HSC §1797.230: (a) (1) A county may contract for emergency ambulance services with a fire agency that will provide those services, in whole or in part, through a written subcontract with a private ambulance service.

(a) (1) A county may contract for emergency ambulance services with a fire agency that will provide those services, in whole or in part, through a written subcontract with a private ambulance service. (2) This subdivision is declaratory of existing law regarding a county’s powers and authority to contract for emergency ambulance services. (b) For purposes of this section, “fire agency” means a fire protection district, including a fire protection district that is governed by the county’s board of supervisors, a joint powers agency created for the provision of fire protection services, a city, a special district that provides fire protection services, or a local agency authorized by statute to provide fire protection services. (c) On and after January 1, 2022, a county shall not enter into or renew a contract for emergency ambulance services unless the county board of supervisors has adopted, by ordinance or resolution, a written policy setting forth issues to be considered for inclusion in the county contract for emergency ambulance services, which may include, but are not limited to, all of the following: (1) Employment retention requirements for the employees of the incumbent ambulance service. (2) Demonstrated experience serving similar populations and geographic areas. (3) Diversity and equity efforts addressing the unique needs of vulnerable and underserved populations of the service area. (4) Financial requirements, including requiring a private ambulance service provider to show proof of insurance and bonding. (5) A description of the ambulance service provider’s public information and education activities and community involvement. (d) If a county contracts for emergency ambulance services as described in this section, the county contract shall demonstrate how the county contract will provide for the payment of comparable wages and benefits to all ambulance service employees that are generally consistent with those provided to ambulance service employees in the same geographic region. The county contract shall also demonstrate that the staffing levels for ambulance service employees will be comparable to the staffing levels under the county’s previous contract. (e) The requirements of this section are within the exclusive jurisdiction of the county’s board of supervisors. (f) This section shall not supersede Section 1797.201 and shall not alter, modify, abridge, diminish, or enlarge the requirements for creating, establishing, or maintaining an exclusive operating area under Section 1797.224.