HomeMy WebLinkAboutPA2023-0128_20230714_Office Parking Analysis transportation ■ noise ■ air quality | GANDDINI GROUP
555 Parkcenter Drive, Suite 225, Santa Ana, CA 92705
(714) 795-3100 | ganddini.com
July 5, 2023
Mr. Gerald Klein, Partner
326 INVESTMENTS, LLC
4770 Von Karman Avenue
Newport Beach, California 92660
RE: 326 Old Newport Boulevard Medical Office Parking Analysis
Project No. 19642
Dear Mr. Klein:
Ganddini Group, Inc. is pleased to provide this Parking Analysis for the proposed 326 Old Newport Boulevard
Medical Office Project in the City of Newport Beach. The purpose of this study is to assess parking adequacy
for the project based on the proposed conversion of the existing office building to medical office use. We
trust the findings will aid you and the City in assessing the project.
PROJECT DESCRIPTION
The project site is located at 326 Old Newport Boulevard in the City of Newport Beach, California. Figure 1
shows the project location map.
The project site is currently developed with an approximately 2,710 square foot building currently permitted
for general office use. The project site currently provides 11 off-street parking spaces in a gated garage below
the existing office building. Figure 2 shows the proposed project site plan.
CITY OF NEWPORT BEACH PARKING REQUIREMENTS
The City of Newport Beach off-street parking requirements are summarized in the City of Newport Beach
Municipal Code Section 20.40.040, Table 3-10: Off-Street Parking Requirements and included in Appendix
A. Based on the City’s Municipal Code requirements, new construction requires off-street parking be provided
as follows:
▪ Offices – Business, Corporate, General, Governmental – First 50,000 square feet: 1 parking space
per 250 square feet;
▪ Offices – Medical and Dental Offices: 1 parking space per 200 square feet.
Table 1 shows the number of off-street parking spaces the proposed project is required to provide in
accordance with the City of Newport Beach Municipal Code. As shown in Table 1, the existing general office
requires 11 parking spaces. The proposed medical office conversion requires 14 parking spaces.
Mr. Gerald Klein, Partner
326 INVESTMENTS, LLC
July 5, 2023
326 Old Newport Boulevard Medical Office
Parking Analysis
2 19642
ITE PARKING GENERATION MANUAL PARKING RATES
Parking generation data from the Institute of Transportation Engineers (ITE) Parking Generation Manual (5th
Edition, January 2019) indicates the average peak period parking demand for a medical-dental office building
(ITE Land Use Code 720) is 3.23 parking spaces per thousand square feet and the 85th-percentile park parking
demand is 4.59 parking spaces per thousand square feet. For the existing 2,710 square foot building, this
equates to nine (9) parking spaces based on the average peak parking demand and 13 parking spaces for the
85th-percentile peak parking demand.
Based on review of the available ITE data, the City’s Municipal Code may overestimate the actual number of
off-street parking spaces required for the proposed medical office conversion. Additionally, ITE rates are
derived from surveys conducted in 1980s through the 2010s. Studies have shown that in-person demand for
medical office uses has been declining in recent years due to the increasing use of telecommuting and
telehealth, resulting in lower parking demand compared to historical levels.
The following sections include an analysis of parking occupancy surveys conducted at comparable local
facilities for a more empirical evaluation and an overview of literature documenting the changing
characteristics of office and medical office operations.
PARKING OCCUPANCY SURVEYS
Parking occupancy surveys were conducted to develop an up-to-date parking demand ratio for the project
based on empirical data for similarly sized medical office facilities in the area. Field observations of parking
occupancy were conducted at three nearby medical office facilities. Figure 3 to Figure 5 show the survey site
locations. The following three nearby medical office facilities were chosen for analysis in consultation with
City staff on the basis of proximity to the project site, similar operations, and contain dedicated parking lots:
▪ Survey Site 1:
□ Tenant: One Health Medical & Surgical Center
□ Address: 425 Old Newport Boulevard, Newport Beach, CA 92663
□ Size: 4,734 square feet
□ Parking Supply: 17 parking spaces (3.59 stalls per 1,000 square feet)
Hours of Operation: 9:00 AM to 5:00 PM Monday to Friday
▪ Survey Site 2:
□ Tenant: TruMD Wellness Center/NewportCare Medical Group
□ Address: 441 Old Newport Boulevard, Newport Beach, CA 92663
□ Size: 12,992 square feet
□ Parking Supply: 39 parking spaces (3.00 stalls per 1,000 square feet)
□ Hours of Operation: TruMD Wellness Center are 8:00 AM to 5:00 PM Monday to Friday;
NewportCare Medical Group are 8:00 AM to 5:00 PM Monday to Friday
and 9:00 AM to 11:00 AM on Saturdays and Sundays
▪ Survey Site 3:
□ Tenant: Strong Families Medical Group
□ Address: 136 Broadway, Costa Mesa, CA 92627
□ Size: 3,402 square feet
□ Parking Supply: 14 parking spaces (4.12 stalls per 1,000 square feet)
□ Hours of Operation: 9:00 AM to 6:00 PM Monday to Friday, 9:00 AM to 1:00 PM on Saturdays
Mr. Gerald Klein, Partner
326 INVESTMENTS, LLC
July 5, 2023
326 Old Newport Boulevard Medical Office
Parking Analysis
3 19642
Based on peak demand periods and public hours of operation, the parking occupancy was observed at each
survey site and documented in one-hour intervals from 8:00 AM to 7:00 PM. The first two locations were
counted on Tuesday, June 6, 2023, and on Thursday, June 8, 2023. The third location was counted on
Tuesday, June 20, 2023, and on Wednesday, June 21, 2023. The survey sites and observation periods were
determined in consultation with City staff and represent the busiest times and days of the week based on
review of ITE time-of-day distribution data for medical offices. According to the ITE Parking Generation Manual,
these facilities typically generate peak parking demand around 9:00 AM to 4:00 PM on weekdays. The parking
occupancy counts also tabulate any users that were observed to park their vehicles on-street adjacent to the
survey site. Appendix B contains the parking survey count worksheets.
Tables 2 through 4 show the parking occupancy survey results for each of the survey sites. Table 5 shows a
summary of the peak parking demand ratios observed. As shown in Table 5, the average peak period parking
demand observed at three comparable medical offices in the project vicinity was 3.41 parking spaces per
1,000 square feet.
PROJECT PEAK PARKING DEMAND FORECAST
The proposed 2,710 square foot medical office is forecast to generate a peak parking demand of 10 parking
spaces based on the average peak parking demand ratio of 3.41 parking spaces per 1,000 square feet
observed from the parking occupancy surveys. Therefore, the existing supply of 11 parking spaces is expected
to provide sufficient on-site parking to accommodate an average medical office use.
RECENT TRENDS/CHANGES IN PARKING DEMAND
General Office
For the past decade or so, office employees have increasingly been working remotely at their personal homes
instead of coming into the office. The COVID-19 pandemic accelerated this phenomenon, forcing many
businesses to implement remote work schedules on a mass scale. This paradigm shift has continued beyond
the lifting of health and safety restrictions, with more employees working remotely than ever before. As such,
this has reduced the parking demand for office land uses.
A May 30, 2023 article from Forbes (see Appendix C) states that “office towers have lost nearly 20 million
square feet of leases in the first quarter of 2023.” Los Angeles now has an occupancy rate of 73.8%, resulting
in a decline in occupancy of 7.8%, and a 50.6% decline in workers going into the office since February 2020.
The main takeaway for purposes of this analysis is that roughly half of all office workers in Los Angeles now
work remotely.
A March 30, 2023 article from Pew Research (See Appendix D) found that 35% of workers with jobs that can
be done remotely are working from home all of the time.
Mr. Gerald Klein, Partner
326 INVESTMENTS, LLC
July 5, 2023
326 Old Newport Boulevard Medical Office
Parking Analysis
4 19642
These numbers are in line with other research that shows that about 30-50% of office employees are now
working remotely. Thus, the parking demand generated for office uses can be reduced by the corresponding
30-50%.
While some medical office roles cannot be performed remotely, other positions, such as administrative roles,
or virtual screenings/visits are having an effect on parking needs for medical office uses as described below.
Medical Office
While telecommuting has been increasing over the past decade for general office type employees, another
type of technological advancement has been occurring in the medical industry. Telehealth utilization showed
a sharp increase since the beginning of the COVID-19 pandemic and has allowed patients to get consultations
with doctors strictly over internet-based video/audio communication without in-person consultation.
Although the COVID-19 pandemic largely forced an increase in the use of telehealth, telehealth is expected
to continue for the foreseeable future.
The U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and
Evaluation issued the following brief on April 19, 2023 entitled “Updated National Survey Trends in Telehealth
Utilization and Modality (2021 – 2022)” (see Appendix E). According to this issue brief, an average of 22% of
adults reported using telehealth in the last four weeks. While telehealth use was lower than previous study
periods (April 14, 2021 – August 8, 2022) it continued to remain above pre-pandemic levels.
Mr. Gerald Klein, Partner
326 INVESTMENTS, LLC
July 5, 2023
326 Old Newport Boulevard Medical Office
Parking Analysis
5 19642
According to the American Medical Association (AMA) 2021 Telehealth Survey Report (see Appendix F), 85%
of physician respondents indicate they currently use telehealth, with 60% of clinicians agreeing or strongly
agreeing that telehealth enables them to provide high quality care. Of those using telehealth, 93% are
conducting live, interactive video visits with patients and 69% are doing audio-only visits. 56% of respondents
are motivated (agree or strongly agree) to increase telehealth use in their practices.
More than 80% of patient respondents indicate that patients have better access to care using telehealth. 62%
of respondents feel patients have higher satisfaction since offering telehealth.
Mr. Gerald Klein, Partner
326 INVESTMENTS, LLC
July 5, 2023
326 Old Newport Boulevard Medical Office
Parking Analysis
6 19642
The technological advances that have allowed more widespread adoption of telecommuting and telehealth
have reduced the need for in-office representation. Based on data from the U.S. Department of Health and
Human Services and the American Medical Association, use of telehealth is trending upward in recent years.
The increasing trend in the use of telehealth is expected to reduce the need for in-person visits, thus lowering
parking demand. These trends and their effect on parking demand are not captured in the historical parking
demand ratios from publications such as the ITE Parking Generation Manual or the City’s Municipal Code but
do appear to be reflected in the parking occupancy surveys conducted for this analysis.
PARKING MANAGEMENT
To further ensure that a future medical office use does not exceed the available parking supply, future medical
office tenants should prepare a brief parking management plan that outlines the following:
▪ Typical hours of operation;
▪ Total number of employees and maximum number of employees on-site during any shift;
▪ A typical patient appointment schedule and maximum number of patients on-site (including those in
waiting room);
▪ If necessary, a staggered appointment schedule should be implemented with a minimum gap of 15-
minutes between patient appointments to avoid overlapping parking demand.
CONCLUSIONS
Based on review of the available ITE data, the City’s Municipal Code may overestimate the actual number of
off-street parking spaces required for the proposed medical office conversion. Additionally, ITE rates are
derived from surveys conducted in 1980s through the 2010s. Studies have shown that in-person demand for
medical office uses has been declining in recent years due to the increasing use of telecommuting and
telehealth, resulting in lower parking demand compared to historical levels.
Mr. Gerald Klein, Partner
326 INVESTMENTS, LLC
July 5, 2023
326 Old Newport Boulevard Medical Office
Parking Analysis
7 19642
The average peak period parking demand observed at three comparable medical offices in the project vicinity
was 3.41 parking spaces per 1,000 square feet.
The proposed 2,710 square foot medical office is forecast to generate a peak parking demand of 10 parking
spaces based on the average peak parking demand ratio of 3.41 parking spaces per 1,000 square feet
observed from the parking occupancy surveys. Therefore, the existing supply of 11 parking spaces is expected
to provide sufficient on-site parking to accommodate an average medical office use.
To further ensure that a future medical office use does not exceed the available parking supply, future medical
office tenants should prepare a brief parking management plan outlining hours of operation, the number of
employees and patients on-site at any given time, and a staggered appointment schedule, if necessary.
It has been a pleasure to assist you with this project. Should you have any questions or if we can be of further
assistance, please do not hesitate to call at (714) 795-3100.
Sincerely,
GANDDINI GROUP, INC.
Bryan Crawford | Senior Associate
Giancarlo Ganddini, PE, PTP | Principal
Quantity Units1
Parking
Spaces
2,710 SF 1.0 Spaces :250 SF 11
2,710 SF 1.0 Spaces :200 SF 14
3
1.
2.
Table 1
Off-Street Parking Requirements
Land Use
Parking Code
Requirement2
Current Use:
SF = Square Feet
Source: City of Newport Beach Municipal Code Section 20.40.040, Table 3-10: Off-Street Parking
Requirements.
Offices - Business, Corporate, General,
Governmental - First 50,000 Square Feet
Proposed Use:
Offices - Medical and Dental Offices
Additional parking spaces required for conversion from general office to medical/dental office:
Notes:
326 Old Newport Medical Office
Parking Analysis
19642 8
Regular Disabled Customer Street Total
8:00 AM - 9:00 AM 5 0 0 0 5
9:00 AM - 10:00 AM 6 0 2 0 8
10:00 AM - 11:00 AM 8 0 1 0 9
11:00 AM - 12:00 PM 10 0 2 0 12
12:00 PM - 1:00 PM 12 1 5 0 18
1:00 PM - 2:00 PM 11 0 4 0 15
2:00 PM - 3:00 PM 8 0 2 0 10
3:00 PM - 4:00 PM 5 1 3 0 9
4:00 PM - 5:00 PM 6 0 1 0 7
5:00 PM - 6:00 PM 5 0 0 0 5
6:00 PM - 7:00 PM 7 0 0 0 7
10 2 5 --17
Regular Disabled Customer Street Total
8:00 AM - 9:00 AM 1 0 0 0 1
9:00 AM - 10:00 AM 3 0 0 0 3
10:00 AM - 11:00 AM 8 0 2 0 10
11:00 AM - 12:00 PM 10 0 1 0 11
12:00 PM - 1:00 PM 9 0 1 0 10
1:00 PM - 2:00 PM 7 0 2 0 9
2:00 PM - 3:00 PM 10 0 2 0 12
3:00 PM - 4:00 PM 9 0 2 0 11
4:00 PM - 5:00 PM 5 0 1 0 6
5:00 PM - 6:00 PM 8 0 1 0 9
6:00 PM - 7:00 PM 6 0 1 0 7
10 2 5 --17
Survey Site #1 Address:
425 Old Newport Boulevard, Newport Beach, CA 92663
Table 2
Parking Occupancy Survey - Site #1
Time Period
Number of Parked Vehicles
Tuesday, June 6, 2023
Inventory
Peak Demand 18
Building Square Footage 4,734
Peak Demand per
Thousand Square Feet 3.80
Thursday, June 8, 2023
Time Period
Number of Parked Vehicles
Peak Demand per
Thousand Square Feet 2.53
Inventory
Peak Demand 12
Building Square Footage 4,734
326 Old Newport Medical Office
Parking Analysis
19642 9
Reserved Regular Disabled Elevator Drop-Off Street Total
8:00 AM - 9:00 AM 11 2 1 5 0 2 21
9:00 AM - 10:00 AM 19 2 1 5 0 1 28
10:00 AM - 11:00 AM 19 2 1 7 1 0 30
11:00 AM - 12:00 PM 17 3 2 7 0 0 29
12:00 PM - 1:00 PM 11 0 1 6 0 0 18
1:00 PM - 2:00 PM 10 1 2 5 0 2 20
2:00 PM - 3:00 PM 18 2 0 8 0 1 29
3:00 PM - 4:00 PM 15 2 1 8 0 0 26
4:00 PM - 5:00 PM 10 1 0 7 0 0 18
5:00 PM - 6:00 PM 4 0 0 4 0 0 8
6:00 PM - 7:00 PM 2 0 0 3 0 0 5
24 3 2 9 1 --39
Reserved Regular Disabled Elevator Drop-Off Street Total
8:00 AM - 9:00 AM 10 1 1 7 0 2 21
9:00 AM - 10:00 AM 13 2 1 7 0 1 24
10:00 AM - 11:00 AM 16 2 2 8 0 1 29
11:00 AM - 12:00 PM 13 3 2 7 0 0 25
12:00 PM - 1:00 PM 8 1 2 8 0 1 20
1:00 PM - 2:00 PM 5 1 0 7 0 0 13
2:00 PM - 3:00 PM 9 2 0 8 0 0 19
3:00 PM - 4:00 PM 10 1 0 7 0 0 18
4:00 PM - 5:00 PM 14 2 0 7 0 0 23
5:00 PM - 6:00 PM 3 1 0 2 0 0 6
6:00 PM - 7:00 PM 3 1 0 2 0 0 6
24 3 2 9 1 --39
Survey Site #2 Address:
441 Old Newport Boulevard, Newport Beach, CA 92663
Table 3
Parking Occupancy Survey - Site #2
Tuesday, June 6, 2023
Time Period
Number of Parked Vehicles
Inventory
Peak Demand 30
Building Square Footage 12,992
Peak Demand per
Thousand Square Feet 2.31
Thursday, June 8, 2023
Time Period
Number of Parked Vehicles
Peak Demand per
Thousand Square Feet 2.23
Inventory
Peak Demand 29
Building Square Footage 12,992
326 Old Newport Medical Office
Parking Analysis
19642 10
Regular Disabled Street Total
8:00 AM - 9:00 AM 1 0 4 5
9:00 AM - 10:00 AM 4 0 7 11
10:00 AM - 11:00 AM 7 2 4 13
11:00 AM - 12:00 PM 8 1 3 12
12:00 PM - 1:00 PM 8 2 4 14
1:00 PM - 2:00 PM 8 1 2 11
2:00 PM - 3:00 PM 7 0 1 8
3:00 PM - 4:00 PM 5 1 1 7
4:00 PM - 5:00 PM 4 1 1 6
5:00 PM - 6:00 PM 2 0 0 2
6:00 PM - 7:00 PM 2 0 0 2
12 2 --14
Regular Disabled Street Total
8:00 AM - 9:00 AM 1 0 1 2
9:00 AM - 10:00 AM 2 0 1 3
10:00 AM - 11:00 AM 2 1 1 4
11:00 AM - 12:00 PM 5 2 2 9
12:00 PM - 1:00 PM 4 1 1 6
1:00 PM - 2:00 PM 6 1 1 8
2:00 PM - 3:00 PM 6 2 2 10
3:00 PM - 4:00 PM 5 1 0 6
4:00 PM - 5:00 PM 4 1 0 5
5:00 PM - 6:00 PM 1 0 0 1
6:00 PM - 7:00 PM 0 0 0 0
12 2 --14
Survey Site #3 Address:
136 Broadway, Costa Mesa, CA 92627
Table 4
Parking Occupancy Survey - Site #3
Tuesday, June 20, 2023
Time Period
Number of Parked Vehicles
Inventory
Peak Demand 14
Building Square Footage 3,402
Peak Demand per
Thousand Square Feet 4.12
Wednesday, June 21, 2023
Time Period
Number of Parked Vehicles
Peak Demand per
Thousand Square Feet 2.94
Inventory
Peak Demand 10
Building Square Footage 3,402
326 Old Newport Medical Office
Parking Analysis
19642 11
Location Peak Parking Demand Ratio
Survey Site 1 3.80
Survey Site 2 2.31
Survey Site 3 4.12
Average 3.41
Summary of Peak Parking Demand Ratios
Table 5
326 Old Newport Medical Office
Parking Analysis
19642 12
Figure 1
Project Location Map
326 Old Newport Boulevard Medical Office
Parking Study
19642
N
HOLMWOOD DR
OLD NEWPORT BLVDNEWPORT BLVD
C A T A L I N A D R
Site
13
Figure 2
Site Plan
326 Old Newport Boulevard Medical Office
Parking Study
19642
N
14
326 Old Newport Boulevard Medical OfficeParking Study
19642
Figure 3
Survey Site #1 Location Map (425 Old Newport Boulevard)
N
Site
OLD NEWPORT BLV
DNEWPORT BLVD
HOSPITAL RD
15
326 Old Newport Boulevard Medical OfficeParking Study
19642
Figure 4
Survey Site #2 Location Map (441 Old Newport Boulevard)
N
OLD NEWPORT BLV
DNEWPORT BLVD
HOSPITAL RD
Site
16
326 Old Newport Boulevard Medical OfficeParking Study
19642
Figure 5
Survey Site #3 Location Map (136 Broadway)
N
Site
FULLE R T O N A VE
B
R
O
A
D
W
AY
17
APPENDIX A
CITY OF NEWPORT BEACH PARKING CODE REQUIREMENTS
Apx-1
Chapter 20.40
OFF-STREET PARKING
Sections:
