# California is a special state



## Gurney Jockey (Jun 29, 2012)

So earlier this morning I received an email. As I'm sure every other AMR employee did. And I'm going to share it with you guys since you need to see what exactly is about to happen to the "amazing" state of CA. I won't link the source, but I know other AMR guys should vouch for me. You will right? I'll buy you dinner! Anyways, here's the content copy-pasted. AB 2389, which is scheduled to be heard July 2, 2012, would require private EMTs, Paramedics and Critical Care Nurses to mark their current uniforms with the term “Contractor to…” in a conspicuous size and color, or alternatively completely remove any patches, badges or other county markings from their uniform. This bill would also require ambulances to display the same terminology on the outside of the vehicle, or potentially subject the ambulance provider to costly unfair business practice lawsuits under California Business Code Section 17200.

The bill’s sponsor, The California Professional Firefighters (CPF), claim that AB 2389 is necessary in order to protect patient safety and provide transparency. However, under most 9-1-1 contracts, the utilization of county patches, badges and vehicle markings by a provider is often a requirement of the contract, and are actually used to ensure public safety and communicate to the patient we have the authority to practice medicine in their jurisdiction.

Moreover, these regional identifiers prove invaluable during major disasters and multi-casualty incidence, and are worn in tandem with a providers own patches and identifying marks which clearly state who an individual is working for. In addition, the provisions of this bill could hinder a provider’s ability to move through different jurisdictions during calls for mutual aid, or when conducting specialty care services such as neonatal and critical care transports.

The fact is, the State of California is predominately served by private EMS providers, many of which have provided services in this State for over 40 years, and there has never been an issue of patient safety or transparency relating to the appearance of our uniforms or. ambulances. I believe AB2389 is simply a means by CPF to stigmatize the private EMS workforce, and burden emergency ambulance service providers with unnecessary costs that do nothing to improve patient care or enhance the delivery of emergency medical services.


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## mycrofft (Jun 30, 2012)

*Quote from the bill (changes edited in).*





Existing law governs certain obligations arising from particular transactions, including credit card disclosures, consumer contracts, and consumer warranties.

This bill would prohibit a contractor, as defined, that provides services that require entering the residence or place of lodging of a member of the public from utilizing a uniform that bears the name or logo of the contracting entity, as defined, unless each uniform meets certain disclosure requirements.

Among these requirements, the bill would require each of the contractor’s uniforms to clearly, conspicuously, and legibly state that the contractor is providing services on behalf of the contracting entity, and the contractor’s name.

In addition to these requirements, the bill would further prohibit a contractor that provides the services described above relating to public health or safety services from using a vehicle that bears the name or logo of the contracting entity unless each vehicle also meets the above requirements. 

The bill would specify that these provisions shall not apply if a contracting entity and a contractor are jointly and severally liable for any claims arising out of work performed pursuant to a contractual agreement.***

The bill would state the intent of the Legislature to increase consumer awareness of the state’s growing and sizeable contract workforce through the disclosures required by these provisions. The bill would make a specified statement of legislative intent regarding the disclosures required by these provisions.

*** I don't know what this means. It replaced the sentence imposing a $250/day fine for not following the law.

It prevents private contractor' vehicles and uniforms from wearing the appearance of being civil service. This introduces transparency and accountability. Also, the contracted agency needs to control uniforms so ex-employees and persons buying (second hand) or stealing such uniforms cannot essentially impersonate civil service employees, unless the uniforms are clearly not those of a civil service agency.


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## Joe (Jun 30, 2012)

I dont know about your guys' amr uniforms or if im even reading the text right but my uniform has the Amr patch and a badge that has an amr seal and the only part laco is the patch on one shpulder


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## VCEMT (Jun 30, 2012)

Yeah, so, I'm guessing that county departments must wear such items to show they are contracted? Since most county fire departments are contracted by cities that can't afford to provide fire personnel. 



"Fire-Based EMS ... The Right Choice for Public Safety
Time. It’s a precious commodity, and it waits for no one. When lives are on the line, seconds count. Fractions of seconds count.

Few individuals in our lives better understand the importance of time than the men and women of the fire service. Highly qualified public servants, trained to handle crises affecting both people and property – often simultaneously. The dedication and training of these professionals and their commitment to quality of care are just two of the many reasons why fire-based Emergency Medical Service is the clear choice for public officials and the communities they serve. 

Higher Survival Rates
As communities evaluate their present emergency medical care needs, they may focus exclusively on patient transportation issues. Most research, however, has demonstrated that rapid, on-scene medical intervention produces the best patient outcomes. The fire service is best positioned to deliver this critical care, as well as rapid patient transport. Fire-based EMS provides a comprehensive approach to emergency care, with trained personnel capable of handling any complication. The bottom line – a better chance for patient survival – is the true measure of quality for any pre-hospital emergency medical system.

Rapid Response Times
The fire service is known for its rapid mobilization. Firefighters are the nation’s first responders and fire-based EMS get to the scene faster. A comprehensive response within time limits set by the emergency medical community should be the goal for other EMS providers. It is routine for the fire service.

Quality of Care
Unacceptably high workloads, stress and perceived lack of commitment to patient care by employers all take their toll on the single-role EMS provider. Unfortunately, the patients they serve also invariably suffer. The teamwork, efficient job performance, and continuous patient contact enjoyed by the fire service, on the other hand, affects patient care in a way that cannot be qualified by dollars. Nevertheless, these are critical areas of inquiry for those who are deciding between competing EMS systems for their communities.

Fire-Based EMS -- The Right Choice
Citizens need a system that works in the field, not only on paper. Decision makers, therefore, must look at what their community is getting for the price, particularly in the areas of response time, personnel capabilities and system efficiency. Only then can a community make an informed choice about a critical service, with the same confidence that they place in the rapid response and effective work of their fire department."

