HomeMy WebLinkAbout9/15/2026 Item 6h, Noble
Otta, Kaitlin
From:Kate Noble <katenoble@outlook.com>
Sent:Friday, October
To:dortizlegg@co.slo.ca.us; Stewart, Erica A; Francis, Emily; Boswell, Mike; Marx, Jan;
Boardofsups@co.slo.ca.us; E-mail Council Website; CityClerk
Subject:SLO County Ambulance Bid
Dear Supervisor Ortiz-Legg and Members of the City Council,
My husband and I were born and raised in San Luis Obispo County. We are proud to call it home and to be raising
our two children, who are 4th generation locals, here in San Luis Obispo. For more than 80 years, San Luis
Ambulance, a family-owned local business, has been part of this community. My husband is a mechanic in its
local shop, and many of its employees are our neighbors, friends, and our children’s coaches. This decision is
personal to our family and to the many local families whose livelihoods are connected to this company.
Concerns about response times deserve attention, but decisions about our emergency medical services should
be based on the full record. The county’s assessment reportedly found generally good care and improvements in
response times overall. If the goal is to improve service, the county should build on the existing system through
clear, enforceable performance standards rather than replace an established local provider without
demonstrating that doing so would produce better outcomes for residents.
San Luis Ambulance also keeps economic investment right here in our county. The company maintains its own
local mechanic shop, supports other local businesses, and purchases supplies from vendors like NAPA and Ace
Hardware. According to the company, it has invested more than $5 million in system improvements and fleet
updates over the past five years. With more than 100 employees, the potential loss extends far beyond the
business itself. Replacing San Luis Ambulance could mean closing its local shop, putting local jobs at risk, and
moving economic activity outside our community. These are real consequences for local families that deserve
serious consideration before any decision is made.
The proposed alternative raises significant questions about cost, too. Morro Bay has reportedly declined to
support the Paso Robles proposal over financial concerns. Estimates of startup costs exceeding $12.5 million
raise a straightforward question: Who will pay, and who will be responsible if costs exceed projections? Before
considering a change, taxpayers deserve a transparent accounting of startup expenses, ongoing operating costs,
long-term financial obligations, and the potential impact on local budgets.
Accountability is equally important. At a City Council meeting last year, I listened as SLO County Fire discussed
transparency and pricing. Yet the county’s ambulance oversight committee includes fire chiefs, city managers,
and Health Agency administrators—public officials involved in the broader effort to advance and oversee the
proposed model. Those responsible for overseeing ambulance services should not also be in a position to police
themselves. When the same groups helping advance a proposal are also responsible for overseeing its
performance, there is a clear conflict of interest. Independent oversight is essential to ensure transparency,
accountability, and decisions that put the public’s interests first.
We must also carefully evaluate the company that would take over ambulance operations. American Medical
Response (AMR) operates under Global Medical Response, which is controlled by private equity firm KKR. AMR has
paid settlements resolving allegations involving improper billing, including more than $9 million in 2006, $2.7
million in 2011, and approximately $602,000 in 2022. These settlements do not establish wrongdoing beyond the
matters resolved, but they raise legitimate questions that deserve consideration when evaluating a company
entrusted with emergency medical services. Residents should be able to examine a competing provider’s full
record before being asked to accept a major change to a system they depend on.
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A competing proposal may look less expensive on paper, but the true cost includes staffing levels, employee
wages, response-time performance, long-term financial commitments, and potential future rate increases. A
lower initial price is no bargain if it compromises service or shifts unforeseen costs to taxpayers.
San Luis Ambulance is more than an ambulance provider. It is an established local employer, a community
partner, and a family-owned business with decades of investment in the people it serves. Replacing it risks
disrupting that investment, affecting local livelihoods, and committing taxpayers to a new system without
sufficient proof that the change would deliver better service or better value.
Our community deserves reliable emergency medical care, responsible use of taxpayer dollars, and decisions
grounded in evidence. Before replacing a trusted local provider, decision-makers should demonstrate that the
proposed alternative would improve service, justify its full cost, and provide stronger accountability.
I urge our elected officials to keep San Luis Ambulance serving our community. After more than 80 years of
local service and investment, this company deserves the opportunity to continue serving the people who
call San Luis Obispo County home.
Sincerely,
Kate Noble
San Luis Obispo
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