Column: California lawmakers didn’t act. Now the private ambulance industry is asking voters to change workplace rules

An American Medical Response paramedic, right, and a Ventura County firefighter help an injured man.
An American Medical Response paramedic, right, and a Ventura County firefighter help an injured man.
(Bryan Chan / Los Angeles Times)
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Sacramento Bureau Chief

Few Californians will have any idea why they’re being asked to vote this fall on workplace conditions in the private ambulance industry. But the backstory is a reminder of how ballot measures are the ultimate Plan B for those who don’t get satisfaction from the Legislature.

The track record for such efforts is mixed. The key question will probably be whether the proposal’s low profile — so far under the mainstream political radar — makes it seem harmless and easy for voters to support, or too obscure and not worth the risk.

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Proposition 11 asks voters to give private ambulance companies the power to keep their workers on duty during meal and rest breaks. If a 911 call comes in, those workers could be required to put away their lunch and respond to the emergency.

The topic has its roots in a 2016 ruling by the California Supreme Court that “on-call” rest breaks are illegal under the state’s labor laws. That case involved employees of a security company who were required to keep their radios on when taking their scheduled breaks. Similar lawsuits had been filed by emergency medical technicians and paramedics against ambulance companies.

In response, labor unions promoted legislation at the state Capitol in 2017 requiring employers to provide rest periods or pay employees extra for any break that has to be skipped. That last provision — extra pay — was a sticking point, given the potential cost to businesses. In turn, some suggested the companies might avoid the costs by cutting back on ambulance crews. Or the companies might compensate for higher worker wages by demanding to renegotiate the payments made to counties as part of ambulance service contracts. That in turn could shrink local government budgets.

Representatives for the workers disputed that the costs would outweigh the benefits and said employees were sometimes pushed to exhaustion. Both sides in the debate said they’d try to work toward a compromise. But the legislation stalled.

And so the industry — seeking not only to close off its exposure to lawsuits, but also to avoid future efforts by organized labor to enshrine the work rules in state law — decided to take its chances with voters. American Medical Response, one of the country’s largest ambulance companies, spent $2.8 million to gather the voter signatures needed to qualify for what became Proposition 11.

Last week, the company put an additional $5 million into a campaign account in support of the ballot measure. For the private ambulance industry, the math here is pretty simple: Even if the entire campaign — signature gathering, consultants, mailers and other materials — ends up costing $10 million, it’s a good investment.


A report by the independent Legislative Analyst’s Office cited a possible loss in revenue statewide of $100 million a year if the new mandatory rest breaks were imposed on ambulance employees and paramedics.

As for opponents, they’ve largely been silent. The California Democratic Party voted to formally oppose Proposition 11, but there’s been little else said. Perhaps the most surprising moment came when no one — not even a member of the public — submitted any written argument against the measure to be included in the statewide voter information guide. At the very least, that seems to suggest voters will never hear more than one side of the argument before election day.

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