For the past 50 years, privately owned and operated ambulance firms in California have had their crews remain on call during their work breaks, making themselves available to answer emergency calls and then taking their breaks as time permits later in their shifts.
It’s a reasonable practice in a life-or-death business. Especially in rural areas, where backup crews are not readily available or practical. But a 2016 state Supreme Court ruling on a private security provider case threw the legality of on-call breaks among paramedics and EMTs into question.
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Workers are now suing private ambulance providers over the issue. In a better world, the Legislature would have negotiated a solution, but talks between labor and ambulance providers over legislation broke down earlier this year.
Proposition 11 on the Nov. 6 ballot offers the necessary remedy, making it state law that ambulance employees can remain on call during work breaks. Voters should back the measure.
The U.S. Department of Health requires that ambulance service reach 75 percent of life-threatening calls within eight minutes. Providers must adequately staff ambulances to meet those targets.
Ambulance companies also lose hundreds of dollars per trip every time they transport a Medi-Cal or Medicare patient. California has one of the lowest reimbursement rates for ambulance services in the United States. Medi-Cal, for example, pays only about $100 per trip, which explains in part why commercial insurers pay, on average, $1,800 per trip to help offset the losses.
If paramedics and EMT workers are not available during their work breaks, the independent state Legislative Analyst’s Office estimates, 25 percent more ambulance crews would be needed to meet state standards. Ambulance providers would be forced to either absorb the additional losses or pass the estimated total cost of more than $100 million a year on to local governments and their taxpayers.
The proposition recognizes that paramedics and EMTs need their meal and rest breaks. It requires that meal breaks not be during the first or last hour of a shift and that rest and meal breaks be spaced at least two hours apart. If workers are needed to respond to a call during a break, that break would not be counted as a required break.
Prop. 11 also calls on ambulance companies to provide access to mental health and wellness education, long-term mental health services and annual natural disaster, active shooter and violence prevention training.
The court decision prompting the proposition, Augustus vs. ABM Security Services, was brought by private security guards objecting to leaving their radios on during their breaks.
Jason Brollini, executive director of United EMS Workers/AFSCME Local 4911, admitted at a legislative hearing that, ” … the Augustus ruling is very difficult, if not impossible to apply to our sector. It leads to safety issues and response issues and we agree with that,” he said. “I find myself in an interesting position today cause we’re sitting here in the opposition table, but yet we actually fundamentally support portions of this initiative and conceptually support most of the initiative.”
Labor unions will continue to formally oppose the ballot measure this fall. But it provides a common-sense solution to a challenging emergency services care issue brought on by the courts. Californians should vote yes on Proposition 11 this fall.
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