Why it's time for an EMS Workers Bill of Rights
California's private EMS providers need to enjoy the same legal protections as firefighter-paramedics
California Assembly Bill #263 — the EMS Workers Bill of Rights, introduced by Assemblymember Freddie Rodriquez on January 31, 2017 cites his intent to "enact legislation relating to the rights and working conditions of Emergency Medical Services workers."
Although the EMS Worker Bill of Rights has yet to include any specifics, Rodriguez intends that it address adequate rest and meal breaks for providers, as well as improving access to mental health care and protections against workplace violence.
Rodriguez has said that, "as a legislator and EMT for over 30 years," he is obligated to stand up and speak out for thousands of hardworking individuals who are integral to the health care system.
To that, I say: BRAVO! But please don’t stop half way.
Since before Unity Ambulance and F+B Ambulance were battling for territory and call volume on the big screen in the 1970s, private EMS providers, EMTs and paramedics alike, have been and continue to be — in many areas — the red-headed stepchildren of EMS.
Equal work, unequal working conditions
While their fire department counterparts are working with the latest and greatest equipment, private providers historically work with older, not-so-state-of-the-art, equipment like vehicles and radios in frequent states of disrepair.
While their fire department counterparts enjoy quiet, comfortable stations with beds, recliners and showers, the private providers fortunate enough to have a station at all often find themselves in cheap motel rooms or converted, yet run down, industrial closets. Many are just stuck on street corners posting for hours at a time.
While their fire department counterparts are enjoying hot, home-cooked meals in giant, fully-equipped kitchens, private providers more often find themselves scrounging what they can at fast food joints ordering unhealthy, but portable food.
While their fire department counterparts are exercising on department-provided gym equipment, burning off the calories from the home-cooked meals, private providers are relegated to sitting in their ambulances, listening to the dispatch radio for the next call.
And, when that call comes in and those private providers respond, it is with the same licensure or certification as their fire department counterparts; it is under the same policies, protocols and procedures; it is with the same degree of liability, but it is with substantially less protection.
California Firefighter Bill of Rights
In California, Government Code sections 3250 – 3262, also known as the Firefighter Bill of Rights, affords specific procedural and legal protections for firefighters facing investigation or discipline by their agency, by the County EMS Agency or by the State Emergency Medical Services Authority. Those protections include rights to counsel, procedures for investigation and interrogation — including informing the accused of the nature of the investigation prior to an interrogation — and a time limit on taking action. Those protections are, according to California’s EMSA, only available to firefighters who are paramedics; private paramedics do not enjoy equal protection by the state EMSA.
Likewise, firefighters who are disciplined by their agency are subject to all of the rights and protections afforded by the Firefighter Bill of Rights. Private EMTs and paramedics enjoy no such protections; private EMTs and paramedics are fungible chattel and California is an at-will state. If a private employer wants to fire a private employee, for anything or nothing at all, they are only two words away: You’re fired!
Protection for all EMS personnel
I can make crafting much of the language for Rodriguez’ AB263 very, very simple: copy and paste AB220 as codified by Government Code sections 3250 – 3262 and modify it to include ALL ambulance personnel, regardless of employment or call type, not just firefighters.
In addition, for paramedics and EMTs who are assigned to units that do not respond to 911 calls; the units exclusively assigned to interfacility transfers, dialysis and doctor office calls, and long-distance transfers, reasonable meal and rest breaks must be required. Likewise, reasonable fatigue must be considered a valid reason to delay a non-emergency transport without consequence. I have seen (and done) 600+ miles driven in a single shift only to be sent on another call. I knew then, as providers know now, to decline another call is to be fired.
Access to adequate mental health resources is essential for all EMS providers. Certainly, the blood and guts and trauma and drama associated with running 911 calls can take their toll, even upon the strongest among us.
However, providers who do not run 911 calls are not necessarily any less susceptible to the psychological and emotional stresses of patient care. Private, non-emergency transport providers frequently face children terminally riddled with cancer; individuals, young and old, on death’s doorstep or actually dying; violent psych patients; weeping family members; rude, condescending doctors and nurses and others demeaning and castigating them for anything or nothing at all. Let’s not forget the stress inherent with working at a private ambulance company.
If the job — even inherently — is known to create substantial anxiety or psycho-emotional stress, it seems only reasonable that the employer be required to provide resources sufficient for employees to manage it and continue to prosper.
Regarding private EMS provider pay
One last thing, private EMS providers notoriously earn substantially less than their public service or fire department counterparts who, when it comes to patient care, do the same job. While that is a serious issue, especially with fast food and other minimum wage workers demanding $15 per hour while many EMS providers earn much less than that, legislation like this is not the place — in my humble opinion — to deal with that issue. Revenue and reimbursement for medical transportation are way too complex and will only overcomplicate this type of legislation, perhaps to the point of rendering it useless.
The type of legislation posited by Assemblymember Rodriguez to improve the lives and working conditions of so many invaluable EMS providers is long overdue in California and, I imagine, in the other 49 U.S. states. My only hope is that it is carefully considered, utterly inclusive and enacted as quickly as possible. Perhaps when this fight is won, and all EMS providers are protected equally, then we can get to the business of improving wages.