For more than eight decades, San Luis Obispo County residents have called 911 seeking immediate medical treatment for a host of heart attacks, broken bones, strokes and seizures, and received care from San Luis Ambulance paramedics.

The ambulances adorned with green and gray waves have been the county’s primary emergency services provider since 1945. But that could change now that the county is preparing to launch a competitive bidding process for its ambulance services contract.

For the first time last October, the SLO County Board of Supervisors voted to move forward with the Request for Proposal process for ground emergency ambulance transport.

San Luis Ambulance will be vying for the contract, along with a Paso Robles-led proposal for a public-private partnership, known as an Alliance model. It’s still unclear whether other companies will also make a bid.

“(The RFP process) provides that opportunity to sharpen pencils to really focus in on what the priorities of the region are and the county are, and ultimately determine if we’re getting the best service today or if there’s another opportunity or opportunities to improve service,” Paso Robles city manager Chris Huot told The Tribune.

San Luis Obispo County is currently working with its consultant, Healthcare Strategists, to draft the Request for Proposal, also called an RFP.

Staff will provide an update on the RFP at the Board of Supervisors meeting on Nov. 3, the county told The Tribune in a statement. The county declined to share any other details about the bidding and selection process. San Luis Ambulance has serviced SLO County for 8 decades

San Luis Ambulance’s current contract is set to end on June 30, 2027, according to Kris Strommen, the operations manager for San Luis Ambulance.

The private company employs 160 people and is the county’s exclusive operating ambulance transport, beside Cambria’s Community Healthcare District’s ambulance service.

San Luis Ambulance deploys ambulances from nine stations spread out along Highway 101 and Highway 1 to deliver quick coverage for medical emergencies at any time of day or night, Strommen said.

The company is contractually obligated to meet specific response times depending on the county zone. An ambulance ride could take anywhere from under 11 to 21 minutes in urban and suburban areas to more than an hour in remote parts of the county, The Tribune previously reported.

The Emergency Medical Services Agency conducts monthly audits of every emergency call and response time, Strommen told The Tribune. Each of the 25 zones must be 90% compliant, meaning paramedics must reach the patient in the allotted amount of time.

From May 2025 through May 2026, San Luis Ambulance had to pay more than $47,000 in penalties after it failed to meet contractual response-time requirements, according to Scott Hallett, the president of SLO County’s Fire Chiefs Association.

Strommen said those lagging response times can be attributed to zones that only receive a handful of calls per month, which “throws the numbers off.” Other times, ambulances struggle to offload patients at busy hospitals, which can also cause belated responses, he added.

Since its most recent contract began in July 2024, San Luis Ambulance has achieved 93.2% compliance among all urban zones, Strommen told The Tribune.

“If we weren’t doing well, we wouldn’t get a contract extension,” he said. “I think that’s probably one sort of misconception is that we’ve had some 80-year magical contract where nobody’s ever looked at it, but those are a series of many mini-contracts and extensions and reviews with heavy oversight from the regulatory agencies. Most SLO County cities throw support behind Paso Robles proposal

In an attempt to change the longstanding private, for-profit ambulance transport model, Paso Robles has proposed leading a public-private partnership known as the Alliance model.

In this partnership approach, Paso Robles committed to serve as the head agency and subcontract with the private vendor, American Medical Response, that would provide countywide ambulance transport services.

Local paramedics would likely be able to keep their jobs, too. State law requires any incoming provider to offer employment to the incumbent workforce as long as they meet standard employment requirements, such as passing a background check, Huot said.

If chosen, Paso Robles would have the contract with the county and participating cities would share oversight and governance of the provider through the Alliance model, Huot told The Tribune.

The public-private model would be more transparent since all response time statistics would be posted online and financial data would be annually reported, he said.

Unlike a private provider, any excess revenue after covering operational costs would be funnelled back into SLO County communities. In the future, Huot said that could look like adding medical air transport or a call center to reduce the number of ambulance deployments.

Participating cities would initially front the start-up costs until insurance payments kick in and reimburse them.

Not all public-private partnership models have been immediately successful elsewhere in the state.

In Sonoma County, the county fire district recently requested a 16% ambulance rate increase due to increased labor costs and operating expenses paired with reimbursement issues, the Press Democrat reported.

Huot said he’s confident the model will be viable and profitable, even if federal reimbursement opportunities don’t pan out.

So far, six City Councils, all seven city managers and the San Luis Obispo County Fire Chiefs Association have expressed their support for Paso Robles to submit a public-private partnership proposal.

Morro Bay was the only city to initially oppose Paso Robles’ bid.

After eight decades with San Luis Ambulance, Huot said it’s time to “get it through a competitive process” and evaluate other options that could integrate modern deployment methods and emergency medical dispatch to provide better medical services across the county.

“The ambulance service in this county has not been bid out. Period,” Huot told The Tribune.

Requests for Proposals are a common government practice in San Luis Obispo County with the county frequently putting contracts out to bid to obtain the best services and costs.

The whole point of the RFP process and conversation is to “ensure that we have a modern and responsive ambulance system that really meets the needs of our community today, but also, you know, 10 to 20 years from now,” Huot said.

San Luis Ambulance told The Tribune it will throw its name into the bidding process whenever the county’s RFP is released. That process “will have significant implications for our organization,” Strommen said.

He declined to speculate about any specific business decisions — including company property and employment statuses — if San Luis Ambulance does not win the bid.

“We’ve been here for 80 years, and we plan to be here for another 80 years,” Strommen said.

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