The Santa Monica Fire Department is rolling out a pair of new programs designed to reshape the city's emergency medical response that officials say is aiming to improve patient care while generating millions in new revenue as part of a broader effort to stabilize the city's finances.
The initiatives — an in-house Ambulance Operator Program launched Feb. 1 and an expanded Advanced Provider Unit approved by the City Council last week — represent key components of the city's two-year strategic Realignment Plan, which seeks to build organizational capacity and deliver more coordinated public safety services.
City Hall said the programs mark a significant shift in how Santa Monica handles emergency medical calls, moving away from reliance on a private ambulance contractor and investing in specialized units that can treat patients in the field, reducing unnecessary hospital transports and freeing up frontline resources.
The Ambulance Operator Program brings emergency medical transport services in house for the first time, ending the city's practice of routing all EMS dispatch calls to McCormick, a private firm.
The program establishes a dedicated team of ambulance operators who work alongside paramedic teams during emergency responses. Under the new staffing model, firefighter-paramedics can focus on patient care while ambulance operators handle vehicle operations and transportation to local medical facilities.
City officials say the financial case for the program is compelling. The Ambulance Operator Program is projected to generate approximately $7 million in new revenue against an annual operating cost of $2.8 million, making it a central piece of the Realignment Plan's budget stability strategy.
"The Ambulance Operator Program reflects our ongoing commitment to innovation, safety and high-quality service for the Santa Monica community," Fire Chief Matt Hallock said. "By formalizing the ambulance operator role, we are strengthening our Emergency Medical Services system, supporting our personnel and improving outcomes for the patients we serve."
The program is also designed to serve as a career pipeline, acting as the first step toward becoming a firefighter-paramedic. Ambulance operators receive specialized training in emergency vehicle operations, safety protocols, communications and teamwork.
The city said it will monitor performance metrics closely as the program expands.
The City Council voted last week to add a second unit to the Fire Department's Advanced Provider Unit program, citing strong results from the first unit, which launched in November 2025.
The APU is a specialized Mobile Integrated Health resource designed to handle complex medical and behavioral health calls and frequent 911 users. Each unit is staffed by a firefighter-paramedic and a nurse practitioner, a combination that allows the team to conduct advanced clinical assessments in the field, provide treatment on scene when appropriate, coordinate follow-up care and reduce unnecessary emergency department transports.
In its first three months of operation, the initial APU responded to more than 130 calls for service, provided advanced-level care to more than 60 patients and successfully treated and discharged more than 20 patients on scene, avoiding unnecessary hospital visits. The unit also avoided the use of ambulances more than 50 times, keeping those resources available for other emergencies, and helped place two elderly, high-utilization patients into long-term care.
The expansion will increase coverage during peak demand periods and extend deployment to seven days per week. The Fire Department anticipates having the second unit fully staffed and operational by March.
The APU program was funded in large part to serve people experiencing homelessness and other vulnerable populations, according to a staff report presented to the council.
The units function as mobile urgent care for the unhoused population, providing point-of-care testing for conditions such as flu, strep and blood abnormalities. Nurse practitioners on the units can medically clear patients — a capability that paramedics and emergency medical technicians do not have — keeping lower-acuity patients out of the hospital and freeing up beds for those with more serious conditions.
The APU also makes house calls to Santa Monica residents, providing post-discharge care, testing and follow-up after hospital release to reduce the likelihood of future 911 calls.
The program additionally supports the Santa Monica Police Department by reducing reliance on external medical partners to medically clear detainees for booking, resulting in cost savings for the city.
To staff the second unit, the council authorized contracts with two nurse practitioners. Each agreement carries an initial one-year term with a not-to-exceed amount of $79,553, including contingency funds, and includes four one-year renewal options for a total not-to-exceed amount of $598,643 per contract.
The Fire Department opted to contract with nurse practitioners rather than create city positions to maximize operational flexibility and scheduling coverage. The department held an informational session attended by more than 40 potential nurse practitioners and conducted two rounds of interviews before selecting the candidates.
The contracts were approved as an exception to the competitive bidding process under the city's Local Emergency on Homelessness, a declaration first adopted by the council in February 2023 and most recently extended in December 2025.
The first APU was authorized as part of the city's fiscal year 2025-27 biennial budget in June 2025, and the second unit was authorized when the council adopted the Realignment Plan in October 2025.