January 2027 will kick off a competitive bidding process to find San Luis Obispo County’s next ambulance provider, with the contract awarded to the most cost-effective and efficient medical service provider.
Following months of back-and-forth at local city council meetings between San Luis Ambulance—which has held the service exclusively for 80 years—and six cities demanding the chance to review other options, stakeholders repeated their opinions to the Board of Supervisors at the Nov. 3 meeting.
“When you talk about the standards of cover, the response time, the thought of those local ambulances going away and becoming ambulances that work on a roving model basis is very concerning to our community,” Morro Bay Mayor Carla Wixom told supervisors. “This AMR [American Medical Response], [Global Medical Response]-owned KKR, all private equity firms, are traded on the New York Stock Exchange and beholded to a corporate spreadsheet, not to a local community. There are approximately 170-plus ambulance companies in California, yet only one bid on the Alliance model.”
Wixom is referring to the proposed “public-private partnership” Alliance model led by Paso Robles and involving the other cities. The model would allow the supervisors to contract with a fire agency, which would then subcontract with a qualified private ambulance provider for emergency medical services.
Paso Robles City Manager Chris Huot told New Times that though San Luis Ambulance attended the city’s pre-proposal conference for the Alliance model’s request for proposals, the company didn’t submit a proposal.
“AMR submitted a comprehensive proposal and was selected through the city’s public procurement process,” Huot said. “If the Alliance group was to submit a proposal to the county and it was awarded the ambulance contract, Paso Robles would hold the ambulance contract with the county, the participating cities would provide public oversight, and AMR would operate the ambulance service under a subcontract.”
‘More consistent collaboration among all parties, combined with greater transparency and accountability on how to improve services may have helped address concerns earlier and avoided some of the tension we see today.’
—Dawn Ortiz-Legg, SLO County 3rd District Supervisor
In September, Morro Bay was the only city that didn’t adopt a resolution of support for that model. Huot said that Morro Bay’s decision wouldn’t alter the Alliance group’s preparation to submit a proposal.
Wixom’s comments at the supervisors meeting mirrored those from many San Luis Ambulance officials and employees—that the company is local, unlike AMR, which has a national corporation headquartered in Texas.
AMR is neighboring Santa Barbara County’s ambulance provider and has faced its share of controversy. Most recently, fire chiefs across the county were unhappy with the Santa Barbara County Board of Supervisors’ decision to renew AMR’s contract despite allegedly unreliable response times.
“We believe our experience, history, and continued investment in our services make us a strong competitor in the RFP process,” San Luis Ambulance Operations Manager Kris Strommen told New Times. “That said, we also recognize that any competitive process comes with uncertainty, and no outcome is ever guaranteed. There are many factors and requirements involved in an RFP, and we take the responsibility of putting forward a complete and competitive proposal very seriously.”
SLO County supervisors clarified that they weren’t going to award the contract on Nov. 3 and that the discussion was simply an update on the bid process.
In January 2026, the county Emergency Medical Services Agency submitted a draft request for proposal to the California Emergency Medical Services Authority for review. But the review was delayed thanks to litigation in another jurisdiction affecting statewide ambulance procurement requirements.
The state returned the draft in August with comments and requested revisions. The county resubmitted the draft in October and anticipated approval within 90 days.
If all goes according to the timeline, proposals would be due in April 2027, and supervisors are expected to approve the agreement that August. Following the transition period, the new contract would be implemented in February 2028.
At the Nov. 3 meeting, 3rd District Supervisor Dawn Ortiz-Legg chastised her predecessors for not acting sooner.
“I really hold past Boards of Supervisors [accountable]; we’re not providing a path for all stakeholders to feel heard,” she said. “They’ve done a great disservice to our county in this manner to have this come to this point at this time. And that’s for both sides of the equation.”
She told New Times that a 2025 health strategists assessment identified issues that had accumulated over time. First responders had raised concerns about collaboration, response times, communication protocols, service investments, transport costs, and other operational matters.
“More consistent collaboration among all parties, combined with greater transparency and accountability on how to improve services may have helped address concerns earlier and avoided some of the tension we see today,” she said.
Ortiz-Legg also pointed to the Centers for Medicare and Medicaid Services publishing a proposed rule that would impose a federal payment ceiling on Medicaid supplemental payments for providers using the public-private model like the Alliance group.
In addition, she said, beginning in January, more than 6,000 Medi-Cal beneficiaries are expected to lose coverage, and approximately 17,000 additional people are at risk of being ineligible if they don’t meet new requirements.
“Another important question remains: What are the actual financial costs associated with transitioning to a new provider or system?” Ortiz-Legg said. “To date, I have not seen a comprehensive financial analysis addressing the full cost of implementation, transition, and ongoing operations.”
Based on these concerns, the county will dig into service gaps and listen to stakeholders in the lead-up to bidding.
“The county has data to understand service needs, new leadership at various levels, and a committed community willing to work together to clearly identify the operational, financial, and community impacts as well as benefits of an open RFP process,” Ortiz-Legg said. ∆
This article appears in Nov 12-19, 2026.
