VISALIA, California- After listening to a pitch to change ambulance services to a single provider, Tulare County supervisors told staffers to continue working on all options to address concerns over response times and the loss of service in rural areas.

Those options include consolidation of services, a joint-powers authority or simply strengthening future county contracts to enforce performance standards.

That is something supervisors currently are not able to do with the county’s nine ambulance providers.

After Tuesday’s presentation, the board didn’t appear convinced that going to a single provider was the only option.

Daniel Lynch, administrator for the Central California Emergency Medical Services Agency, said the county’s current setup using nine providers doesn’t ensure the closest ambulance responds to an incident.

Ambulance companies have exclusive operating areas that preclude providers from crossing boundaries, Lynch said.

Under a single-provider system, one ambulance company would cover all of Tulare County, except Dinuba, where the Fire Department operates the city’s tax-supported ambulance service.

Lynch said a contract with a single provider could include performance standards — not included in the county’s current contracts.

Supervisors questioned why the contracts lack standards. They also asked whether a joint powers authority agreement among the nine providers might work.

Opinions on what the county should do varied among the dozens of residents, paramedics and ambulance company administrators attending Tuesday’s hearing.

Some people wore blue ribbons symbolizing support for some kind of improvement in ambulance services.

Scott Scheer, human resources manager for Imperial Ambulance in Porterville, asked that the board give providers a chance to address concerns.

“We have not been given an opportunity, and I believe we could come up with an amicable solution to take care of these problems,” he said.

David Cooper, owner of American Ambulance of Visalia, said he and other providers have talked about an alliance and believe they can draft a plan.

He said providers showed they can work collectively after consolidating dispatch services a few years ago.

But Visalia paramedic Ralph Herrera said companies have had “ample time” to make changes, including improving response times and coverage. Different company management styles wouldn’t work well under a joint powers authority, he said.

“This ambulance service is in desperate need of change — I’ve seen it,” he said.

Diana Pearcy said she has experienced the inefficiency of the county’s current setup and thinks a single-provider system would have helped her family.

About a year and a half ago, she found her 29-year-old daughter in a coma-like state on her bed in their home between Woodlake and Ivanhoe. A fire unit arrived within 10 minutes, but it took more than an hour for an ambulance to arrive, she said.

“Are we to assume taking one hour to arrive to our home must be expected practice? No, we are not,” she said.

Supervisors agreed more information and research is needed before any decision is made. That includes discussions among providers and the county outlining performance standards they want to see.

Supervisor Phil Cox said the county has an opportunity to improve services and he hoped ambulance companies walked away Tuesday thinking about how they can be a part of it.

“There needs to be some performance measures in place,” he said. “I can’t believe we’ve gone on this long without something in writing.”