20.40.010 Purpose.
20.40.020 Applicability.
20.40.030 Requirements for Off-Street Parking.
20.40.040 Off-Street Parking Spaces Required.
20.40.050 Parking Requirements for Shopping Centers.
20.40.060 Parking Requirements for Food Service Uses.
20.40.070 Development Standards for Parking Areas.
20.40.080 Parking for Nonresidential Uses in Residential Zoning Districts.
20.40.090 Parking Standards for Residential Uses.
20.40.100 Off-Site Parking.
20.40.110 Adjustments to Off-Street Parking Requirements.
20.40.120 Parking Management Districts.
20.40.130 In-Lieu Parking Fee.
20.40.010 Purpose.
The purpose of this chapter is to provide off-street parking and loading standards to:
A. Provide for the general welfare and convenience of persons within the City by ensuring that
sufficient parking facilities are available to meet the needs generated by specific uses and that
adequate parking is provided, to the extent feasible;
B. Provide accessible, attractive, secure, and well-maintained off-street parking and loading
facilities;
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
1 of 24 6/27/2023, 4:16 PM
Apx-2
C. Increase public safety by reducing congestion on public streets and to minimize impacts to
public street parking available for coastal access and recreation;
D. Ensure access and maneuverability for emergency vehicles; and
E. Provide loading and delivery facilities in proportion to the needs of allowed uses. (Ord.
2010-21 § 1 (Exh. A)(part), 2010)
20.40.020 Applicability.
A. Off-Street Parking Required. Each use, including a change or expansion of a use or structure,
except as otherwise provided for in Chapter 20.38 (Nonconforming Uses and Structures) shall have
appropriately maintained off-street parking and loading areas in compliance with the provisions of
this chapter. A use shall not be commenced and structures shall not be occupied until
improvements required by this chapter are satisfactorily completed.
B. Change, Enlargement, or Intensification of Use. Changes in use and enlargement or
intensification of an existing use shall require compliance with the off-street parking requirements of
this chapter, except as allowed in Chapter 20.38 (Nonconforming Uses and Structures). (Ord.
2010-21 § 1 (Exh. A)(part), 2010)
20.40.030 Requirements for Off-Street Parking.
A. Parking Required to Be On-Site. Parking shall be located on the same lot or development site
as the uses served, except for the following:
1. Townhouses and Multi-Tenant Uses. Where parking is provided on another lot within the
same development site, the parking shall be located within two hundred (200) feet of the units
they are intended to serve.
2. Off-Site Parking Agreement. Parking may be located off-site with the approval of an off-
site parking agreement in compliance with Section 20.40.100(C) (Parking Agreement).
B. Permanent Availability Required. Each parking and loading space shall be permanently
available and maintained for parking purposes for the use it is intended to serve. The Director may
authorize the temporary use of parking or loading spaces for other than parking or loading in
conjunction with a seasonal or intermittent use allowed in compliance with Section 20.52.040
(Limited Term Permits).
C. Maintenance. Parking spaces, driveways, maneuvering aisles, turnaround areas, and
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
2 of 24 6/27/2023, 4:16 PM
Apx-3
landscaping areas shall be kept free of dust, graffiti, and litter. Striping, paving, walls, light
standards, and all other facilities shall be permanently maintained in good condition.
D. Vehicles for Sale. Vehicles, trailers, or other personal property shall not be parked upon a
private street, parking lot, or private property for the primary purpose of displaying the vehicle,
trailer, or other personal property for sale, hire, or rental, unless the property is appropriately zoned,
and the vendor is licensed to transact a vehicle sales business at that location.
E. Calculation of Spaces Required.
1. Fractional Spaces. Fractional parking space requirements shall be rounded up to the next
whole space.
2. Bench Seating. Where bench seating or pews are provided, eighteen (18) linear inches of
seating shall be considered to constitute a separate or individual seat.
3. Gross Floor Area. References to spaces per square foot are to be calculated on the basis
of gross floor area unless otherwise specified.
4. Net Public Area. “Net public area” shall be defined as the total area accessible to the
public within an eating and/or drinking establishment, excluding kitchens, restrooms, offices
pertaining to the use, and storage areas.
5. Spaces per Occupant. References to spaces per occupant are to be calculated on the
basis of maximum occupancy approved by the City of Newport Beach Fire Department.
6. Spaces Required for Multiple Uses. If more than one use is located on a site, the number
of required off-street parking spaces shall be equal to the sum of the requirements prescribed
for each use.
F. Nonconforming Parking and Loading. Land uses and structures that are nonconforming due
solely to the lack of off-street parking or loading facilities required by this chapter shall be subject to
the provisions of Section 20.38.060 (Nonconforming Parking). (Ord. 2010-21 § 1 (Exh. A)(part),
2010)
20.40.040 Off-Street Parking Spaces Required.
Off-street parking spaces shall be provided in compliance with Table 3.10. These standards shall
be considered the minimum required to preserve the public health, safety, and welfare, and more
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
3 of 24 6/27/2023, 4:16 PM
Apx-4
extensive parking provisions may be required by the review authority in particular circumstances.
Unless otherwise noted parking requirements are calculated based on gross floor area.
TABLE 3-10
OFF-STREET PARKING REQUIREMENTS
Land Use Parking Spaces Required
Industry, Manufacturing and Processing, Warehousing Uses
Food Processing 1 per 2,000 sq. ft.
Handicraft Industry 1 per 500 sq. ft.
Industry
Small—5,000 sq. ft. or less 1 per 500 sq. ft.
Large—Over 5,000 sq. ft.1 per 1,000 sq. ft.
Industry, Marine-Related 1 per 750 sq. ft.
Personal Storage (Mini Storage)2 for resident manager, plus additional
for office as required by minor use
permit
Research and Development 1 per 500 sq. ft.
Warehousing and Storage 1 per 2,000 sq. ft., plus one per 350
sq. ft. for offices. Minimum of 10
spaces per use
Wholesaling 1 per 1,000 sq. ft.
Recreation, Education, and Public Assembly Uses
Assembly/Meeting Facilities 1 per 3 seats or one per 35 sq. ft.
used for assembly purposes
Commercial Recreation and Entertainment As required by conditional use permit
Cultural Institutions 1 per 300 sq. ft.
Schools, Public and Private As required by conditional/minor use
permit
Residential Uses
Accessory Dwelling Units As required per Section 20.48.200
Single-Unit Dwellings—Attached 2 per unit in a garage
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
4 of 24 6/27/2023, 4:16 PM
Apx-5
Land Use Parking Spaces Required
Single-Unit Dwellings—Detached and less than 4,000 sq. ft.
of floor area
2 per unit in a garage
Single-Unit Dwellings—Detached and 4,000 sq. ft. or
greater of floor area
3 per unit in a garage
Single-Unit Dwellings—Balboa Island 2 per unit in a garage
Multi-Unit Dwellings—3 units 2 per unit covered, plus guest parking;
1—2 units, no guest parking required
3 units, 1 guest parking space
Multi-Unit Dwellings—4 units or more 2 per unit covered, plus 0.5 space per
unit for guest parking
Two-Unit Dwellings 2 per unit; 1 in a garage and 1
covered or in a garage
Live/Work Units 2 per unit in a garage, plus 2 for
guest/customer parking
Senior Housing—Market rate 1.2 per unit
Senior Housing—Affordable 1 per unit
Retail Trade Uses
Appliances, Building Materials, Home Electronics, Furniture,
Nurseries, and Similar Large Warehouse-type Retail Sales
and Bulk Merchandise Facilities
1st 10,000 sq. ft.—1 space per 300
sq. ft.
Over 10,000 sq. ft.—1 space per 500
sq. ft.
Plus 1 per 1,000 sq. ft. of outdoor
merchandise areas
Food and Beverage Sales 1 per 200 sq. ft.
Marine Rentals and Sales
Boat Rentals and Sales 1 per 1,000 sq. ft. of lot area, plus 1
per 350 sq. ft. of office area
Marine Retail Sales 1 per 250 sq. ft.
Retail Sales 1 per 250 sq. ft.
Shopping Centers 1 per 200 sq. ft. See Section
20.40.050
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
5 of 24 6/27/2023, 4:16 PM
Apx-6
Land Use Parking Spaces Required
Service Uses—Business, Financial, Medical, and Professional
Convalescent Facilities 1 per 3 beds or as required by
conditional use permit
Emergency Health Facilities 1 per 200 sq. ft.
Financial Institutions and Related Services 1 per 250 sq. ft.
Hospitals 1 per bed; plus 1 per resident doctor
and 1 per employee.
Offices*—Business, Corporate, General, Governmental
First 50,000 sq. ft.1 per 250 sq. ft. net floor area
Next 75,000 sq. ft.1 per 300 sq. ft. net floor area
Floor area above 125,001 sq. ft.1 per 350 sq. ft. net floor area
* Not more than 20% medical office uses.
Offices—Medical and Dental Offices 1 per 200 sq. ft.
Outpatient Surgery Facility 1 per 250 sq. ft.
Service Uses—General
Adult-Oriented Businesses 1 per 1.5 occupants or as required by
conditional use permit
Ambulance Services 1 per 500 sq. ft.; plus 2 storage
spaces.
Animal Sales and Services
Animal Boarding/Kennels 1 per 400 sq. ft.
Animal Grooming 1 per 400 sq. ft.
Animal Hospitals/Clinics 1 per 400 sq. ft.
Animal Retail Sales 1 per 250 sq. ft.
Artists’ Studios 1 per 1,000 sq. ft.
Catering Services 1 per 400 sq. ft.
Care Uses
Adult Day Care—Small (6 or fewer)Spaces required for dwelling unit only
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
6 of 24 6/27/2023, 4:16 PM
Apx-7
Land Use Parking Spaces Required
Adult Day Care—Large (7 or more)2 per site for drop-off and pick-up
purposes (in addition to the spaces
required for the dwelling unit)
Child Day Care—Small (6 or fewer)Spaces required for dwelling unit only
Child Day Care—Large (9 to 14)2 per site for drop-off and pick-up
purposes (in addition to the spaces
required for the dwelling unit)
Day Care—General 1 per 7 occupants based on maximum
occupancy allowed per license
Residential Care—General (7 to 14)1 per 3 beds
Eating and Drinking Establishments
Accessory (open to public)1 per each 3 seats or 1 per each 75
sq. ft. of net public area, whichever is
greater
Bars, Lounges, and Nightclubs 1 per each 4 persons based on
allowed occupancy load or as required
by conditional use permit
Food Service with/without alcohol, with/without late hours 1 per 30—50 sq. ft. of net public area,
including outdoor dining areas
exceeding 25% of the interior net
public area or 1,000 sq. ft., whichever
is less. See Section 20.40.060
Food Service—Fast food 1 per 50 sq. ft., and 1 per 100 sq. ft.
for outdoor dining areas
Take-Out Service—Limited 1 per 250 sq. ft.
Wine Tasting Room 1 per each 4 persons based on
allowed occupancy load or as required
by conditional use permit
Emergency Shelter 1 per 4 beds plus 1 per staff; and if
shelter is designed with designated
family units then 0.5 parking space per
bedroom designated for family units
Funeral Homes and Mortuaries 1 per 35 sq. ft. of assembly area
Health/Fitness Facilities
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
7 of 24 6/27/2023, 4:16 PM
Apx-8
Land Use Parking Spaces Required
Small—2,000 sq. ft. or less 1 per 250 sq. ft.
Large—Over 2,000 sq. ft.1 per 200 sq. ft.
Laboratories (medical, dental, and similar)1 per 500 sq. ft.
Maintenance and Repair Services 1 per 500 sq. ft.
Marine Services
Boat Storage—Dry 0.33 per storage space or as required
by conditional use permit
Boat Yards As required by conditional use permit
Dry Docks 2 per dry dock
Entertainment and Excursion Services 1 per each 3 passengers and crew
members
Marine Service Stations As required by conditional use permit
Sport Fishing Charters 1 per each 2 passengers and crew
members
Water Transportation Services—Office 1 per 100 sq. ft., minimum 2 spaces
Personal Services
Massage Establishments 1 per 200 sq. ft. or as required by
conditional use permit
Nail Salons 1 per 80 sq. ft.
Personal Services, General 1 per 250 sq. ft.
Studio (dance, music, and similar)1 per 250 sq. ft.
Postal Services 1 per 250 sq. ft.
Printing and Duplicating Services 1 per 250 sq. ft.
Recycling Facilities
Collection Facility—Large 4 spaces minimum, but more may be
required by the review authority
Collection Facility—Small As required by the review authority
Visitor Accommodations
Bed and Breakfast Inns 1 per guest room, plus 2 spaces
Hotels and accessory uses As required by conditional use permit
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
8 of 24 6/27/2023, 4:16 PM
Apx-9
Land Use Parking Spaces Required
Motels 1 per guest room or unit
Recreational Vehicle Parks As required by conditional use permit
Time Shares As required by conditional use permit
Transportation, Communications, and Infrastructure Uses
Communication Facilities 1 per 500 sq. ft.
Heliports and Helistops As required by conditional use permit
Marinas 0.75 per slip or 0.75 per 25 feet of
mooring space
Vehicle Rental, Sale, and Service Uses
Vehicle/Equipment Rentals
Office Only 1 per 250 sq. ft.
Limited 1 per 300 sq. ft., plus 1 per rental
vehicle (not including bicycles and
similar vehicles)
Vehicle/Equipment Rentals and Sales 1 per 1,000 sq. ft. of lot area
Vehicles for Hire 1 per 300 sq. ft., plus 1 per each
vehicle associated with the use and
stored on the same site
Vehicle Sales, Office Only 1 per 250 sq. ft., plus 1 as required by
DMV
Vehicle/Equipment Repair (General and Limited) 1 per 300 sq. ft. or 5 per service bay,
whichever is more
Vehicle/Equipment Services
Automobile Washing 1 per 200 sq. ft. of office or lounge
area; plus queue for 5 cars per
washing station
Service Station 1 per 300 sq. ft. or 5 per service bay,
whichever is more; minimum of 4
Service Station with Convenience Market 1 per 200 sq. ft., in addition to 5 per
service bay
Vehicle Storage 1 per 500 sq. ft.