This is from the CPF website, :censored::censored::censored::censored::censored::censored::censored::censored::censored:s.


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## Achilles (Jun 30, 2012)

California has a bunch of stupid laws and it affects the whole country, at least with common companies (Coca cola, any manufacture of a gas can, cars, and a ton more) that's my opinion. 
Anyways, I'm proud to wear my uniform where I go, however if I had to put in big letters "Contracted to..." I just don't see the need, you've got a badge on your left breast and a patch on the right! 
Is this just privates or  FD also?


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## Anonymous (Jun 30, 2012)

So how would a company lime CARE who runs in multiple cities display that on their uniform? Contracted to: and then a list of every city.


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## Veneficus (Jun 30, 2012)

Has anyone considered that "contractors" provide a higher level of care than municiple EMS providers?

I don't see too many municiple specialty transport providers. 

I especially don't see places like LA Co fielding something like a Neonatal Critical Care transport. 
(and even if they did, I think I would like to have the "contractor.")

I also don't think they thought the matter through very well. 

The fact there are more contractors and they are more visible and collectively have more patient encounters everyday, may make the firefighters look like they are the odd person out. Which would actually harm their public relations more than it would help.

I am a contract medical provider.

But I prefer the term "mercenary."


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## JPINFV (Jun 30, 2012)

I don't think that this is too much of a big deal. The big contracting companies aren't really affected based on my reading of the bill. When Care is providing services to a city, for example, it's done in Care Ambulance ambulances by EMTs wearing Care Ambulance uniforms. The only place I've seen where the contracting entity is mentioned is where it says, "Proudly serving the city/county of _______" on the side of the vehicle, normally right below the ambulance service name and logo. As such, the vehicle is clearly stating that "the contractor is providing services on behalf of the contracting entity" as well as stating "the name of the contractor."

The problem is the cities and counties where a contractor is brought in, but the employees respond in the contractee's vehicles and uniforms (isn't this how the Garden Grove contract is ran with Shoreline?). I agree that that is a problem as the contractor's employees are presented in a manner that gives the impression that they are employed by the city, no the contractor.


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## exodus (Jun 30, 2012)

JPINFV said:


> I don't think that this is too much of a big deal. The big contracting companies aren't really affected based on my reading of the bill. When Care is providing services to a city, for example, it's done in Care Ambulance ambulances by EMTs wearing Care Ambulance uniforms. The only place I've seen where the contracting entity is mentioned is where it says, "Proudly serving the city/county of _______" on the side of the vehicle, normally right below the ambulance service name and logo. As such, the vehicle is clearly stating that "the contractor is providing services on behalf of the contracting entity" as well as stating "the name of the contractor."
> 
> The problem is the cities and counties where a contractor is brought in, but the employees respond in the contractee's vehicles and uniforms (isn't this how the Garden Grove contract is ran with Shoreline?). I agree that that is a problem as the contractor's employees are presented in a manner that gives the impression that they are employed by the city, no the contractor.



Just like SDMSE in San Diego


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## socalmedic (Jul 1, 2012)

I am an AMR employee and I can verify that this was emailed out...

to touch on a few points mentioned above.

to the LACO AMR employee, you would have to remove your LAcoEMT patch.

CARE would not be affected as they do not have any county logos, they have their own logos on both shoulders.

"proudly serving...." would no suffice, I would have to say "contractor to..." and then that ambulance would not be able to respond into a neighboring city, care would simply have to remove all the "proudly serving..." from the ambulance.

they contractors who wear the city uniform and drive city vehicles would be exempt under the;

 "The bill would specify that these provisions shall not apply if a contracting entity and a contractor are jointly and severally liable for any claims arising out of work performed pursuant to a contractual agreement"


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## Uclabruin103 (Jul 2, 2012)

JPINFV said:


> I don't think that this is too much of a big deal. The big contracting companies aren't really affected based on my reading of the bill. When Care is providing services to a city, for example, it's done in Care Ambulance ambulances by EMTs wearing Care Ambulance uniforms. The only place I've seen where the contracting entity is mentioned is where it says, "Proudly serving the city/county of _______" on the side of the vehicle, normally right below the ambulance service name and logo. As such, the vehicle is clearly stating that "the contractor is providing services on behalf of the contracting entity" as well as stating "the name of the contractor."
> 
> The problem is the cities and counties where a contractor is brought in, but the employees respond in the contractee's vehicles and uniforms (isn't this how the Garden Grove contract is ran with Shoreline?). I agree that that is a problem as the contractor's employees are presented in a manner that gives the impression that they are employed by the city, no the contractor.



Garden Grove is CARE Ambulance. Shoreline has only westminister, which rumor has it was going out for bid soon. Doubt they'll get it again. 

And as the person above me said, it looks like it'll only happen when you do have Los Angeles County or any other county patch on their uniforms. If only they had a bill for white uniforms not being allowed to be worn!


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## CodeBru1984 (Jul 2, 2012)

What's the likeliness of this bill being passed into law? It seems like every single county in the state of California would be affected by this...


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## JPINFV (Jul 2, 2012)

Uclabruin103 said:


> Garden Grove is CARE Ambulance. Shoreline has only westminister, which rumor has it was going out for bid soon. Doubt they'll get it again.
> 
> And as the person above me said, it looks like it'll only happen when you do have Los Angeles County or any other county patch on their uniforms. If only they had a bill for white uniforms not being allowed to be worn!



Westminster... that's it. There was a news article a few months ago about Shoreline being renewed because of a community outcry. Apparently community service is required to be on the dedicated 911 ambulances.


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