Fire chiefs across Santa Barbara County are unhappy with the county’s decision to settle a lawsuit with American Medical Response (AMR) and renew the ambulance provider’s contract.
“Fire chiefs have consistently called for an EMS system that emphasizes transparency, accountability, and increases units on the street. Unfortunately, it seems like these concerns have largely fallen on deaf ears,” Lompoc Fire Department Chief Brian Fallon told the Board of Supervisors during its Feb. 11 meeting. “AMR has a documented history of unreliable response times, yet the county is deciding today to potentially extend that contract for another four years.”
Fallon and other fire personnel lamented the county’s recent policy direction change, which came about thanks to a settlement agreement with AMR over the lawsuit it filed in 2023 after the county awarded its ambulance services contract to the county Fire Department. The new four-year contract requires longtime county emergency medical services provider AMR to implement new performance standards and an option for the county Fire Department to provide services in Lompoc, Carpinteria, Summerland, and Montecito via a subcontract. County Fire will continue to serve Vandenberg Village, Cuyama, and UC Santa Barbara.
The new performance standards system was part of the original request for proposal put out by the county in 2022. Lars Seifert with the Public Health Department said the system was “a leading effort” in the state to monitor delivery of care and that the feedback from fire personnel was initially positive.
But fire chiefs including Fallon expressed dismay that AMR might get away with longer response times thanks to the way the contract is set up.
For instance, the contract requires that AMR respond to at least 90 percent of urban priority 1 calls within seven minutes and 59 seconds. For anything less than that, AMR must pay the county penalties—but AMR can also get a discount on those fines by meeting certain other performance standards, such as the quality of care provided on the scene.
“We rely on you to make the decisions that ultimately impact the communities we serve. … This contract is ultimately a bad deal for the communities we serve,” Bryan Fernandez with the Santa Barbara County firefighters union said. “You need definitive care at a hospital, quickly, and that depends on how quickly you get help.”
If AMR dipped below that 90 percent standard for three months in a row, it could be considered a breach of contract, Seifert said.
Fifth District Supervisor Steve Lavagnino pushed back on the assertion that AMR could get away with longer response times, saying he wouldn’t approve a contract that he felt would put his 89-year-old father in danger.
“To point to this board and say that if somebody gets killed, if somebody gets hurt, it’s on us, I really thought you were better than that,” Lavagnino said. “We have a. Responsibility to this county. … We also have a fiduciary responsibility as well. We had the attorney general for California weigh in on this issue, and not on your side, not on our side.”
Shortly after the AMR lawsuit was filed, state Attorney General Rob Bonta filed a brief in the case questioning the legality of the county’s methods in awarding the contract to the Fire Department. The county had overruled the Local Emergency Medical Services Authority, which had originally awarded the contract to AMR. In addition, a Santa Barbara County Superior Court judge sided with AMR, granting an injunction against the county and its Fire Department contract and extending AMR’s contract.
While 4th District Supervisor Bob Nelson said he didn’t necessarily align with some of his board colleagues on this issue, he said he respected them.
“They are making a decision that I think is still a responsible one,” Nelson said. “I’ve been very frustrated by what I would call ‘lawfare,’ which is what AMR has deployed.”
He added that the new rates in the contract could be some of the highest in the state. Critical care transport will cost $6,213 per ride with the new contract, advanced life support will cost $4,606, and basic life support transport $2,994. According to county Communications Manager Kelsey Buttitta, it currently costs $5,608 for critical care transport, $3,412 for advanced life support, and $2,218 for basic.
The Board of Supervisors voted 3-2 to move ahead with the AMR contract for emergency medical and ambulance services and repeal the ordinance that enabled it to contract those services the Fire Department. Nelson and new 1st District Supervisor Roy Lee dissented.
This article appears in Feb 13-23, 2025.