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Campaign to hurt private ambulances may have violated privacy laws

Website detailed specific medical calls handled by private ambulances

By Joe Schoenmann
Las Vegas Sun

LAS VEGAS, Nev. — Three firefighters unions, worried that budget-strapped municipalities want private ambulance companies instead of firefighters to answer less-critical medical calls, are mounting an Internet campaign suggesting the private ambulances are slow to respond.

But the effort to discredit the private firms might have backfired because in detailing specific medical calls handled by private ambulances, the website seemed to be violating patient privacy laws.

The website, latefor911.com, includes a taped phone call with dispatchers appearing to show that private ambulances didn’t make it to an emergency call in September 2011. It also includes a list of calls in which, according to the unions, the private ambulances took longer than the 12 minutes allowed by contract for them to respond.

That list, however, contains such detailed information about some emergency calls, one Las Vegas lawyer said, that their dissemination might violate patient privacy laws contained in the federal Health Insurance Portability and Accountability Act, widely known as HIPAA.

(After the Sun left messages Friday with the three firefighters unions -- Las Vegas, North Las Vegas and Clark County -- the detailed emergency calls on the website disappeared. None of the union representatives returned a call for comment.)

One such call from earlier this year, for instance, identified a home address where an ambulance was sent in response to an incident characterized as “Psychiatric/Suicide.” Other calls linked specific addresses to cardiac and “overdose/indegestion/poison” issues.

Attorney Matthew Milone, who specializes in HIPAA regulations, said the information likely violated patient privacy laws.

Milone added that the person or people posting the information aren’t necessarily violating the law.

“It’s the people who had the information that allowed it to go out (who are responsible),” he said.

Tim Szymanski, Las Vegas Fire Department spokesman, said no one from the Fire Alarm Office, which dispatches fire departments in the Las Vegas Valley, released that information formally to the firefighters unions but that it was possible that someone “got their hands” on it.

Las Vegas City Councilman Bob Beers said he had not seen the unions’ website but was disappointed if, indeed, the information posted was a violation of a federal act.

“As a longtime user of government data, my first concern would be that this information was cherry-picked in order to reach a pre-ordained conclusion,” Beers said. “And this sounds like this website was designed to lead people to a conclusion regarding who should transport medical patients.”

County Manager Don Burnett said Friday he wants county staff to look into the matter.

“If personal health information is being released, I want to know how that happened,” he said.

Latefor911.com was created as local governments struggle to deal with dwindling tax revenues and look at trimming budgets of expensive fire departments.

In North Las Vegas, for instance, MedicWest ambulances, not those from the fire department, respond to minor emergencies.

The unions’ website states that in 2010, AMR/MedicWest was late to calls 10,763 times. Mike Gorman, AMR/MedicWest general manager, said that amounts to about 4 percent of about 250,000 calls the private ambulance service responds to each year -- far below the 10 percent of calls to which ambulances are allowed to be late.

“With any 911 system, you try and forecast (EMT calls) the best you can as to when they come and where they come,” Gorman said. “Naturally, there are calls we don’t get to in the desired time, but we are well above the threshold.”

One difference between EMT calls in the Las Vegas Valley and in other urban areas, he added, is that both the private and public ambulances respond to calls, a so-called “dual service.” So even if AMR/Medic West is late, the publicly funded ambulance is on its way, as well.

Fire department ambulances have an advantage over private ones: They are equipped with devices to turn signal lights green to facilitate their passage. AMR and MedicWest aren’t allowed to have those devices, but Beers said he is looking into changing that policy. He said has asked city staff to give him a history of how the decision to exclude private companies from using the device was made.

“If we’re presenting an analysis of response times and it’s based on something other than a fair competition (between fire department and private ambulance services), we need to get that fixed,” he said.

Gorman said the time saved with those devices would likely cut down the numbers of instances in which private ambulances are late to a dispatched call.

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