From: James Warner
To: Kassi Dee; Robert Robert; Jules Tuggle; Clint Weirick Subject: Emergency Medical Services Proposal: RECOMMEND DENIAL Date: Monday, September 14, 2026 1:11:04 PM
Hello Honorable Grover Beach City Council Members:
I am writing to you today in regards to your Agenda Packet 9-14-2026, the Proposal to adopt the Paso Robles Model of EMS Services for all of San Luis Obispo County.
I am writing to you to recommend that you DENY the resolution.
As a retired paramedic I am generally aware of American Medical Response's (AMR) unfavorable reputation as a provider of EMS Services among both the public and many who have worked for this massive national corporation, owned by a larger multinational corporation Global Medical Response.
My nephew, Mr. Andrew Westby, Senior Paramedic and Training Officer with the Austin {Texas}-Travis County EMergency Medical Services agency. Mr. Westby worked for AMR for 10 years as a Paramedicbefore relocating to Austin, to his current position.
When I contacted him yesterday to inquire as to his opinion of the proposal before you this evening he warned me in the strongest possible terms to dissuade any city or public safety agency in San Luis Obispo County from engaging in any partnership with AMR.
Why? Mr. Westby advised me AMR has made this kind of proposal to many jurisdictions and public safety agencies; always with the same core idea: Take over your region's EMS transport in partnership with AMR and your agency will realize a new funding source. New funds will become available, but so do new business and legal responsibilities and significant expenses to collect said monies. Mr. Westby advised my that in his experience and observation that the monies obtain never exceeded the cost to obtain them.
More significantly, after the existing local EMS transport company, San Luis Ambulance in our case, is dissolved, the next contract that AMR will offer for EMS transport to our county will cost significantly more. With San Luis Ambulance dissolved and defunct, what choice will there be?
The CITY OF MORRO BAY assessed these facts and other significant details that I do not have access to as of this writing, and they voted 5/0 to DENY the proposed resolution before you.
Please, do not approve this proposal, it is a false promise of funding and will be very damaging to the public welfare.
James Warner
Morro Bay Fire Engineer/Paramedic (Retired)
Morro Bay, CA
From: betty winholtz
To: Kassi Dee; Robert Robert; Jules Tuggle; Clint Weirick Cc: Matthew Bronson; [email protected]
Subject: monday agenda item no. 9
Date: Saturday, September 12, 2026 12:11:11 AM
Dear City Council:
I am a resident of Morro Bay, and last Tuesday our City Council voted 5-0 to support Alternative #3, Do not adopt the Resolution. This was a Business Item on the Morro Bay agenda not a Consent Item.
I urge you to pull this item for discussion. Through Morro Bay Public Comment, we learned way more than what was in the Morro Bay staff report, which is similar to the Grover Beach staff report. For example, the reports state that "the City of Paso Robles is seeking to change the EMS system from the current “private-for-profit” based emergency transportation model to a subcontracting-based “public-private partnership” known as the “Alliance” model.
We learned through Public Comment the company chosen for this Alliance model is AMR, the largest ambulance service in the U.S., operating globally, and traded on the New York stock exchange. In other words, the company is beholding to investors, not the people using the ambulance service in Grover Beach and SLO County. AMR has merged, and been bought and sold several times. It is owned by a private equity firm in Texas. To me, this is not local control. Could Paso choose a different company? AMR is the only one who responded out of 170 ambulance companies in California. The implication is the Alliance model, publicprivate partnerships aren't as viable; they have issues.
As the fiduciary responsible party for the City, the City Council should be concerned about cost as well as reliability. Each County city will have to invest literally hundreds of thousands of dollars as start-up fees to buy vehicles, equipment, personnel, etc. It is reported that this will be paid back with interest after several years. However, the amount is unknown, the length of time is unknown. In the Morro Bay staff report a source of money for public and not private entities is a government program known as Ground Emergency Medical Transport (GEMT). This is a federal program whose funds are being cut back. If this is a source of money that the public-private business depends on, when it gets cut back, won't it fall to the County's cities to make up the difference?
