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County reviews EMS system design with focus on integration, non‑transport options and provider agreements
Summary
Santa Clara County heard high‑level EMS system design concepts and asked staff to pursue regional dispatch integration, expand non‑transport/social‑service responses, and explore three‑party contractual arrangements so local jurisdictions can better enforce performance and financial terms.
The Santa Clara County Health and Hospital Committee on Monday reviewed high‑level concepts for redesigning the county’s emergency medical services system and asked staff to pursue regional integration, non‑transport alternatives and clearer contractual arrangements with ambulance providers.
The committee heard from the county’s Emergency Medical Services Agency leadership, introduced to the body as Nick Cleo, who said the current effort is an EMS system design exercise and that a solicitation (RFP) will be only one transactional component of broader system redesign. Cleo told supervisors the county is still drafting solicitation language and sought feedback on concepts rather than presenting final contract text.
Supervisors pressed staff about dispatch and communications interoperability. A committee member asked whether the county can bridge existing platforms (referred to in the presentation as “Marvelous”) with other regional tools or whether a tablet‑command regional system should be adopted. EMS leadership replied that integration is a priority and that staff will continue conversations with regional partners and stakeholders to determine the best path.
Committee members also asked how the system could handle a growing share of low‑acuity 911 calls that do not require ambulance transport. EMS staff described a “social‑service bridge” approach intended to route certain low‑acuity callers to nurse navigators or social‑service providers rather than default ambulance transport and emergency‑department visits, with the goal of reducing ED burden while maintaining access to care.
Cities and some committee members raised the need for clearer contractual relationships between ambulance providers and local jurisdictions. A supervisor described requests from cities to convert informal agreements into contracts that could include performance and compensation terms when contractor response times exceed targets. EMS staff said they envision three‑party arrangements involving the provider, the county, and the local jurisdiction so resources are visible and jurisdictions retain the ability to negotiate financial terms directly with providers, while the county would avoid serving as an ongoing financial intermediary.
The committee voted to accept the EMS system design report and asked staff to continue stakeholder engagement and return with more detailed proposals in the next design phase.
What happens next: Staff said draft solicitation language remains under development and will be shared for comment as the design advances. The committee’s vote to accept the report does not yet authorize a final contract award.
