AMR Granted Exclusive Santa Barbara Ambulance Contract

After being left very little legal wiggle room, the Board of Supervisors voted 3-2 on February 11 to grant exclusive ambulance rights to American Medical Response West (AMR), which has operated as the only ambulance provider in the county for more than 40 years. The newly approved contract promises shorter response times and increased oversight to ensure a high quality of care for patients. The county’s firefighters, however, showed up to the Board of Supervisors meeting with a bone to pick.

“Our disappointment … cannot be overstated,” said Lompoc Fire Chief Brian Fallon. Firefighters from Montecito, Carpinteria/Summerland, and Santa Maria joined in the sentiment, blasting the Board for approving this new contract that had previously been granted to Santa Barbara County Fire.

“This contract is the best that we can do for now,” said Supervisor Joan Hartmann. “We’ve contorted ourselves every which way to try and get through this.”

AMR sued the county in 2023 shortly after the supervisors granted the $1 billion contract to County Fire, despite AMR scoring more than 300 points higher in their bid for it. AMR’s attorneys argued that the county ignored the competitive process required by law when deciding who provides emergency medical services to a community. By tilting the scales in County Fire’s favor, they argued, the supervisors were facilitating a monopoly.

In Santa Barbara Superior Court, Judge Donna Geck issued a blistering opinion in agreement with AMR later that year. Further, a friend-of-the-court brief from State Attorney General Rob Bonta on AMR’s behalf worsened the county’s odds. A jury trial on the matter was set to begin in the next couple of months.

AMR has promised to settle its litigation against the county as a condition of the contract approval. To date, Santa Barbara County has spent $830,000 on outside counsel to litigate the matter, said Kelsey Buttitta, a spokesperson for the county.

AMR will have the contract for an initial four-year term, with the option for County Fire to sub-contract to provide EMS services in Lompoc, Carpinteria, Summerland, and Montecito. In 2024, there were 7,140 calls for service in these areas, Buttitta said, making up about 15 percent of all calls in the county, not including Cuyama, UCSB, and Mission Hills.

The new contract reduces the required ambulance response time by two minutes, and AMR must meet the appropriate response times 90 percent of the time. If they fall short for three consecutive months, explained Deputy Director of the Public Health Department Lars Seifert, they will be considered in breach of contract. 

AMR will be evaluated based on a clinical scorecard system that measures both response times and the quality of care delivered, and they can be eligible for credits based on their performance. One can offset the other, interim EMS Agency Director Vince Pierucci explained to the supervisors. For example, if there is a delayed response time, but the paramedic provides an “above-standard” quality of care, then it can “offset” the initial shortcoming to make them eligible for a credit.

Oversight will fall on the newly created Emergency Medical Care Committee (EPCC), which will include emergency medical care providers and representatives from each supervisorial district. The committee will provide an annual report to the Board of Supervisors and quarterly reports to the public to ensure AMR’s contractual compliance and increased data transparency overall.

“This agreement allows us to build upon our strong foundation and continue working closely with Santa Barbara County, and in partnership with Santa Barbara County Fire Protection District, to enhance EMS services for all residents,” said AMR Vice President of Operations Michael Rice in a February 6 press release. “We look forward to serving this community with excellence, innovation, and compassion.”

“We’re all on the same side,” Chair Laura Capps stated, despite votes from Supervisors Bob Nelson and Roy Lee against the contract. “I hope we can move forward as one county.”