GOVERNOR'S VETO

GV Bill Id:AB 2092

Author:(Rodriguez)

As Enrolled Ver:September 1, 2020

2/3 vote

SUMMARY:

Requires a private emergency medical service ambulance employer to establish a voluntary personal protective equipment (PPE) program that allows emergency ambulance employees to purchase multithreat body protective gear using an employer-funded stipend.

The Senate Amendments:

1. Define "multithreat body protective gear" as material and equipment worn by an employee that is bullet, strike, slash, and stab resistant.
2. Clarify that an "emergency ambulance employee" means a person who is an emergency medical technician, paramedic or other licensed or certified ambulance transport personnel who contributes to the delivery of ground ambulance services.
3. Clarify that an "emergency ambulance provider" means an employer that provides ground ambulance services but does not include the state, or any political subdivision of the state, in its capacity as the direct employer of an emergency ambulance employee.
4. Require an emergency ambulance employer to establish a voluntary PPE program that allows emergency ambulance employees to purchase multithreat body protective gear using an employer-funded stipend.
5. Provide that an emergency ambulance employee is not required to participate in the PPE purchase program.
6. Provide that an emergency ambulance employer may not prevent an emergency ambulance employee from wearing protective gear purchased under a PPE program while on duty.
7. Require an emergency ambulance employer to inform an emergency ambulance employee, upon initial employment and on an annual basis, of the opportunity to purchase subsidized multithreat body protective gear through a PPE program.

Governor's Veto Message:

This bill would require private entities providing emergency ground ambulance services to establish a voluntary program that allows employees of private ambulance providers to purchase employer-subsidized multithreat body protective gear.

Existing regulations impose an affirmative obligation on employers to evaluate workplace hazards and provide PPE as appropriate at no cost to employees. This bill would hold employers responsible for only part of the multithreat body protective gear which conflicts with long-standing law requiring employers to furnish and providers [sic] safety devices and safeguards necessary to protect their employees.

I support efforts to maximize the safety of all of California's life-saving EMS personnel, especially those that would prevent life-threatening injury. However, it is unclear how these provisions would effectively contribute toward that goal.

COMMENTS:

Reports suggest that emergency medical services professionals are exposed to great physical stress, which includes working with potentially violent patients. Studies assert that emergency medical services personnel in the United States have a rate of occupational violence injuries that is approximately 22 times higher than the average for all workers. These studies further suggest that there is high turnover among emergency medical services workers with few workers staying with private providers for more than four years. To address the physical safety risks and high turnover rates among emergency service workers, some studies recommend improving working conditions in this sector by minimizing health risks to these workers.

According to the Author:

"The frequent occurrences of violence committed against EMTs and paramedics have been ignored for far too long. Each call that an ambulance worker responds to has the potential of escalating into a dangerous situation, often times with that danger coming from the very same patient they are trying to help. This bill provides these first responders adequate safeguards from hazards associated with their occupation and affirms their right to a safe and protected workplace."

Arguments in Support:

The International Association of EMTs and Paramedics (IAEP) argues, in support, "[i]n the last six months alone, our members have responded to three active shooter calls in three separate states including the shooting at Saugus High School. In all three cases, none of the responding EMTs and paramedics had protective gear available on their assigned rigs. They braved clear and present dangers to do their jobs, exposing themselves to bodily harm as well as potential post-traumatic stress injuries (PTSI), in the hopes of savings lives. We strongly believe that with this legislation and constructive negotiations with providers . . . the safety of our members will be greatly improved."

Arguments in Opposition:

None on file.

FISCAL COMMENTS:

According to the Senate Appropriations Committee, the Department of Industrial Relations (DIR) indicates that it would incur a one-time cost of $180,000 to implement the provisions of the bill (Labor Enforcement and Compliance Fund). The bill would not have additional costs to the State, as it only would apply to private sector emergency ambulance providers.

VOTES:

ASM LABOR AND EMPLOYMENT: 5-1-1

YES: Kalra, Carrillo, Gonzalez, Jones-Sawyer, Luz Rivas

NO: Diep

ABS, ABST OR NV: Flora

ASM APPROPRIATIONS: 13-5-0

YES: Gonzalez, Bauer-Kahan, Bloom, Bonta, Calderon, Carrillo, Chau, Eggman, Gabriel, Eduardo Garcia, Petrie-Norris, McCarty, Robert Rivas

NO: Bigelow, Megan Dahle, Diep, Fong, Voepel

ASSEMBLY FLOOR: 57-15-7

YES: Aguiar-Curry, Arambula, Bauer-Kahan, Berman, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Grayson, Holden, Jones-Sawyer, Kalra, Kamlager, Levine, Limón, Low, Maienschein, McCarty, Medina, Mullin, Nazarian, O'Donnell, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Weber, Wicks, Wood, Rendon