Currently in Morro Bay, the City pays nothing for ambulance service. In fact, San Luis Ambulance pays the City $108,000 annually. Why would you want to put your City on the hook to pay money when currently there is no cost to you? Should governments compete with businesses? Do we need another layer of government bureaucracy when a successful, private company to doing a fine job. Do we need one more thing for our city managers to oversee?
If the real issue is that the County has not gone out to bid for a number of years, it finally is. If the real problem is that San Luis Ambulance provides inferior service or just needs tweaking, like paying for dispatch, then have the company pay for dispatch. Don't reinvent the wheel with taxpayer money.
Sincerely,
Betty Winholtz
From: Justin Kelton
To: Kassi Dee; Robert Robert; Jules Tuggle; Kathy McCorry-Driscoll; Clint Weirick Subject: Please Pull Consent Agenda 9 For Discussion
Date: Saturday, September 12, 2026 1:18:33 PM
Dear Mayor and Council Members,
I am writing to share concerns regarding the proposed resolution supporting the Paso Robles-led Alliance model for countywide ambulance services.
I support the goals of improved response-time accountability, better technology and dispatch, expanded behavioral-health resources, greater transparency, and continued improvement in patient care. However, the more fundamental question is whether the City should enter this new arrangement given the significant financial and operational commitments it could create.
The Alliance would require millions of dollars in startup costs, yet it remains unclear what each participating city would be responsible for or what its maximum financial exposure could be. Before moving forward, the City should understand its responsibility for startup expenses, operating deficits, capital expenditures, fleet replacement, administrative costs, and unforeseen liabilities.
The financial projections also appear to rely significantly on PPGEMT reimbursement.
Potential changes recently considered by CMS could tie reimbursement more closely to Medicare rates and substantially reduce anticipated revenue. The Alliance should therefore be evaluated under scenarios in which this revenue is significantly reduced.
There is also an important difference between projected benefits and actual obligations.
Greater efficiency, additional revenue, and improved services are anticipated but have not yet been demonstrated. The costs and liabilities of creating the new system, however, would be very real.
The Council should also consider what “local and community-based” really means.
While the Alliance may be locally administered, ambulance operations would still be subcontracted to a private provider, with American Medical Response (AMR) proposed as a partner.
At its core, the Council is considering replacing a locally owned, family-operated San Luis Obispo County ambulance company with a large, out-of-state corporate provider backed by private investment. San Luis Ambulance has served this community for more than 80 years, employs 160 local residents, and reinvests its resources here in San Luis Obispo County. This is also a decision about where local ambulance dollars, jobs, accountability, and decision-making will reside.
At least one city has already chosen not to participate in the Alliance. That withdrawal also changes the financial equation. The original assumptions were based on costs and revenues being shared among participating jurisdictions. With one city no longer participating, those costs do not simply disappear—they must be absorbed by the remaining participants. Before supporting the Alliance, the Council should require updated financial projections showing what each remaining city's financial responsibility will now be.
The financial comparison is significant. Under the current model, the City invests zero dollars in operating the ambulance system and your contracted Fire Department receives first responder fees from San Luis Ambulance. Under the Alliance, the City could instead assume a share of millions of dollars in startup costs and future financial liabilities.
The existing system already provides personnel, ambulances, equipment, stations, infrastructure, and decades of operational experience without requiring City startup investment. San Luis Ambulance is also charging approximately $1,300 less than the maximum ambulance rates permitted under the existing County structure.
Many of the proposed improvements, including stronger performance standards, better technology, greater transparency, improved response accountability, and expanded specialized services, could potentially be achieved through contractual and operational requirements without creating an entirely new organizational and financial structure.
Before supporting the Alliance, the Council should have clear answers regarding:
Updated startup costs and each remaining city's financial responsibility.
The City's maximum potential financial exposure.
