Santa Monica takes over emergency services to boost revenue and improve patient care

SANTA MONICA, Calif. — The Santa Monica Fire Department is launching two new initiatives to overhaul the city’s emergency medical response system, a move officials say will improve patient care while generating millions of dollars in new revenue.

Starting Feb. 1, the department’s Ambulance Operation program will bring emergency medical transport services under city management. The shift moves away from the city's previous model of utilizing private contractors.

The new ambulance model is projected to generate approximately $7 million in revenue against $2.8 million in operating costs.

The City Council also approved the expansion of the Advanced Provider Unit (APU) program, authorizing a second unit for the fleet. Each APU is staffed by a fire-paramedic and a nurse practitioner who can treat complex medical cases in the field, specifically targeting the needs of the homeless population.

The first APU, which has been operational since November 2025, has already shown positive results. According to the department, the unit has reduced unnecessary hospital trips and freed up emergency resources for other high-priority calls.

Santa Monica’s latest initiative serves as a sophisticated blueprint for American municipalities grappling with the dual pressures of fiscal volatility and compounding social crises. By internalizing ambulance services and terminating third-party contracts, the city has effectively transitioned its emergency medical services (EMS) from a cost center into a revenue-generating asset. This move toward insourcing not only ensures tighter quality control but also allows the city to capture significant revenue streams previously lost to private contractors—a model likely to be scrutinized by other financially strained urban centers.

However, the more profound policy innovation lies in the deployment of the Advanced Provider Unit (APU). This specialized division represents a formal recognition that the legacy 911 dispatch system is fundamentally ill-equipped to manage chronic socio-medical challenges, such as homelessness and acute mental health crises. By deploying high-level nurse practitioners directly to the field, the APU provides targeted, site-specific care that bypasses the need for costly and overburdened emergency rooms.

This strategic pivot shifts the focus from symptom-based reaction to root-cause mitigation. Ultimately, Santa Monica’s framework signals a broader evolution in public administration: a move away from passive crisis response toward proactive, fiscally disciplined problem-solving. As cities across the U.S. search for sustainable solutions to systemic social issues, the success of this integrated fiscal and social policy will offer critical lessons in municipal governance.

Vietnamese-American residents and business owners in Santa Monica—from those in the nail salon industry to our local phở restaurants—will benefit alongside all city residents from a more efficient, upgraded emergency medical response system. This modernized system is better equipped to handle complex situations on the ground, ensuring our community has access to faster and more effective care when it matters most.