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
9 of 24 6/27/2023, 4:16 PM
Apx-10
Land Use Parking Spaces Required
Other Uses
Caretaker Residence 1 per unit
Special Events As required by Chapter 11.03
Temporary Uses As required by the limited term permit
in compliance with Section 20.52.040
(Ord. 2021-6 § 2, 2021; Ord. 2017-11 § 5, 2017; Ord. 2015-15 § 8, 2015; Ord. 2013-4 § 3, 2013; Ord. 2010-21 § 1 (Exh. A)(part),
2010)
20.40.050 Parking Requirements for Shopping Centers.
A. An off-street parking space requirement of one space for each two hundred (200) square feet
of gross floor area may be used for shopping centers meeting the following criteria:
1. The gross floor area of the shopping center does not exceed 100,000 square feet; and
2. The gross floor area of all eating and drinking establishments does not exceed fifteen (15)
percent of the gross floor area of the shopping center.
B. Individual tenants with a gross floor area of ten thousand (10,000) square feet or more shall
meet the parking space requirement for the applicable use in compliance with Section 20.40.040
(Off-Street Parking Spaces Required).
C. Shopping centers with gross floor areas in excess of 100,000 square feet or with eating and
drinking establishments occupying more than fifteen (15) percent of the gross floor area of the
center shall use a parking requirement equal to the sum of the requirements prescribed for each
use in the shopping center. (Ord. 2010-21 § 1 (Exh. A)(part), 2010)
20.40.060 Parking Requirements for Food Service Uses.
A. Establishment of Parking Requirement. The applicable review authority shall establish the off-
street parking requirement for food service uses within a range of one space for each thirty (30) to
fifty (50) square feet of net public area based upon the following considerations:
1. Physical Design Characteristics.
a. The gross floor area of the building or tenant space;
b. The number of tables or seats and their arrangement;
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
10 of 24 6/27/2023, 4:16 PM
Apx-11
c. Other areas that should logically be excluded from the determination of net public
area;
d. The parking lot design, including the use of small car spaces, tandem and valet
parking and loading areas;
e. Availability of guest dock space for boats; and
f. Extent of outdoor dining.
2. Operational Characteristics.
a. The amount of floor area devoted to live entertainment or dancing;
b. The amount of floor area devoted to the sale of alcoholic beverages;
c. The presence of pool tables, big screen televisions or other attractions;
d. The hours of operation; and
e. The expected turnover rate.
3. Location of the Establishment.
a. In relation to other uses and the waterfront;
b. Availability of off-site parking nearby;
c. Amount of walk-in trade; and
d. Parking problems in the area at times of peak demand.
B. Conditions of Approval. If during the review of the application, the review authority uses any of
the preceding considerations as a basis for establishing the parking requirement, the substance of
the considerations shall become conditions of the permit application approval and a change to any
of the conditions will require an amendment to the permit application, which may be amended to
establish parking requirements within the range as noted above. (Ord. 2010-21 § 1 (Exh. A)(part),
2010)
20.40.070 Development Standards for Parking Areas.
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
11 of 24 6/27/2023, 4:16 PM
Apx-12
A. Access to Parking Areas. Access to off-street parking areas shall be provided in the following
manner:
1. Nonresidential and Multi-Unit. Parking areas for nonresidential and multi-unit uses:
a. Adequate and safe maneuvering aisles shall be provided within each parking area so
that vehicles enter an abutting street or alley in a forward direction.
b. The Director may approve exceptions to the above requirement for parking spaces
immediately adjoining a public alley, provided not more than ten (10) feet of the alley
right-of-way is used to accommodate the required aisle width, and provided the spaces
are set back from the alley the required minimum distances shown in Table 3-11.
TABLE 3-11
PARKING SETBACK FROM ALLEY
Alley Width Minimum Setback
15'0" or less 5'0"
15'1" to 19'11" 3'9"
20'0" or more 2'6"
c. The first parking space within a parking area accessed from a public street shall be
set back a minimum of five feet from the property line.
2. Access Ramps. Ramps providing vehicle access to parking areas shall not exceed a
slope of fifteen (15) percent. Changes in the slope of a ramp shall not exceed eleven (11)
percent and may occur at five-foot intervals. Refer to Public Works Standard 160L-B, C and
805L-B. The Director of Public Works may modify these standards to accommodate specific
site conditions.
B. Location of Parking Facilities.
1. Residential Uses. Parking facilities serving residential uses shall be located on the same
site as the use the parking is intended to serve. Additional requirements are provided in
Section 20.40.090 (Parking Standards for Residential Uses).
2. Nonresidential Uses. Parking facilities for nonresidential uses shall be located on the
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
12 of 24 6/27/2023, 4:16 PM
Apx-13
same site as the use the parking is intended to serve, except where an off-site parking facility
is approved in compliance with Section 20.40.100 (Off-Site Parking).
3. Parking Structures. When adjacent to a residential zoning district, the development of
structured parking, including rooftop parking, shall require the approval of a conditional use
permit to address potential impacts to adjacent residential uses.
4. Parking on Slopes. Parking shall not be allowed on slopes greater than five percent. This
shall not apply to parking spaces located within a parking structure. The Director of Public
Works may adjust these standards to accommodate specific site conditions.
C. Parking Space and Lot Dimensions.
1. Minimum Parking Space and Drive Aisle Dimensions. Each parking space, drive aisle,
and other parking lot features shall comply with the minimum dimension requirements in
Tables 3-13 and 3-14 and as illustrated in Figure 3-6.
2. Width of Parking Aisle. The width of parking aisles may be reduced by the Public Works
Director in unique situations arising from narrow lots or existing built conditions when traffic
safety concerns have been addressed.
TABLE 3-12
MINIMUM STANDARD PARKING SPACE SIZE
Minimum Standard Space Requirements
Width Length
8 ft. 6 in. 17 ft.
TABLE 3-13
STANDARD VEHICLE SPACE REQUIREMENTS
Angle (degrees) Stall Width (1)(3) Stall Depth (2)
Stall Length
(3)
Aisle Width
One-Way Two-Way
Parallel 8 ft.N/A 22 ft.14 ft. 24 ft.
30 8 ft. 6 in.16 ft. 17 ft. 14 ft.N/A
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
13 of 24 6/27/2023, 4:16 PM
Apx-14
Angle (degrees) Stall Width (1)(3) Stall Depth (2)
Stall Length
(3)
Aisle Width
One-Way Two-Way
45 8 ft. 6 in.18 ft. 17 ft. 14 ft.N/A
60 8 ft. 6 in.19 ft. 17 ft. 18 ft.N/A
90 8 ft. 6 in.17 ft. 17 ft. 26 ft.26 ft.
(1) When the length of a parking space abuts a wall, or similar obstruction, the required width of the space
shall be increased to nine feet.
(2) Measured perpendicular to aisle.
(3) Structural elements shall not encroach into the required stall, with the exception of a one square foot
area at the front corners.
3. Bumper Overhang Areas. A maximum of two and one-half feet of the parking stall depth
may be landscaped with low-growing, hearty materials in lieu of paving or an adjacent
walkway may be increased, allowing a two and one-half foot bumper overhang while
maintaining the required parking dimensions.
4. Compact Parking. Compact parking spaces shall not be allowed. However, where they
exist at the time of adoption of this Zoning Code they may remain and shall not be considered
a nonconforming condition.
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
14 of 24 6/27/2023, 4:16 PM
Apx-15
Figure 3-6
Parking Lot Dimensions
D. Required Parking Area Improvements. Off-street parking areas shall have the following
improvements:
1. Curbing and Wheel Stops.
a. Continuous concrete curbing shall be installed a minimum of five feet from a wall,
fence, building, or other structure. Curbs shall be a minimum of four inches high.
b. The minimum standard curb radius shall be six feet at all aisle corners. Alternative
curb radii may be approved by the Director of Public Works.
c. Individual wheel stops may be provided in lieu of continuous curbing when the
parking is adjacent to a landscaped area, and the parking area drainage is directed to the
landscaped area subject to the approval of the Director of Public Works. Wheel stops
shall be placed to allow for two feet of vehicle overhang area within the dimension of the
parking space. Wheel stops shall not be used in conjunction with continuous curbing,
including adjacent to raised walkways.
2. Drainage. Parking lots shall be designed in compliance with the stormwater quality and
quantity standards of the City’s best management practices and the City’s Standard
Specifications and Plans.
3. Landscaping. Landscaping for new surface parking lots with ten (10) or more spaces shall
be provided as indicated below. These requirements do not apply to routine maintenance and
restriping of existing parking lots.
a. Perimeter Parking Lot Landscaping.
i. Adjacent to Streets.
(A) Parking areas abutting a public street shall be designed to provide a
perimeter landscape strip a minimum five feet wide between the street right-of-
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
15 of 24 6/27/2023, 4:16 PM
Apx-16
way and parking area. The Director may grant an exception to this requirement if
existing structures, substandard lots, or unique site conditions preclude its
implementation. In this case, the maximum feasible planting strip area shall be
provided based on site conditions.
(B) Landscaping, other than trees, shall be designed and maintained to screen
cars from view from the street and shall be maintained at approximately thirty-six
(36) inches in height.
(C) Screening materials may include a combination of plant materials, earth
berms, raised planters, low walls, or other screening devices that meet the intent
of this requirement as approved by the Director.
(D) Plant materials, walls, or structures within a traffic sight area of a driveway
shall not exceed thirty-six (36) inches in height in compliance with Section
20.30.130 (Traffic Safety Visibility Area).
ii. Adjacent to Residential Use.
(A) Parking areas for nonresidential uses adjoining residential uses shall
provide a landscaped buffer yard with a minimum of five feet in width between
the parking area and the common property line bordering the residential use. A
solid masonry wall and landscaping in compliance with Section 20.30.020(D)
(Screening and Buffering Between Different Zoning Districts) shall be provided
along the property line.
(B) Trees shall be provided at a rate of one for each thirty (30) square feet of
landscaped area and shall be a minimum twenty-four (24) inch box container at
time of planting.
b. Interior Parking Lot Landscaping.
i. Trees Required.
(A) Number and Location. Trees shall be evenly spaced throughout the interior
parking area at a rate of one tree for every five parking spaces. Trees shall be
located in planters that are bounded on at least two sides by parking area
paving. Planters shall have a minimum exterior dimension of five feet.
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
16 of 24 6/27/2023, 4:16 PM
Apx-17
(B) Size. All trees within the parking area shall be a minimum twenty-four (24)
inch box container at time of planting.
ii. Ends of Aisles. All ends of parking aisles shall have landscaped islands planted
with trees, shrubs, and groundcover.
iii. Larger Projects. Parking lots with more than one hundred (100) spaces shall
provide an appropriate entry feature consisting of a concentration of landscape
elements, including specimen trees, flowering plants, enhanced paving, and project
identification.
4. Lighting. Parking lots shall be lighted so that there is a minimum illumination over the
entire lot of 1.0 footcandle and an average over the entire lot of 2.5 footcandles. Lighting shall
comply with the standards in Section 20.30.070 (Outdoor Lighting).
5. Stall Markings, Directional Arrows, and Signs.
a. Parking spaces shall be clearly outlined with four-inch-wide lines painted on the
surface of the parking facility. Carpool and vanpool spaces shall be clearly identified for
exclusive use of carpools and vanpools.
b. Parking spaces for the disabled shall be striped and marked so as to be clearly
identified in compliance with the applicable Federal, State, and City standards.
c. Driveways, circulation aisles, and maneuvering areas shall be clearly marked with
directional arrows and lines to ensure the safe and efficient flow of vehicles.
d. The Director of Public Works may require the installation of traffic signs in addition to
directional arrows to ensure the safe and efficient flow of vehicles in a parking facility.
6. Surfacing. Parking spaces and maneuvering areas shall be paved and permanently
maintained with asphalt, concrete, or interlocking paving stones or other City-approved
surfaces.
E. Enclosed Parking. The following regulations shall apply to enclosed commercial off-street
parking:
1. Doors shall remain open during regular business hours;
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
17 of 24 6/27/2023, 4:16 PM
Apx-18
2. A sign shall be posted on the business frontage that advises patrons of the availability
and location of parking spaces;
3. Signs shall be posted on the site containing the following information:
a. Doors are to remain open during business hours; and
b. A number to call for Code Enforcement.
4. The location, size, and color of the signs required above shall be approved by the
Department. (Ord. 2010-21 § 1 (Exh. A)(part), 2010)
20.40.080 Parking for Nonresidential Uses in Residential Zoning Districts.
Where parking lots for nonresidential uses are allowed in residential zoning districts in compliance
with Chapter 20.18 (Residential Zoning Districts), they shall be developed in compliance with the
following requirements in addition to other applicable standards provided in this chapter.
A. Conditional Use Permit Required. Approval of a conditional use permit shall be required in
order to locate a parking lot intended for nonresidential use within a residential zoning district.
B. Location of Parking Area. The parking area shall be accessory to, and for use of, one or more
abutting nonresidential uses allowed in an abutting commercial zoning district. The Commission
may grant a waiver for noncontiguous parking lots, but only under all of the following conditions:
1. The parking lot is designed to be compatible with the neighborhood;
2. There are no residential uses between the parking lot and the commercial zoning district;
3. The location of the parking lot does not fragment the adjacent neighborhood;
4. The parking lot is not detrimental or injurious to property and improvements in the
neighborhood; and
5. The parking lot is located within a reasonable walking distance of the use to which it is an
accessory.
C. Access. Access to parking lots shall be from commercial streets or alleys. An exception may
be granted by the Commission if no commercial streets are available for access.
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
18 of 24 6/27/2023, 4:16 PM
Apx-19
D. Passenger Vehicle Parking Only. Parking lots shall be used solely for the parking of passenger
vehicles.
E. Signs. No signs, other than signs designating entrances, exits, and conditions of use shall be
maintained in parking areas. Signs shall not exceed four square feet in area and five feet in height.
The number and location shall be approved by the Director before installation.
F. Perimeter Wall. The parking lot shall have a solid masonry wall six feet in height along all
interior property lines adjacent to residential zoning districts and thirty-six (36) inches in height
adjacent to streets and the front setback area of an abutting residential use.
G. Development Standards. The parking lot shall be developed in compliance with the
development standards of this chapter and the outdoor lighting standards in Section 20.30.070
(Outdoor Lighting).
H. No Overnight Parking. Overnight parking shall be prohibited and the parking lot shall be
secured after business hours to prevent any use of the facility. (Ord. 2010-21 § 1 (Exh. A)(part),
2010)
20.40.090 Parking Standards for Residential Uses.
A. Parking Space and Driveway Dimensions.
1. Minimum Interior Dimensions. The minimum interior dimensions for parking spaces in
residential zoning districts shall be as provided in Table 3-14. The Director may approve a
reduced width for duplex units when two separate single car garages are proposed side by
side and the applicant has proposed the maximum width possible.
TABLE 3-14
MINIMUM INTERIOR DIMENSIONS
Lot Width
Single
Car/Tandem* Two Car
30 feet or less 9'3" x 19' (35')* 17'6" x 19'
30.1—39.99
feet
10' x 19' (35')* 18'6" x 19'
40 feet or more 10' x 20' 20' x 20'
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
19 of 24 6/27/2023, 4:16 PM
Apx-20
* The minimum depth for a two-car tandem space is thirty-five (35) feet.
2. Tandem Parking. Tandem parking for a maximum of two cars in depth shall be allowed in
residential districts subject to the minimum interior dimensions provided in Table 3-14.
3. Driveway Width. Driveways visible from a public right-of-way shall not be wider than
required to access an adjacent garage as follows:
a. One car garage: ten (10) feet wide.
b. Two car garage: twenty (20) feet wide.
c. Three car garage: twenty-five (25) feet wide.
d. Four car garage: thirty-two (32) feet wide.
4. Vertical Clearances. The minimum unobstructed vertical clearance for parking spaces
shall be seven feet, except that the front four feet may have a minimum vertical clearance of
four feet.
B. Access to Parking.
1. Direct Access Required. Each parking space shall be capable of being accessed directly
from an adjoining vehicular right-of-way or over an improved hard surfaced driveway, except
for approved tandem parking spaces.
2. Clear Access Required. Where access to a required parking space is taken over a
driveway, the driveway shall be maintained free and clear at all times except for the parking of
currently registered, licensed motor vehicles, and for temporary obstructions that are
incidental to the use of the property. Temporary obstructions in the driveway shall be allowed
only for a period up to seventy-two (72) hours.
C. Location of Parking.
1. Allowed Parking Areas. Parking of vehicles is allowed only in permanent parking areas
and on driveways leading to allowed parking areas. Under no circumstances shall landscaped
areas or hardscaped areas in front yards, other than driveways, be used for the parking of
vehicles.
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
20 of 24 6/27/2023, 4:16 PM
Apx-21
2. Garages Facing the Street. Garages with doors that face the street that are located within
twenty (20) feet of the front property line shall be equipped with automatic roll-up doors.
