The perennial risk of fires and mudslides comes with the county’s wild southern coastal terrain. Now, Big Sur Volunteer Fire Brigade Chief Martha Karstens worries about another threat: the loss of the area’s dedicated ambulance service.

“Lives could be lost,” she says. “We would like to make sure the Big Sur ambulance service stays in Big Sur.”

This fall, the county supervisors are expected to approve a new emergency medical services contract for the unincorporated county. Several of the cost-cutting options would scale back service in remote Big Sur, where medical emergencies can be severe.

Big Sur’s current Advanced Life Support ambulance, stationed at the firehouse at Post Ranch and staffed by an emergency medical technician and a paramedic, takes roughly 180 calls per year, Karstens reports. “They can respond right away instead of waiting an hour or longer for an ambulance to come from the Peninsula,” she says. “It’s important for the community, and the tourists that come through here, to have medical care available to them on a timely basis.”

But that care is expensive. Kathleen Lee, chief of staff for County Supervisor Dave Potter, estimates taxpayers subsidize Big Sur’s ambulance by more than $600,000 per year. “Their call volume does not support staffing down there full-time,” she says. Compounding the cost, senior EMS personnel – who draw higher salaries and benefits – jostle to be stationed in the scenic region. “It’s the cherry assignment among staff,” Lee adds.

County EMS Director Tom Lynch says the request for proposals drew two bids: one from the current provider, Colorado-based national outfit American Medical Response, and one from Solano County-based Medic Ambulance.

The staff recommendation isn’t public yet, but Lynch says options include keeping Big Sur’s full-time ambulance service, shifting to part-time, and downsizing to a paramedic with a quick response vehicle.

On Sept. 22, Potter held a public meeting on the topic at the Big Sur Lodge. The Supervisors are expected to vote in October, and Lynch anticipates having a new five-to-10-year contract in place by Dec. 1. “We appear to be on track,” he says.