed effective date has been posted.2 Nevertheless, employers may wish to monitor the rulemaking closely and consider planning now for the anticipated changes.
What Would Change for Employers?
The proposed amendments would substantially change the emergency medical services and first-aid provisions of the General Industry Safety Orders and Construction Safety Orders. It would not amend first aid and emergency medical services regulations under other industry-specific standards, including those governing logging and sawmills, mines, and agricultural operations.3
General Industry Employers (Section 3400)
The proposed amendments would significantly revise Section 3400, particularly through replacing the current physician-approved first-aid materials framework with an alternative compliance approach based on detailed requirements for first-aid kits, contents, accessibility, and hazard-based evaluations. The stated purpose of the proposal is to facilitate employer compliance and reduce costs by harmonizing the requirements for first-aid kits with the 2021 ANSI standard, while also allowing consultation with a physician or other licensed health care professional in lieu of only a physician.
The table below captures some of the major proposed changes to Section 3400:
Issue | Existing Requirement | September 2026 Proposed Requirement | Significance |
Kit Contents | Adequate first-aid materials must be readily available to employees. No express requirement for first-aid “kits.”
No prescribed minimum first-aid materials, but such materials must be approved by a consulting physician.4 | Employers would be required to provide a sufficient number of first-aid kits. They could use either: (1) the ANSI/ISEA Z308.1-2021 Class A contents; or (2) contents selected by an employer-authorized physician or other licensed healthcare professional. | Creates an express first-aid kit requirement and existing kits may need to be replaced or supplemented. |
Access and Visibility | No express requirement to communicate or have signage identifying first-aid kit locations. | Employers would have to communicate first-aid kit locations to employees and, where practicable, use signage, labeling, or other means to make the locations reasonably visible. | Creates a new employee-awareness obligation. |
First-Aid Guide | No mandatory first-aid guide. | Kits would need to include an ANSI-based first-aid guide or guide selected by an employer-authorized licensed healthcare professional. | Introduces a new requirement to add and update informational materials kept with kits. |
Workplace Evaluation | No express hazard assessment required or requirement of specialized supplies for unique hazards. | Based upon the location(s) of employees and the types and severity of occupational hazards at the worksite, employers must evaluate the need for a sufficient number of first-aid kits.
Where the hazard assessment identifies any unique, reasonably anticipated, and potentially serious workplace hazards, employers must provide additional specialized first-aid items suitable for those hazards. | Creates an express evaluation requirement and may require industry-specific and/or hazard-specific supplies. Although the proposal does not expressly require documentation, employers may wish to document their evaluation. |
Chemical Injury Supplies | No express requirement for chemical injury supplies beyond suitable facilities for quick drenching or flushing of the eyes and body if a person may be exposed to injurious corrosive materials. | If an employer provides chemical injury treatment supplies in first-aid kits, hazard communication emergency procedure training requirements apply.5 | Ensure chemical emergency procedures and Safety Data Sheets (SDS) are aligned with first-aid kit contents. |
Additional Considerations for Construction Employers (Section 1512)
Because Section 1512 already contains detailed first-aid requirements, the construction revisions are arguably narrower. Most existing requirements governing trained first-aid personnel, emergency communications, emergency washing facilities, emergency call systems, basket litters, and written emergency medical services plans would remain unchanged. The principal operational changes are frequency and coverage: construction employers would need to provide enough kits based on access needs, check each kit when placed into service, and ensure the contents remain readily available. These requirements may be especially significant for large, dispersed, transient, or multi-employer projects.
This table identifies the main proposed changes to Section 1512:
Issue | Existing Requirement | September 2026 Proposed Requirement | Issue |
Kit Contents and Number of Kits | At least one weatherproof first-aid kit is required.
Employee-count-based inventory table governs quantity of first-aid supplies.
| At least one weatherproof first-aid kit is still required. However, construction employers would be required to provide a sufficient number of first-aid kits based on employees’ need to access.