NO: Bigelow, Brough, Chen, Choi, Cunningham, Megan Dahle, Diep, Fong, Gallagher, Kiley, Lackey, Mathis, Obernolte, Patterson, Voepel

ABS, ABST OR NV: Flora, Gray, Irwin, Mayes, Muratsuchi, Quirk, Waldron

SENATE FLOOR: 30-8-2

YES: Allen, Archuleta, Atkins, Beall, Bradford, Caballero, Chang, Dodd, Durazo, Galgiani, Glazer, Lena Gonzalez, Hertzberg, Hill, Hueso, Hurtado, Jackson, Leyva, McGuire, Mitchell, Monning, Pan, Portantino, Roth, Rubio, Skinner, Umberg, Wieckowski, Wiener, Wilk

NO: Bates, Borgeas, Dahle, Grove, Melendez, Moorlach, Morrell, Nielsen

ABS, ABST OR NV: Jones, Stern

ASSEMBLY FLOOR: 58-12-9

YES: Aguiar-Curry, Arambula, Bauer-Kahan, Berman, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Grayson, Holden, Jones-Sawyer, Kalra, Kamlager, Lackey, Levine, Limón, Low, Maienschein, McCarty, Medina, Mullin, Muratsuchi, Nazarian, O'Donnell, Petrie-Norris, Quirk, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Waldron, Weber, Wood, Rendon

NO: Bigelow, Brough, Choi, Cunningham, Megan Dahle, Diep, Fong, Gallagher, Kiley, Mathis, Obernolte, Patterson

ABS, ABST OR NV: Chen, Eggman, Flora, Frazier, Gray, Irwin, Mayes, Voepel, Wicks

UPDATED:

VERSION: September 1, 2020

CONSULTANT: Justin Delacruz / L. & E. / (916) 319-2901 FN: 0003703

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2092

Author:(Rodriguez)

As Amended Ver:July 16, 2020

Majority vote

SUMMARY:

Requires a private emergency medical service ambulance employer to establish a voluntary personal protective equipment (PPE) program that allows emergency ambulance employees to multithreat body protective gear using an employer-funded stipend.

The Senate Amendments:

1. Define "multithreat body protective gear" as material and equipment worn by an employee that is bullet, strike, slash, and stab resistant.
2. Clarify that an "emergency ambulance employee" means a person who is an emergency medical technician, paramedic or other licensed or certified ambulance transport personnel who contributes to the delivery of ground ambulance services.
3. Clarify that an "emergency ambulance provider" means an employer that provides ground ambulance services but does not include the state, or any political subdivision of the state, in its capacity as the direct employer of an emergency ambulance employee.
4. Require an emergency ambulance employer to establish a voluntary PPE program that allows emergency ambulance employees to purchase multithreat body protective gear using an employer-funded stipend.
5. Provide that an emergency ambulance employee is not required to participate in the PPE purchase program.
6. Provide that an emergency ambulance employer may not prevent an emergency ambulance employee from wearing protective gear purchased under a PPE program while on duty.
7. Require an emergency ambulance employer to inform an emergency ambulance employee, upon initial employment and on an annual basis, of the opportunity to purchase subsidized multithreat body protective gear through a PPE program.

COMMENTS:

Reports suggest that emergency medical services professionals are exposed to great physical stress, which includes working with potentially violent patients. Studies assert that emergency medical services personnel in the United States have a rate of occupational violence injuries that is approximately 22 times higher than the average for all workers. These studies further suggest that there is high turnover among emergency medical services workers with few workers staying with private providers for more than four years. To address the physical safety risks and high turnover rates among emergency service workers, some studies recommend improving working conditions in this sector by minimizing health risks to these workers.

According to the Author:

"The frequent occurrences of violence committed against EMTs and paramedics have been ignored for far too long. Each call that an ambulance worker responds to has the potential of escalating into a dangerous situation, often times with that danger coming from the very same patient they are trying to help. This bill provides these first responders adequate safeguards from hazards associated with their occupation and affirms their right to a safe and protected workplace."

Arguments in Support:

The International Association of EMTs and Paramedics (IAEP) argues, in support, "[i]n the last six months alone, our members have responded to three active shooter calls in three separate states including the shooting at Saugus High School. In all three cases, none of the responding EMTs and paramedics had protective gear available on their assigned rigs. They braved clear and present dangers to do their jobs, exposing themselves to bodily harm as well as potential post-traumatic stress injuries (PTSI), in the hopes of savings lives. We strongly believe that with this legislation and constructive negotiations with providers . . . the safety of our members will be greatly improved."

