The San Luis Obispo County Board of Supervisors voted to authorize the Health Agency to proceed with a request for proposals for ground emergency ambulance transport services, setting in motion a competitive process that could reshape emergency medical coverage across the county.

Supporters — including mayors, city managers, multiple fire chiefs and unions — urged the board to move forward, saying the existing system has operated without open competition for decades and needs modernization. Mayor John Hammond of Paso Robles told the board the county’s ambulance system has “remained largely unchanged for more than 30 years” and called the RFP an opportunity to bring the system into the 21st century. Mayor Erica Stewart of the City of San Luis Obispo said a transparent RFP would create “incentive for ongoing improvement, including better coordination, transparency, and clear performance standards.”

Why it matters: County stakeholders described long response times in some rural areas, rising transport costs and an incumbent contract that has not been fully tested by open competition. Several city managers and multiple fire chiefs warned that the county’s ambulance model must adapt as population and housing growth drive more calls for service.

What the board decided: The Board voted to permit the Health Agency/EMS to advance the ground emergency ambulance transport RFP process initiated in 02/2022. The decision was contentious: public safety leaders and city officials largely supported the RFP; many employees and executives of the incumbent provider, San Luis Ambulance, including its owner Justin Kelton and numerous long‑service paramedics, urged the board not to release an RFP and warned of disruption.

Key arguments for an RFP
- Public safety officials: County and city fire chiefs, county fire officers and union leaders said the current structure limits transparency and performance accountability. County Fire Chief John Owens and other chiefs argued rural communities face long response times and that a competitive process could produce new deployment models and performance measures.
- Cities and county staff: Several city managers (Whitney McDonald, Jorge Garcia, Jim Lewis, Chris Huot) and the county’s Health Agency director reiterated that the RFP honors prior investments and stakeholder work dating back to earlier grand jury recommendations and to the county’s 2022 planning for an RFP. City leaders framed the RFP as a way to ensure the county gets “the best service possible” at a competitive price.

Key arguments against an RFP
- Incumbent provider and staff: San Luis Ambulance leaders and many current paramedics and staff said the company has 80 years in the county, presented quality‑of‑care examples (CPR training, AED placements), and argued the county may lawfully negotiate with a grandfathered provider under state Health & Safety Code provisions. Several incumbent employees warned an RFP could destabilize experienced staff and reduce service quality during transitions.
- Legal and transition risks: Former examples in other counties (Santa Barbara, Monterey) were cited by speakers who argued that transitions after a contract award can produce litigation, service interruptions or higher costs.

Implementation details and state process
- Consultant and state review: The county’s consultant Healthcare Strategists (Bill Bullard) explained that a state review is required to grant an exclusive operating area (monopoly protection) for up to 10 years to the selected provider. The full RFP draft is under county review and will be submitted to the state for approval before going to bid. If approved by the state, respondents would be evaluated by an impartial panel and the highest‑scoring bidder would be recommended for contract award.
- Employment retention and contract safeguards: County staff and counsel noted California Health & Safety Code provisions require bidders to describe plans to retain incumbent employees; the RFP evaluation will include workforce pay and benefits as scored criteria.
- Timeline: The consultant estimated state review and a competitive procurement schedule typically require several months for solicitation, evaluation, and up to six months for implementation after award; the county estimated finalizing the RFP draft and returning to the state could take about 90 days, followed by a 90‑day bid window and possible additional implementation lead time.

Public testimony and evidence
- Public safety leaders and city managers, including Paso Robles Mayor John Hammond and San Luis Obispo Mayor Erica Stewart, urged approval of the RFP. County Fire Chief John Owens, multiple city fire chiefs, and the professional firefighter unions supported a competitive process.
- San Luis Ambulance owner Justin Kelton, clinical manager Serena Genuso, general manager Chris Jervin and many long‑tenured paramedics argued the incumbent provides high quality care and urged renegotiation instead of a competitive solicitation. They also disputed some county response‑time data as inaccurate.

Vote and next steps: The Board approved moving forward with the RFP process (motion: Supervisor Gibson; second: Supervisor Paulding). The roll call recorded three votes in favor and two opposed. By authorizing the Health Agency to proceed, the board directed staff to continue the RFP path and to coordinate with the state and the consultant on the technical and legal steps required for a compliant, competitive procurement.