On June 19, 2017 EMS1.com published a press release from American Medical Response regarding their opposition to the EMS Worker Bill of Rights (AB-263) in California. The online media campaign has been named “Lives Before Lunch” with a website, a Facebook Page, and it’s own hashtag #LivesBeforeLunch. There are two parts about the press release that I would like to address.
The first part from the press release with added references that I want to address:
The standard practice of EMS is that the closest ambulance to an emergency responds because patient care takes precedent to rest and meal breaks. AB 263 will prohibit that standard.(1)
The online media campaign ‘Lives Before Lunch’ highlights the onerous limitations AB 263 puts into place. Its purpose is to educate members of the public to the dangers of the bill, and urge them to contact their legislators to vote “NO” when it comes before them.
As written, AB 263 is an unprecedented political power grab, and will heavily penalize private – but not public – employers of EMTs and paramedics (2) for break interruptions during responses to disasters, and prevent or delay responses to medical emergencies. What’s more, it requires private emergency responders to release their employees from patient care duties even if it places patient care at risk, and allows private EMTs and paramedics to walk away from their ambulances and station houses while on duty.(3)
The points I would like to make are as follows:
(1) Just because a practice is a “standard” does not make it a best practice. The best practice for unit selection is not necessarily the closest ambulance, but the one that would make it there the quickest. This may seem like a minute point but in heavily urban areas where traffic can be a huge impediment, the difference can actually be many minutes. Additionally IF patient “care” TRULY took precedent, then you would ensure that your providers are well rested and ready to respond with compassion. Studies on fatigue have shown the need for rest periods. By ignoring these studies and not guaranteeing these rest periods, patient care is not taking precedence.
(2) I actually agree with AMR on this point. I believe both public and private EMS agencies should be held to the same minimum standard. The argument that most municipal agencies already have better working conditions is anecdotal. I would like to see it in a hard table listing all the municipal agencies and their practices before buying into the idea that it is only the private side that needs regulation.
(3) This is false. The bill text actually specifically amended in committee that the employer would specify the grounds for interrupting a rest/meal period as outlined in 226.9 (C).
The other part of the press release is a few paragraphs towards the end and it reads:
The reality is that only 6 percent of AMR’s workforce misses a meal period during their shift. Under current law, when a meal period is missed employees not only receive their paid lunch break compensation but also an additional hour of pay for not having their lunch break rescheduled.
Employees that have rest breaks that are interrupted and not rescheduled are also issued an hour of additional compensation, but this impacts less than 1 percent of the workforce because 40 percent to 60 percent of our crews’ shift time can be spent inactive, not providing patient care or responding to an emergency.
First I have to ask, which law would this be? Why isn’t there a citation?? Or is this an internal policy specific to AMR??? If that is actually what it is, and they actually do it, I commend AMR for caring about their providers and making sure they are compensated for their sacrifices. Unfortunately the truth is, not all ambulance agencies are AMR. I’m sure there are plenty of agencies in California that have no problem constantly grinding their providers down. This legislation is meant to help protect them.
The second thing that I HAVE to comment on is the “40 percent to 60 percent” of shift time being spent inactive. I will assume that this means they are parked, sitting, on available status waiting for an assignment. To this I would have to say that your problem isn’t with AB-263, it’s with your scheduling/staffing. Sure there may be a “slow” day here and there, but if you are planning and scheduling correctly then your units should not have this much free time.
I have already been critical of The EMS Worker’s Bill of Rights for omitting a living wage in the legislation. I view this as a classic disconnect between what the true concerns and frustrations for EMTs and Paramedics is versus what politicians are willing and able to do.
The truth is it is demoralizing for an EMS agency to actively work against legislation meant to provide a positive impact on the lives of all EMTs and Paramedics. Undoubtedly there will be actual AMR EMTs and Paramedics who will speak out against AB-263, possible victims of Stockholm Syndrome as those who argued against a Federally Mandated Minimum Wage for EMS Providers. It is this type of infighting, campaigning, and self-harm that prevents us from progressing on the more meaningful topics such as reimbursement rates and wages.
That is the real tragedy of the situation.