Employers may use either: (1) the ANSI/ISEA Z308.1-2021 Class A first-aid kit contents; or (2) rely on contents determined by an employer-authorized physician or other licensed healthcare professional.
| May require employers to upgrade existing first-aid kits and large or dispersed projects may require additional first-aid kits. |
Access and Visibility | No express requirement for first-aid kits to be “readily available” for use by employees and no express requirement to communicate or have signage identifying first-aid kit locations. | Express requirement for first-aid kits to be “readily available.”6
The location of each first-aid kit must be communicated to employees. To the extent practicable, the location of each first-aid kit must be clearly indicated, using signage, labeling, or other means to ensure reasonable visibility at the jobsite. | Creates a new employee-awareness obligation. |
First-Aid Guide | Existing mandatory first-aid manual. | Kits would need to include an ANSI-based first-aid guide or guide selected by an employer-authorized licensed healthcare professional. | Updates informational materials kept with kits. |
First-Aid Kit Inspection | First-aid kits must be inspected regularly to ensure expended items are promptly replaced. | First-aid kit contents must be checked when the kit is put into service to ensure that any expended items are promptly replaced. | Mandatory kit check. |
Workplace Evaluation | No express hazard-assessment required or requirement of specialized supplies for unique hazards (but additional supplies must follow physician recommendations). | Based upon the location(s) of employees and the types and severity of occupational hazards at the worksite, employers must evaluate the need for a sufficient number of first-aid kits. Additional supplies may be required based on workplace hazards. | Creates a new express evaluation requirement. Although the proposal does not expressly require documentation, employers may wish to document their evaluation.
Expands planning obligations for higher-risk activities. |
Chemical Injury Supplies | No express requirement for chemical injury supplies beyond suitable facilities for drenching the body or flushing the eyes. | If an employer provides chemical injury treatment supplies in first-aid kits, hazard communication emergency procedure training requirements apply. | Ensure chemical emergency procedures and SDSs are aligned with first-aid kit contents. |
What Can Employers Do Now?
Although no changes are required unless and until a final rule takes effect, employers may wish to assess their readiness in six main areas.
1. First-Aid Kit Contents
Many employers may need to review existing kits to determine whether they meet the proposed ANSI-based inventory requirements. Organizations relying on older or basic kits may find that additional supplies are necessary.
In addition, employers may want to consider evaluating the workplace to determine if “unique, reasonably anticipated, and potentially serious workplace hazards” exist requiring specialized first-aid items. Potential examples of such items could include first-aid materials for the treatment of chemical injuries, serious insect bites, snake bites, specialized trauma supplies, heat illness supplies, and the like.
Construction employers should consider the logistics of inspecting first-aid kits when they are placed into service.
2. First-Aid Kit Location Communication and Signage
Employers should consider how they will communicate the location of each first-aid kit to employees and provide appropriate signage or other labeling. It may be helpful to include first-aid kit locations on existing emergency response and/or evacuation maps shared with employees and/or posted on safety bulletin boards/intranet pages.
3. First-Aid Kit Availability
The Standards Board has explained that the proposal is intended to ensure employees have access to a first-aid kit within approximately three to four minutes, based on federal OSHA guidance. This provision will likely impact the number of first-aid kits required at a worksite, as well as the communication and signage provisions.
4. Chemical Injury Response Training
If a chemical injury response is likely, and relevant supplies are provided in first-aid kits, consider how and whether employees are trained to respond. This will likely require a review of specific chemical SDSs, the Hazard Communication Plan, and emergency response information.
5. First Aid Evaluation/Hazard Assessment Process
The most significant (and vigorously debated) aspect of the proposal would require employers to evaluate their workplaces and determine whether additional first-aid kits, supplies, or specialized equipment are necessary based on employee locations and workplace hazards. This requirement raises questions such as who should conduct the assessment, how often it must be conducted/reviewed, and how it must be documented.
The ANSI standard’s Appendix C (informative) offers guidance on selection of contents for first-aid kits, acknowledges there are many ways to conduct a hazard assessment, and suggests four basic steps for implementation:
- Does a Class A or Class B minimum kit best fit the hazards at the worksite?
- What are the hazards that exist?
- What kinds of injuries have occurred or could occur in relation to these hazards?
- What types of first-aid supplies are needed to treat these injuries?
6. Consider Reviewing Emergency Action Plans and Emergency Medical Services Plans
This may be an opportune time for employers to review their emergency medical services plans,7 first-aid programs, and emergency action plans to prepare for the practical implications of the upcoming potential changes.
Conclusion
While public comment will be permitted at the Standards Board meeting on September 17, 2026, the proposal is on the agenda as an action item and the Board may vote to approve it. The proposal could require meaningful changes to first-aid planning across California workplaces and may implicate important timing and implementation questions. Employers with California operations may wish to monitor the rulemaking and coordinate with safety professionals and employment counsel before making significant program changes.
