DATE: October 13, 2026
CATEGORY: Consent
DEPT.: Fire
TITLE: Ambulance Billing and User Fees
RECOMMENDATION
Adopt a Resolution of the City Council of the City of Mountain View Adopting the Revised Ambulance Billing and User Fees to Be Used by the Mountain View Fire Department for Advanced Life Support Emergency Ambulance Transportation Services and Authorizing the Applicable Fees to Be Reflected in the City’s Master Fee Schedule as “Actual Costs (as Established by Santa Clara County),” to be read in title only, further reading waived (Attachment 1 to the Council report).
BACKGROUND
The Santa Clara County Emergency Medical Services (EMS) 9-1-1 System for emergency ambulance transport includes advanced life support (ALS) first responder services provided by fire agencies (including Mountain View Firefighters responding in a fire apparatus), and ALS ambulance transport services by a private ambulance provider. In recent years, there have been challenges with the availability and timeliness of the private ambulance response. There have also been instances in which ambulances are dispatched without paramedics, thus requiring the City’s Firefighter Paramedics to staff the private ambulances.
To enhance patient transport service to Mountain View residents, the City Council approved the purchase of a Fire ambulance in Fiscal Year 2022-23. The ambulance arrived in October 2024, and was placed in service in Mountain View on April 9, 2025.
Ambulance Billing and User Fees
October 13, 2026
Figure 1: New City of Mountain View Ambulance
ANALYSIS
The Mountain View Fire Department (MVFD) provides ALS Emergency Ambulance Transportation Services under a contract with the Santa Clara County EMS Agency. Per this contract, the City must bill patients for ambulance transport based on the established Santa Clara County-approved Ambulance Billing and User Fees as shown in Exhibit A to the Resolution (Attachment 1). These are considered the standard fees charged for ALS Ambulance Services across Santa Clara County and are the same fees that the private ambulance company currently charges to City residents that they transport. Effective July 1, 2026, Santa Clara County revised the Ambulance Billing and User Fees in Exhibit M of the agreement with Rural/Metro of California, Inc. and County of Santa Clara.
Since the City does not independently establish Ambulance Billing and User Fee rates, staff recommends that the City Council authorize the applicable ambulance fees in the City’s Master Fee Schedule be identified as “Actual costs (as established by Santa Clara County)” rather than as fixed dollar amounts. This will streamline future administrative updates and allow the City to implement future County-approved rate adjustments as they become effective without requiring separate City Council action. Staff will update the Master Fee Schedule, as appropriate, to reflect the then-current County-established rates. This will ensure that the City’s ambulance billing remains consistent with the rates required under the County agreement while avoiding the need for recurring Council actions when the County adjusts its rates.
Ambulance Billing and User Fees
October 13, 2026
While this emergency transport resource is primarily committed to serving the City of Mountain View, it is possible that in the rare event of a multi-casualty incident in the County, or in surrounding counties under the local and state mutual aid plans, the Mountain View Fire Department may be required to respond and render aid utilizing the City’s ambulance. Billing for use of this City resource for mutual aid will be in accordance with Ambulance Billing and User Fees established by Santa Clara County.
FISCAL IMPACT
Fiscal Year 2025-26 was the first full fiscal year that the City’s ambulance was operational, generating $237,935 in ambulance billing and user fee revenue. This revenue is in addition to the County EMS reimbursement for MVFD-provided ALS services and provides additional recovery of the City’s costs to operate ALS-level EMS services.
Adoption of the revised ambulance billing and user fees will align the City’s charges for ambulance transportation services with the applicable fees established by Santa Clara County, as reflected in the City’s Master Fee Schedule as “Actual Costs (as established by Santa Clara County)”. The revised fees are expected to result in additional cost recovery. Actual revenues will depend on ambulance transport volume, payer mix, insurance reimbursement rates, collection experience, and future changes to County-established fees. Revenue from ambulance billing and user fees will be deposited into the General Operating Fund to offset a portion of the costs associated with providing these services.
LEVINE ACT
California Government Code Section 84308 (also known as the Levine Act) prohibits city officials from participating in any proceeding involving a “license, permit, or other entitlement for use” if the official has received a campaign contribution exceeding $500 from a party, participant, or agent of a party or participant within the last 12 months. The Levine Act is intended to prevent financial influence on decisions that affect specific, identifiable persons or participants. For more information see the Fair Political Practices Commission website: www.fppc.ca.gov/learn/pay-toplay-limits-and-prohibitions.html.
Please see below for information about whether the recommended action for this agenda item is subject to or exempt from the Levine Act.
EXEMPT FROM THE LEVINE ACT
☒ General policy and legislative actions
For more information about the Levine Act, please see the Fair Political Practices Commission website: www.fppc.ca.gov/learn/pay-to-play-limits-and-prohibitions.html.
Ambulance Billing and User Fees
October 13, 2026
ALTERNATIVES
1. Do not adopt the Resolution.
2. Direct staff to provide additional information.
3. Provide other direction.
PUBLIC NOTICING—Agenda posting.
Prepared by:
Amanda Slovick
Senior Management Analyst
Approved by:
Brian Jones
Fire Chief
Audrey Seymour Ramberg
Assistant City Manager
Attachments 1. Resolution