National City could soon move its ambulance services in-house

National City could soon run its own ambulance services as it nears the likely end of its decadeslong relationship with a private company.

The city’s contract with American Medical Response is set to expire by the end of next month, and staff are exploring the funding and recruitment needed to launch an in-house service under the fire department.

A spokesperson with AMR said that the ambulance company is negotiating a contract extension to allow the city to finalize plans.

“We remain committed to ensuring there is no disruption in emergency services for the community and continue to work with the National City Fire Department leadership on solutions,” the company said in a statement.

City Manager Doug Schulze said ambulance service changes in neighboring cities have made an impact. Chula Vista brought its emergency medical services in-house and San Diego is considering doing the same. 

Schulze, who took the city’s top administrative job last month, said AMR has told his staff that servicing National City alone would not be profitable.

“That would leave National City as kind of a donut hole served by AMR,” he said. “So with the loss of Chula Vista and San Diego, it’s highly likely they couldn’t continue to serve this area.”

No formal action to move forward has taken place yet, and National City wants to “keep AMR available here to the community until we are ready to launch something,” he said.

In the meantime, the city’s Fire Department is revving up to launch an ambulance service. Start-up costs could total more than $6 million, Battalion Chief Jeremy Day said at a City Council meeting in May.

The change would come after the city again dipped into its reserves this year, this time to balance a $13 million budget deficit.

Officials could choose to take on bank loans to buy necessary equipment, and borrow from its own funding to cover personnel and operational costs — reducing borrowing costs and providing greater flexibility, staff said.

The city has also secured a $370,000 federal grant to help buy equipment.

“It’s a thoughtful way to do it,” Councilmember Ditas Yamane said. “It’s not gonna infringe too much on our general fund.”

Councilmember Jose Rodriguez agreed. “We’re reinvesting back into our own staff and it’s going to pay dividends at the end, like it has been for every other city I’ve spoken to,” he said.

Chula Vista launched its own in-house ambulance services in 2021 and has serviced Bonita and Imperial Beach, according to the city’s website. Chula Vista officials say the move yields many benefits, including regulations on rate increases and more ambulances based in the South Bay.

San Diego has considered moving its ambulance services in-house after AMR and a second provider, Falck USA, have increased what they charge the city, the Union-Tribune reported last year. 

Day said the goal is for National City to establish a new enterprise account for the internal loan, and use future transport revenue to repay startup costs without relying on the city’s general fund.

“I can’t say that general fund dollars will not be used, but that’s not the aim of this project,” Day said.

Staff is now “identifying financial strategies” and finding vendors for billing services and medical supplies, he said.

It’s unclear when an in-house ambulance service in National City will officially launch. Officials expect to return in August with a formal funding proposal and implementation plan, and the Fire Department plans to start recruiting employees in January.