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County EMS review set timeline, plans RFP; pilot nurse‑navigator program to expand to dispatch centers
Summary
Santa Clara County EMS staff told supervisors the ambulance‑services request for proposals remains on a multiyear timeline and depends on state review; the county will expand a Nurse Navigator pilot and deploy a new ambulance‑management overlay (Marvelous) to increase ambulance availability.
County EMS leaders updated the Health and Hospital Committee on the EMS system assessment, an ambulance request‑for‑proposals process and a Nurse Navigator pilot designed to reduce unnecessary ambulance transports. “All data analysis has been submitted for analysis and completed by our consultant,” EMS Chief Nick Clay said, describing data collection and the next community engagement steps.
Why it matters: the county’s ambulance contract expires in December with unilateral option years available; a competitive procurement is planned but dependent on state review and forthcoming state regulations. Clay said the RFP must be submitted to the state for review in mid‑2026; the county expects a state review period and a multi‑year timeline that could lead to a new contract and an implementation date around 2029 for any new provider.
Assessment and RFP timeline: Clay said the county’s consultant, AP Triton, will deliver ambulance delivery models after community and stakeholder surveys. The county asked supervisors for input on groups to include in outreach and said the draft assessment should be available for local review by year end.
State regulation gaps: supervisors expressed concern that the state has not finalized key regulations in the ambulance/EMS chapter. Committee members and staff described a prolonged regulatory vacuum that has spawned litigation and inconsistent approaches across California. One supervisor asked staff to engage the county’s intergovernmental relations team and legislators about the need for clear state rules.
Nurse Navigator and operations: the committee heard results from a Nurse Navigator pilot that began in November; Clay summarized how it works: at low‑acuity 911 calls dispatchers offer a nurse consultation, the nurse asks questions and can recommend at‑home care, clinic referral, pharmacy pickup or nonemergency transport. “The total time on task for this from the moment the 911 call is answered to the nurse navigation disposition is about 10 minutes,” Clay said. The pilot covered roughly 1% of calls in the test area and identified operational, training and data gaps; Clay said countywide deployment could reduce system costs and free ambulances for higher‑acuity calls.
Computer‑aided dispatch overlay and data: EMS staff told the committee they will deploy an overlay system (Marvelous) to the county CAD to improve ambulance placement, unit recommendations and data reporting. The county anticipates fuller Marvelous deployment in November and said richer data feeds will support future RFP design and performance monitoring.
Committee action: the committee received the EMS assessment and RFP update and the annual EMS and quality reports (items 6–8) and voted to receive the reports. Vice Chairperson Abe Koga and Chairperson Lee both voted yes.
