The Santa Barbara County Board of Supervisors appointed a new emergency medical oversight committee last week as the county and ambulance provider push the trial date over a disputed contract.
Members include hospital emergency department managers, Public Health employees, Fire Department representatives and community members.
American Medical Response has provided ambulance services for more than 40 years. When the county put a new contract out to bid, AMR and the county Fire Department both applied.
In moves that are being challenged in court, the Board of Supervisors threw out the bid process after AMR’s proposal was ranked higher by a review panel.
The board created a non-exclusive permit system, then the supervisors denied AMR’s application and accepted County Fire’s application for 9-1-1 emergency medical response ambulance services.
AMR sued, and a Superior Court judge ordered an injunction on the new permits, meaning AMR’s current contract is extended until the trial is over.
That trial has been delayed several times and is now scheduled for February.
The new Emergency Medical Care Committee (EMCC) advises the Board of Supervisors and the Local Emergency Medical Services Agency (LEMSA) on emergency medical care and ambulance services. The committee will be the appellate body for decisions on ambulance service permit renewal applications, rather than the Public Health Department.
The ordinance creating the permit system and the committee is the one being challenged in court right now.
Committee members include:
- Dr. Lars (Ola) Sjoholm, emergency physician and surgeon at Marian Regional Medical Center
- Denise McDonald, emergency department registered nurse at Santa Barbara Cottage Hospital
- Lompoc City Manager Dean Albro
- Ryland McCracken, a Montecito Fire Protection District firefighter/paramedic and former EMT for AMR in the county
- Montecito Fire Chief David Neels, who is also chair of the Santa Barbara County Fire Chiefs Association
- Melinda DeHoyos, Lompoc Valley Medical Center executive director of nursing
- Lisa Abeloe, Marian Regional Medical Center trauma director, registered nurse
- Dr. John Anis, Cottage Health emergency department medical director
- Edwin Weaver, Fighting Back Santa Maria Valley executive director
- Dr. Henning Ansorg, public health officer
- Wade Horton, assistant county executive officer
- Mark Ingalls, property manager of Camino Real Marketplace (District 2 representative)
- Don Barkas, retired firefighter and paramedic (District 3 representative)
- Leonard Champion, retired Santa Maria fire chief (District 4 representative)
- Timothy Romero, emergency manager for Stockton with public health and military experience (District 5 representative)
- A District 1 representative has not been appointed yet.
The EMCC does not appear to include County Fire employees or AMR employees, although it has members who openly advocated for County Fire to get the ambulance services contract — such as Neels and Ingalls.
Fire chiefs and city leaders want County Fire to take over the contract, alleging it will lead to faster response times and better overall service.
AMR leaders say the company meets response times, has never been out of contract compliance, and its original bid proposal came out on top.
The county plans to pursue a multi-provider system with the Fire Department as one of its providers.
The contentious back-and-forth over the contract has focused on 9-1-1 emergency response, while hospital leaders have lingering concerns about inter-facility transfers.
There are thousands of transfers each year: patients moved between hospitals for a higher level of care; patients moved to and from skilled nursing facilities; and mental health transports, which can take a long time and often go outside the county.
In a June 2023 letter to the Board of Supervisors, hospital CEOs wrote: “The system must ensure that medically necessary, albeit unprofitable, (inter-facility transfers and critical care transports) must still be provided in a manner that retains or improves existing standards of care.”
The new county system separates ambulance services into different permits for 9-1-1 emergency medical response, inter-facility transfer services, critical care transport and special events standby.
Mike Sanders, regional director for AMR Santa Barbara and Ventura, said that to provide services for critical-care transport and inter-facility transfers, AMR would need all three permits.
The company didn’t want to risk getting the two unprofitable permits and not the emergency medical permits, so it only applied for — and was denied — the emergency medical calls permit.