Arguments in Opposition:

None received.

FISCAL COMMENTS:

According to the Senate Appropriations Committee, the Department of Industrial Relations (DIR) indicates that it would incur a one-time cost of $180,000 to implement the provisions of the bill (Labor Enforcement and Compliance Fund). The bill would not have additional costs to the State, as it only would apply to private sector emergency ambulance providers.

VOTES:

ASM LABOR AND EMPLOYMENT: 5-1-1

YES: Kalra, Carrillo, Gonzalez, Jones-Sawyer, Luz Rivas

NO: Diep

ABS, ABST OR NV: Flora

ASM APPROPRIATIONS: 13-5-0

YES: Gonzalez, Bauer-Kahan, Bloom, Bonta, Calderon, Carrillo, Chau, Eggman, Gabriel, Eduardo Garcia, Petrie-Norris, McCarty, Robert Rivas

NO: Bigelow, Megan Dahle, Diep, Fong, Voepel

ASSEMBLY FLOOR: 57-15-7

YES: Aguiar-Curry, Arambula, Bauer-Kahan, Berman, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Grayson, Holden, Jones-Sawyer, Kalra, Kamlager, Levine, Limón, Low, Maienschein, McCarty, Medina, Mullin, Nazarian, O'Donnell, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Weber, Wicks, Wood, Rendon

NO: Bigelow, Brough, Chen, Choi, Cunningham, Megan Dahle, Diep, Fong, Gallagher, Kiley, Lackey, Mathis, Obernolte, Patterson, Voepel

ABS, ABST OR NV: Flora, Gray, Irwin, Mayes, Muratsuchi, Quirk, Waldron

SENATE FLOOR: 30-8-2

YES: Allen, Archuleta, Atkins, Beall, Bradford, Caballero, Chang, Dodd, Durazo, Galgiani, Glazer, Lena Gonzalez, Hertzberg, Hill, Hueso, Hurtado, Jackson, Leyva, McGuire, Mitchell, Monning, Pan, Portantino, Roth, Rubio, Skinner, Umberg, Wieckowski, Wiener, Wilk

NO: Bates, Borgeas, Dahle, Grove, Melendez, Moorlach, Morrell, Nielsen

ABS, ABST OR NV: Jones, Stern

UPDATED:

VERSION: July 16, 2020

CONSULTANT: Justin Delacruz / L. & E. / (916) 319-2091 FN: 0003578

 THIRD READING  

Bill No: AB 2092

Author: Rodriguez (D)

Amended: 7/16/20 in Senate

Vote: 21

SENATE LABOR, PUB. EMP. & RET. COMMITTEE: 4-1, 8/5/20

AYES: Hill, Jackson, Mitchell, Pan

NOES: Morrell

SENATE APPROPRIATIONS COMMITTEE: 5-2, 8/20/20

AYES: Portantino, Bradford, Hill, Leyva, Wieckowski

NOES: Bates, Jones

ASSEMBLY FLOOR: 57-15, 6/8/20 - See last page for vote

SUBJECT: Emergency ambulance employees: subsidized protective gear

SOURCE: Author

DIGEST:

This bill requires emergency ambulance employers to establish a program to provide stipends to EMT employees who wish to purchase multi-threat body protective gear.

ANALYSIS:

Existing law:

1. Requires every employer to furnish employment and a place of employment that is safe and healthful for the employees. (Labor Code §6400)
2. Requires every employer to furnish and use safety devices and safeguards, and adopt and use practices, means, methods, operations, and processes which are reasonably adequate to render employment and place of employment safe and healthful. Every employer must do every other thing reasonably necessary to protect the life, safety, and health of employees. (Labor Code §6401)

This bill:

1. Defines “Emergency Ambulance Employee” to mean a person who meets both of the following requirements:
2. Is an emergency medical technician (EMT), paramedic, or other licensed or certified ambulance transport personnel who contributes to the delivery of ground ambulance services.
3. Is employed by an emergency ambulance provider.
4. Defines “Emergency Ambulance Provider” to mean an employer that provides ground ambulance services, but does not include the state or any political subdivision of the state of California.
5. Allows an emergency ambulance provider to establish a voluntary protective personal equipment (PPE) program that allows for the purchase of multithreat body protective gear by an emergency ambulance employee pursuant to an employer-funded stipend. An emergency ambulance employee’s participation must be voluntary.
6. Defines “Multithreat body protective gear” to mean material or equipment worn by an employee that is bullet, strike, slash, and stab resistant.
7. Requires an emergency ambulance provider to inform an emergency ambulance employee, upon initial employment and subsequently on an annual basis, of the opportunity to purchase subsidized multithreat body protective gear through a PPE program.
8. Prohibits an emergency ambulance employer from preventing an emergency ambulance employee from wearing protective gear purchased under a PPE program while on duty as an emergency ambulance employee.