Responsibility for operating deficits and future capital expenses.
The impact of potential reductions in PPGEMT reimbursement.
Measurable improvements over the existing ambulance system.
Long-term administrative and operational costs.
Financial consequences if another city withdraws.
This is an important decision involving essential public safety services and potentially significant long-term financial obligations.
The question is straightforward: Why replace a proven, locally owned company that has served this county for more than 80 years, employs 160 local residents, and costs the City nothing, with a model that could put millions of public dollars at risk while subcontracting ambulance operations to a large out-of-state corporate provider?
I respectfully ask the Council to carefully consider whether that change is truly in the best interests of your residents, taxpayers, and the broader San Luis Obispo County community.
Thank you for your consideration and your service to the community. I would be happy to answer any questions or concerns.
Sincerely,
Justin Kelton
President/CEO
San Luis Ambulance
From: Brian Bernay
To: Wendi Sims
Subject: Public comment, Agenda Item 9
Date: Monday, September 14, 2026 1:09:30 PM
To the honorable members of the Grover Beach City Council:
In comment on Item 9, "Support for the City of Paso Robles Proposal for Emergency Medical Services," to be blunt, the Board of Supervisors was sold a load of subjective nonsense, and it is on the basis of the Board's action that the Grover Beach City Council is addressing this issue now.
In that Board of Supervisors meeting, we heard from various local fire chiefs presenting unsupported claims about the performance of San Luis Ambulance and their employees. What we did not hear was that San Luis Ambulance has operated in this county for many, many years, under a performance-based contract promulgated by the County of San Luis Obispo, and supervised by the County's Emergency Medical Services Agency. What we did not hear in that meeting is that San Luis Ambulance has, for all those years, met every performance measure required by the county contract.
We heard from the county fire chief of his great concern for response times in the rural area of San Luis Obispo County, such as Creston, Shandon, Lake Nacimiento, and so on. What he didn't tell the Board is that he has a staff of paramedics that he could easily assign to those areas to provide early advanced life support while awaiting ambulance response, but he doesn't. In fact, the other thing we didn't hear from our county fire chief is that he had to shut down paramedic staffing at one of his own stations because he couldn't support it.
We heard from the Cambria fire chief about how often the Cambria Healthcare District (not his agency) ambulances cover response areas typically covered by San Luis Ambulance. What we did not hear is any numbers to support his claim, or how often that left Cambria uncovered, or how often San Luis Ambulance units move to cover Cambria. We also did not hear from him that, particularly in the suburban/rural communities that make up San Luis Obispo County, that no one agency does things alone. Paso Robles Fire Department crews frequently respond with Templeton crews. CalFire personnel frequently respond with SLO City, Morro Bay, and Five Cities crews. Our county sheriff's deputies support and are supported by CHP, State Parks, and local police departments. We all support each other as a combined services team to ensure the best possible outcome for the people who need our help.
So, yes, I am a San Luis Ambulance employee. I have been in EMS in this county for 20 years, and almost 20 years outside this county. I have a "forever" pension, and I could choose not to work. While I could give you my entire CV, suffice it to say that I have the credentials to work anywhere I choose in this industry. I work for San Luis Ambulance because I choose to do so. And I commute from out the of the area to do it. I work for San Luis Ambulance because of how they provide this crucial service to the community, because of the quality of the people they employ, and because of the above-and-beyond care that the Keltons and San Luis Ambulance have always provided for the people who live, work, and play in and around San Luis Obispo County.
If there are compliance problems with how San Luis Ambulance is executing the county's long-standing contractual requirements, then let the County's Emergency Medical Services Agency officers and whatever other interested parties, such as the fire chiefs, present those, and then let's move forward with a new contract, a new model, a new provider. If the county's contractual requirements are now insufficient based on a changing demographic, then let the County provide new performance measures.
But do everything you can to keep the San Luis Ambulance family, long-established here, as the company that provides those services.
Respectfully submitted,
Brian Bernay
Paramedic