The Question

Should the Labor Code be amended to allow private ambulance employees to remain on call during work breaks and to exempt their employers from potential liability for violations of existing law regarding work breaks?

The Situation

California counties oversee local Emergency Medical Services (EMS). Private ambulance providers (Providers) enter into contracts to perform EMS in a specific area, subject to performance requirements. Periodic contract renegotiations address changes in Providers’ costs. 

Ambulances are geographically positioned based on service demand. When an ambulance is dispatched, other area ambulances are repositioned.

Historically EMS personnel remain “on call” during work breaks, which are often interrupted by 911 calls or repositioning. In a 2016 case (Augustus) involving private security guards required to remain “on call” during rest breaks, the California Supreme Court held that such breaks do not comply with state labor law; rather they must be off-duty and uninterruptible (even in an emergency). The security guards were awarded penalties and damages.

Given the similarity between EMS personnel and Augustus, it appears probable that Provider personnel practices must change. Providers estimate that, relative to current practice, 25 percent more ambulances would be required to meet the requirements of Augustus.

The Proposal

Prop.11 would amend state labor laws applicable to Providers’ personnel, allowing them to remain on call throughout their breaks. It also would change several other rules regarding meal and rest breaks, while requiring Providers to operate enough ambulances to meet performance requirements.

Prop.11 would limit legal liability that Providers might face if the Augustus decision is applied to Providers’ personnel. Several lawsuits regarding the work break practices for ambulance employees are in the court system. The on-call rules established by this proposition would be applied retroactively to such lawsuits.

The measure also requires ambulance providers to offer EMS personnel additional training, education, counseling and services.

Fiscal Effect

The fiscal effects of Prop.11 are calculated on the assumption that Augustus will be held to apply to Provider personnel, including past period legal liability.

Prop. 11 would relieve Providers of the cost of operating more ambulances to cover off-duty breaks—potentially over $100 million annually. Other provisions might require Providers to ensure that there are more ambulances in an area. Providers that do not offer training and education at the levels required under Prop. 11 would have new costs, likely in the low tens of millions of dollars annually.

Prop. 11 will result in local government net savings, likely in the tens of millions of dollars annually, due to lower emergency ambulance contract costs.

A YES Vote Means

Private ambulance companies could continue their current practice of having emergency medical technicians (EMTs) and paramedics stay on duty during their meal and rest breaks in order to respond to 911 calls. Private ambulance companies would attempt to reschedule meal and rest breaks that are interrupted by a 911 call.

A NO Vote Means

Private ambulance companies would be subject to labor laws for this industry. Based on a recent court decision, these laws likely would require ambulance companies to provide EMTs and paramedics with off-duty meal and rest breaks that cannot be interrupted by a 911 call.

Supporters Say

• Prop 11 establishes into law the longstanding industry practice of paying medical personnel to be on call during their work breaks.
• It is essential that emergency personnel are able to respond quickly and deliver lifesaving medical care during mass casualty events. Prop 11 mandates that such personnel receive additional training to meet emergency standards.

Opponents Say

No arguments have been filed against Prop. 11

Official Support

Yes on 11—Californians for Emergency Preparedness & Safety

Official Opposition

At press time, there is no known campaign in opposition to this proposition.