3. Parking Located in Required Setback Areas. The following requirements shall apply to the
parking or storage of motor vehicles, recreational vehicles, watercraft, trailers, and similar
items in residential zoning districts:
a. Front Setback Areas. Parking or storage in required front setback areas shall be
prohibited, except on driveways in front of garages that set back a minimum of twenty
(20) feet from the front property line.
b. Side Setback Areas. Parking or storage in required side setback areas (behind the
rear line of the required front setback area) shall be allowed.
c. Rear Setback Areas Without Alleys. Parking or storage in required rear setback
areas shall be allowed.
d. Rear Setback Areas with Alleys. Parking or storage in required rear setback areas
shall not be allowed. (Ord. 2010-21 § 1 (Exh. A)(part), 2010)
20.40.100 Off-Site Parking.
A. Conditional Use Permit Required. Approval of a conditional use permit shall be required for a
parking facility or any portion of required parking that is not located on the same site it is intended
to serve.
B. Findings. In order to approve a conditional use permit for an off-site parking facility the
Commission shall make all of the following findings in addition to those required for the approval of
a conditional use permit:
1. The parking facility is located within a convenient distance to the use it is intended to
serve;
2. On-street parking is not being counted towards meeting parking requirements;
3. Use of the parking facility will not create undue traffic hazards or impacts in the
surrounding area; and
4. The parking facility will be permanently available, marked, and maintained for the use it is
intended to serve.
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
21 of 24 6/27/2023, 4:16 PM
Apx-22
C. Parking Agreement. A parking agreement, which guarantees the long-term availability of the
parking facility for the use it is intended to serve, shall be recorded with the County Recorder’s
Office. The agreement shall be in a form approved by the City Attorney and the Director.
D. Loss of Off-Site Parking.
1. Notification of City. The owner or operator of a business that uses an approved off-site
parking facility to satisfy the parking requirements of this chapter shall immediately notify the
Director of any change of ownership or use of the property where the spaces are located, or
changes in the use that the spaces are intended to serve, or of any termination or default of
the agreement between the parties.
2. Effect of Termination of Agreement. Upon notification that the agreement for the required
off-site parking has terminated, the Director shall establish a reasonable time in which one of
the following shall occur:
a. Substitute parking is provided that is acceptable to the Director; or
b. The size or capacity of the use is reduced in proportion to the parking spaces lost.
(Ord. 2010-21 § 1 (Exh. A)(part), 2010)
20.40.110 Adjustments to Off-Street Parking Requirements.
The number of parking spaces required by this chapter may be reduced only in compliance with the
following standards and procedures.
A. ADA Compliance. The Director may administratively reduce parking requirements due to a
loss of parking spaces because of ADA requirements associated with tenant improvements.
B. Reduction of Required Off-Street Parking. Off-street parking requirements may be reduced
with the approval of a conditional use permit in compliance with Section 20.52.020 (Conditional Use
Permits and Minor Use Permits) as follows:
1. Reduced Parking Demand. Required off-street parking may be reduced with the approval
of a conditional use permit in compliance with the following conditions:
a. The applicant has provided sufficient data, including a parking study if required by the
Director, to indicate that parking demand will be less than the required number of spaces
or that other parking is available (e.g., City parking lot located nearby, on-street parking
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
22 of 24 6/27/2023, 4:16 PM
Apx-23
available, greater than normal walk in trade, mixed-use development); and
b. A parking management plan shall be prepared in compliance with subsection (C) of
this section (Parking Management Plan).
2. Joint Use of Parking Facilities. Required off-street parking may be reduced with the
approval of a conditional use permit where two or more nonresidential uses on the same site
or immediately adjacent sites have distinct and differing peak parking demands (e.g., a theater
and a bank). The review authority may grant a joint use of parking spaces between the uses
that results in a reduction in the total number of required parking spaces in compliance with
the following conditions:
a. The most remote space is located within a convenient distance to the use it is
intended to serve;
b. The amount of reduction is no greater than the number of spaces required for the
least intensive of the uses sharing the parking;
c. The probable long-term occupancy of the structures, based on their design, will not
generate additional parking demand;
d. The applicant has provided sufficient data, including a parking study if required by the
Director, to indicate that there is no conflict in the peak parking demand for the uses
proposing to make joint use of the parking facilities;
e. The property owners involved in the joint use of parking facilities shall record a
parking agreement approved by the Director and City Attorney. The agreement shall be
recorded with the County Recorder, and a copy shall be filed with the Department; and
f. A parking management plan shall be prepared in compliance with subsection (C) of
this section (Parking Management Plan).
C. Parking Management Plan. When a parking management plan to mitigate impacts associated
with a reduction in the number of required parking spaces is required by this chapter, the parking
management plan may include, but is not limited to, the following when required by the review
authority:
1. Restricting land uses to those that have hours or days of operation so that the same
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
23 of 24 6/27/2023, 4:16 PM
Apx-24
parking spaces can be used by two or more uses without conflict;
2. Restricting land uses with high parking demand characteristics;
3. Securing off-site parking in compliance with Section 20.40.100 (Off-Site Parking);
4. Providing parking attendants and valet parking; and
5. Other appropriate mitigation measures.
D. Required Data. In reaching a decision to allow a reduction of required parking spaces, the
review authority shall consider data submitted by the applicant or collected/prepared at the
applicant’s expense. (Ord. 2010-21 § 1 (Exh. A)(part), 2010)
20.40.120 Parking Management Districts.
Properties within a parking management district, established through the Parking Management
(PM) Overlay District, may be exempted from all or part of the off-street parking requirements of
this chapter in compliance with the provisions of the adopted parking management district plan.
(Ord. 2010-21 § 1 (Exh. A)(part), 2010)
20.40.130 In-Lieu Parking Fee.
The number of parking spaces required by Section 20.40.040 (Off-Street Parking Spaces
Required) may be reduced if the review authority authorizes the use of an in-lieu fee to be paid by
the applicant towards the development of public parking facilities. The in-lieu fee shall be paid to
the Citywide Parking Improvement Trust Fund. The amount of the fee and time of payment shall be
established by Council resolution. (Ord. 2010-21 § 1 (Exh. A)(part), 2010)
The Newport Beach Municipal Code is current through Ordinance 2023-2, passed February 14, 2023.
Disclaimer: The City Clerk’s office has the official version of the Newport Beach Municipal Code. Users should
contact the City Clerk’s office for ordinances passed subsequent to the ordinance cited above.
City Website: https://www.newportbeachca.gov/
City Telephone: (949) 644-3005
Code Publishing Company
Chapter 20.40 OFF-STREET PARKING https://www.codepublishing.com/CA/NewportBeach/#!/NewportBeach...
24 of 24 6/27/2023, 4:16 PM
Apx-25
APPENDIX B
PARKING SURVEY DATA
Apx-26
Parking Occupancy Study, Tuesday, 6/06/23
425 Old Newport Boulevard, Newport Beach, CA 92663
Prepared by AimTD LLC cs@aimtd.com
Category Regular Disabled Customer
Only Street
Inventory 10 2 5
8:00 AM - 9:00 AM 5 0 0 0
9:00 AM - 10:00 AM 6 0 2 0
10:00 AM - 11:00 AM 8 0 1 0
11:00 AM - 12:00 PM 10 0 2 0
12:00 PM- 1:00 PM 12 1 5 0
1:00 PM- 2:00 PM 11 0 4 0
2:00 PM- 3:00 PM 8 0 2 0
3:00 PM- 4:00 PM 5 1 3 0
4:00 PM- 5:00 PM 6 0 1 0
5:00 PM- 6:00 PM 5 0 0 0
6:00 PM- 7:00 PM 7 0 0 0
NOTES: All personell and visitors parked in the designated office parking lot
Apx-27
Parking Occupancy Study, Thursday, 6/08/23
425 Old Newport Boulevard, Newport Beach, CA 92663
Prepared by AimTD LLC cs@aimtd.com
Category Regular Disabled Customer
Only Street
Inventory 10 2 5
8:00 AM - 9:00 AM 1 0 0 0
9:00 AM - 10:00 AM 3 0 0 0
10:00 AM - 11:00 AM 8 0 2 0
11:00 AM - 12:00 PM 10 0 1 0
12:00 PM- 1:00 PM 9 0 1 0
1:00 PM- 2:00 PM 7 0 2 0
2:00 PM- 3:00 PM 10 0 2 0
3:00 PM- 4:00 PM 9 0 2 0
4:00 PM- 5:00 PM 5 0 1 0
5:00 PM- 6:00 PM 8 0 1 0
6:00 PM- 7:00 PM 6 0 1 0
NOTES: All personell and visitors parked in the designated office parking lot
Apx-28
Parking Occupancy Study: Tuesday, 6/06/23
441 Old Newport Boulevard, Newport Beach, CA 92663
Prepared by AimTD LLC cs@aimtd.com
Category Reserved Regular Disabled Elevator Drop-Off Street
Inventory 24 3 2 9 1
8:00 AM - 9:00 AM 11 2 1 5 0 2
9:00 AM - 10:00 AM 19 2 1 5 0 1
10:00 AM - 11:00 AM 19 2 1 7 1 0
11:00 AM - 12:00 PM 17 3 2 7 0 0
12:00 PM- 1:00 PM 11 0 1 6 0 0
1:00 PM- 2:00 PM 10 1 2 5 0 2
2:00 PM- 3:00 PM 18 2 0 8 0 1
3:00 PM- 4:00 PM 15 2 1 8 0 0
4:00 PM- 5:00 PM 10 1 0 7 0 0
5:00 PM- 6:00 PM 4 0 0 4 0 0
6:00 PM- 7:00 PM 2 0 0 3 0 0
NOTES: Street Parking: persons only going to the office bldg
Apx-29
Parking Occupancy Study: Thursday, 6/08/23
441 Old Newport Boulevard, Newport Beach, CA 92663
Prepared by AimTD LLC cs@aimtd.com
Category Reserved Regular Disabled Elevator Drop-Off Street
Inventory 24 3 2 9 1
8:00 AM - 9:00 AM 10 1 1 7 0 2
9:00 AM - 10:00 AM 13 2 1 7 0 1
10:00 AM - 11:00 AM 16 2 2 8 0 1
11:00 AM - 12:00 PM 13 3 2 7 0 0
12:00 PM- 1:00 PM 8 1 2 8 0 1
1:00 PM- 2:00 PM 5 1 0 7 0 0
2:00 PM- 3:00 PM 9 2 0 8 0 0
3:00 PM- 4:00 PM 10 1 0 7 0 0
4:00 PM- 5:00 PM 14 2 0 7 0 0
5:00 PM- 6:00 PM 3 1 0 2 0 0
6:00 PM- 7:00 PM 3 1 0 2 0 0
NOTES: Street Parking: persons only going to the office bldg
Apx-30
Parking Occupancy Study
136 Broadway Costa Mesa CA 92627
Prepared by AimTD LLC cs@aimtd.com
Category Regular Disabled
Patrons
Going
Inside the
Medical
Inventory 12 2
8:00 AM - 9:00 AM 1 0 4
9:00 AM - 10:00 AM 4 0 7
10:00 AM - 11:00 AM 7 2 4
11:00 AM - 12:00 PM 8 1 3
12:00 PM- 1:00 PM 8 2 4
1:00 PM- 2:00 PM 8 1 2
2:00 PM- 3:00 PM 7 0 1
3:00 PM- 4:00 PM 5 1 1
4:00 PM- 5:00 PM 4 1 1
5:00 PM- 6:00 PM 2 0 0
6:00 PM- 7:00 PM 2 0 0
Apx-31
Parking Occupancy Study
136 Broadway Costa Mesa CA 92627
Prepared by AimTD LLC cs@aimtd.com
Category Regular Disabled
Patrons
Going
Inside the
Medical
Inventory 12 2
8:00 AM - 9:00 AM 1 0 1
9:00 AM - 10:00 AM 2 0 1
10:00 AM - 11:00 AM 2 1 1
11:00 AM - 12:00 PM 5 2 2
12:00 PM- 1:00 PM 4 1 1
1:00 PM- 2:00 PM 6 1 1
2:00 PM- 3:00 PM 6 2 2
3:00 PM- 4:00 PM 5 1 0
4:00 PM- 5:00 PM 4 1 0
5:00 PM- 6:00 PM 1 0 0
6:00 PM- 7:00 PM 0 0 0
Apx-32
APPENDIX C
FORBES ARTICLE
Apx-33
Apx-34
is now vacant in the United States—20.2% of the
country’s entire stock.
In the absence of workers, social problems are
proliferating, making downtown spaces even less
appealing. Petty crime in New York is up 29%
since 2019. Homelessness in the San Francisco
Bay Area has surged by more than a third in four
years. Last July, Starbucks closed 16 stores
around the country, including six in Seattle, two
in Portland, Oregon, and one at D.C.’s Union
Station, citing safety issues including drug use.
All of this is wreaking havoc on America’s urban
centers. The pain is being felt most acutely in six
cities: New York, Chicago, Los Angeles, San
Francisco, Houston and Washington, D.C.,
which have lost an estimated $171 billion in
office real estate value since 2019. Here’s how
they’re faring and what their mayors are doing
about it.
Apx-35
New York’s office buildings lost an estimated
$70 billion in value between December 2019 and
2022, according to a research paper by Columbia
and New York University professors. Mayor Eric
Adams announced tax incentives in May to those
who renovate older office buildings south of 59th
Street in an effort to halt the stampede.
Chicago is providing financial assistance to
developers who are spending $570 million to
convert Great Depression–era offices in the
LaSalle Street Corridor to mixed-use residential.
The city is also betting on tech giants like Google
Apx-36
, which bought the Thompson Center
government building for $105 million last year.
“The ideal end state is in three years Google is
going to be opening a new major Chicago
presence that’s anchoring one end, and then you
have the Board of Trade on the other end,” says
Samir Mayekar, former deputy mayor for
economic and neighborhood development.
Mayor Karen Bass, who was elected on a
platform of getting control of the city’s homeless
crisis, in February announced plans to turn
vacant city-owned buildings into emergency
housing. In April, Bass said the city has
identified more than 3,000 public properties
that could be converted to housing.
Apx-37
Mayor London Breed introduced legislation to
allow developers to convert underused office
buildings downtown to housing and give
buildings in the core Union Square area
additional flexibility for diverse uses. “Clearing
the way for office conversions . . . while not
flashy, these critical roll-up-your sleeves
technical improvements will help keep our
downtown engine running,” says San Francisco’s
planning director, Rich Hillis.
Apx-38
Sylvester Turner, Houston’s mayor and former
housing director, was accused in 2021 of
favoring specific developers for his plans to build
affordable housing projects using $15 million of
Hurricane Harvey relief funds. (Turner denied
the accusations.) He has not announced any
further plans.
Apx-39
The capital’s Comeback Plan aims to create
35,000 jobs and boost its population to 725,000
residents by 2028—a roughly 8% increase
—largely through incentivizing tech companies
to relocate to the district or keep their offices
open by covering certain expenses such as rent
and employee recruiting. The city is also giving
tax relief of up to $2.5 million for office-to-
residential conversion projects in its business
district.
Sources: Savills for occupancy rate and decline
in occupancy; Kastle Systems for data on
workers going into the office.
These American Cities Have Been Hardest Hit By Flight Of Commuters https://www.forbes.com/sites/giacomotognini/2023/05/30/these-america...
7 of 8 6/26/2023, 8:46 PM
Apx-40
These American Cities Have Been Hardest Hit By Flight Of Commuters https://www.forbes.com/sites/giacomotognini/2023/05/30/these-america...
8 of 8 6/26/2023, 8:46 PM
Apx-41
APPENDIX D
PEW RESEARCH ARTICLE
Apx-42
Apx-43
time, according to a new Pew Research Center survey. This is down from 43% in January
2022 and 55% in October 2020 – but up from only 7% before the pandemic.
While the share working from home all the time has fallen off somewhat as the pandemic
has gone on, many workers have settled into hybrid work. The new survey finds that 41%
of those with jobs that can be done remotely are working a hybrid schedule – that is,
working from home some days and from the office, workplace or job site other days. This
is up from 35% in January 2022.
Among hybrid workers who are not self-employed, most (63%) say their employer requires
them to work in person a certain number of days per week or month. About six-in-ten
hybrid workers (59%) say they work from home three or more days in a typical week, while
41% say they do so two days or fewer.
Related: How Americans View Their Jobs
Many hybrid workers would prefer to spend more time working from home than they
currently do. About a third (34%) of those who are currently working from home most of
the time say, if they had the choice, they’d like to work from home all the time. And among
those who are working from home some of the time, half say they’d like to do so all (18%)
or most (32%) of the time.
35% of workers who can work from home now do this all the time in U.S...https://www.pewresearch.org/short-reads/2023/03/30/about-a-third-of-...
2 of 8 6/26/2023, 8:57 PM
Apx-44
The majority of U.S. workers overall (61%) do not have jobs that can be done from home.
Workers with lower incomes and those without a four-year college degree are more likely
to fall into this category. Among those who do have teleworkable jobs, Hispanic adults and
those without a college degree are among the most likely to say they rarely or never work
from home.
When looking at all employed adults ages 18 and older in the United States, Pew Research
Center estimates that about 14% – or roughly 22 million people – are currently working
from home all the time.
Workers who are not self-employed and who are teleworking at least some of the time see
one clear advantage – and relatively few downsides – to working from home. By far the
biggest perceived upside to working from home is the balance it provides: 71% of those
who work from home all, most or some of the time say doing so helps them balance their
work and personal lives. That includes 52% who say it helps them a lot with this.
