During the Sept. 19 meeting, the supervisors heard from American Medical Response—its current ambulance provider—and County Fire about their proposals to provide ambulance services for the county. These applications came forward after the supervisors unanimously approved a nonexclusive ambulance services agreement to help combat duplicated services and costs to provide a streamlined medical response.
“They save lives on a daily basis; where I come down on this is we need to provide the most integrated and best service to our constituents,” 4th District Supervisor Bob Nelson said.
The nonexclusive program set up a tiered system and a new permitting process where applicants could apply for specific ambulance services they’d like to provide—including emergency medical calls; interfacility transport and special events transport; or critical care transport.
In order to be approved, applicants had to demonstrate their experience, the proposal’s feasibility and economic viability, and community benefits like innovative service delivery and local reinvestment, according to the staff report.
Santa Barbara County Fire applied for an emergency medical call permit, an interfacility transport and special event standby permit, and a critical care transport permit. Fire Chief Mark Hartwig highlighted that the entire system would be integrated and working with other first responders, provide 24/7 priority-based deployment and a dedicated interfacility and mental health transport fleet, have financial transparency for the community, and provide paramedicine opportunities where paramedics could conduct outreach.
“We can use these employees at work that aren’t running calls to do other work. We found through Behavioral Wellness and Public Health and the hospital that visits to discharged patients keeps them out of the hospital before it turns into an extreme situation,” Hartwig said.
American Medical Response applied for only the emergency medical call permit, to respond when someone calls in need of immediate medical attention.
In its proposal, AMR Regional Director Mike Sanders said that it will continue to provide services as it has over the past 50 years, using its communications infrastructure; providing local CPR, “stop the bleed,” and school educational opportunities; and will provide data to develop a strong deployment strategy.
“The reason we did that is because permits two [interfacility transport] and three [critical care transport] in themselves simply aren’t sustainable,” AMR Regional Director Mike Sanders told the Supervisors. “We need permit one to make two and three work. We didn’t want to be denied one and be with two and three; we view ourselves as a 911 emergency provider primarily, but we realize the important services with interfacility transfers and critical care transport.”
Fourth District Supervisor Nelson said that this application was not complete and it didn’t consider how it would integrate with the current 37 fire stations to provide services and how it would respond to calls in rural areas like Cuyama, Tepusquet, and Sisquoc, when it hasn’t in the past, while County Fire had plans to have 24-hour coverage in those areas and incorporates its new substation in Cuyama.
Initially, Nelson said he wanted to approve AMR’s proposal with conditions that they come back with changes, but after further discussion he said he was ready to deny it altogether.
“If AMR walked away tomorrow, we would have to step up. We could have a further discussion for what could be shared, but I was disappointed you can’t even find the word Cuyama in their application. There’s no integration with the 37 stations,” Nelson said. “Being under different roofs is good for accountability, but it creates problems when we are trying to serve the public, and I want to keep it under one line.”
As of press time, the supervisors hadn’t voted to deny AMR’s contract.