It is operated by the Alameda Health System. It is the primary trauma center and a county hospital in Alameda County. It has been an adult Level I trauma center since August 3, 2017[1] and an adult Level II trauma center since 1985 and operates the most trafficked emergency department in the county.[2] Highland Hospital is affiliated with the University of California, San Francisco (UCSF) and is also home to the UCSF East Bay Surgery Program. Their medical residency programs are among the most competitive and highly sought after in the nation.