About one-in-ten (12%) of those who are at least occasionally working from home say it
hurts their ability to strike the right work-life balance, and 17% say it neither helps nor
hurts. There is no significant gender difference in these views. However, parents with
children younger than 18 are somewhat more likely than workers without children in that
age range to say working from home is helpful in this regard (76% vs. 69%).
35% of workers who can work from home now do this all the time in U.S...https://www.pewresearch.org/short-reads/2023/03/30/about-a-third-of-...
3 of 8 6/26/2023, 8:57 PM
Apx-45
A majority of those who are working from home at least some of the time (56%) say this
arrangement helps them get their work done and meet deadlines. Only 7% say working
from home hurts their ability to do these things, and 37% say it neither helps nor hurts.
There are other aspects of work – some of them related to career advancement – where
the impact of working from home seems minimal:
When asked how working from home affects whether they are given important
assignments, 77% of those who are at least sometimes working from home say it
neither helps nor hurts, while 14% say it helps and 9% say it hurts.
When it comes to their chances of getting ahead at work, 63% of teleworkers say
working from home neither helps or hurts, while 18% say it helps and 19% say it
hurts.
A narrow majority of teleworkers (54%) say working from home neither helps
nor hurts with opportunities to be mentored at work. Among those who do see
an impact, it’s perceived to be more negative than positive: 36% say working
from home hurts opportunities to be mentored and 10% say it helps.
One aspect of work that many remote workers say working from home makes more
challenging is connecting with co-workers: 53% of those who work from home at least
some of the time say working from home hurts their ability to feel connected with co-
workers, while 37% say it neither helps nor hurts. Only 10% say it helps them feel
connected.
In spite of this, those who work from home all the time or occasionally are no less satisfied
with their relationship with co-workers than those who never work from home. Roughly
two-thirds of workers – whether they are working exclusively from home, follow a hybrid
schedule or don’t work from home at all – say they are extremely or very satisfied with
these relationships. In addition, among those with teleworkable jobs, employed adults who
work from home all the time are about as likely as hybrid workers to say they have at least
one close friend at work.
35% of workers who can work from home now do this all the time in U.S...https://www.pewresearch.org/short-reads/2023/03/30/about-a-third-of-...
4 of 8 6/26/2023, 8:57 PM
Apx-46
Feeling connected with co-workers is one area where many workers who rarely or never
work from home see an advantage in their setup. About four-in-ten of these workers (41%)
say the fact that they rarely or never work from home helps in how connected they feel to
their co-workers. A similar share (42%) say it neither helps nor hurts, and 17% say it hurts.
At the same time, those who rarely or never work from home are less likely than
teleworkers to say their current arrangement helps them achieve work-life balance. A third
of these workers say the fact that they rarely or never work from home hurts their ability to
balance their work and personal lives, while 40% say it neither helps nor hurts and 27%
say it helps.
35% of workers who can work from home now do this all the time in U.S...https://www.pewresearch.org/short-reads/2023/03/30/about-a-third-of-...
5 of 8 6/26/2023, 8:57 PM
Apx-47
When it comes to other aspects of work, many of those who rarely or never work from
home say their arrangement is neither helpful nor hurtful. This is true when it comes to
opportunities to be mentored (53% say this), their ability to get work done and meet
deadlines (57%), their chances of getting ahead in their job (68%) and whether they are
given important assignments (74%).
Most adults with teleworkable jobs who work from home at least some of the time (71%)
say their manager or supervisor trusts them a great deal to get their work done when
they’re doing so. Those who work from home all the time are the most likely to feel
trusted: 79% of these workers say their manager trusts them a great deal, compared with
64% of hybrid workers.
Hybrid workers feel about as trusted when they’re not working from home: 68% say their
manager or supervisor trusts them a great deal to get their work done when they’re not
teleworking.
Note: Here are the questions used for this analysis, along with responses, and the
survey’s methodology.
Apx-48
Apx-49
35% of workers who can work from home now do this all the time in U.S...https://www.pewresearch.org/short-reads/2023/03/30/about-a-third-of-...
8 of 8 6/26/2023, 8:57 PM
Apx-50
APPENDIX E
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ARTICLE
Apx-51
April 2023 ISSUE BRIEF 1
HP-2023-09
Updated National Survey Trends in Telehealth
Utilization and Modality (2021-2022)
Telehealth utilization rapidly expanded during the onset of the COVID-19 pandemic
and continues to provide critical access to health care services. Updated trends show
a steady use of telehealth with a slightly higher proportion of video-based versus
audio-only services by March 2022; however, disparities persist in populations and
across insurance types.
Euny C. Lee, Violanda Grigorescu, Idia Enogieru, Scott R. Smith, Lok Wong Samson, Ann B. Conmy,
and Nancy De Lew
KEY POINTS
•Telehealth utilization has changed since the steep increase from the early stages of the COVID-19
pandemic. This report updates prior findings on national trends of telehealth use through an analysis
using the Census Bureau’s Household Pulse Survey data from April 2021 through August 2022.
Understanding patterns and factors associated with telehealth use are important to inform policy
decisions.1-4
•Compared to earlier periods in the pandemic, telehealth utilization was lower during the study
period (April 14, 2021 through August 8, 2022), but continued to remain above pre-pandemic
levels.5
•Telehealth use rates varied throughout the study period between 20.5% and 24.2%, with an average
of 22.0% of adults reporting use of telehealth in the last four weeks.
•Telehealth use rates were lowest among people who are uninsured (9.4%), young adults ages 18 to
24 (17.6%), and residents of the Midwest (18.7%).
•The highest rates of telehealth visits were among those covered by Medicaid (28.3%) and Medicare
(26.8%), individuals who are Black (26.1%), and those earning less than $25,000 (26.4%).
•Individuals who are Hispanic or Latino, Black, and Asian were more likely to use telehealth,
specifically audio-only telehealth, than individuals who are White; however, they were less likely to
use video telehealth services than individuals who are White. There were significant disparities
among subgroups in terms of audio-only versus video-based telehealth use.
•Persistent disparities in accessing video telehealth services requires further study on patient
preferences and how broadband programs, technology resources, and technology literacy training
programs can improve patient access to video telehealth services.
April 19, 2023
Apx-52
April 2023 ISSUE BRIEF 2
BACKGROUND
Telehealth use in the United States grew significantly within the first three months of the COVID-19 pandemic
(January – March 2020), providing access to critical health services, enabling communication between health
care providers and patients, and remote monitoring of conditions through the use of synchronous, real-time
modalities via audio-only or internet-based video on mobile phones and digital devices as well as
asynchronous methods (e.g., store and forward and patient portals).
5, 6
Telehealth use in the last half of 2020 remained high, accounting for 30.2% of all health center visits during
June – November 2020, according to one study.
7 By April 2021, the national telehealth utilization rate among
adults ages 18 years and older was at 27%, which is lower than early pandemic telehealth use, but then
declined to 22% by mid-late 2021 based on an earlier ASPE study.
1 Analyses of commercial claims have shown
that telehealth services were mostly rendered by social workers and primary care and psychiatry/psychology
clinicians, with more than a quarter (26%) of claims for psychotherapy delivered through telehealth.
8 However,
while evidence on patient preferences regarding modality and the impact of telehealth on quality of care and
patient outcomes is still being explored, equitable access to telehealth services – particularly synchronous,
real-time video telehealth – remains a significant concern and potential barrier to health care during the
pandemic.9
The expected end of the public health emergency on May 11, 2023 may impact telehealth flexibilities
introduced during the pandemic for various state Medicaid programs and private payers.
4 In addition, recent
legislation extended telehealth flexibilities for Medicare until December 31, 2024 to further understand
ongoing patterns of telehealth utilization and disparities which are critical to informed policy-making.
10
This report provides an update to an earlier ASPE Issue Brief that analyzed telehealth utilization using the
Census Bureau’s Household Pulse Survey (HPS) from April 14, 2021 to October 11, 2021.
1 Specifically, in this
study, national trends in telehealth utilization were analyzed from April 14, 2021 through August 8, 2022 with
results that are similar to the previous analysis. In addition, descriptive and multivariable regression analyses
were performed to better understand telehealth use and more specifically video-enabled telehealth among
different populations.
METHODS
Data Sources
We used the Household Pulse Survey (HPS) data. This is an online survey, administered by the Census Bureau
to measure U.S. households’ experiences and impact of emerging issues during the COVID-19 pandemic. The
HPS response rate ranges from 1.3% to 10.3% and varies across survey cycles.
11
Respondents must be adults ages 18 and older and they are asked to answer questions on use of telehealth for
both themselves and children in their household.
*
_______________________
*The survey telehealth questions included the following: “At any time in the last 4 weeks, did you have an appointment with a doctor,
nurse, or other health professional by video or by phone?Please only include appointments for yourself and not others in your
household.” “At any time in the last 4 weeks, did any children in the household have an appointment with a doctor, nurse, or other
health professional by video or by phone?” For those who selected Yes: “Did the appointment(s) take place over the phone without
video or did the appointment(s) use video?”
† We grouped respondents based on their answers to health insurance coverage into five mutually exclusive categories: 1) Medicare; 2)
Medicaid; 3) Private; 4) Other Health Insurance, and 5) Uninsured.
‡ Biological sex and gender identity were excluded from the overall telehealth analysis, due to a change in the definition of gender in
the survey as of July 21, 2021.
Apx-53
April 2023 ISSUE BRIEF 3
Data on overall telehealth use was available for the weeks between April 14, 2021 through August 8, 2022, our
study period. Information on telehealth service by modality (audio-only vs. video telehealth) was available only
for the weeks from July 21, 2021 to August 8, 2022.
12
Data Analysis
Overall telehealth use was evaluated from April 14, 2021, to August 8, 2022, for adult telehealth users
(N=265,367). Analysis by telehealth modality (video vs. audio-only) was performed on a secondary cohort* (N=
143,462 respondents from July 21, 2021 through August 8,2022)) representing a subset of the first cohort of
overall telehealth users.
The data were weighted using person-level weights and replicate weights to account for sampling and
response bias.
11 Descriptive statistics followed by bivariate analysis (stratification and crosstabulations) and
multivariable logistic regression modeling were conducted for both cohorts to identify predictors of telehealth
use. Independent variables in the multivariable model included race and ethnicity, age, gender, education,
income, insurance, and region. We repeated our multivariable analysis with the sample stratified by insurance
type. A p-value below .05 was considered statistically significant. All analyses used survey weights to mitigate
non-response bias and Taylor Series Expansion/Linearization for variance estimation.
RESULTS
Characteristics of Telehealth Users
Among the 1,180,248 adults who answered the
telehealth question, 22.5% reported having utilized
telehealth services (audio-only or video) within the
last four weeks. Among 367,887 adults with a child in
the household, 18.1% reported that a child in the
household had used telehealth services in the prior
four weeks.
Figure 1 shows trends in the percentage of adults and
children that had used telehealth services in the prior
four weeks. There was a slight decline in overall
telehealth use in July 2021 that persisted until June
of 2022 before climbing again slightly; however,
telehealth use among adults remained above 20% throughout the study period. Rates for children were slightly
lower, and the gap compared to adults has gradually widened over time. While other studies have found that
overall rates of telehealth use have remained fairly stable for adults, rates for children have gradually declined
in 2022.
13 In one study, telehealth use among pediatric patients varied by subspecialty ranging from 6% to 73%
of total visits with a preference for in-person visits among those having non-English language preference.
14, 15
Telehealth use consistently
remained above 20% from
2021-2022 and for all
population groups.
Disparities persisted in video
utilization from July 2021 to
August 2022.
Apx-54
April 2023 ISSUE BRIEF 4
Figure 1. Percentage of Adults and Children* Who Used Telehealth Services, April 14, 2021 – August 8, 2022
Figure 2 illustrates the share of adults with telehealth visits who utilized audio-only versus video telehealth.
More than half of telehealth users reported use of video telehealth during each wave of the survey from July
2021 to August, 2022, but decreased during June 1, 2022 through August 8, 2022, for reasons that are not yet
well understood.
Note:*Reflects telehealth use reported by adult respondents for any child in the household over the
previous 4 weeks. Note that the survey is typically on a bi-weekly basis, although some weeks were
not surveyed, such as weeks in November of 2021.
Apx-55
April 2023 ISSUE BRIEF 5
Figure 2. Percentage of Adults Who Used Audio-only vs. Video Telehealth Services, July 21, 2021 – August 8,
2022
Demographic Characteristics of Overall and Audio-only vs. Video Adult Telehealth Use
Table 1 presents the findings by demographic categories for each of the two cohorts analyzed: overall
telehealth users (first cohort) and the proportion of survey respondents who reported the modality of
telehealth visit in the prior four weeks from July 2021-August 2022 (second cohort).
Among survey respondents (first cohort), telehealth utilization was lowest among people who were uninsured
(9.4%), individuals ages 18-24 (17.6%), and those residing in the Midwest (18.7%). Telehealth use was highest
among those with Medicaid (28.3%) and Medicare (26.8%), Black respondents (26.1%), and those earning less
than $25,000 (26.4%).
Subgroup analysis comparing audio-only vs. video telehealth among telehealth users was conducted for the
second cohort* surveyed between July and August 2021. Although we acknowledge differences in the two
cohorts that make them not comparable, we noted that the characteristics of those reporting higher
proportion of video services (second cohort) were similar with those having a lower overall telehealth use (first
cohort). Among these respondents (second cohort), higher proportion of video visits compared to audio-only
visits were observed in those having lower overall rates of telehealth use. For example, White respondents
reported having an overall telehealth use of 19.6% but had a higher proportion of their telehealth visits using
video (61.3%) compared to audio-only (38.7%). This pattern remained consistent among telehealth users who
were between 18 and 24 years of age (72.5%), and private health insurance enrollees (65.3%). Audio-only
telehealth use was highest among those with less than a high school education (64.2%) and adults ages 65 and
58 58 57 58 60 58 57 56 58 60 60 57 55 54 53
42 42 43 42 40 42 43 44 42 40 40 43 45 46 47
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Pe
r
c
e
n
t
a
g
e
(
%
)
o
f
a
u
d
i
o
v
s
.
v
i
d
e
o
t
e
l
e
h
e
a
l
t
h
u
s
e
Week Survey was Administered
(HPS weeks 34-48)
Audio vs. Video Telehealth Use
Video Telehealth
Audio Telehealth
Apx-56
April 2023 ISSUE BRIEF 6
older (56.5%). These results are similar to the findings from our previous analysis of Census HPS data through
October 11, 2021.
1
* Note: The telehealth modality question was included in the Household Pulse Survey (HPS) starting July 21,
2021.
Table 1. Rates of Telehealth Use and Audio-only vs. Video Modality, by Demographic Categories, April 14,
2021 – August 8, 2022
% with a
Telehealth Visit
in Previous Four
Weeks
April 14, 2021 to
August 8, 2022
Second Cohort* (July 21, 2021 to August 8, 2022)
% with a
Telehealth Visit in
Previous Four
Weeks
% of Telehealth
Visits by Video in
Previous Four
Weeks
% of Telehealth
Visits by Audio-
only in Previous
Four Weeks
Race and Ethnicity
Hispanic or Latino 23.9 22.7 49.7 50.3
White alone, not Latino 20.7 19.6 61.3 38.7
Black alone, not Latino 26.1 25.0 50.1 49.9
Asian alone, not Latino 21.7 20.8 49.5 50.5
Two or more races + Other 25.5 24.2 59.8 40.2
Age
18-24 years 17.6 16.0 72.5 27.5
25-39 years 20.7 18.6 69.3 30.7
40-54 years 22.7 20.9 60.9 39.1
55-64 years 23.6 21.1 52.1 47.9
> 65 years 24.6 22.0 43.5 56.5
Education
Less than high school 24.5 24.0 35.8 64.2
High school or GED 20.7 19.7 46.5 53.5
Some college/Associate’s
degree
22.8 21.6 58.3 41.7
Bachelor’s degree or higher 22.4 21.3 66.7 33.3
Household Income
Less than $25,000 26.4 25.3 47.6 52.4
$25,000 - $34,999 23.3 21.9 48.9 51.1
$35,000 - $49,999 21.8 20.6 53.3 46.7
$50,000 - $74,999 21.0 19.9 56.9 43.1
$75,000 - $99,999 20.2 19.2 62.0 38.0
> $100,000 20.4 19.4 67.9 32.1
Insurance
Medicare 26.8 25.5 46.1 53.9
Medicaid 28.3 26.8 53.4 46.6
Private 20.2 19.2 65.3 34.7
Other Health Insurance 24.4 23.1 53.8 46.2
Uninsured 9.4 9.0 46.9 53.1
Census Region
Northeast 23.3 22.3 59.6 40.4
South 21.3 20.1 58.0 42.0
Midwest 18.7 17.7 57.7 42.3
West 24.9 23.9 54.1 45.9
Apx-57
April 2023 ISSUE BRIEF 7
Figure 3 illustrates disparities in video telehealth use by race and ethnicity; video telehealth as a share of all
telehealth use was lower among Hispanic or Latino (49.7%), Asian (49.5%), and Black (50.1%) survey
respondents.
