The El Dorado County Emergency Preparedness, Healthcare Access and Wildfire Prevention Initiative FAQ
El Dorado Ready is a partnership of local healthcare leaders, firefighters, paramedics, public safety leaders, business leaders and others working to keep the residents and communities of El Dorado County safe and healthy. We must do more to prepare for emergencies by ensuring rapid 9-1-1 emergency response, preserving access to emergency rooms and quality healthcare services, and reducing the risk of wildfires in our communities.
In El Dorado County, lifesaving emergency preparedness and response is provided by an integrated and inseparable continuum of services that starts with the volunteers and professionals who help plan for, mitigate and prevent disasters, continues with the firefighters and paramedics who respond to emergencies and transport patients to local emergency rooms which provide life-saving medical care in emergencies, enabling patients to live healthy and productive lives. Approximately 80% of 9-1-1 emergency calls in El Dorado County are for medical emergencies like heart attacks, strokes, and accidents that require rapid response and often require patients to be transported to the nearest hospital emergency room.
By law, all hospitals must meet stringent building safety standards by 2030 – just a few years from now. Any hospitals that do not meet these standards by the deadline will likely lose their license to operate and be forced to close. With aging facilities dating back to its founding in 1959, many of Marshall’s core facilities do not meet the standards required by law and will likely be forced to close unless upgraded.
Like all smaller, independent hospitals, Marshall faces declining state and federal funding and is impacted by the rapidly rising cost of providing healthcare. Marshall has limited options to finance upgrades to hospital facilities to meet mandated requirements, without significantly impacting healthcare services provided and the financial viability of the hospital. In recent years, many hospitals like Marshall have been forced to close due to similar pressures, leaving those communities without a local hospital and Emergency Room. Many others are currently at risk of closure.
Marshall is the primary healthcare provider serving residents of the western slope of El Dorado County, from Echo Summit to Sacramento County. Marshall’s Level III Trauma Center is one of only two Emergency Rooms in El Dorado County and the only Emergency Room in the County west of Echo Summit for victims of heart attacks, strokes, accidents and other emergencies requiring rapid treatment. Without Marshall and its Emergency Room, many residents of western El Dorado County would be more than an hour away from the nearest Emergency Room. When seconds are the difference between life and death, access to a nearby Emergency Room is essential for the safety of the community.
With over 1,400 employees, Marshall is the largest employer in western El Dorado County and a major contributor to the local economy. If Marshall wasn’t here, the loss of jobs and related economic impact on the surrounding area would be catastrophic. Without the community’s support, Marshall won’t be able to provide the services local residents and visitors need and deserve.
Marshall has already spent over $70 million to meet the state mandate. Marshall has achieved the 2020 “safe and standing” requirement. The looming 2030 deadline added additional structural requirements and mandates that hospitals be prepared to remain fully open for at least three days after a major seismic event, which means three days of operational water, gases, power, fuel, food, supplies, etc and it’s these additional costs – which do nothing to enhance or improve access to care – that Marshall has left to complete. California’s Health Care Access & Information division (HCAI) has set forth a series of milestones for hospitals to meet to comply with the 2030 deadline and Marshall is meeting those milestones on schedule.
Emergency medical care and medical technologies are advancing rapidly, and local doctors, nurses, specialists, paramedics, and firefighters need access to the latest advances in medicine and treatments for heart attacks, strokes, injuries, cancer, and other diseases.
Local fire departments and protection districts that provide rapid 9-1-1 emergency medical response and firefighting are underfunded and have experienced cuts. Without stable, locally-controlled funding to support local fire districts, rapid emergency response times will increase, endangering the health and safety of El Dorado County residents. In emergencies like heart attacks, strokes, and accidents, seconds can be the difference between life and death. Preserving rapid 9-1-1 emergency response and quick access to the nearest emergency room and healthcare facility will save lives.
Allocations of property tax revenues set in the 1970s and 1980s reflect a time when most local fire departments relied heavily on volunteer firefighters. These same funding allocations remain in place today and cannot support a modernized, professional fire department. Furthermore, in the early 1990s, the State of California shifted approximately 10% of local property tax revenue to the State. This funding has never been restored and has reduced funding for some local fire departments by millions annually.
Historically, El Dorado County has historically responded to fires with a “two strike team,” meaning when a major fire occurs, 10 engines with two chiefs would respond. With funding reductions, local fire districts now struggle to respond with one strike team with five engines and one chief. For 9-1-1 emergency response, fewer paramedics and ambulances are available to respond to emergencies. It is common for all ambulances to be responding to calls at the same time, leaving no available ambulances to respond until calls are completed, delaying response times.
Firefighter and paramedic recruitment and retention is a significant problem within the fire service across the nation. El Dorado County’s proximity to the Sacramento Valley and Bay Area add to the challenge as firefighters can easily transition to those departments for 40–60% higher wages. Increasingly, firefighters come to El Dorado County for their first few years of training and experience and then leave the County for better pay. This leaves our communities with fewer qualified and experienced firefighters and paramedics.
