Finance committee seeks options to restore engine at Mitchell Park (Station 4) and phase in single-role ambulances

The Finance Committee received an extensive presentation and public comment on options to expand Palo Alto Fire Department emergency response, focusing on restoring engine service at Mitchell Park (Fire Station 4) and improving ambulance availability. Chief Blackshire and fire staff reviewed three new staffing options (cross-staff engine/medic at Station 4; a 12-hour peak ambulance staffed with civilian single-role personnel; or a fully staffed engine at Station 4 plus a 12-hour peak ambulance) and reiterated that the department is running about 9,400 calls per year with a heavy and growing share of emergency medical transports.

Chief Blackshire and Deputy Chief Kevin McNally described how the department currently runs as a system (automatic vehicle location dispatching the closest unit) and why cross-staffing reduces availability for either an engine or an ambulance when simultaneous calls occur. Staff reviewed system performance metrics: in FY24 Palo Alto called Santa Clara County ambulances about 327 times; staff said the 90th percentile county ambulance response was roughly 29 minutes 53 seconds while Palo Alto ambulances’ 90th percentile was about 12 minutes 2 seconds. The department reiterated its 8-minute response standard (90th percentile) as a life-safety performance target.

Staff summarized implementation considerations and costs for the options. The single-role (civilian) ambulance program would require a new administrative structure, negotiations with labor, and coordination with CalPERS for benefit and classification issues; staff estimated full program setup could take 12–18 months. As a near-term path, staff offered using firefighter overtime to staff a 12-hour peak ambulance (a faster but less-preferred approach for labor and staffing wellness) while the city establishes a single-role division. Financial staff and analysts noted the order of magnitude for several options would be in the low single-digit millions annually; CFO Lauren Lai told the committee that the City’s General Fund long-range outlook has weakened since December and that new recurring costs must be weighed against ongoing revenue pressures.

Fire department finance staff also explained revenue offsets: (1) ambulance transport fees are billed to insurers; Medicare/Medicaid caps mean actual collections per transport are often well below a $3,000 charge, but commercial insurers typically cover billed amounts; (2) adding a peak ambulance would capture more transports (staff estimated captured-call revenue from county-transported calls would be roughly $70,000–$100,000 annually in staff analysis); and (3) a proposed first-responder fee (under review as part of a municipal fee study) could produce roughly $350,000–$400,000 annually if adopted. Staff stressed these revenues would partially offset but not fully cover the operating cost of new units.

Committee members also heard more than a dozen public speakers — including firefighters and local residents — strongly urging a staffed engine at Station 4 and quicker expansion of ambulance capacity. Labor representatives and the firefighters’ union urged that cross-staffing be minimized and that the department be returned to a more stable staffing model. The committee provided staff direction to return with a set of budget-ready scenarios showing (a) how to restore a dedicated engine at Station 4 (timing and cost), (b) phased options for single-role ambulance implementation (12-hour peak first, then additional single-role ambulances), (c) costs and timelines for each scenario, and (d) revenue offsets and risks (including CalPERS/pension impacts and interdependencies with other budget pressures). No formal committee vote was required for this item; staff will use the committee’s guidance while preparing the May budget transmittal and the City Council’s upcoming budget deliberations.