A Local Advocacy Win March 10, 2026 From the President This past month, ACCMA helped secure an important victory for patients and physicians across Alameda County. For more than three decades, Alameda County has maintained what is known as an “Exclusive Operating Area (EOA)” for emergency ambulance services. By having one contracted ambulance company, the County has been able to ensure equitable access to emergency medical services, consistent response standards across communities, and the ability to implement advanced clinical innovations. The current system is not without its opportunities for improvement, but the model has ensured that the County has oversight and leverage with the sole ambulance company that is contracted to take our patients to our local emergency rooms for care. Every 5 to 10 years, the County goes out to bid for a new contract. In 2025, however, the Board of Supervisors declined to approve a new contract and raised the possibility of a rapid shift to an open EMS system, whereby upwards of a dozen different ambulance providers could operate in the County without the same consistency, oversight and accountability as a sole provider under the EOA. This raised significant concerns about equity, patient safety, and accountability – particularly for Medi-Cal and uninsured patients and for residents of underserved neighborhoods. Working closely with emergency physicians and County EMS experts, ACCMA helped elevate the clinical and equity implications of this issue. Our message was simple: decisions about emergency medical services must prioritize patient care. A rapid move away from the current model to an untested open system was a risky bet that could harm patients. After careful deliberation – and strong advocacy from our Association and physician leaders – the Alameda County Board of Supervisors voted to extend the current ambulance services contract for at least 2.5 years, while undertaking a more deliberate, data-driven planning process to evaluate any potential transition to a non-exclusive EMS system. The Board’s decision to slow the process, maintain stability, and require thoughtful planning reflects that message – and reflects the power of physician advocacy. This outcome did not happen by accident. It happened because ACCMA has the credibility, relationships, and resources to engage effectively with local decision-makers. That capacity exists because you support us through membership. At every level – local, state, and federal – ACCMA serves as your voice. We translate your frontline clinical experience into policy advocacy that decision-makers can understand and act on. When it matters most, we show up.