As expected, the Santa Barbara County Fire Department and American Medical Response applied to provide emergency medical ambulance services, and the Board of Supervisors will pick the countywide providers at Tuesday’s meeting.

It’s been a long, contentious road getting to this point.

AMR has been the ambulance provider for Santa Barbara County for about 50 years, excluding the Cuyama Valley, Vandenberg Village and UC Santa Barbara.

AMR and County Fire submitted proposals to become exclusive, countywide providers during last year’s bidding process for a new contract, and a review panel ranked AMR’s higher.

That decision was upheld after multiple protests and appeals from County Fire Chief Mark Hartwig.

The supervisors were disappointed with the results and decided to throw out the bidding process and develop a permit system that will allow multiple providers doing different types of ambulance services – emergency medical calls, transfers between facilities, special event standbys, and critical care transport.

Even though breaking ambulance services into three permits makes it a non-exclusive system, it’s possible the county will award all three contracts to one provider, making it essentially an exclusive contract for ambulance services.  

AMR only applied for the emergency medical call permit, while County Fire applied for all three permits.

Emergency Medical Services Agency Director Nick Clay, as permit officer, evaluated the applications and said all of them meet or exceed the minimum qualifications.

The county also used a consultant to review applications – William Bullard of Healthcare Strategists, who is also fire chief of Graton Fire Protection District in Sonoma County.

This is not the same consultant the county used to review proposals in last year’s bidding process. That was Fitch & Associates, and the supervisors cut the consultant out of the protest review process.

Public Health Director Dr. Mouhanad Hammami and Bullard will give the presentation at Tuesday’s meeting, which starts at 9 a.m. in the Joseph Centeno Betteravia Government Administration Building, at 511 East Lakeside Parkway in Santa Maria.

It is livestreamed on the county’s YouTube page and CSBTV page.

Public comments can be submitted in writing by 5 p.m. Monday to the Clerk of the Board, at They can also be made during the meeting in person or by joining via Zoom.

Once the Board of Supervisors approves ambulance provider permits, emergency medical system staff will meet with the providers to negotiate the contracts, which are supposed to start March 1, 2024.

When Noozhawk asked Clay last month if the county was negotiating another contract extension with AMR, given the short timeline to a new contract starting, he said, “not at this time.”

The county Fire Department bought 35 ambulances for $3.4 million without having the contract. Having the vehicles was a “vital component” of their bid to be the ambulance services provider, county spokeswoman Kelsey Gerckens Buttitta told Noozhawk.

If County Fire doesn’t get the permits and doesn’t need all the vehicles, they could be resold, she said.

AMR has objected to the bid process being abandoned and the new permit system, calling it disappointing and unfair.

CEOs from local hospitals wrote a letter to the Board of Supervisors voicing concerns about the new system’s ability to provide 24/7 access to transfers between facilities. It’s an unprofitable but vital part of ambulance services, they wrote.