{ORGANIZATION LETTERHEAD}

SAMPLE LETTER

{DATE}

Dear Honorable {NAME}:

My organization, {SERVICE NAME}, provides essential ambulance services to the community

of {CITY NAME}. {Enter a brief DESCRIPTION of your ambulance service: number of
employees, number of ambulances, services provided, length of service, community
distinctions}.

I am writing to request that you support an exemption for lifesaving ambulance services from
the Medi-Cal rate cut. As you know, Governor Brown has announced cuts to the Medi-Cal
program including a permanent 10 percent reduction to Medi-Cal ambulance rates. It is critical
that you support an exemption because a Medi-Cal cut will impact every patient that dials 9-1-1.

Ambulance providers are unique in three ways. First, no other Medi-Cal provider is required to
respond, treat and transport all emergency patients without exception and without regard to a
patient’s ability to pay and 90% of all Medi-Cal ambulance transports are for emergencies.
Second, emergency ambulance services are required to respond within mandated response times.
Third, ambulance providers deliver an estimated $320 million in annual charity care statewide to
the uninsured, and yet, do not have access to federal and state funds available to other safety net
providers to offset the cost of this care. In fact, based upon an independent federal study, today’s
inadequate Medi-Cal reimbursement rates for medically necessary ambulance services cover
only one quarter of the cost of service and actually need to be substantially increased. Attached
is additional information about the proposed Medi-Cal ambulance rate cut.

Please contact the legislative leadership and the Budget Committee and express your strong
support of an ambulance exemption. Thank you for supporting lifesaving essential ambulance
services in our community.
If I can provide additional information or answer any questions, please do not hesitate to contact
me at {NAME AND CONTACT INFO}.

Sincerely,

{NAME}
{ORGANIZATION}

Enclosure