Finance and Management Services
www.santa-ana.org/finance
Item # 12
City of Santa Ana
20 Civic Center Plaza, Santa Ana, CA 92701
Staff Report
March 3, 2026
TOPIC: Standards of Coverage / Emergency Medical Services Study
AGENDA TITLE
Agreement with PWW Advisory Group, LLC for Consultant Services to Conduct a Citywide Standards of Coverage / Emergency Medical Services Study (Specification No. 25-136) (General Fund)
RECOMMENDED ACTION
Authorize the City Manager to execute an agreement with PWW Advisory Group, LLC to conduct a Standards of Coverage / Emergency Medical Services Study in an amount not to exceed $154,983 for a term beginning March 3, 2026 and expiring March 2, 2027, with provisions for one 1-year extension (Agreement No. A-2026-XXX).
GOVERNMENT CODE §84308 APPLIES: Yes
DISCUSSION
In 2012, the City of Santa Ana dissolved its municipal fire department, and began delivering fire suppression and Emergency Medical Services (EMS) through external contracts. Since this transition, the City has navigated significant complexities in managing its contracts with the Orange County Fire Authority (OCFA) and Falck Mobile Health, Inc. (Falck).
Concerns regarding the EMS program have been voiced in the past; and during the FY 25-26 budget cycle, the City Council funded an additional ambulance unit. While the City expected this to improve response-time performance, it did not resolve the underlying challenges of contractual oversight. Recognizing a lack of in-house subject-matter expertise, staff issued Contractual Oversight Outsource for Emergency Medical Services (EMS) RFP 25-106 on August 21, 2025 for professional assistance. However, this RFP was later canceled for two reasons: proposals received were not what was requested, and staff determined it would be best to start with a comprehensive review of the City’s entire EMS structure.
Prior to the initial RFP, the City discovered its ambulance contract was unclear regarding response-time calculations, leading to disagreements between ambulance and fire on how response-time performance is measured. Additionally, the emergency dispatch
Standards of Coverage / Emergency Medical Services Study March 3, 2026
5 6
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process remains a concern; as current routing procedures illustrated below can delay ambulance deployment.
Figure 1. Call Intake Workflow
Note: The time it takes to process a call is variable and depends on factors such as system infrastructure, call type, the amount of information needed, connectivity of the phone service, the mental/emotional state of the caller, and the experience of the dispatcher taking the call.
The City’s oversight structure has also created potential conflicts of interest. Under the current ambulance agreement, OCFA has some responsibility for overseeing Falck; however, the City’s contract with OCFA does not include this responsibility. When the County released a 9-1-1 ambulance services RFP on March 3, 2025, both OCFA and Falck competed for the contract, which the Board of Supervisors ultimately awarded to Falck on August 12, 2025. During 2025, the City began collaborating with Orange County Emergency Medical Services (OCEMS), the regional regulatory body, to better understand EMS mandates and verify Falck compliance. To date, information from OCEMS indicates the ambulance provider is meeting its contractual obligations.
Staff anticipates that a comprehensive "Standards of Coverage" study will identify the root causes of recurring concerns and provide a roadmap for regional EMS innovation. This study will include a deep legal and operational analysis of current constraints and opportunities. A critical component will be identifying sustainable funding strategies, particularly given the City’s heavy reliance on Medicare and Medi-Cal, and the rising costs of service from both Falck and OCFA. Most recently, OCFA has requested $2.5 million of funding for an additional paramedic unit in the City. Beyond finances, the review will explore modernizing service delivery through telehealth and telemedicine, while developing public education initiatives on the most effective ways to utilize the ambulance system.
To facilitate this study, staff issued RFP No. 25-136 on November 10, 2025, via the City’s online bid management system. A summary of the vendor participation and results follows:
Person
needing
emergency
services dials
911
Call answered
by SAPD
(exception
may be if
caller is near a
freeway, then
CHP picks up
1st then
transfers to
SAPD)
SAPD
identifies
types of call as
medical / fire-
related then
transfers to
OCFA
OCFA
determines if
an ambulance
is needed
Call is routed
to Falck to
dispatch an
ambulance
APPROX 15 SECONDS – 1 MINUTE APPROX 30 SEC
Standards of Coverage / Emergency Medical Services Study March 3, 2026
5 6
0 7
970 Vendors Notified
0 Santa Ana Vendors Notified
20 Vendors Downloaded the RFP Packet
3 Proposals Received
0 Proposals Received from Santa Ana Vendors
Proposals were solicited, opened on December 4, 2025, and evaluated. Three (3) proposals were submitted by the RFP deadline and determined to be responsive to the specifications, and met the City’s requirements. An evaluation committee reviewed the responsive proposals and rated them according to the criteria listed in the RFP.
Staff recommends awarding an agreement to the highest-ranked firm, PWW Advisory Group (“PWW | AG”) (Exhibit 1). The proposal submitted by PWW | AG was found to meet the City’s needs, offers the best value, and is appropriate for the services requested.
PWW | AG possesses a strong background and experience, understanding of the scope of work, and value-added customer service. The agreement also includes flexibility to address unforeseen or additional services, as needed.
ENVIRONMENTAL IMPACT
There is no environmental impact associated with this action.
FISCAL IMPACT
Funding is included in the approved FY 2025-26 budget; no additional allocations are requested at this time.
Fiscal
Year
Accounting Unit –
Acct #
Fund
Description
Accounting Unit,
Acct Description Amount
2025-26 01115017 - 62300 General Fund Contact Services
Professional $154,983
EXHIBIT(S)
1. Consultant Agreement with PWW Advisory Group, LLC
Submitted By: Kathryn Downs, Assistant City Manager
Alexander Trinidad, Executive Director Finance and Management Services Agency
Approved By: Alvaro Nuñez, City Manager