Figure 3. Telehealth Modality (Video vs. Audio-only) Among Telehealth Users, By Race/Ethnicity, July 21,
2021 – August 8, 2022
Demographic Predictors Associated with Telehealth Use (Multivariable Model: First Cohort)
Table 2 shows the demographic factors that were predictors of recent telehealth use after multivariable
adjustment (first cohort). Those who were Hispanic or Latino, Black, or reported two or more races or other
race had higher odds of using telehealth in the last 4 weeks than White non-Latino respondents. In addition,
telehealth use was highest among those with lower incomes and declined as income rises. Individuals with
Medicare, Medicaid, or Other insurance
†were more likely to use telehealth than those with Private Insurance,
while people without any health insurance were the least likely to use telehealth.
_______________________
†Other insurance includes: TRICARE or other military health care, Veteran’s Administration (VA) Health Care, Indian Health Service
(IHS), and Other health insurance.
49.7 61.3 50.1 49.5 59.8
50.3
38.7 49.9 50.5 40.2
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Hispanic or
Latino
White Black Asian Two or more
races + Other
%
o
f
u
t
i
l
i
z
a
t
i
o
n
b
y
t
e
l
e
h
e
a
l
t
h
u
s
e
r
s
TelehealthUse by Modality
% video telehealth % audio telehealth
Apx-58
April 2023 ISSUE BRIEF 8
Table 2: Adjusted Odds of Telehealth Utilization by Respondent Demographics, April 14, 2021 – August 8,
2022
Demographics Odds Ratios
(95% Confidence Interval)
P-value
Race and Ethnicity
Hispanic or Latino 1.27 (1.22, 1.33)<.0001
Black alone, not Latino 1.36 (1.30, 1.42)<.0001
Asian alone, not Latino 1.02 (0.96, 1.08)0.6085
Two or more races + Other Races, not Latino 1.27 (1.20, 1.35)<.0001
White alone, not Latino Ref*Ref*
Age
18-24 years 1.06 (0.96, 1.16)0.2701
25-39 years 1.19 (1.12, 1.26)<.0001
40-54 years 1.35 (1.28, 1.43)<.0001
55-64 years 1.39 (1.32, 1.46)<.0001
> 65 years Ref*Ref*
Education
Less than high school 0.91 (0.78, 1.05)0.1988
High school or GED 0.77 (0.74, 0.80)<.0001
Some college/Associate’s degree 0.95 (0.92, 0.97)<.0001
Bachelor’s degree or higher Ref*Ref*
Household Income
Less than $25,000 1.41 (1.34, 1.48)<.0001
$25,000 - $34,999 1.27 (1.21, 1.34)<.0001
$35,000 - $49,999 1.15 (1.10, 1.21)<.0001
$50,000 - $74,999 1.06 (1.03, 1.10)0.0011
$75,000 - $99,999 1.03 (0.99, 1.07)0.1532
> $100,000 Ref*Ref*
Insurance
Medicare 1.70 (1.62, 1.79)<.0001
Medicaid 1.36 (1.30, 1.44)<.0001
Private Ref*Ref*
Other Health Insurance 1.24 (1.13, 1.35)<.0001
Uninsured 0.35 (0.32, 0.38)<.0001
Census Region
Northeast 0.91 (0.88, 0.95)<.0001
South 0.82 (0.79, 0.85)<.0001
Midwest 0.70 (0.67, 0.72)<.0001
West Ref*Ref*
†Telehealth modalities were unavailable until HPS week 34 conducted on July 21, 2021.
‡ Insurance categories were coded to be mutually exclusive.
* Reference value/control group for calculation of odds ratios intervals.
Table 3 shows the demographic predictors of video telehealth among telehealth users after multivariable
adjustment (second cohort). Age was the strongest predictor of video telehealth use, with young adults having
an odds ratio of 4.55 compared to adults 65 and older and a declining rate of video telehealth use for each
older age group. Compared to females, males were less likely to use video telehealth, whereas transgender
individuals were 3.12 times more likely to use video telehealth.
Apx-59
April 2023 ISSUE BRIEF 9
Video telehealth use was less likely among lower income households and those with lower educational
attainment compared to those who had a household income of ≥$100,000 and a bachelor’s degree or higher.
The rates of video telehealth use rose steadily as household income or educational attainment increased.
Black, Hispanic or Latino, and Asian individuals were less likely to use video telehealth than White respondents,
with Asians having the lowest odds ratio of 0.55. Respondents who were insured by Medicare were 1.23 times
more likely to use video telehealth compared to those who were insured by a private payer. Lastly, those
residing in the Midwest region were less likely to use video telehealth compared to those residing in the West.
Table 3: Predictors of Video Telehealth Utilization Among Telehealth Users, July 21, 2021 – August 8, 2022
Demographics Odds Ratios
(95% Confidence Interval)
P-value
Race and Ethnicity
Hispanic or Latino 0.74 (0.66, 0.83)<.0001
Black alone, not Latino 0.85 (0.76, 0.96)0.0077
Asian alone, not Latino 0.55 (0.47, 0.64)<.0001
Two or more races + Other, not Latino 0.98 (0.84, 1.14)0.7527
White alone, not Latino Ref*Ref*
Gender Identity
Male 0.929 (0.87, 1.00)0.038
Female Ref*Ref*
Transgender 3.12 (1.72, 5.68)0.0002
Other 1.10 (0.83,1.46)0.4998
Age
18-24 years 4.55 (3.51, 5.91)<.0001
25-39 years 4.12 (3.60, 4.71)<.0001
40-54 years 2.73 (2.42, 3.08)<.0001
55-64 years 1.92 (1.70, 2.16)<.0001
> 65 years Ref*Ref*
Education
Less than high school 0.50 (0.347 0.709)0.0001
High school or GED 0.60 (0.541 0.657)<.0001
Some college/associate’s degree 0.81 (0.753 0.864)<.0001
Bachelor’s degree or higher Ref*Ref*
Household Income
Less than $25,000 0.61 (0.54, 0.69)<.0001
$25,000 - $34,999 0.61 (0.54, 0.70)<.0001
$35,000 - $49,999 0.69 (0.61, 0.78)<.0001
$50,000 - $74,999 0.76 (0.69, 0.84)<.0001
$75,000 - $99,999 0.82 (0.74, 0.91)0.0002
> $100,000 Ref*Ref*
Insurance
Medicare 1.23 (1.09, 1.38)0.0005
Medicaid 0.99 (0.87, 1.13)0.8709
Private Ref*Ref*
Other Health Insurance 0.97 (0.78, 1.22)0.8145
Uninsured 0.73 (0.57, 0.94)0.0137
Census Region
Northeast 1.07 (0.96, 1.19)0.2474
South 1.05 (0.96, 1.14)0.2648
Midwest 0.86 (0.78, 0.94)0.0015
West Ref*Ref*
Apx-60
April 2023 ISSUE BRIEF 10
†Telehealth modalities were unavailable until HPS week 34 conducted on July 21, 2021.
‡ Insurance categories were coded to be mutually exclusive.
*Reference value/control group for calculation of odds ratios intervals.
Table 4 shows demographic predictors of video telehealth use by individuals, stratified by different insurance
types. Disparities in access to video telehealth were observed in most insurance types similar to the overall
telehealth users. Generally, younger adults, those with higher incomes, and those with more education were
more likely to use video telehealth across insurance types. One notable exception is the absence of disparities
among Black and Latino respondents compared to White respondents covered by Medicare; however,
disparities in video telehealth access were greater among Asian respondents. These findings suggest Medicare
may provide more equitable access to video telehealth services compared to other payers but can improve its
access for Asians.
Apx-61
Ap
r
i
l
2
0
2
3
IS
S
U
E
B
R
I
E
F
11
Ta
b
l
e
4
:
P
r
e
d
i
c
t
o
r
s
o
f
V
i
d
e
o
T
e
l
e
h
e
a
l
t
h
U
t
i
l
i
z
a
t
i
o
n
A
m
o
n
g
T
e
l
e
h
e
a
l
t
h
U
s
e
r
s
,
S
t
r
a
t
i
f
i
e
d
b
y
I
n
s
u
r
a
n
c
e
T
y
p
e
,
J
u
l
y
2
1
,
2
0
2
1
–
A
u
g
u
s
t
8
,
2
0
2
2
*
S
i
g
n
i
f
i
c
a
n
t
–
p
-
v
a
l
u
e
b
e
l
o
w
0
.
0
5
**
R
e
f
e
r
e
n
c
e
v
a
l
u
e
/
c
o
n
t
r
o
l
g
r
o
u
p
f
o
r
c
a
l
c
u
l
a
t
i
o
n
o
f
o
d
d
s
r
a
t
i
o
s
i
n
t
e
r
v
a
l
s
.
De
m
o
g
r
a
p
h
i
c
s
Me
d
i
c
a
r
e
OR
(
9
5
%
C
I
)
P
-
v
a
l
u
e
Me
d
i
c
a
i
d
OR
(
9
5
%
C
I
)
P
-
v
a
l
u
e
Pr
i
v
a
t
e
OR
(
9
5
%
C
I
)
P
-
v
a
l
u
e
Ot
h
e
r
H
e
a
l
t
h
I
n
s
u
r
a
n
c
e
OR
(
9
5
%
C
I
)
P
-
v
a
l
u
e
Un
i
n
s
u
r
e
d
OR
(
9
5
%
C
I
)
P
-
v
a
l
u
e
Ra
c
e
a
n
d
E
t
h
n
i
c
i
t
y
His
p
a
n
i
c
o
r
L
a
t
i
n
o
0.
8
8
(
0
.
7
1
,
1
.
1
1
)
0
.
2
8
6
0
.
5
7
(
0
.
4
3
,
0
.
7
7
)
0
.
0
0
0
2
*
0
.
7
6
(
0
.
6
6
,
0
.
8
8
)
0.
0
0
0
3
*
1
.
0
8
(
0
.
6
1
,
1
.
9
1
)
0
.
7
8
7
0
.
5
0
(
0
.
2
8
,
0
.
8
9
)
0
.
0
1
7
*
Bl
a
c
k
a
l
o
n
e
,
n
o
t
L
a
t
i
n
o
1.
0
8
(
0
.
8
9
,
1
.
3
1
)
0.
4
5
3
0.
6
2
(
0
.
4
6
,
0
.
8
3
)
0.
0
0
1
*
0.
8
3
(
0
.
7
0
,
0
.
9
9
)
0.
0
3
7
*
0.
5
7
(
0
.
3
1
,
1
.
0
3
)
0.
0
6
0
0.
9
9
(
0
.
4
9
,
1
.
9
9
)
0.
9
6
9
As
i
a
n
a
l
o
n
e
,
n
o
t
L
a
t
i
n
o
0.
4
9
(
0
.
3
4
,
0
.
7
0
)
0
.
0
0
0
1
*
0
.
4
2
(
0
.
2
3
,
0
.
7
6
)
0
.
0
0
4
*
0
.
5
9
(
0
.
4
9
,
0
.
7
1
)
<.
0
0
0
1
*
1
.
5
1
(
0
.
5
2
,
4
.
3
2
)
0
.
4
4
7
0
.
2
4
(
0
.
0
9
,
0
.
6
6
)
0
.
0
0
6
*
Tw
o
+
r
a
c
e
s
/
O
t
h
e
r
,
n
o
t
L
a
t
i
n
o
0.
9
8
(
0
.
7
3
,
1
.
3
3
)
0.
9
1
5
0.
7
6
(
0
.
5
2
,
1
.
1
0
)
0.
1
4
2
1.
0
1
(
0
.
8
2
,
1
.
2
3
)
0.
9
5
2
1.
6
2
(
0
.
7
5
,
3
.
4
8
)
0.
2
2
1
0.
7
8
(
0
.
2
5
,
2
.
4
1
)
0.
6
5
9
Wh
i
t
e
a
l
o
n
e
,
n
o
t
L
a
t
i
n
o
Re
f
*
*
R
e
f
*
*
R
e
f
*
*
Re
f
*
*
R
e
f
*
*
R
e
f
*
*
Re
f
*
*
R
e
f
*
*
R
e
f
*
*
Re
f
*
*
Ge
n
d
e
r
I
d
e
n
t
i
t
y
Ma
l
e
0.
9
2
(
0
.
8
2
,
1
.
0
4
)
0
.
1
7
1
0
.
9
7
(
0
.
7
6
,
1
.
2
5
)
0
.
8
3
3
0.
9
6
(
0
.
8
8
,
1
.
0
5
)
0
.
3
8
7
0
.
9
7
(
0
.
6
5
,
1
.
4
5
)
0
.
8
6
3
0.
5
0
(
0
.
3
1
,
0
.
7
9
)
0
.
0
0
3
*
Fe
m
a
l
e
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Tr
a
n
s
g
e
n
d
e
r
4.
3
7
(
0
.
9
2
,
20
.
7
5
)
0.
0
6
3
3
.
1
8
(
1
.
2
6
,
8
.
0
4
)
0
.
0
1
5
*
2
.
2
1
(
1
.
0
2
,
4
.
7
6
)
0.
0
4
4
*
7
5
5
.
8
8
,
(
1
9
.
5
2
,
>9
9
9
.
9
9
)
0.
0
0
0
4
*
2
.
2
6
(
0
.
2
,
2
5
.
3
4
)
0
.
5
1
0
Ot
h
e
r
1.
0
1
(
0
.
5
9
,
1
.
7
3
)
0.
9
8
7
1.
2
(
0
.
6
3
,
2
.
3
)
0.
5
7
5
1.
1
5
(
0
.
7
7
,
1
.
7
1
)
0.
4
9
5
0.
7
5
(
0
.
2
1
,
2
.
6
6
)
0.
6
5
2
0.
8
3
(
0
.
1
8
,
3
.
9
4
)
0.
8
1
4
Ag
e
18
-
2
4
y
e
a
r
s
9.
9
2
(
3
.
5
7
,
2
7
.
6
)
<.0
0
0
1
*
3.
1
4
(
1
.
3
0
,
7
.
5
6
)
0.
0
1
1
*
5.
0
4
(
3
.
6
3
,
7
.
0
0
)
<.
0
0
0
1
*
3.
4
9
(
1
.
0
3
,
1
1
.
7
5
)
0.
0
4
4
*
2.
2
6
(
0
.
4
8
,
10
.
7
7
)
0.
3
0
5
25
-
3
9
y
e
a
r
s
4.
0
2
(
2
.
6
7
,
6
.
0
5
)
<
.
0
0
0
1
*
3
.
8
5
(
1
.
9
2
,
7
.
7
3
)
0
.
0
0
0
1
*
4
.
3
4
(
3
.
6
0
,
5
.
2
4
)
<.
0
0
0
1
*
2
.
3
7
(
1
.
1
7
,
4
.
8
3
)
0
.
0
1
7
*
2
.
2
(
0
.
6
7
,
7
.
2
6
)
0
.
1
9
7
40
-
5
4
y
e
a
r
s
2.
3
1
(
1
.
8
8
,
2
.
8
3
)
<.0
0
0
1
*
2.
2
6
(
1
.
1
3
,
4
.
5
1
)
0.
0
2
1
*
3.
1
3
(
2
.
6
1
,
3
.
7
6
)
<.
0
0
0
1
*
1.
4
4
(
0
.
7
3
,
2
.
8
5
)
0.
2
9
0
1.
4
1
(
0
.
4
3
,
4
.
6
9
)
0.
5
7
1
55
-
6
4
y
e
a
r
s
2.
2
5
(
1
.
9
0
,
2
.
6
7
)
<
.
0
0
0
1
*
1
.
6
9
(
0
.
8
3
,
3
.
4
6
)
0
.
1
5
1
1
.
9
7
(
1
.
6
3
,
2
.
3
7
)
<.
0
0
0
1
*
0
.
9
9
(
0
.
5
3
,
1
.
8
4
)
0
.
9
6
7
1
.
0
7
(
0
.
3
2
,
3
.
6
2
)
0
.
9
1
4
>
6
5
y
e
a
r
s
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Ed
u
c
a
t
i
o
n
Le
s
s
t
h
a
n
h
i
g
h
s
c
h
o
o
l
0.
5
1
(
0
.
2
8
,
0
.
9
4
)
0.
0
3
0
*
0.
5
0
(
0
.
2
4
,
1
.
0
4
)
0.
0
6
2
*
0.
3
4
(
0
.
1
7
,
0
.
6
7
)
0.
0
0
2
*
0.
0
3
(
0
.
0
0
,
0
.
3
2
)
0.
0
0
4
*
1.
5
1
(
0
.
5
0
,
4
.
5
9
)
0.
4
6
6
Hig
h
s
c
h
o
o
l
o
r
G
E
D
0.
6
7
(
0
.
5
8
,
0
.
7
9
)
<
.
0
0
0
1
*
0
.
5
7
(
0
.
4
3
,
0
.
7
5
)
<
.
0
0
0
1
*
0
.
5
9
(
0
.
5
1
,
0
.
6
8
)
<.
0
0
0
1
*
0
.
5
3
(
0
.
2
9
,
0
.
9
5
)
0
.
0
3
3
*
0
.
7
0
(
0
.
4
1
,
1
.
1
9
)
0
.
1
8
7
So
m
e
c
o
l
l
e
g
e
/
a
s
s
o
c
i
a
t
e
’
s
d
e
g
r
e
e
0.
8
4
(
0
.
7
5
,
0
.
9
4
)
0.
