City Council Meeting
March 4, 2025
City-Operated Ambulance Program Proposal
Adam Loeser, Fire Chief
Jon Fugitt,
Deputy Chief
Rhonda Rosati,EMS Manager
Andrew Yang, Admin Analyst II
1 Fullerton Ambulance History
Current Ambulance Model Benefits
Stable partnership with Falck (formerly Care) for over 20 years Current contract offers competitive pricing
Expires 12/31/26 with two optional 1-year extensions
No staffing liabilities, vehicles, or equipment under City responsibility
Current Ambulance Deployment
Three 24-hour ambulance units deployed at Fire Station #1, #3, and #6 One 12-hour ambulance unit deployed at Fire Station #1 (8 AM to 8 PM) Staffed by two Falck Ambulance Operators per shift, under the supervision of the on-duty Fire Captain Ambulance Operators (AO) reside at fire stations with residential quarters for sleeping and meals 4 Ambulance Operators
Ambulance Operator (EMT-B)
146 hours coursework + 24 hours clinical training
Skills and Responsibilities
Basic Life Support (BLS): CPR, splinting, oxygen therapy, and bleeding control Transport patients to hospitals
Operate emergency vehicles safely
Monitor basic patient vitals
Firefighter Paramedic (EMT-P)
450 hours coursework + 160 hours of clinical training + 480 hours field internship Skills and Responsibilities:
Advanced Life Support (ALS): Intubation, IV medications, EKG interpretation, defibrillation Perform more advanced medical interventions
Administer controlled substances and advanced airway management Handle critical or life-threatening conditions
5 Year 1 (2024)
Year 2 (2025)
Year 3 (2026)
$85.00
$90.00
$95.00
January 2024
July 2025
December 2026
Current Unit Hour Cost
Proposed Ambulance Model Benefits
Identical service levels
Direct oversight of staffing, training, patient care, and emergency response times Complete vertical integration with current fire and emergency medical services Customized ambulance vehicle specifications to City’s EMS needs Recruitment pool into Fire Suppression
Significant cost savings
7 Cost Breakdown
Labor Costs
Eighteen (18) Full-Time AOs
Six (6) Part-Time AOs
Vehicles and Equipment
Seven (7) Type III Ambulances
Power gurney and automatic patient loading system
Communications equipment (radio equipment, mobile data computer, phone) Vehicle Maintenance and Fuel
Operating Expenses
Telecom, Insurance, IT Allocation
8 City-operated Cost Structure
EXPENSE
CY 2026†
CY 2027
CY 2028
CY 2029
CY 2030
LABOR
$1,808,764
$1,867,115
$1,932,519
$1,989,876
$2,054,438
VEHICLES AND EQUIPMENT
$355,621
$355,621
$355,621
$355,621
$355,621
OPERATING EXPENSES
$119,710
$123,302
$127,001
$130,811
$134,735
SUBTOTAL
$2,284,095
$2,346,037
$2,415,141
$2,476,308
$2,544,794
10% CONTINGENCY
$228,409
$234,604
$241,514
$247,631
$254,479
TOTAL COST
$2,512,504
$2,580,641
$2,656,655
$2,723,938
$2,799,273
UNIT HOUR COST
$81.95
$84.17
$86.33
$88.84
$91.30
† Based on a full year of city-operated service beginning January 1, 2026
5-Year Cost Comparison
YEAR
CONTRACTED RATE
CITY RATE
CONTRACTED ANNUAL COST
CITY ANNUAL COST
ANNUAL SAVINGS
2026†
$95.00
$81.95†
$2,912,700
$2,512,504†
$400,196†
2027‡
$105.00
$84.17†
$3,219,300
$2,580,642
$638,659‡
2028‡
$108.15
$86.33†
$3,324,964
$2,656,655
$668,309‡
2029‡
$111.39
$88.84†
$3,415,355
$2,723,939
$691,417‡
2030‡
$114.74
$91.30†
$3,517,816
$2,799,273
$718,543‡
† Based on a full year of city-operated service beginning January 1, 2026 ‡ Estimated
Department Qualifications
Fullerton Fire Department
Longstanding experience managing EMS operations, including patient care, EMS system performance, and billing administration Advanced Life Support (ALS) resources and emergency response coordination Expertise in Emergency Medical Services (EMS)
EMS Manager Rhonda Rosati
Registered Nurse with 15 years of EMS experience
Extensive background in clinical oversight, EMS operations, and regulatory compliance Deputy Chief of Administration Jon Fugitt
Supervised Ambulance Operators as both a Fire Captain and Battalion Chief Preparations - Business Operations
Deputy Chief Jonathan Fugitt, EMS Manager Rhonda Rosati, and Administrative Analyst Andrew Yang completed an intensive 3-week Ambulance Business Academy course 11 Schedule:
24-hour rotating shifts to mirror Fire Suppression (48 on | 96 off) 56-hour average workweek (full-time)
Qualifications
18 years of age; High school diploma or GED
Pass background check and drug screening
CA Class C Driver License
CA DMV Ambulance Driver Certificate
CA EMT-1 Certification
CPR Certification (American Heart Association or American Red Cross) Non-Regular Employee Resolution
Competitive base hourly rate
Paid 15x overtime rate after 40 hours per week
CalPERS enrollment (Misc) for full-time employees (enrollment for part-time employees after 1,000 hours worked) Limited Term Classification with maximum 2-year employment tenure (extendable at Fire Chief’s discretion) Ambulance Operator Classification
AO Recruitment & Retention
Competitive labor market for EMTs in Southern California Need to balance wages and benefits to remain competitive with cost control Vehicle Procurement & Supply Chain Delays
Global supply chain disruptions could delay ambulance acquisition Lead times for new ambulances are 8–12 months
Challenges And Considerations
Transition Logistics
Terminate existing contract while ensuring uninterrupted service Coordinating staffing, training, licensing, and deployment readiness before go-live New Administrative Responsibilities
Absorbing new responsibilities without adding administrative positions Increased workload for Fire Administration and Operations, as well as for City (HR and Finance)
Implementation Timeline
Immediately: Place initial reservations for ambulances for December 2025 delivery July 2025: Return to City Council for Vehicle and Equipment Purchase Authorization August 2025: Finalize AO Position Classification with HR September 2025: Open AO recruitment process
October 2025: Finalize Agreements for Mutual Aid and Surge December 2025: Conduct background checks, personnel onboarding January 2026: Two-week AO Training Academy
February 2026: Launch City-Operated Ambulance Program
Proposed Motion
Approve the proposed transition to the city-operated ambulance program:
Authorize the City Manager, or designee, to initiate the process of terminating the agreement with Falck Mobile Health Corp.
Direct the Fire Department to develop a detailed transition plan for a city-operated ambulance program, targeting February 2026 for implementation.
Questions?
16