Comments

Need for this bill? According to the author:

In California, roughly 80% of EMTs and paramedics are employed by the private sector. In 2015, there were 16,720 ambulance workers in CA. EMTs and paramedics work in a field that is inherently dangerous with high rates of mortality, injury, and mental and physical trauma. Naturally, being an ambulance worker is often physically, emotionally, and mentally demanding. Ambulance workers also face a high risk of injury when on the job, with the most common causes of injury being due to physical exertion, exposure to harmful substances, and patient assaults. According to studies, reports, surveys and anecdotal evidence on the working conditions of ambulance workers, EMTs and paramedics are frequently assaulted by the patients they are trying to help. It occurs so frequently that EMTs and paramedics often decide not to report any incidents of violence, because they consider it as a part of the job.

Staff Comments. According to the Center of Disease and Control, 3,500 EMS workers were injured nationwide as a result of “violence” in 2017. This statistic includes firefighters acting in an emergency medical capacity, who would not be covered under this bill. However, despite this qualifier, this data indicates a high relative injury rate for emergency medical service employees. Lending further credence to this data is a 2018 national survey report titled Prehospital Disaster Medicine, which found that ambulance workers are 22 times more likely to experience workplace violence than all other occupations. Finally, a 2019 survey by the National Association of Emergency Medical Technicians reported that approximately 2/3 of respondents had experienced physical assault of some kind while performing their duties. All of the research noted the possibility of underrepresenting the total number of cases, due to a view among EMTs that injuries are part of the job and therefore not worthy of reporting.

Given the above research, there is evidence to suggest that wider utilization of multithread protective gear could have a positive impact on rates of EMT injury and contribute to a greater sense of safety among EMTs. Creation of a stipend program allows employers to subsidize the costs of protective gear for their employee in two ways, by directly reducing the cost via the stipend and by allowing employers to bundle purchases to take advantage of wholesale prices. Both of these result in savings for the employee, increasing the chance that they purchase and utilize the gear.

The author could consider whether steps could be taken to further increase utilization of multi-threat protective gear. Existing law provides that employers must do everything reasonable to protect the life, safety and health of their employees. If this program is shown to be successful, expansion could be considered to further subsidize costs or to cover the remaining 20% of EMTs who work for public entities and are therefore not covered under this bill.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

According to the Senate Appropriations Committee:

• The Department of Industrial Relations (DIR) indicates that it would incur a one-time cost of $180,000 to implement the provisions of the bill (Labor Enforcement and Compliance Fund). The bill would not have additional costs to the State, as it only would apply to private sector emergency ambulance providers.

SUPPORT: (Verified 8/21/20)

American Federation of State, County and Municipal Employees, AFL-CIO

International Association of EMTs and Paramedics

OPPOSITION: (Verified 8/21/20)

None received

ARGUMENTS IN SUPPORT: The International Association of EMTs and Paramedics write in support:

In the last six months alone, our members have responded to three active shooter calls in three separate states including the shooting at Saugus High School. In all three cases, none of the responding EMTs and paramedics had protective gear available on their assigned rigs. They braved clear and present dangers to do their jobs, exposing themselves to bodily harm as well as potential post-traumatic stress injuries (PTSI), in the hopes of saving lives. We strongly believe that with this legislation and constructive negotiations with providers on the changes in working conditions created by mandating the provision of this equipment, the safety of our members will be greatly improved.

ASSEMBLY FLOOR: 57-15, 6/8/20

AYES: Aguiar-Curry, Arambula, Bauer-Kahan, Berman, Bloom, Boerner Horvath, Bonta, Burke, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooley, Cooper, Daly, Eggman, Frazier, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez, Grayson, Holden, Jones-Sawyer, Kalra, Kamlager, Levine, Limón, Low, Maienschein, McCarty, Medina, Mullin, Nazarian, O'Donnell, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Salas, Santiago, Smith, Mark Stone, Ting, Weber, Wicks, Wood, Rendon

NOES: Bigelow, Brough, Chen, Choi, Cunningham, Megan Dahle, Diep, Fong, Gallagher, Kiley, Lackey, Mathis, Obernolte, Patterson, Voepel

NO VOTE RECORDED: Flora, Gray, Irwin, Mayes, Muratsuchi, Quirk, Waldron

Prepared by: Jake Ferrera / L., P.E. & R. / (916) 651-1556

8/23/20 7:48:33

**** END ****

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anthony Portantino, Chair

2019 - 2020 Regular Session

AB 2092 (Rodriguez) - Emergency ambulance employees: subsidized protective gear

Bill Summary:

AB 2092 would require emergency ambulance employers to establish a program to provide stipends to EMT employees who wish to purchase multi-threat body protective gear.