Wildfires are growing faster, deadlier, and more common. Reducing wildfire risk by removing fire hazards, providing early and reliable emergency fire alerts and communications, and planning fast and safe evacuation routes are more important than ever.
Local fire districts operate at a minimum staffing level, which inhibits the ability to expand into programs such as vegetation management, defensible space inspections, property owner support and education, and other programs. With additional funding, local fire districts can focus more resources on proven prevention strategies.
Many areas of El Dorado County can easily be cut-off from outside help during major fires, earthquakes, storms, or other disasters. Having local access to emergency medical care, an emergency room with reasonable wait times, medical clinics, and a full-service hospital is critical for residents to receive medical care during emergencies.
The leaders of El Dorado Ready have developed a comprehensive plan to strengthen El Dorado County’s emergency preparedness system, including rapid 9-1-1 emergency response, maintaining access to emergency medical care and strengthening our county-wide wildfire prevention planning. To keep El Dorado County healthy and safe, a stable source of locally controlled revenue is needed that will require voter approval in the form of a citizens’ initiative called the El Dorado County Emergency Preparedness, Healthcare Access and Wildfire Prevention Initiative.
If approved by a majority of El Dorado County voters, the initiative would increase the local sales tax rate paid by residents and visitors in El Dorado County by a modest 3/8¢ to provide stable, locally-controlled revenue exclusively for emergency preparedness by ensuring rapid 9-1-1 emergency response, preserving access to emergency rooms and quality healthcare services, and reducing the risk of wildfires in El Dorado County.
No. All funds from this measure would be used and controlled locally for emergency preparedness, healthcare access, and wildfire prevention and suppression only. No funds from the measure could be taken away or redirected by the county, state, or federal governments.
Yes. The initiative will create good jobs for local residents by:
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Ensuring fire departments are fully staffed
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Investing in vegetation management, creating fire breaks, improving evacuation routes, and other wildfire prevention work
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Creating construction jobs for healthcare facility improvements
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These dollars would be reinvested locally, producing $100M–$150M in increased annual economic activity in our county.
This measure would add just 4¢ to a $10 purchase, 38¢ on a $100 purchase, and $3.80 on a $1,000 purchase. On average, most households spend about 20% of their income on taxable purchases. With the median household income in El Dorado County of $106,000, the typical local resident would pay just $63 per year or about $5 per month.
Yes. As a major transportation corridor and tourist destination, an estimated $1 out of every $3 paid in sales tax in El Dorado County is paid by a visitor from outside the County. A 3/8¢ increase in the local sales tax rate will provide over $13 million annually in reliable, local revenue to prepare for emergencies while minimizing the cost to local residents.
Yes. Groceries, prescription medicine, diapers and other essential purchases are not subject to sales tax, helping to ensure the cost is not a burden to those on fixed or limited incomes.
To ensure funds from the initiative are used as promised, an independent oversight committee comprised of El Dorado County residents is required to oversee the use of funds and report their findings to the public.
Funding from the El Dorado Ready initiative would be distributed throughout all of El Dorado County to support fire prevention, emergency response and local healthcare. Specifically, Marshall receives revenue to support $125M in bond issuance to fund capital improvements. After the debt service is paid annually, 5% of the remaining revenue would be allocated to a non-profit such as the El Dorado Fire Safe Council to be distributed to local organizations for wildfire prevention work. The remaining revenue, approximately 49%, would be allocated to local fire districts proportionally based on the number of engine companies operated by each district.
Even with this measure, the sales tax rate in most of El Dorado County will remain lower than neighboring communities like Folsom, Rancho Cordova and Sacramento, so it will not put local businesses at a disadvantage. Sales tax for large purchases like cars are taxed based on where the car is registered, so there is no incentive to shop around for lower sales tax rate.
The high risk of wildfire poses a significant threat to the local economy in El Dorado County. For example, the Caldor Fire (Aug–Oct 2021) burned 221,835 acres across El Dorado, Amador, and Alpine counties, disrupted tourism, damaged property, and severely degraded air quality.
Estimated direct tourism spending losses exceeded $268 million, with total impacts reaching $400 million when including multiplier effects.
With the growing threat of wildfire to properties in El Dorado County, homeowners and property insurance are becoming more expensive and difficult to secure. Investing in wildfire prevention and ensuring adequate numbers of firefighters are available to provide local fire protection can help stabilize the cost and availability of homeowners and property insurance for local residents and businesses, as has happened in other communities who have passed similar initiatives.
El Dorado Ready must collect signatures from local voters to qualify for the ballot. The initiative is planned for the November 2026 General Election ballot.
To learn more about El Dorado Ready or to ask questions, please email info@eldoradoready.org.