A Better Emergency Response Starts With a Better System

For You. For the Community.
For a Safer San Luis Obispo County.

Faster, Smarter Emergency Response

Ambulances should be positioned where emergencies are most likely to occur, helping improve coverage and response during the busiest times.

More Ambulances Available for Emergencies

Reducing the impact of non-emergency transports helps keep ambulances available when someone calls 9-1-1.

Sending the Right Help

Modern dispatch tools help match the response to the emergency, improving safety while reducing unnecessary lights-and-sirens responses.

Accountability You Can See

Public oversight, competitive procurement, financial transparency, and performance reporting help build community trust.

Building for the Future

The partnership creates opportunities for community paramedicine, behavioral health response, telemedicine, and other innovative services.

Why now? A solution is long overdue.

There have been years of warning signs. First responders, city and community leaders, and concerned citizens are taking action.

The EMS transport system is largely unchanged from the 1980’s.
- Current Legacy Deployment Model (Static) – Ambulances are based at stations. A modern deployment model (Dynamic) places available ambulances in locations based on data and probability, resulting in more responsive service.
- Interfacility Transfers - (transports from hospital to specialty care facilities) deplete 9-1-1 system ambulances, creating delays for true emergencies.
- Emergency Medical Dispatch (EMD) -SLO COUNTY IS THE ONLY COUNTY IN THE STATE THAT DOES NOT PROVIDE EMD. This lack of emergency prioritization triggers “lights and sirens” for both ambulances and fire engines, increasing community risk and safety, whether the call is for a possible sprained ankle or cardiac arrest. This is an Ineffective use of resources.
Current provider does not pay for dispatch costs. SLO County absorbs $2 million+ annually; fire departments pay $67 per call for dispatch services.
- Fire departments without a dispatch center pay the county to provide those services at a cost of $67/call.
  • The current for-profit provider does not pay any county dispatch costs.
  • $2 Million + estimate.
  • Gift of Public Funds: TAXPAYERS PAY FOR FIRE DISPATCH, WHILE FOR PROFIT PROVIDER PAYS NOTHING.
Problems with the system have persisted for years, even after two Grand Jury reports.
- 1995-96 Grand Jury – The Grand Jury recommended that the current ambulance contract be extended for two years, at which time the “privilege of providing ambulance services should be put out to bid.”
- 1997-98 Grand Jury - The Grand Jury investigated a flawed competitive bidding process in the Southern Ambulance Zone (District). While the Board of Supervisors awarded the contract to Five Cities Ambulance (FCAS) due to a threat of litigation, it should be noted that when FCAS experienced significant financial hardship, San Luis Ambulance was given the Southern Zone without a competitive process, or a purchase of FCAS as determined by the California EMS Authority. The Southern Zone has been “non-exclusive” for over a decade, meaning that any other ambulance company could enter the Southern Zone at any time and demand to be dispatched by the County.
We have not seen response compliance data in over a year.
- Transparency – Current contract requires specific response time compliance by zone (Urban, Suburban, Rural, Remote). Reporting has not been shared in over a year.
- Accountability & Transparency – The PPP will have this information available and posted on-line.
SLO County has not put this contract out for competitive bidding in over 70 years.
- Transparency – Government agencies routinely put contracts out to a competitive bidding process to ensure they are getting the best cost for a product or service. The County of San Luis Obispo has such a policy. While the California EMS Act does contain provisions for “grandfathering” operating areas without a competitive bid, the Southern Zone has been determined “non-exclusive” which warrants a competitive bidding process.
- Grand Jury Reports – have addressed this need over the years, and the California EMS Authority requires the process on a continuing basis (at least every 10 years) once the competitive bidding process is implemented.
Ambulance rates increased by 62% without public notice.
- Rate Review requested by current provider in 2024 – Incumbent had placed a 24-hour ambulance in Los Osos to meet contractual response time obligations, triggering the base rate review requirement for “significant change in financial conditions.”
- Consultant Analysis – As the current provider has a contractually guaranteed 5%-7% profit margin, the recommended 62% increase was intended to keep the county in compliance with this contractual requirement.
- Transparency – The current provider cites “proprietary” confidentiality and does not provide audited financial statements when requesting these reviews.
- Transparency – The PPP would hold open meetings to consider rate increases approvals, along with full financial disclosure.
Current ambulance provider requests rate review in 2024. Review recommends a significant increase to keep County in compliance with contractual 5-7% profit margin for current provider.
- Consultant Analysis – As the current provider has a contractually guaranteed 5%-7% profit margin, the recommended 62% increase was intended to keep the county in compliance with this contractual requirement.
- Transparency – The current provider cites “proprietary confidentiality’ and does not provide audited financial statements when requesting these reviews. Transparency – The PPP would hold open meetings to consider rate increases approvals, along with full financial disclosure. Government agencies are required to provide audited financial statements.
Current ambulance provider tells the Board of Supervisors they will not accept a rate increase… then increase rates?
- Rate Review requested by current provider in 2024.
- Current Provider states, “We Don’t Intend to Accept the Rate Increase...” at October 2025 Board of Supervisors Meeting.
- 62% Rate Increase effective February 2026.
- Current Provider placed Basic Life Support (BLS) ambulance into service. There was not a rate allowing this service prior to the rate increase.
- Transparency - Is the current provider not charging for all services at the new rates? Is the current provider advocating against higher rates in an attempt to dissuade other vendors?
- Transparency – If the PPP requested a rate review, the entire process would require public noticing, staff reports, and city council deliberation.
Current ambulance provider is spreading misinformation, and continues to make inaccurate statements at public events. Here are two examples:
“ Employees Will Lose Their Jobs”
- Fact: The incumbent workforce will be vital to a transition to a new ambulance transport provider. See California Health & Safety Code 1797.230(c):
- On and after January 1, 2022, a county shall not enter into or renew a contract for emergency ambulance services unless the county board of supervisors has adopted, by ordinance or resolution, a written policy setting forth issues to be considered for inclusion in the county contract for emergency ambulance services, which may include, but are not limited to, all of the following:
- (1) Employment retention requirements for the employees of the incumbent ambulance service.
“Ambulance Rates are set by the County, Fire Chief Stornetta was actually the Chair of the committee that suggested these rates – even though San Luis Ambulance did not ask for them…”
- Fact: The current provider requested a rate review in 2024.
- Fact: The consultant recommended 62% increase was to maintain the provider’s 5%-7% profit margin to remain compliant with the county contract.