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: 

• Lake Valley Fire Protection District
• City of South Lake Tahoe
• Fallen Leaf Lake Community Service District

 Cal Tahoe JPA operates three full-time ambulances, one part-time ambulance 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. The current contract, signed in September 2021, is for an initial 10 year term, with a possible 5 year extension. 

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:

• Regulatory compliance for both State and County policies and procedure
• Operates within California Code of Regulations, Title 22
• Continuous Quality Improvement (CQI) through the County
• Medical oversight by EMS Medical Director
• Contractor performance monitoring
• Works with Paramedic Base Hospitals, Barton Memorial Hospital in South Lake Tahoe as the primary and Marshall Hospital in Placerville.
• Ambulance Billing through the County contracted to Wittman Enterprises

In return the EMS Agency that is a Division of the Public Health Department provides 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.