The Santa Barbara County Board of Supervisors voted unanimously Tuesday to let the exclusive ambulance services contract with American Medical Response expire and enter into a nonexclusive, multiprovider ambulance arrangement for the county.

That likely means both AMR and the County Fire Department will provide ambulance services for the county.

The Board Hearing Room in Santa Barbara was filled with first responders from both organizations — which submitted proposals for an exclusive ambulance services contract to begin March 2024 — and members of other local fire departments and community members.

The county started a public bidding process for the exclusive ambulance contract last year, and a review panel ranked AMR’s proposal higher than County Fire’s proposal with total scores of 2,077.75 for AMR and 1,760 for County Fire.

In response, County Fire Chief Mark Hartwig filed a protest to the notice of intent to award the contract to AMR, and when that was denied, he filed an appeal. The appeal was later denied by a protest resolution committee.

The public fight over the multimillion-dollar contract has included tense exchanges between fire and ambulance personnel at previous public meetings and local cities approving resolutions in support of County Fire’s proposal.

Dozens of public commenters, including most of the fire chiefs countywide, spoke in support of County Fire on Tuesday, and some others spoke in support of AMR.

“Your county fire chiefs have given their word that they will assist in any way possible to ensure our community has the best possible fire and ambulance response system,” Santa Barbara City Fire Chief Chris Mailes said.

“A fire-based transport system will enhance service while not requiring any government-injected subsidy. In fact, as has been stated, revenue after expenses will be brought back to our local community.

“Our system will be transparent, accountable, robust, reflexive with an expert patient-centric experience with the highest clinical quality for everyone needing EMS care in our community.”

“Lompoc currently operates in a nonexclusive area. In our current system, we utilize a primary provider for ambulance service; however, with countless missed opportunities for prompt ETAs and available ambulances, we have relied on the Santa Barbara County Fire Department for available medic ambulances,” Lompoc Fire Chief Brian Fallon said.

“Over the years, the Santa Barbara County Fire Department has supported the primary provider when ambulances were either unavailable or with extended ETAs. Because our call volume has increased by 1,200 calls over 18 months, we have called for assistance from County Fire medic ambulance 34 180 times in 2022 alone.”

While there was substantial public support for County Fire, Supervisor Steve Lavagnino questioned why the department’s proposal had a lower score in the review process.

Hartwig said he is “tormented by that,” and that he doesn’t have an answer. He said he was comfortable reading how his department’s proposal compared to AMR’s, but wasn’t there when the panel scored it.

AMR representatives said they took the RFP process as an opportunity to innovate their local system.

“The item before you marks the end of a five-year process of identifying much-needed improvements in the EMS system through extensive stakeholder input with the goal to seek out innovation and to ensure comprehensive improvements for our EMS system. Awarding the RFP as recommended is the only option that accomplishes this goal,” said Dave Schierman, AMR director of operations.

“Other options will add years to the process and will likely end with less benefit to the community and chaos in our system.”

AMR has provided ambulance services for about 50 years in the county. County Fire provides ambulance services in three specific areas that AMR does not: Vandenberg Village, Cuyama and UC Santa Barbara.

Last month, the Board of Supervisors approved a construction contract for an Emergency Operations and Regional Fire Communications Center, which will consolidate fire and emergency medical services dispatch in one center.

However, according to county staff, an issue to consider with a nonexclusive ambulance arrangement is the time gap between the end of AMR’s current contract and the new dispatch center being operational. The staff report says that this gap “creates a fragmented EMS system.”

The Board of Supervisors directed county staff to pursue a nonexclusive ambulance agreement and bring it back to the board, along with potential amendments to the county’s emergency medical services plan.

“American Medical Response has been providing EMS transport services to our communities for several decades,” the Santa Barbara County Fire Department said in a news release Tuesday evening. “The County Fire Department looks forward to partnering with AMR to provide exceptional services to our communities.”