The California Tahoe Emergency Services Operations Authority (or "Cal Tahoe") is a Joint Powers Authority (JPA) formed in 2001 to provide ambulance service under a contract with the County of El Dorado to the Tahoe South Shore CSA-3service area and parts of northwestern Alpine County. The original make up of Cal Tahoe JPA included Lake Valley Fire Protection District, City of South Lake Tahoe Fire Department and North Tahoe Fire Department. North Tahoe Fire Department later withdrew from the JPA organization.

As of October 31, 2017 the JPA includes three member agencies: 

 Cal Tahoe JPA operates three full-time ambulances and maintains two reserve ambulances that are dispatched by the City of South Lake Tahoe Police Department. Paramedics from The Cal Tahoe JPA and Lake Valley Fire District responded to over 3,400 emergency medical calls annually. 

This contract for ambulance service is funded thru County Service Area No. 3, and Cal Tahoe has a $2.3 million operating budget for FY 2017-18. The JPA was originally awarded a five-year contract for 911 ambulance services effective September 1, 2001, and has received five additional one-year contract extensions following satisfactory performance reviews by the EMS Agency in 2002, 2003, 2004, 2005 and 2006.

In addition to emergency calls, the Cal Tahoe JPA provides interfacility transports. This is where a patient is moved from one healthcare facility to another primarily for a level of care not available at the sending facility.

Under the contract with El Dorado County EMSA the Cal Tahoe JPA maintains compliance with both County and California State regulations in the following areas:

In return the EMS Agency that is a Division of the Public Health Departmentprovides oversight required by the Health & Safety Code for the quality and delivery of emergency medical services and ambulance transportation in El Dorado County. The mission of Cal Tahoe is to work collaboratively with fire districts, hospitals, air ambulance services and other stakeholders to insure highquality services. The EMS office is located in Placerville, CA.

In 2011 Cal Tahoe completed its 10th year of service under the original contract.  During the end of the contract Cal Tahoe participated in the RFP process with El Dorado County and was selected to continue pre-hospital EMS operations for CSA- 3 portion of El Dorado County and portions of Alpine County. The contract awarded is similar to the first in that it is for exclusive 911 and interfacility transfer operations in CSA-3 for a period of 5 years with the ability to earn a total of 5 one year contract extensions based performance.