Actually, there's still a handful of Mom & Pop BLS companies around SD City, and SD County that are key players in the IFT "game."
Scripps = pacific, Kaiser = R/M, Sharp = R/M. Those 3 corporations are the major players in the San Diego IFT game. I'm not talking about dialysis or nursing home 911 as the companies that specialize in those have no long term viability or stability.