Fiscal Impact:

The Department of Industrial Relations (DIR) indicates that it would incur a one-time cost of $180,000 to implement the provisions of the bill (Labor Enforcement and Compliance Fund). The bill would not have additional costs to the State, as it only would apply to private sector emergency ambulance providers.

Background:

Current law requires every employer to “furnish and use safety devices and safeguards” to keep an employee and their place of work safe. Generally, Cal/OSHA, within DIR, enforces workplace safety laws, including (1) the above provision, and (2) the requirement that an employer have an injury and illness prevention program.

The ambulance services industry employs tens of thousands of employees statewide. Data from the California Ambulance Association indicate that roughly 75 percent of ambulances are operated by private providers. Research and available statistics suggest that emergency ambulance employees have a higher injury rate than that of other occupations.

Proposed Law:

This bill would, among other things do the following:

• Define “Emergency Ambulance Provider” to mean an employer that provides ground ambulance services, but does not include the state or any political subdivision of the State of California.
• Allow an emergency ambulance provider to establish a voluntary protective personal equipment (PPE) program that allows for the purchase of multithreat body protective gear by an emergency ambulance employee, as defined, pursuant to an employer-funded stipend. An emergency ambulance employee’s participation must be voluntary.
• Define “Multithreat body protective gear” to mean material or equipment worn by an employee that is bullet, strike, slash, and stab resistant.
• Require an emergency ambulance provider to inform an emergency ambulance employee, upon initial employment and subsequently on an annual basis, of the opportunity to purchase subsidized multithreat body protective gear through a PPE program.
• Prohibit an emergency ambulance employer from preventing an emergency ambulance employee from wearing protective gear purchased under a PPE program while on duty as an emergency ambulance employee.

Related Legislation:

AB 26 (Rodriguez, 2019) would have required emergency ambulance providers to provide emergency ambulance employees with body argument and safety equipment to wear during the employee’s work shift. The bill did not receive a policy committee hearing.

Staff Comments:

As noted previously, this bill would require private emergency ambulance providers to establish a voluntary PPE program for their emergency ambulance employees that would provide an employer-funded stipend to subsidize purchases of “multithreat body protective gear,” as specified. DIR’s Division of Occupational Safety and Health (DOSH) would have to promulgate rules to implement the requirements of the bill, at a one-time cost of $180,000.

Any local government costs resulting from the mandate in this measure are not state-reimbursable because the mandate only involves the definition of a crime or the penalty for conviction of a crime.

-- END --

SENATE COMMITTEE ON LABOR, PUBLIC EMPLOYMENT AND RETIREMENT

Senator Jerry Hill, Chair

2019 - 2020 Regular

Bill No: AB 2092 Hearing Date: August 5, 2020

SUBJECT: Emergency ambulance employees: subsidized protective gear.

KEY ISSUE

Should the Legislature require emergency ambulance employers to establish a program to provide stipends to EMT employees who wish to purchase multi-threat body protective gear?

ANALYSIS

Existing law:

1. Requires every employer to furnish employment and a place of employment that is safe and healthful for the employees. (Labor Code §6400)
2. Requires every employer to furnish and use safety devices and safeguards, and adopt and use practices, means, methods, operations, and processes which are reasonably adequate to render employment and place of employment safe and healthful. Every employer must do every other thing reasonably necessary to protect the life, safety, and health of employees.

(Labor Code §6401)

This bill:

1. Defines “Emergency Ambulance Employee” to mean a person who meets both of the following requirements:
2. Is an emergency medical technician (EMT), paramedic, or other licensed or certified ambulance transport personnel who contributes to the delivery of ground ambulance services.
3. Is employed by an emergency ambulance provider.
4. Defines “Emergency Ambulance Provider” to mean an employer that provides ground ambulance services, but does not include the state or any political subdivision of the state of California.
5. Allows an emergency ambulance provider to establish a voluntary protective personal equipment (PPE) program that allows for the purchase of multithreat body protective gear by an emergency ambulance employee pursuant to an employer-funded stipend. An emergency ambulance employee’s participation must be voluntary.
6. Defines “Multithreat body protective gear” to mean material or equipment worn by an employee that is bullet, strike, slash, and stab resistant.
7. Requires an emergency ambulance provider to inform an emergency ambulance employee, upon initial employment and subsequently on an annual basis, of the opportunity to purchase subsidized multithreat body protective gear through a PPE program.
8. Prohibits an emergency ambulance employer from preventing an emergency ambulance employee from wearing protective gear purchased under a PPE program while on duty as an emergency ambulance employee.

