I am talking to myself here....But I have a battery on off switch under my drivers seat that controls most of the power to the entire vehicle. Any reason I cant replace that with a 1/2/both switch and just feed a second battery into that?
Is this a Type II Ambulance, which is basically just a van with a raised top?
Without seeing the actual wiring it's hard to say for sure, but I believe you may be able to add a second 'House' battery at that point. However, you would still need to provide an isolated charging system, such as the Blue Sea ACR in order to get charging current to the new battery. Even though you switch the load using the new 1/2/Both battery switch from the OEM Starting batteries to the House battery, it is disconnected it from the alternator. If you put it in the 'Both' position, you connect all batteries together in parallel, but this defeats the purpose of the ACR.
A House battery should be a true Deep Cycle battery of some type, which differs from Starting batteries. Starting batteries are designed for shallow discharge (no more than down to 10V) and quick recharge. Deep Cycle batteries are designed for deep discharge down to 50% and slow recharge.
The ACR will charge both types of batteries by combining, while keeping them separate when charging stops. It doesn't matter if the batteries (Starting vs. House) are different types, as long as your alternator has the ability to charge both types and there is not too much differences their sizes.
A dual-sensing ACR will sense an active charge source on one or both batteries and not solely on a designated battery. The ACR will operate if the measured voltage on either of the terminals is of a level to initiate a connection or disconnection. An ACR does not direct the charge to the battery that “needs it the most” or has the lowest terminal voltage. If there is a charge present on either battery, indicated by a high enough voltage, the ACR will combine the batteries.
See Blue Sea System's reference here:
https://www.bluesea.com/support/articles/1366/Automatic_Charging_Relay_[ACR]_Explained
However, unless you separate the 'House loads' from the 'Vehicle loads', you will be running everything off of one or the other. You would never want to use the 'Both' position with the ACR in place. As a matter of fact, I would probably use a 1/2/OFF switch instead so that couldn't happen.
A disadvantage to using that type of switch is you have to remember to switch it appropriately when the time comes, and back when you're driving. Lots of room for human error here.