The Case for Proposition 11 on the November Ballot

Chris Micheli
Chris Micheli is a Principal with the Sacramento governmental relations firm of Aprea & Micheli, Inc.

For the benefit of Californians across the state, the California Ambulance Association supports Proposition 11 on the November 6, 2018 statewide ballot and urges the state’s citizens to vote in favor of this important ballot measure.

CAA’s members are private-sector emergency ambulance service providers. However, not only are we healthcare first responders, but also, we are sometimes the only responder in some areas of the state. Our member companies provide lifesaving care to those in need. When individuals dial 911, we respond.

Many do not know, but only ambulance providers and hospital ERs are required by law to respond to each emergency. But we are different than ERs because we have to respond within a contracted period of time. As such, private-sector ambulance operators are critical to California’s public safety net.

In the ballot materials to be provided to voters, the Legislative Analyst’s Office states that private ambulance crews respond to about 75% of the state’s 9-1-1 emergency calls. Our state’s population depend on private EMTs and paramedics to treat and transport critically injured patients during medical emergencies, as well as respond to terrorist attacks, natural disasters and other mass casualty incidents.

CAA’s companies are also outstanding community partners. Why? We provide over $300 million in uncompensated care each year. Moreover, we provide free CPR training and work closely with schools, senior citizen centers and hospitals. We sponsor hundreds of community events – from baseball little league teams to driving seniors in care facilities home to their families on Christmas.

So, what does Proposition 11 do? The basic premise is to require private-sector emergency ambulance employees to remain “on call” during meal periods and rest breaks. While we believe our employees should be entitled to take these work breaks, they must be on-call to respond to 911 calls. Prop. 11 will also require employers to pay for employees to be trained regarding certain emergency incidents, violence prevention, and mental health and wellness. And Prop. 11 will require employers to provide employees with certain mental-health services.

In the LAO’s fiscal analysis, they have determined that local government net savings likely in the tens of millions of dollars annually due to lower emergency ambulance contract costs.

How did we get to Prop. 11? The California Supreme Court issued a decision in 2016 called Augustus v. ABM Security Services. In that case, the Supreme Court decision threatens all of our public safety. The decision stated, “During required rest periods, employers must relieve their employees of all duties and relinquish any control over how employees spend their break time.” That means employees must have all radios, cell phones and pagers turned off on their ten-minute rest breaks.

While this case dealt specifically with security guards, all of California’s Wage Orders contain the same language regarding rest breaks and meal periods. Thereafter, the California Department of Industrial Relations stated that this court decision is to be applied to all other industries that are covered by similar wage orders.

Applying the security guard ruling to private-sector ambulance crews would have serious implications for those in need of immediate medical care. This is because EMTs and paramedics must be entirely unreachable while on break and cannot be dispatched to a 9-1-1 call to provide lifesaving care, even if the medical emergency is just blocks away.

Let us put this into context for you. If the closest ambulance to your emergency is on break when you call 911 for help, EMTs and paramedics would be required to have ALL communications devices turned OFF and 911 dispatchers would have absolutely NO WAY to reach them. In an emergency, seconds can be the difference between life and death. It is entirely unrealistic if the ambulance industry had to adhere to the ABM decision, which would force our employees to turn-off pagers, radios, phones, etc.

In some areas of this state, EMS is not only the first responder; it is the only responder. What might be appropriate is busy, urban settings is not appropriate for low call volume rural settings where there could be life-threatening delays. While the Legislature looked at this issue, it did not enact any legislation during the recently-concluded 2017-18 Session.

Why does Prop. 11 contain its provisions. Known formally as the Emergency Ambulance Employee Safety and Preparedness Act intends to ensure that 9-1-1 emergency care will not be delayed. Specifically, Prop. 11 establishes into law the longstanding industry practice of paying EMTs and paramedics to remain reachable during their work breaks – just like public EMTs, paramedics, firefighters and police officers.

Prop. 11 would also guarantee that ALL emergency crews – both public and private – will continue operating under these same standards which have been commonplace for the last 50 years. As such, this is not a new concept. As you can imagine, emergencies are not predictable. Some days can be busier than others.

However, EMTs and paramedics should have workplace protections to ensure they are well-rested for when they do receive a 9-1-1 call. That is why the initiative requires private ambulance operators to maintain high enough staffing levels to provide coverage for breaks. In addition, Prop. 11 says that, if emergency medical crews do miss a break and it cannot be made up during their work shift, they will receive an additional hour of pay.

In the end, the employees will likely make more money than they would without Prop. 11 as they are paid to remain reachable during their breaks, and receive an additional hour of pay if they miss a break and cannot reschedule it.

Prop. 11 includes two additional provisions. With active shooter incidents on the rise in California and throughout the nation and increased natural disasters, it is essential that EMTs and paramedics are properly trained to protect and save patients. Prop. 11 requires private emergency ambulance operators to provide paid annual training that meets FEMA standards for violence prevention, active shooter, mass casualty and natural disaster incidents.

Prop. 11 also requires private emergency ambulance operators to provide employees with mental health coverage, as well as yearly mental health and wellness training. These are important benefits for ambulance company employees who serve a critical role as part of the first responder community.

Chris Micheli is the Legislative Advocate for the California Ambulance Association.

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