0
0
2
*
0.
8
7
(
0
.
6
9
,
1
.
1
0
)
0.
2
4
0
0.
7
6
(
0
.
6
9
,
0
.
8
4
)
<.
0
0
0
1
*
1.
1
4
(
0
.
7
6
,
1
.
7
0
)
0.
5
3
7
1.
0
4
(
0
.
6
4
,
1
.
6
8
)
0.
8
8
2
Ba
c
h
e
l
o
r
’
s
d
e
g
r
e
e
o
r
h
i
g
h
e
r
Re
f
*
*
R
e
f
*
*
R
e
f
*
*
Re
f
*
*
R
e
f
*
*
R
e
f
*
*
Re
f
*
*
R
e
f
*
*
R
e
f
*
*
Re
f
*
*
Ho
u
s
e
h
o
l
d
I
n
c
o
m
e
Le
s
s
t
h
a
n
$
2
5
,
0
0
0
0.
5
0
(
0
.
4
1
,
0
.
6
1
)
<
.
0
0
0
1
*
0
.
6
6
(
0
.
4
2
,
1
.
0
4
)
0
.
0
7
3
0
.
6
1
(
0
.
4
9
,
0
.
7
8
)
<.
0
0
0
1
*
*
1
.
0
4
(
0
.
5
2
,
2
.
0
9
)
0
.
9
0
6
0
.
9
7
(
0
.
4
3
,
2
.
1
8
)
0
.
9
3
8
$2
5
,
0
0
0
-
$
3
4
,
9
9
9
0.
5
7
(
0
.
4
6
,
0
.
7
)
<.0
0
0
1
*
0.
6
2
(
0
.
3
8
,
1
.
0
0
)
0.
0
5
0
*
0.
6
5
(
0
.
5
3
,
0
.
7
9
)
<.
0
0
0
1
*
0.
6
9
(
0
.
3
5
,
1
.
3
4
)
0.
2
6
8
0.
7
(
0
.
2
9
,
1
.
7
1
)
0.
4
2
9
$3
5
,
0
0
0
-
$
4
9
,
9
9
9
0.
7
2
(
0
.
5
9
,
0
.
8
8
)
0
.
0
0
1
*
0
.
6
2
(
0
.
3
7
,
1
.
0
3
)
0
.
0
6
5
0.
6
9
(
0
.
5
7
,
0
.
8
2
)
<
.
0
0
0
1
*
0
.
7
7
(
0
.
4
,
1
.
4
7
)
0
.
4
2
3
0.
9
4
(
0
.
3
7
,
2
.
3
7
)
0
.
8
9
5
$5
0
,
0
0
0
-
$
7
4
,
9
9
9
0.
7
1
(
0
.
5
9
,
0
.
8
5
)
0.
0
0
0
2
*
0.
7
9
(
0
.
4
6
,
1
.
3
5
)
0.
3
8
6
0.
7
9
(
0
.
7
0
,
0
.
9
0
)
0.
0
0
0
2
*
0.
7
1
(
0
.
3
6
,
1
.
4
2
)
0.
3
3
6
1.
1
3
(
0
.
4
8
,
2
.
6
4
)
0.
7
7
7
$7
5
,
0
0
0
-
$
9
9
,
9
9
9
0.
8
6
(
0
.
7
1
,
1
.
0
4
)
0
.
1
2
5
0
.
9
1
(
0
.
4
4
,
1
.
9
1
)
0
.
8
1
0
0.
8
1
(
0
.
7
2
,
0
.
9
2
)
0
.
0
0
1
*
0
.
7
8
(
0
.
3
8
,
1
.
6
)
0
.
4
9
8
0.
9
(
0
.
3
2
,
2
.
5
8
)
0
.
8
5
0
>
$
1
0
0
,
0
0
0
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Re
f
*
*
Ce
n
s
u
s
R
e
g
i
o
n
No
r
t
h
e
a
s
t
0.
8
5
(
0
.
7
,
1
.
0
2
)
0.
0
8
6
1.
0
3
(
0
.
7
6
,
1
.
3
9
)
0.
8
6
6
1.
2
4
(
1
.
0
7
,
1
.
4
2
)
0.
0
0
3
*
1.
4
2
(
0
.
6
4
,
3
.
1
7
)
0.
3
8
7
0.
9
1
(
0
.
3
9
,
2
.
1
4
)
0.
8
2
5
So
u
t
h
0.
6
6
(
0
.
5
6
,
0
.
7
7
)
<
.
0
0
0
1
*
0
.
8
7
(
0
.
6
6
,
1
.
1
5
)
0
.
3
2
5
0
.
9
8
(
0
.
8
6
,
1
.
1
1
)
0.
7
1
2
1
.
2
(
0
.
6
5
,
2
.
1
9
)
0
.
5
6
3
0
.
8
5
(
0
.
4
2
,
1
.
7
1
)
0.
6
4
3
Mi
d
w
e
s
t
0.
8
0
(
0
.
7
,
0
.
9
3
)
0.
0
0
3
*
1.
1
2
(
0
.
8
6
,
1
.
4
5
)
0.
4
2
1
1.
1
8
(
1
.
0
6
,
1
.
3
3
)
0.
0
0
3
*
1.
5
6
(
0
.
9
6
,
2
.
5
2
)
0.
0
7
3
0.
7
9
(
0
.
4
6
,
1
.
3
7
)
0.
4
0
1
We
s
t
Re
f
R
e
f
Re
f
R
e
f
Re
f
R
e
f
Re
f
R
e
f
Re
f
R
e
f
Apx-62
April 2023 ISSUE BRIEF 12
DISCUSSION
Overall, 22.0% of adults reported using telehealth in the last four weeks of the study period (from April 2021 to
August 2022), which is comparable to ASPE’s previous analysis.
1 It should be noted that the Census Pulse data
on telehealth use reported in this paper is markedly lower, most likely due to the shorter reference period of
telehealth use (four weeks only), compared to higher rates of telehealth use by adults (37.0%) in twelve
months that was reported using the 2021 National Health Interview Survey (NHIS) administered by CDC.
16-18
The methodology is different as well. The NHIS is a long running nationally-representative health survey that
tracks a number of health care metrics. The HPS, launched in 2020, was designed as an experimental data
collection initiative to provide near real-time national estimates based on weighting procedures and
administered as a 20-minute online survey to adults 18 years and older. Another difference to note is that the
HPS included questions on modality, (video, and audio-only), while this information cannot be obtained using
the NHIS because no questions related to telehealth modality were included in the survey.
During the COVID-19 pandemic, telehealth has emerged as an important modality for many, especially
those in underserved communities where it has resulted in a reduction of no-show rates.
19,20 Despite the
enhanced access to health care, disparities in video telehealth access continue to persist among older
patients, people of color, and those with low technology literacy.21, 22 In addition, factors such as inadequate
infrastructure (e.g., internet connection, technology access, workflows) may impact a provider’s ability to
offer video telehealth.
23 One study found that providers in small practices from communities with high
social vulnerability
‡were almost twice as likely as providers in communities with low social vulnerability to
use telephones as their primary telehealth modality.
24, 25
Emerging evidence suggests patient satisfaction is higher with video telehealth visits compared to audio-only
telehealth.26, 27 Studies have also shown that consults via video telehealth are preferred by patients,
28 with
evidence of improved patient outcomes
29 and being less likely to have emergency department (ED) visits, in-
person, and hospital visits compared to those who did not use video telehealth.
30 However, there is conflicting
evidence on whether there are disparities in patient satisfaction with telehealth services among Asian
patients.31 More evidence is needed on patient preferences of telehealth modalities (e.g., video vs. audio
telehealth) compared to each other and to usual care (in-person visits).
32 In addition, it is important to expand
on smaller studies
33 and studies outside of the U.S.
34 to assess whether there are any differences in these
preferences and patient perceptions of their care across populations in the U.S.
Our subgroup analysis found disparities in video telehealth use across payers. For example, Black, Hispanic or
Latino, and Asian individuals covered by Medicaid and private insurance were less likely to use video
telehealth; however, our model showed that only Asians were less likely to use video telehealth among those
covered by Medicare while both Hispanic or Latinos and Asians were less likely to use video telehealth among
individuals who are uninsured.
Those covered by Medicaid had the highest rate of telehealth utilization compared to individuals with other
sources of coverage, comparable to findings from a previous ASPE analysis.
1 However, based on an ASPE report
from January 2022, the status of state Medicaid telehealth flexibilities varied widely and continued to change
frequently throughout the pandemic.
4 Some states expanded the use of telehealth permanently, others
rescinded all or some of their telehealth flexibilities making some permanent through state legislation, while
others were maintained pending the expiration of their state or federal PHE declaration. Variations in state
_______________________
‡The CDC defines social vulnerability as “the potential negative effects on communities caused by external stresses on human health.
Such stresses include natural or human-caused disasters, or disease outbreaks. Reducing social vulnerability can decrease both human
suffering and economic loss.”
23
Apx-63
April 2023 ISSUE BRIEF 13
Medicaid telehealth policies may impact patients’ and providers’ understanding of what types of visits will be
covered and how services should be billed. There are also numerous equity implications in a telehealth
landscape that is constantly shifting. When both federal and state PHEs expire and Medicaid redeterminations
resume starting on April 1, 2023, millions of those insured by Medicaid will be impacted through changes in
health insurance coverage and may experience changes in their access to health care services, including those
provided by telehealth.
10
The findings of our study suggest those insured by Medicare as being more likely to use telehealth and video
telehealth. These findings are consistent with our previous HPS analysis
1 and Medicare FFS claims analyses
conducted by ASPE which showed significant increases in use of telehealth by those insured by Medicare
during the pandemic.
2 However, those responding to the HPS survey may have higher digital literacy or
internet access given its administration as an online survey. Another study found individuals covered by
Medicare are less likely to use video telehealth. This study also noted that a potential reason for an overall
decrease in telehealth use among older patients may be related to their demographic and geographic
distribution, such as a higher share of older adults living in rural areas and lower rates of internet access.
35
Our study also found respondents reporting as Hispanic or Latino, Black, two or more races and other races
had higher overall telehealth use than White or Asian respondents. Despite higher odds of overall telehealth
use, Hispanic or Latino, Black, and Asian respondents were significantly less likely to use video telehealth—
particularly among those with Medicaid or private coverage—compared to their White counterparts. Video
telehealth use rates increased with higher income and education levels and younger age. These results are
somewhat counter to a study based on an analysis of the American Life Panel survey, which showed that video
telehealth use was highest in early 2021 among Black adults, and among those who were younger, had less
than high school education, and had lower income. In addition, the study reported respondents’ desire to use
video telehealth had increased from pre-pandemic estimates.
36
Our results are, however, similar to other studies finding disparities in video access to telehealth. For instance,
in a study of neurology patients, demographic predictors of those less likely to use video telehealth compared
to audio-only telehealth use included patients who were low-income, Black, and those insured by Medicare or
Medicaid.30
Other studies have also shown lower success in initiating video telehealth visits among Hispanic or Latino
patients, those who had low socioeconomic status (SES), and individuals insured by Medicare or Medicaid.
21, 37,
38 Potential reasons for unsuccessful initiation of video telehealth visits may be potential technology barriers,
as evidenced in one study including those who did not activate their patient portal prior to the visit.
39 Another
study compared video telehealth utilization pre and post COVID-19 PHE and found lower video telehealth rates
among males, Asian, Black, American Indian / Alaska Native patients, patients who had limited English
proficiency, and those who were insured by Medicaid or Medicare.
40 Younger patients had a preference for
video telehealth compared to older adults.
41
In general, these patterns of disparities likely reflect structural barriers to video telehealth, such as access to
technology, devices, broadband internet, technology literacy, and structural racism.
40 Additional research is
needed on which health conditions and health services are clinically appropriate to be delivered via telehealth
as well as whether video or audio may be a clinically preferred telehealth modality. For example, video
telehealth visits may be more appropriate than audio visits for certain clinical conditions and health services
requiring visual clues and examination (e.g., dermatology and surgical wound care).
42 However, if health
services cannot be accessed in the modality (in-person, video or audio telehealth) associated with the
strongest evidence, patient populations may be limited in accessing higher quality care which may affect
health outcomes.
43 Further assessment of telehealth’s impact on health outcomes will also require
Apx-64
April 2023 ISSUE BRIEF 14
standardized measures such as the Health Care Effectiveness Data and Information Set (HEDIS) quality
performance measures.
44
Limitations
This analysis has several limitations including the survey’s response rate that ranges from 1.3 percent to 10.3
percent, depending on the week. Despite applying weights to mitigate non-response bias, the inherent nature
of internet-based surveys can produce a bias based on the respondents’ internet accessibility and level of
comfort and familiarity with technology. Those who have access to technology and higher levels of health
literacy in general, as well as digital literacy, are more likely to respond to online surveys such as the HPS,
which can limit its generalizability to other populations. Our analysis was not able to control for baseline
differences in overall rates of health care use. Groups reporting higher telehealth use in the last four weeks
may simply reflect groups that are more likely to use health care services. Finally, the HPS did not include data
to distinguish rural and urban geographic areas; therefore, a comparison could not be made.
Policy Implications
Recent studies showed that video telehealth utilization is associated with a clinical provider’s perception of its
quality and comparability to in-person visits,
45 as well as whether available technologies are functional and
user-friendly in supporting video telehealth.
46 Furthermore, limited technology and health literacy continue to
pose challenges for accessing telehealth services among patients with limited English proficiency (LEP). New
evidence suggests prior video visit experience may help overcome barriers to video telehealth use.
47 However,
the current state of technology and user-friendliness of remote monitoring devices that link to telehealth visits
vary, as well as its acceptance among patients, especially those requiring assistance from others initiating
telehealth visits and interventions.
48
A resource that has been studied to enhance accessibility of telehealth has been the use of patient navigators
and community health workers to support patients in a telehealth visit. In addition to improving access to
video visits, one study demonstrated a return on investment (ROI) through increased adherence to clinic visits
that offset implementation costs.
49 This suggests additional policies may be considered for patient navigators
and community health workers to assist patients with telehealth visits.
While video telehealth may be more comparable to in-person visits, audio-only telehealth continues to be
important as it provides critical health care access for marginalized populations who lack access to technology,
broadband or ability to navigate a video telehealth visit. More work needs to be done to enable equitable
access to video telehealth by addressing disparities that are further exacerbated by lack of broadband access
or limitations in high-speed access impacting those residing in rural areas the most.
50 The challenge with
adequate broadband access are being addressed through programs and grants offered by the Federal
Communications Commission (FCC) and the U.S. Department of Commerce National Telecommunications and
Information Administration (NTIA) with appropriations from the Infrastructure Investment and Jobs Act
(IIJA).51,52,53 In the future, new alternative models for telehealth expansion may need to consider potential
access issues
54 especially among individuals who are uninsured.
19
CONCLUSION
Our study describes recent trends in the use of telehealth during the pandemic that may have implications for
policymakers as they consider whether to continue policies and flexibilities that enable access to telehealth
services. In addition, our study suggests the importance of reducing disparities in accessing telehealth services,
especially video, and highlights the need to improve access by providing more focused outreach to
communities who have lower levels of video telehealth utilization.
Apx-65
April 2023 ISSUE BRIEF 15
REFERENCES
1. Karimi M, Lee EC, Couture SJ, Gonzales AB, Grigorescu V, Smith SR, De Lew N, Sommers BD.National Trends in
Telehealth Use in 2021: Disparities in Utilization and Audio vs. Video Services. (Research Report No. HP-2022-04). Office
of the Assistant Secretary for Planning and Evaluation, U. S. Department of Health andHuman Services.Research Report.
February 2022. Accessed August 2, 2022.
https://aspe.hhs.gov/sites/default/files/documents/4e1853c0b4885112b2994680a58af9ed/telehealth-hps-ib.pdf
2. Samson L, Tarazi W, Turrini G, Sheingold S.Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary
Characteristics and Location. (Issue Brief No. HP-2021-27). U.S. Department of Health and Human Services. December
2021. Accessed August 2, 2022.
https://aspe.hhs.gov/sites/default/files/documents/a1d5d810fe3433e18b192be42dbf2351/medicare-telehealth-
report.pdf
3. Chu R, Peters C, De Lew, N, and Sommers BD.State Medicaid Telehealth Policies Before and During the COVID-19 Public
Health Emergency. (Issue Brief No. HP-2021-17). U.S. Department of Health and Human Services. July 2021. Accessed
August 2, 2022.https://aspe.hhs.gov/sites/default/files/documents/eb9e147935a2663441a9488e36eea6cb/medicaid-
telehealth-brief.pdf
4. Rudich J, Conmy AB, Chu R, Peters C, De Lew N, Sommers BD.State Medicaid Telehealth Policies Before and During the
COVID-19 Public Health Emergency: 2022 Update. Office of the Assistant Secretary for Planning and Evaluation, U.S.