COMMENTS

1. Need for this bill?

According to the Author:

“In California, roughly 80% of EMTs and paramedics are employed by the private sector. In 2015, there were 16,720 ambulance workers in CA. EMTs and paramedics work in a field that is inherently dangerous with high rates of mortality, injury, and mental and physical trauma. Naturally, being an ambulance worker is often physically, emotionally, and mentally demanding. Ambulance workers also face a high risk of injury when on the job, with the most common causes of injury being due to physical exertion, exposure to harmful substances, and patient assaults. According to studies, reports, surveys and anecdotal evidence on the working conditions of ambulance workers, EMTs and paramedics are frequently assaulted by the patients they are trying to help. It occurs so frequently that EMTs and paramedics often decide not to report any incidents of violence, because they consider it as a part of the job.”

1. Staff Comments

According to the Center of Disease and Control, 3,500 EMS workers were injured nationwide as a result of “violence” in 2017. This statistic includes firefighters acting in an emergency medical capacity, who would not be covered under this bill. However, despite this qualifier, this data indicates a high relative injury rate for emergency medical service employees. Lending further credence to this data is a 2018 national survey report titled Prehospital Disaster Medicine, which found that ambulance workers are 22 times more likely to experience workplace violence than all other occupations. Finally, a 2019 survey by the National Association of Emergency Medical Technicians reported that approximately 2/3 of respondents had experienced physical assault of some kind while performing their duties. All of the research noted the possibility of underrepresenting the total number of cases, due to a view among EMTs that injuries are part of the job and therefore not worthy of reporting.

Given the above research, there is evidence to suggest that wider utilization of multithread protective gear could have a positive impact on rates of EMT injury and contribute to a greater sense of safety among EMTs. Creation of a stipend program allows employers to subsidize the costs of protective gear for their employee in two ways, by directly reducing the cost via the stipend and by allowing employers to bundle purchases to take advantage of wholesale prices. Both of these result in savings for the employee, increasing the chance that they purchase and utilize the gear.

The author could consider whether steps could be taken to further increase utilization of multi-threat protective gear. Existing law provides that employers must do everything reasonable to protect the life, safety and health of their employees. If this program is shown to be successful, expansion could be considered to further subsidize costs or to cover the remaining 20% of EMTs who work for public entities and are therefore not covered under this bill.

1. Proponent Arguments

The International Association of EMTs and Paramedics write in support:

“In the last six months alone, our members have responded to three active shooter calls in three separate states including the shooting at Saugus High School. In all three cases, none of the responding EMTs and paramedics had protective gear available on their assigned rigs. They braved clear and present dangers to do their jobs, exposing themselves to bodily harm as well as potential post-traumatic stress injuries (PTSI), in the hopes of saving lives. We strongly believe that with this legislation and constructive negotiations with providers on the changes in working conditions created by mandating the provision of this equipment, the safety of our members will be greatly improved.”

1. Opponent Arguments:

None received.

1. Prior Legislation:

AB 26 (Rodriguez) of 2019, referred to but not heard by Assembly Labor would have required emergency ambulance providers to provide emergency ambulance employees with body argument and safety equipment to wear during the employee’s work shift.

SUPPORT

American Medical Response

International Association of EMTs and Paramedics

OPPOSITION

None on file.

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2092

Author:(Rodriguez)

As Amended Ver:May 4, 2020

Majority vote

SUMMARY:

Requires private emergency medical service ambulance employers to inform their emergency ambulance employees, upon employment and once annually thereafter, of the employee's right to request safety devices and safeguards at the beginning of their shift.

Major Provisions

1. Defines "emergency ambulance employee" as a person who is both:
   1. An emergency medical technician (EMT), dispatcher, paramedic, or other licensed or certified ambulance transport personnel who contributes to the delivery of ambulance services; and
   2. Employed by an emergency ambulance provider.
2. Defines "emergency ambulance provider" as an employer that provides ambulance services but does not include a public entity in its capacity as the employer of an emergency ambulance employee.
3. Provides that safety devices and safeguards for private EMS employees include, but are not limited to, material or equipment worn by the employee that is intended to provide body protection from ballistic, slashing, and stabbing attacks and bodily orifice protection from flying particles, sparks, bodily fluids, and biohazard splatter.
4. Requires emergency ambulance providers to inform their employees, upon initial employment and subsequently on an annual basis, of the employee's right to request safety devices and safeguards at the beginning of the employee's shift.

