Arroyo Grande and Atascadero support Paso Robles’ ambulance service proposal

Atascadero has joined a growing list of San Luis Obispo County cities calling for a competitive shakeup of the county's ambulance system. On Sept. 8, the Atascadero City Council adopted a resolution supporting a proposal by Paso Robles to create an alternative emergency medical service structure — a move that challenges the 80-year service monopoly held by San Luis Ambulance across the county.

The New Times SLO (Atascadero) reported that Arroyo Grande adopted the same resolution the same night, while Pismo Beach had previously expressed support. Morro Bay's City Council, by contrast, voted unanimously on Sept. 8 against adopting the resolution. San Luis Obispo and Grover Beach are expected to consider the resolution at future meetings.

For Atascadero residents, the stakes are straightforward: who shows up when you call 911, how fast they arrive, and how much the service costs taxpayers and patients.

What the Alliance model would do

The proposal, led by Paso Robles and backed by all of the county's city managers and the county Fire Chiefs Association, would establish a "public-private partnership" for emergency medical services.

"[The Alliance model] allows a county board of supervisors to contract with a fire agency, which then subcontracts with a qualified private ambulance provider to support the delivery of emergency medical services," Paso Robles City Manager Chris Huot told New Times. "This is not based on a predetermined conclusion that one provider is best. The county's competitive process will allow the Alliance and other qualified providers to present their proposed service models for objective evaluation."

The effort traces back to last October, when the SLO County Board of Supervisors greenlit a request-for-proposals process after fire chiefs, mayors, city managers, and community members raised concerns about long response times and what critics describe as an outdated service model. The competitive bidding process will award the ambulance services contract to the most cost-effective emergency medical service that best serves residents.

Huot argued the Alliance would offer a level of oversight the current arrangement lacks. Because it would be governed by local public agencies, he said, its decisions, finances, contracts, and performance would be subject to public transparency requirements — open meetings, public records, public budgeting, and audits — which generally do not apply to a private ambulance provider operating independently. If selected, he said, the Alliance would continuously evaluate response performance, call demand, unit availability, geographic coverage, staffing, equipment, training, and overall system capacity.

San Luis Ambulance pushes back

Leadership and employees of San Luis Ambulance urged councils in Atascadero, Arroyo Grande, and Morro Bay to reject the resolutions.

At the Arroyo Grande meeting, San Luis Ambulance Operations Manager Kris Strommen questioned whether the proposal would actually deliver improvements. "Will this proposal actually improve emergency medical services in Arroyo Grande? Will it put more ambulances on the street? Will it improve response times?" Strommen asked. "I don't believe the evidence provided in the packet demonstrates that it will."

In a letter to Arroyo Grande and Atascadero, San Luis Ambulance President Justin Kelton argued that calling the Alliance "local" and "community-based" is misleading because it would subcontract day-to-day ambulance operations to American Medical Response (AMR), a large national ambulance company.

"When the day-to-day ambulance operations are subcontracted to [AMR], a large national corporation headquartered in Texas, it's hard to see it as a truly local EMS partnership," General Manager Chris Javine told the Atascadero City Council. Javine also cautioned that the Alliance model doesn't yet exist, making it risky to implement. Paramedic Field Supervisor Nate Otter, a longtime Atascadero resident, added that the company has deep community ties, including donating ambulances and sponsoring local events.

A split Atascadero council

The Atascadero City Council's support was not unanimous. Councilmembers Seth Peek and Heather Newsom declined to back Paso Robles' efforts, while most city leaders from Atascadero and Arroyo Grande agreed it was time to explore a new way of delivering emergency service.

Mayor Charles Bourbeau framed his support around the principle of competition rather than any particular provider. "To have a contract out for 80 years without rebidding it, that does not sit well with me," Bourbeau said. "It's wise to go to the next step and see how things shake out from there."

Notably, adopting the resolution does not commit Atascadero or any other city to joining the Alliance. Significant details remain unresolved, including the cost of providing services under the model and the consequences if a city later withdraws from the agreement. The final decision on who wins the county's ambulance contract rests with the SLO County Board of Supervisors, not the cities.

What comes next for 805 residents

The county's request-for-proposals process is now the battleground. Huot noted that past efforts to encourage San Luis Ambulance to implement improvements have been unsuccessful — but the RFP process could change that dynamic by setting updated performance standards and service requirements regardless of who wins.

"If [San Luis Ambulance] is selected through the competitive process, it would operate under these new expectations for modernizing ambulance service delivery throughout San Luis Obispo County," Huot said. "Regardless of the provider ultimately selected, the RFP presents an important opportunity to move beyond a decades-old service model and establish a more modern, responsive, transparent, and accountable countywide ambulance system."

For Atascadero residents, the practical effects — response times, unit availability, and cost — won't be known until the county evaluates the competing bids. In the meantime, residents can watch for the San Luis Obispo and Grover Beach city councils to take up the resolution, and for the Board of Supervisors to move forward with the RFP process that will determine the future of emergency medical care across the 805 region.