Department of Health and Human Services. November 2022. Accessed February 21, 2023.
https://aspe.hhs.gov/sites/default/files/documents/190b4b132f984db14924cbad00d19cce/Medicaid-Telehealth-IB-
Update-Final.pdf
5. Koonin LM, Hoots B, Tsang CA, et al. Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic -
United States, January-March 2020.MMWR Morb Mortal Wkly Rep. Oct 30 2020;69(43):1595-1599.
doi:10.15585/mmwr.mm6943a3
6. HRSA. What is telehealth? Department of Health and Human Services. Accessed June 9, 2021.
https://telehealth.hhs.gov/patients/understanding-telehealth/
7. Demeke HB, Merali S, Marks S, et al.Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic
— United States, June 26–November 6, 2020. Vol. 70.240–244.MMWR Morb Mortal Wkly Rep 2021. February 19, 2021
https://www.cdc.gov/mmwr/volumes/70/wr/mm7007a3.htm
8. FAIR HEALTH. Telehealth Utilization Fell Nearly Four Percent Nationally in June 2022. CISION PR Newswire; 2022.
September 12, 2022.https://www.prnewswire.com/news-releases/telehealth-utilization-fell-nearly-four-percent-
nationally-in-june-2022-301621770.html
9. White-Williams C, Liu X, Shang D, Santiago J. Use of Telehealth Among Racial and Ethnic Minority Groups in the United
States Before and During the COVID-19 Pandemic.Public Health Rep. Sep 16 2022:333549221123575.
doi:10.1177/00333549221123575
10. Department of Health and Human Services Assistant Secretary for Public Affairs.Fact Sheet: COVID-19 Public Health
Emergency Transition Roadmap. HHS Press Office; February 9, 2023, Accessed February 21, 2023.
https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html
11. United States Census Bureau. Household Pulse Survey Technical Documentation. Updated February 17, 2023. Accessed
March 16, 2023,https://www.census.gov/programs-surveys/household-pulse-survey/technical-documentation.html
12. U.S. Census Bureau. Data from: Measuring Household Experiences during the Coronavirus Pandemic. 2022.
https://www.census.gov/programs-surveys/household-pulse-survey/datasets.html.
13. Rabbani N, Chen JH. National Trends in Pediatric Ambulatory Telehealth Utilization and Follow-Up Care.Telemed J E
Health. Jan 2023;29(1):137-140. doi:10.1089/tmj.2022.0137
14. Ortega P, Shin TM, Martínez GA. Rethinking the Term "Limited English Proficiency" to Improve Language-Appropriate
Healthcare for All.J Immigr Minor Health. Jun 2022;24(3):799-805. doi:10.1007/s10903-021-01257-w
15. Uscher-Pines L, McCullough C, Dworsky MS, et al. Use of Telehealth Across Pediatric Subspecialties Before and During
the COVID-19 Pandemic.JAMA Netw Open. Mar 1 2022;5(3):e224759. doi:10.1001/jamanetworkopen.2022.4759
16. Lucas JW, Villarroel MA.Telemedicine use among adults: United States, 2021. Vol. no. 445. National Center for Health
Statistics.NCHS Data Brief. October 2022. Accessed January 9, 2023.
https://www.cdc.gov/nchs/products/databriefs/db445.htm
17. Villarroel MA, Lucas JW.QuickStats: Percentage of Persons Who Used Telemedicine During the Past 12 Months, by Age
Group — National Health Interview Survey, United States, 2021. Vol. 72.132.MMWR Morb Mortal Wkly Rep 2023.
Apx-66
April 2023 ISSUE BRIEF 16
February 3, 2023. Accessed March 16, 2023.
https://www.cdc.gov/mmwr/volumes/72/wr/mm7205a2.htm#suggestedcitation
18. Lucas JW, Villarroel MA, Cohen R.QuickStats: Percentage of Adults Aged 18–64 Years Who Used Telemedicine in the
Past 12 Months, by Sex and Health Insurance Coverage — National Health Interview Survey, United States 2021. Vol.
72.244.MMWR Morb Mortal Wkly Rep. March 3, 2023. Accessed March 16, 2023.
https://www.cdc.gov/mmwr/volumes/72/wr/mm7209a5.htm?s_cid=mm7209a5_w
19. Khairat S, Yao Y, Coleman C, McDaniel P, Edson B, Shea CM. Changes in Patient Characteristics and Practice Outcomes of
a Tele-Urgent Care Clinic Pre- and Post-COVID-19 Telehealth Policy Expansions.Perspect Health Inf Manag. Spring
2022;19(Spring):1k.
20. Sun CA, Perrin N, Maruthur N, Renda S, Levin S, Han HR. Predictors of Follow-Up Appointment No-Shows Before and
During COVID Among Adults with Type 2 Diabetes.Telemed J E Health. Nov 4 2022;doi:10.1089/tmj.2022.0377
21. Cousins MM, Van Til M, Steppe E, et al. Age, race, insurance type, and digital divide index are associated with video visit
completion for patients seen for oncologic care in a large hospital system during the COVID-19 pandemic.PLoS One.
2022;17(11):e0277617. doi:10.1371/journal.pone.0277617
22. Lau KHV, Anand P, Ramirez A, Phicil S. Disparities in Telehealth use During the COVID-19 Pandemic.J Immigr Minor
Health. Dec 2022;24(6):1590-1593. doi:10.1007/s10903-022-01381-1
23. Ranganathan C, Balaji S. Key Factors Affecting the Adoption of Telemedicine by Ambulatory Clinics: Insights from a
Statewide Survey.Telemed J E Health. Feb 2020;26(2):218-225. doi:10.1089/tmj.2018.0114
24. Chang JE, Lai AY, Gupta A, Nguyen AM, Berry CA, Shelley DR. Rapid Transition to Telehealth and the Digital Divide:
Implications for Primary Care Access and Equity in a Post-COVID Era.Milbank Q. Jun 2021;99(2):340-368.
doi:10.1111/1468-0009.12509
25. Centers for Disease Control and Prevention. CDC/ATSDR Social Vulnerability Index. Updated November 16, 2022.
Accessed March 14, 2023, 2023.https://www.atsdr.cdc.gov/placeandhealth/svi/index.html
26. Chen K, Lodaria K, Jackson HB. Patient satisfaction with telehealth versus in-person visits during COVID-19 at a large,
public healthcare system.J Eval Clin Pract. Sep 22 2022;doi:10.1111/jep.13770
27. Hays RD, Skootsky SA. Patient Experience with In-Person and Telehealth Visits Before and During the COVID-19
Pandemic at a Large Integrated Health System in the United States.J Gen Intern Med. Mar 2022;37(4):847-852.
doi:10.1007/s11606-021-07196-4
28. Srinivasulu S, Manze MG, Jones HE. "I totally didn't need to be there in person": New York women's preferences for
telehealth consultations for sexual and reproductive healthcare in primary care.Fam Pract. Sep 19
2022;doi:10.1093/fampra/cmac102
29. Graetz I, Huang J, Muelly ER, Hsueh L, Gopalan A, Reed ME. Video Telehealth Access and Changes in HbA1c Among
People With Diabetes.Am J Prev Med. May 2022;62(5):782-785. doi:10.1016/j.amepre.2021.10.012
30. Kummer BR, Agarwal P, Sweetnam C, et al. Trends in the Utilization of Teleneurology and Other Healthcare Resources
Prior to and During the COVID-19 Pandemic in an Urban, Tertiary Health System.Front Neurol. 2022;13:834708.
doi:10.3389/fneur.2022.834708
31. Acoba JD, Yin C, Meno M, et al. Racial Disparities in Patient-Provider Communication During Telehealth Visits Versus
Face-to-face Visits Among Asian and Native Hawaiian and Other Pacific Islander Patients With Cancer: Cross-sectional
Analysis.JMIR Cancer. Dec 9 2022;8(4):e37272. doi:10.2196/37272
32. Huang J, Graetz I, Millman A, et al. Primary care telemedicine during the COVID-19 pandemic: patient's choice of video
versus telephone visit.JAMIA Open. Apr 2022;5(1):ooac002. doi:10.1093/jamiaopen/ooac002
33. Knaus ME, Kersey K, Ahmad H, et al. Both sides of the screen: Provider and patient perspective on telemedicine in
pediatric surgery.J Pediatr Surg. Aug 2022;57(8):1614-1621. doi:10.1016/j.jpedsurg.2022.03.015
34. Rasmussen B, Perry R, Hickey M, et al. Patient preferences using telehealth during the COVID-19 pandemic in four
Victorian tertiary hospital services.Intern Med J. May 2022;52(5):763-769. doi:10.1111/imj.15726
35. Ng BP, Park C, Silverman CL, Eckhoff DO, Guest JC, Díaz DA. Accessibility and utilisation of telehealth services among
older adults during COVID-19 pandemic in the United States.Health Soc Care Community. Sep 2022;30(5):e2657-e2669.
doi:10.1111/hsc.13709
36. Fischer SH, Predmore Z, Roth E, Uscher-Pines L, Baird M, Breslau J. Use Of And Willingness To Use Video Telehealth
Through The COVID-19 Pandemic.Health Aff (Millwood). Nov 2022;41(11):1645-1651. doi:10.1377/hlthaff.2022.00118
37. Odukoya EJ, Andino J, Ng S, Steppe E, Ellimoottil C. Predictors of Video versus Audio-Only Telehealth Use among
Urological Patients.Urol Pract. May 2022;9(3):198-204. doi:10.1097/upj.0000000000000301
38. Webber EC, McMillen BD, Willis DR. Health Care Disparities and Access to Video Visits Before and After the COVID-19
Pandemic: Findings from a Patient Survey in Primary Care.Telemed J E Health. Aug 27 2021;doi:10.1089/tmj.2021.0126
Apx-67
April 2023 ISSUE BRIEF 17
39. Shee K, Liu AW, Yarbrough C, Branagan L, Pierce L, Odisho AY. Identifying Barriers to Successful Completion of Video
Telemedicine Visits in Urology.Urology. Nov 2022;169:17-22. doi:10.1016/j.urology.2022.07.054
40. Sachs JW, Graven P, Gold JA, Kassakian SZ. Disparities in telephone and video telehealth engagement during the COVID-
19 pandemic.JAMIA Open. Jul 2021;4(3):ooab056. doi:10.1093/jamiaopen/ooab056
41. Pasquinelli MM, Patel D, Nguyen R, et al. Age-based disparities in telehealth use in an urban, underserved population in
cancer and pulmonary clinics: A need for policy change.J Am Assoc Nurse Pract. May 1 2022;34(5):731-737.
doi:10.1097/jxx.0000000000000708
42. Chen J, Li KY, Andino J, et al. Predictors of Audio-Only Versus Video Telehealth Visits During the COVID-19 Pandemic.J
Gen Intern Med. Apr 2022;37(5):1138-1144. doi:10.1007/s11606-021-07172-y
43. Lori Uscher-Pines LS. Rethinking The Impact Of Audio-Only Visits On Health Equity.Health Affairs Forefront. DECEMBER
17, 2021 2021;doi:10.1377/forefront.20211215.549778
44. Baughman DJ, Jabbarpour Y, Westfall JM, et al. Comparison of Quality Performance Measures for Patients Receiving In-
Person vs Telemedicine Primary Care in a Large Integrated Health System.JAMA Netw Open. Sep 1 2022;5(9):e2233267.
doi:10.1001/jamanetworkopen.2022.33267
45. Gately ME, Quach ED, Shirk SD, Trudeau SA. Understanding Variation in Adoption of Video Telehealth and Implications
for Health Care Systems.Med Res Arch. Jun 1 2022;10(5)doi:10.18103/mra.v10i5.2751
46. Connolly SL, Miller CJ, Gifford AL, Charness ME. Perceptions and Use of Telehealth Among Mental Health, Primary, and
Specialty Care Clinicians During the COVID-19 Pandemic.JAMA Netw Open. Jun 1 2022;5(6):e2216401.
doi:10.1001/jamanetworkopen.2022.16401
47. Hsueh L, Huang J, Millman AK, et al. Disparities in Use of Video Telemedicine Among Patients With Limited English
Proficiency During the COVID-19 Pandemic.JAMA Netw Open. Nov 1 2021;4(11):e2133129.
doi:10.1001/jamanetworkopen.2021.33129
48. Marsh Z, Teegala Y, Cotter V. Improving diabetes care of community-dwelling underserved older adults.J Am Assoc
Nurse Pract. Oct 1 2022;34(10):1156-1166. doi:10.1097/jxx.0000000000000773
49. Mechanic OJ, Lee EM, Sheehan HM, et al. Evaluation of Telehealth Visit Attendance After Implementation of a Patient
Navigator Program.JAMA Netw Open. Dec 1 2022;5(12):e2245615. doi:10.1001/jamanetworkopen.2022.45615
50. O'Shea AMJ, Baum A, Haraldsson B, et al. Association of Adequacy of Broadband Internet Service With Access to Primary
Care in the Veterans Health Administration Before and During the COVID-19 Pandemic.JAMA Netw Open. Oct 3
2022;5(10):e2236524. doi:10.1001/jamanetworkopen.2022.36524
51. Infrastructure Investment and Jobs Act, Public Law 117-58 (Rep. DeFazio PA 2021). November 15, 2021. Accessed
October 12, 2022.https://www.congress.gov/bill/117th-congress/house-bill/3684
52. National Telecommunications and Information Administration. NTIA’s Role in Implementing the Broadband Provisions of
the 2021 Infrastructure Investment and Jobs Act. Accessed October 12, 2022,
https://broadbandusa.ntia.doc.gov/news/latest-news/ntias-role-implementing-broadband-provisions-2021-
infrastructure-investment-and
53. National Telecommunications and Information Administration. Grants: Infrastructure Investment and Jobs Act
Overview. Accessed November 6, 2022,https://www.ntia.doc.gov/category/grants
54. Tang M, Chernew ME, Mehrotra A. How Emerging Telehealth Models Challenge Policymaking.Milbank Q. Sep 28
2022;doi:10.1111/1468-0009.12584
Apx-68
April 2023 ISSUE BRIEF 18
APPENDIX
Appendix exhibit 1. Table of telehealth utilization percentage (%) from each HPS survey period weeks 28-48 (April
2021 – August 2022)
DATES Adults Children
Apr 14 – Apr 26, 2021 26.9 24.1
Apr 28 – May 10, 2021 26.1 23.4
May 12 – May 24, 2021 25.9 23.2
May 26 – Jun 7, 2021 25.3 22.7
Jun 9 – Jun 21, 2021 24.5 22.6
Jun 23 – Jul 5, 2021 24.6 22.1
Jul 21 – Aug 2, 2021 20.6 16.2
Aug 4 – Aug 16, 2021 20.2 15.3
Aug 18 – Aug 30, 2021 20.5 15.8
Sep 1 – Sep 13, 2021 20.6 16.5
Sept 15 – Sep 27, 2021 20.9 16.5
Sep 29 – Oct 11, 2021 20.9 16.8
Dec 1 – Dec 13, 2021 19.7 15.8
Dec 29 – Jan 10, 2022 20.2 16.2
Jan 26 – Feb 7, 2022 22.0 16.4
Mar 2 – Mar 14, 2022 21.2 15.9
Mar 30 – Apr 11, 2022 20.7 15.2
Apr 27 - May 9, 2022 20.5 15.1
Jun 1 - Jun 13, 2022 24.1 16.7
Jun 29 - Jul 11, 2022 24.2 16.0
Jul 27 - Aug 8, 2022 22.8 15.5
Apx-69
April 2023 ISSUE BRIEF 19
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Assistant Secretary for Planning and Evaluation
200 Independence Avenue SW, Mailstop 447D
Washington, D.C. 20201
For more ASPE briefs and other publications, visit:
aspe.hhs.gov/reports
ABOUT THE AUTHORS
Euny C. Lee is a Social Science Analyst in the Office of Health Policy at ASPE.
Violanda Grigorescu is a Senior Health Scientist in the Office of Health Policy at ASPE.
Idia Enogieru is an ORISE Fellow in the Office of Health Policy at ASPE.
Scott R. Smith is the Division Director in the Office of Health Policy at ASPE.
Lok Wong Samson is a Health Policy Analyst in the Office of Health Policy at ASPE.
Ann B. Conmy is a Social Science Analyst in the Office of Health Policy at ASPE.
Nancy De Lew is the Acting Deputy Assistant Secretary, Health Policy, at ASPE.
SUGGESTED CITATION
Lee, E.C., Grigorescu, V., Enogieru, I., Smith, S.R., Samson, L.W., Conmy, A., De Lew,
N. Updated National Survey Trends in Telehealth Utilization and Modality: 2021-
2022 (Issue Brief No. HP-2023-09). Office of the Assistant Secretary for Planning
and Evaluation, U. S. Department of Health and Human Services. April 2023.
COPYRIGHT INFORMATION
All material appearing in this report is in the public domain
and may be reproduced or copied without permission;
citation as to source, however, is appreciated.
DISCLOSURE
This communication was printed, published, or produced and
disseminated at U.S. taxpayer expense.
___________________________________
Subscribe to ASPE mailing list to receive
email updates on new publications:
https://list.nih.gov/cgi-bin/wa.exe?SUBED1=ASPE-HEALTH-POLICY&A=1
For general questions or general
information about ASPE:
aspe.hhs.gov/about
HP-2023-09
Apx-70
APPENDIX F
AMERICAN MEDICAL ASSOCIATION ARTICLE
Apx-71
Apx-72
Apx-73
Apx-74
Apx-75
Apx-76
Apx-77
Apx-78
Apx-79
Apx-80
Apx-81
Apx-82
Apx-83
Apx-84
Apx-85
Apx-86
Apx-87
Apx-88
Apx-89
Apx-90
Apx-91
Apx-92
Apx-93