COMMENTS:

Reports suggest that emergency medical services professionals are exposed to great physical stress, which includes physical demands such as lifting patients, working with potentially violent patients, and being exposed to pathogens. These reports further assert that this stress is so commonplace that some emergency medical service professionals believe they must accept these risks as part of the job. To address the physical stress placed on these employees, some studies recommend widely disseminating safety policies and procedures so that emergency medical service professionals are aware of them.

According to the Author:

"The frequent occurrences of violence committed against EMTs and paramedics have been ignored for far too long. Each call that an ambulance worker responds to has the potential of escalating into a dangerous situation, often times with that danger coming from the very same patient they are trying to help. This bill provides these first responders adequate safeguards from hazards associated with their occupation and affirms their right to a safe and protected workplace."

Arguments in Support:

The International Association of EMTs and Paramedics (IAEP) argues, in support, "[i]n the last six months alone, our members have responded to three active shooter calls in three separate states including the shooting at Saugus High School. In all three cases, none of the responding EMTs and paramedics had protective gear available on their assigned rigs. They braved clear and present dangers to do their jobs, exposing themselves to bodily harm as well as potential post-traumatic stress injuries (PTSI), in the hopes of savings lives. We strongly believe that with this legislation and constructive negotiations with providers . . . the safety of our members will be greatly improved."

Arguments in Opposition:

The American Medical Response West argues, in opposition, "[t]his bill seeks to require private, but not public, ground and air emergency ambulance providers to issue emergency ambulance employees with ballistic vests and unidentified safety devices or be subject to criminal charges. While this legislation is drafted to appear as simply an advisory of an employee's existing rights under CalOSHA, it is in fact a new requirement that is predicated on false claims and intended to restrict private 911 ground and air ambulance providers from operating in the state of California."

FISCAL COMMENTS:

According to the Assembly Appropriations Committee,

1. Additional costs of approximately $80,000 for California Division of Occupational Safety and Health (Cal/OSHA) to conduct rulemaking to implement the requirements of this bill.
2. No additional state or local government costs because this bill applies only to private sector emergency ambulance providers.

VOTES:

ASM LABOR AND EMPLOYMENT: 5-1-1

YES: Kalra, Carrillo, Gonzalez, Jones-Sawyer, Luz Rivas

NO: Diep

ABS, ABST OR NV: Flora

ASM APPROPRIATIONS: 13-5-0

YES: Gonzalez, Bauer-Kahan, Bloom, Bonta, Calderon, Carrillo, Chau, Eggman, Gabriel, Eduardo Garcia, Petrie-Norris, McCarty, Robert Rivas

NO: Bigelow, Megan Dahle, Diep, Fong, Voepel

UPDATED:

VERSION: May 4, 2020

CONSULTANT: Justin Delacruz / L. & E. / (916) 319-2091 FN: 0002830

Date of Hearing: June 2, 2020

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 2092

Author:(Rodriguez) – As Amended Ver:May 4, 2020

Urgency: No State Mandated Local Program: Yes Reimbursable: No

SUMMARY:

This bill requires an emergency ambulance provider to inform an emergency ambulance employee, as defined, of the employee’s right to request safety devices and safeguards, such as body protection from ballistic or stabbing attacks, at the beginning of the employee’s shift.

FISCAL EFFECT:

1. Additional costs of approximately $80,000 for California Division of Occupational Safety and Health (Cal/OSHA) to conduct rulemaking to implement the requirements of this bill.
2. No additional state or local government costs because this bill applies only to private sector emergency ambulance providers.

COMMENTS:

1. Background. Existing law requires every employer to “furnish and use safety devices and safeguards” to keep an employee and their place of work safe. Generally, Cal/OSHA enforces this provision and other workplace safety laws, such as the requirement that an employer have an injury and illness prevention program.

The California ambulance services industry employs tens of thousands of employees statewide. According to the California Ambulance Association, there are 715 public and private ambulance service statewide, and 75% of ambulances are operated by private providers.

