San Diego Leaders Consider In-House Ambulance Services

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News Summary

San Diego city officials are exploring the transition of ambulance services to in-house management despite the financial success of the existing partnership with private companies. Mayor Todd Gloria is proposing a hybrid approach to enhance response times while tackling a $300 million budget deficit. The move, which includes the possibility of creating new oversight positions, aims to balance operational costs and improves emergency medical services. As the city reassesses its approach, it acknowledges the need for careful planning in navigating current contracts with private providers.


San Diego city leaders are considering transitioning the city’s ambulance service in-house, despite the profitable partnership currently in place with private ambulance companies. Over the past 19 months, this collaboration has generated significant revenue for the city, with projections of $11.2 million expected for the next fiscal year. As the city grapples with a $300 million budget deficit, Mayor Todd Gloria plans to allocate $17.3 million from these profits to cover shortfalls in other city departments.

Discussions led by Mayor Gloria and Fire Chief Robert Logan are focused on how to shift the ambulance service to in-house personnel, with plans for a hybrid approach. This model would allow city ambulance crews to respond to less critical emergencies while private ambulances manage more serious calls. Presently, private contractors provide 852 hours of advanced life support services and 120 hours of basic life support each day.

If this hybrid model proves successful, the city could gradually take over all ambulance services. Other major California cities, including Los Angeles, San Francisco, and Chula Vista, operate similar in-house ambulance services, although outsourcing remains common across the nation. The advantages of in-house service often include improved response times; however, operational costs could increase, leading to varying results depending on the city’s infrastructure and management.

The proposal also includes the creation of a new assistant fire chief position to oversee emergency medical services. Meanwhile, the city is set to issue a formal request for proposals for future ambulance services, indicating that private companies will still retain a role in the system at least until existing contracts run through late 2026.

City officials reported that the private partnership has exceeded initial profit expectations. Fire Chief Colin Stowell previously expressed doubts about the partnership’s profitability, but recent results have shown a positive financial impact. Nevertheless, regular updates regarding the partnership’s success have not been communicated to taxpayers, leading to some public unawareness of the program’s financial benefits.

An independent budget analyst noted that the partnership model has indeed generated profits, enabling Mayor Gloria to redirect funds to help stabilize the city’s budget. The initial decision to establish this partnership stemmed from poor ambulance response times and a state law that increased reimbursement rates for government-managed transports. However, the transition to this partnership was not immediate, as it faced delays in transport payments and mistimed financial projections.

As San Diego proceeds with this strategy, the city’s ambulance revenues will be further supplemented by raised transport fees aimed at accommodating rising service costs. These increases reflect the need for more ambulance hours and higher rates being paid to private providers. Ultimately, any transition to an in-house system hinges on the completion of current contracts and the successful implementation of a hybrid operational method.

In summary, while San Diego leaders investigate the potential for in-house ambulance service, the current partnership with private providers continues to yield profit, allowing city officials to address budgetary challenges effectively. The city’s approach reflects a careful balancing act between maintaining efficient emergency medical services and navigating the complexities of municipal finances.

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