California Professional Firefighters

Unified Fire Service Urges New Standards for Outsourcing Public EMS Services

A united California fire service task force called on the state EMS Authority to take steps to increase fiscal and public accountability in the outsourcing of EMS services to private, for-profit providers.

In a white paper issued July 22, 2009, California Professional Firefighters, CalChiefs and the League of Cities Fire Chiefs unanimously concluded that some Local EMS Agencies (LEMSAs) were overstepping their statutory authority in fashioning contracts with private ambulance companies.


The report further concludes that, in some cases, the new Medicare reimbursement schedule creates an incentive for counties to wrest control of EMS away from cities and, in the process, divert 9-1-1 tax dollars to for-profit companies.

“Regrettably, several city fire agencies are experiencing repeated attempts by some LEMSAs to inexorably and systematically remove them from the provision of prehospital emergency medical services,” stated the report.

The public safety implications of these actions are stark. In some cases, most notably San Joaquin County, the local EMSA has wrested control of a city’s ambulance service, then proceeded to declare it an “unlawful” provider. In the process, the county also takes away 9-1-1 emergency response funding from the city and hands it over to the private provider.

The white paper outlines a number of steps that should be taken. The state EMSA is urged to set up a stakeholders group to establish accountable, transparent standards for EMS contracting. Cities and fire districts, meanwhile are urged not to sign any deal with a LEMSA for EMS service that doesn’t specifically reaffirm the city’s rights and obligations under the state EMS Act.