Data on the safety of the ambulance industry presents a conflicting picture. According to the Bureau of Labor Statistics, nationally the ambulance services industry had one of the highest incidence rates of injuries and illnesses, with more than 60,000 cases in 2018. Fortunately, fatalities are rare. According to American Legion, an opponent to this bill, there was just one fatality among emergency medical technicians (EMTs) nationwide between 2011 and 2018

1. Purpose. According to the author, this bill will provide EMTs and first responders “adequate safeguard associated with their occupation and affirms their right to a safe and protected workplace.”
2. Recent legislation. AB 26 (Rodriguez), of 2019-20 Legislative Session, proposes to require emergency ambulance providers to supply emergency ambulance employees with body armor and safety equipment to wear during the employee’s work shift. This bill is pending in the Assembly Labor and Employment Committee.

Analysis Prepared by: Luke Reidenbach / APPR. / (916) 319-2081

Date of Hearing: May 20, 2020

ASSEMBLY COMMITTEE ON LABOR AND EMPLOYMENT

Ash Kalra, Chair

ABPCA Bill Id:AB 2092 (

Author:Rodriguez) – As Amended Ver:May 4, 2020

SUBJECT: Emergency ambulance employees: safety devices and safeguards

SUMMARY: Requires private emergency medical service ambulance employers to inform their emergency ambulance employees, upon employment and once annually thereafter, of the employee’s right to request safety devices and safeguards at the beginning of their shift. Specifically, this bill:

1. Defines “emergency ambulance employee” as a person who is both:
   1. An emergency medical technician (EMT), dispatcher, paramedic, or other licensed or certified ambulance transport personnel who contributes to the delivery of ambulance services; and
   2. Is employed by an emergency ambulance provider.
2. Defines “emergency ambulance provider” as an employer that provides ambulance services but does not include a public entity in its capacity as the employer of an emergency ambulance employee.
3. Provides that safety devices and safeguards for private EMS employees include, but are not limited to, material or equipment worn by the employee that is intended to provide body protection from ballistic, slashing, and stabbing attacks and bodily orifice protection from flying particles, sparks, bodily fluids, and biohazard splatter.
4. Requires emergency ambulance providers to inform their employees, upon initial employment and subsequently on an annual basis, of the employee’s right to request safety devices and safeguards at the beginning of the employee’s shift.

EXISTING LAW:

1. Requires an employer to furnish employment and a place of employment that is safe and healthful for its employees.
2. Requires an employer to furnish and use safety devices and safeguards, and shall adopt and use practices, means, methods, operations, and processes, which are reasonably adequate to render employment and the place of employment safe and healthful.
3. Requires an employer to do everything reasonably necessary to protect the life, safety, and health of employees.

FISCAL EFFECT: Unknown

COMMENTS: Reports suggest that emergency medical services professionals are exposed to great physical stress, which includes physical demands such as lifting patients, working with potentially violent patients, and being exposed to pathogens. These reports further assert that this stress is so commonplace that some emergency medical service professionals believe they must accept these risks as part of the job. To address the physical stress placed on these employees, some studies recommend widely disseminating safety policies and procedures so that emergency medical service professionals are aware of them.

According to the author, “[t]he frequent occurrences of violence committed against EMTs and paramedics have been ignored for far too long. Each call that an ambulance worker responds to has the potential of escalating into a dangerous situation, often times with that danger coming from the very same patient they are trying to help. This bill provides these first responders adequate safeguards from hazards associated with their occupation and affirms their right to a safe and protected workplace.”

Arguments in Support

The International Association of EMTs and Paramedics (IAEP) argues, in support, “[i]n the last six months alone, our members have responded to three active shooter calls in three separate states including the shooting at Saugus High School. In all three cases, none of the responding EMTs and paramedics had protective gear available on their assigned rigs. They braved clear and present dangers to do their jobs, exposing themselves to bodily harm as well as potential post-traumatic stress injuries (PTSI), in the hopes of savings lives. We strongly believe that with this legislation and constructive negotiations with providers . . . the safety of our members will be greatly improved.”

Arguments in Opposition

The American Medical Response West argues, in opposition, “[t]his bill seeks to require private, but not public, ground and air emergency ambulance providers to issue emergency ambulance employees with ballistic vests and unidentified safety devices or be subject to criminal charges. While this legislation is drafted to appear as simply an advisory of an employee’s existing rights under CalOSHA, it is in fact a new requirement that is predicated on false claims and intended to restrict private 911 ground and air ambulance providers from operating in the state of California.”

Prior Legislation

AB 26 (Rodriguez) of 2019 proposed to require emergency ambulance providers to provide emergency ambulance employees with body argument and safety equipment to wear during the employee’s work shift. This bill was not heard in the Assembly Labor and Employment Committee.

REGISTERED SUPPORT / OPPOSITION:

Support

International Association of EMTs and Paramedics

Oppose

American Medical Response West

Analysis Prepared by: Justin Delacruz / L. & E. /