After deciding to switch to the Santa Barbara County Fire Department as the county ambulance provider, the Santa Barbara County Board of Supervisors voted 4-1 (with 5th District Supervisor Steve Lavagnino dissenting) to approve an $18 million investment to cover startup costs as the county fire department gets ready to take over ambulance services on March 1, 2024.
The approval allows County Fire to add 123 full-time positions and to use $18 million from fire district reserves to purchase equipment needed in the ambulances, provide employees with proper training, and cover their salaries until the county starts getting reimbursed from insurance, County Fire Chief Mark Hartwig told the Sun.
“The key for today was getting some equipment that we know has a lag time, and starting the recruitment process is the most time-sensitive issue that we’re dealing with now,” Hartwig said.
AMR was the sole ambulance service provider in Santa Barbara County for the last 40 years. The Board of Supervisors launched a request for proposal (RFP) in 2019 to see what could be changed in the current system, according to previous Sun reporting. County Fire and AMR responded in May 2022, and the county’s Local Emergency Medical Services Agency (LEMSA)—an independent agency that oversees ambulance services—awarded the contract to AMR.
In April 2023, the county switched to a nonexclusive ambulance services agreement where there could be more than one ambulance provider. The nonexclusive agreement set up a tiered system and a new permitting process where multiple applicants could apply for emergency medical calls, interfacility and special events transport, and/or critical care transport.
County Fire will now handle all three services after the Board of Supervisors unanimously approved the fire department’s proposal during its Sept. 19 meeting and voted 4-1 (with Lavagnino dissenting) to deny AMR’s proposal to handle only emergency medical calls.
With fewer than 120 days left until March 1, Hartwig said that County Fire is using an implementation plan to create a smooth transition and to ensure an effective delivery of services. The department is currently in phase two of four phases, which focuses on hiring positions and a fee study to evaluate ambulance rate costs, according to the staff report.
Once hiring is complete or near complete, County Fire will continue to train employees and present billing policies and agreements for final approval to the Board of Supervisors at a later date.
“It’s safe to say that we looked at what it would take very carefully, and we applied for the permit without expressing concerns for March 1 because we were comfortable and confident we could meet that date,” Hartwig said.
After the supervisors denied AMR’s proposal, it filed a lawsuit against the county, claiming that the decision violated the state EMS Act by awarding contracts solely to County Fire in a nonexclusive agreement.
“The county cannot ‘enhance’ its power to enact policies and procedures under the EMS Act; once it established an EMS program, the county was statutorily required to designate a LEMSA responsible for planning and implementing an EMS system,” court documents read. “The LEMSA, not the county, is responsible for administrating and regulating EMS; the county cannot impose an effective power-sharing scheme under the EMS Act.”
Michael Rice, AMR’s vice president of operations, told the Sun in a statement that the first hearing is scheduled for Dec. 1 in Santa Barbara County Superior Court.
While Fire Chief Hartwig couldn’t comment on pending litigation, he said that County Fire will not stop implementing its ambulance services plan.
“We’re not pausing to wait to hear from any legal action. … It’s not lost that a day off is not allowable right now, we’re going to be ready for March 1,” Hartwig said. “We’re full speed ahead; we have a very tight window to be up and ready for March 1. Unless we hear otherwise, we will prepare to be ready and live by March 1, 2024.”
This article appears in Nov 9-19, 2023.