Calif. fire district seeks 25% hike in EMS transport rates

In city and county after city and county in California, the firefighters’ unions are trying to take over the EMS—ambulance—service.  They low ball the bid, get the contract, and then have a monopoly.  Try opposing it or ending it, and the unions will spend its dues money to defeat those that do not like socialism.

“In response to follow-up questions, Busch, just before 5 p.m. Friday, shared a March 19 letter from the fire district to County Executive Christina Rivera outlining the district’s request for a significant increase in ambulance transportation and related expenses.

The district is seeking two increases totaling just under 25%. The first increase would be 9.9% and would require the approval of county health officials. The second increase being sought is 14.35% and would have to be approved by the Sonoma County Board of Supervisors following an audit of the district’s ambulance service and finances.”

 Yup, you kill off the private sector, owned the government, so you can charge what you want.  If your city or county is thinking of doing the same, remember the lessor of Sonoma County.

Calif. fire district seeks 25% hike in EMS transport rates

Less than 18 months into a $30M contract, Sonoma County Fire District is pushing for a major ambulance rate increase, citing rising labor costs and payer mix challenge

By Martin Espinoza, Emma Murphy, The Press Democrat, 5/29/25  https://www.ems1.com/billing-and-administration/calif-fire-district-seeks-25-hike-in-ems-transport-rates?utm_source=facebook&utm_medium=referral&fbclid=IwY2xjawKmGKxleHRuA2FlbQIxMQBicmlkETFpdGVlaGs5dFdYT2s2UGhMAR5J30gkNmzfRpZwCxFj1LA9bevppbkjB2_Z6_bknUqVAuvmzXN7SZl9Zywhgg_aem_xSabPIA_tBrAy0qv3pv2RA

SONOMA COUNTY, Calif. — Less than a year and a half into an exclusive and lucrative contract for ambulance service in Sonoma County’s urban core, local health officials and the Sonoma County Fire District are quietly negotiating a rate increase, The Press Democrat has learned.

Both fire district and county officials at first refused to discuss details about the increase the district is seeking, citing ongoing “active negotiations.” “You are asking about matters that are part of active negotiations with the County of Sonoma over contract amendments,” Sonoma County Fire District Chief Ron Busch said Friday morning in an email. “SCFD does not negotiate contracts through the media.”

In response to follow-up questions, Busch, just before 5 p.m. Friday, shared a March 19 letter from the fire district to County Executive Christina Rivera outlining the district’s request for a significant increase in ambulance transportation and related expenses.

The district is seeking two increases totaling just under 25%. The first increase would be 9.9% and would require the approval of county health officials. The second increase being sought is 14.35% and would have to be approved by the Sonoma County Board of Supervisors following an audit of the district’s ambulance service and finances.

Busch in his letter to Rivera said the increase request was being triggered a number of factors, including unexpected labor costs and a negative change in “payor mix,” which is the share of private insurance, Medicare and Medicaid patients. For their part, county health officials declined to discuss the negotiations with the district.

Gilbert Martinez, a county communications specialist, said in an email that the fire district had “encountered unexpected costs.” He did not specify what those costs were. He declined to specify how significant a rate increase the district had requested, citing ongoing negotiations. The Sonoma County Fire District, in partnership with private subcontractor Medic Ambulance, has exclusive rights to provide ambulance services in the county’s central core.

The negotiations come as district and county officials are locked in a dispute over the fundamental criteria used to calculate ambulance response times, which are a key component of the district’s performance evaluation. The fire district is not affiliated with the county and operates independently, under the oversight of its elected board.

The ambulance contract, which took effect January 2024, is worth $30 million annually for at least five years. It spells out rates for various services, with base rates of $3,100 for advanced life support transport and $2,850.90 for basic life support transport. It also outlines rates for other expenses including mileage, oxygen, IV supplies and 12-lead cardiogram care. Under the district’s rate increase proposal, advanced life support transport would go from $3,100 to $3,851.75 after the second increase, while basic life support would go from $2,850.90 to $3,542.24.

Sonoma County Fire District ambulance rates chart The territory covered by the contract includes Santa Rosa, Oakmont, Kenwood, Rohnert Park, Cotati, Sebastopol, Graton, Occidental and Freestone. The emergency medical transport giant AMR, a private provider known locally as Sonoma Life Support, previously held the exclusive contract for three decades.

According to the contract, rates can be adjusted annually to compensate for inflation. But, any increase greater than inflation must be approved by an “authorized” county official who can review documentation including “system statements” and “audited financial reports.” Rate increases greater than 10% require approval from the Board of Supervisors. Requests for such increases also trigger an extensive audit of invoices, agreement amendments, regulatory requirements, accounting records, financial reports, correspondence and other records, according to the contract.

The contract also limits the district from requesting more than one increase a year unless it can prove it has experienced “undue financial hardship” because of reasons beyond the district’s control.

Martinez, the county communications specialist, did not specify whether the county was seeking an audit but said the county was “seeking a holistic solution to bring great clarity in the contract, enhanced transparency around compliance for the community, continued assurance of excellent service and responsiveness, and assuring resources to the district that are commensurate with economic circumstances.”

Neither Busch nor county officials answered questions about when the discussion and any specific rate increase would be made public. Busch pointed out that the fire district is governed by a seven-member board that would have to discuss any proposed rate changes in a public meeting before being approved.