When you dial 911 with a medical emergency, dispatchers typically send an ambulance and a fire engine.

They come right away. The firefighters and paramedics don’t finish their lunch first. They cut their coffee breaks short. In life and death situations, seconds matter.

Unlike the firefighters, however, the ambulance crew probably is employed by a private company. In California, most counties — Sonoma County included — contract with private companies to respond to calls for emergency medical aid. Why? For one thing, it’s less expensive than maintaining a fleet of publicly owned ambulances, staffed by paramedics and emergency medical technicians.

But a recent legal decision threatens to drive up the cost of ambulance service by hundreds of millions of dollars.

In a 2016 case involving private security guards, the state Supreme Court ruled that on-call meal and rest breaks violate California labor law. Now, some EMTs and paramedics are suing for an end to on-call breaks and back pay for past breaks. They’re likely to prevail, according to legal experts.

Unless voters approve Proposition 11 on the Nov. 6 ballot.

Proposition 11 would reaffirm the decades-long practice of keeping ambulance crews on call during meals and rest breaks, just as other first responders remain on call during their breaks.

Private companies handle three-quarters of emergency ambulance calls in California. To meet required response times — a common standard is arriving within eight minutes on 75 percent of emergency calls — companies typically station ambulances at various spots around a community rather than keeping them all at a fixed location. Then, as calls come in, ambulances are repositioned to maintain response times.

If paramedics and EMTs aren’t available during meal and rest breaks, the state’s nonpartisan legislative analyst estimates that 25 percent more ambulance crews would be required to meet response standards, adding an estimated $100 million in annual costs that ambulance companies are likely to pass on, either through higher fees for patients with health insurance or directly to taxpayers. Rural areas, which tend to have less ambulance coverage, would feel the biggest impact.

EMTs and paramedics have demanding jobs. They need meals and rest breaks, and Proposition 11 wouldn’t take them away. If a break is interrupted, it says crew members must be given another one of full duration. And if that isn’t possible on a given shift, crew members must be given an extra hour of pay. Moreover, meal breaks can’t be scheduled in the first or last hour of a shift.

Proposition 11 also requires that mental health services be made available for ambulance crew members, and it mandates annual training for natural disasters and active-shooter situations and in violence prevention.

Ambulance crews are first responders, just like police officers and firefighters, and they need to be available when people need help.

No one submitted a ballot argument against Proposition 11, and The Press Democrat recommends a yes vote to ensure that help arrives as quickly as possible in a medical emergency.

You can send a letter to the editor at letters@pressdemocrat.com