Las Vegas Sun

September 2, 2014

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In trying to prevent takeover, firefighters unions may have violated privacy laws

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The website LateFor911.com had provided a list of calls in which, according to firefighters unions, private ambulances took longer than the 12 minutes allowed by contract for them to respond. A Las Vegas lawyer said that the list's dissemination might violate patient privacy laws. The Sun has blurred the column that identified the reason for the emergency call. The information has been removed from the website.

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The official Fire Alarm Office site (fire.co.clark.nv.us) lists emergency calls that firefighters from Las Vegas, North Las Vegas and Clark County went to. The information given is very general.

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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  1. Wow, no comment from the knuckleheads in the FD... There is a shocker. Can't wait for them to slither out of this one. Only if the firefighters knew that they were the laughing stock of the nation (in firefighter circles) then maybe they would grow up. Until then this will continue. Only problem is that the public will most likely never know how deep this really gets....

  2. Interesting that the Clark County website is down also. A story bought and paid for by the private ambulance company

  3. Once again, nothing matters but their pay checks in toto. Where is our leadership? Cut compensation already.

  4. This article is a real reach. HIPPA protects an individual's medical information. With the documentation that you have provided, how does an address violate patient privacy laws? The address could be a business, park, hospital, or inside a car in the street in front of a home. You have no idea who the patient is.
    Using your thinking, when the paper puts out medical information about the state of Nevada, you could be in violation of HIPPA. Come on Joe your a better reporter than this.

  5. Meanwhile, the insurance companies got hold of the information on the website and those folks won't be able to buy affordable health or life insurance. The insurance industry should send a check to the Firefighters next union soiree.

  6. Tick,
    As the article states, the HIPPA concerns occur when the first responders are sent to a *specific* home address (including, in the case of a condo or apartment complex, the specific unit), so it is possible to link an occupant of that particular address with a sensitive medical issue. There have been such incidents of specific addresses being published on the website.

  7. Check out the website listed in the article, latefor911.com. It's pretty scary to see the number of times that the private ambulance can't get to the call in a decent amount of time if at all. The twitter feeds to the right of the page are interesting too. Cannot respond to a cardiac arrest? Seems that the way the system is set up, with a fire department and a private ambulance responding is the best way. Not sure why anyone would want to change it. If the private ambulance can't show up to my emergency, at least I know that the fire department is only a few minutes away.

  8. It would be nice if the real concern was patient care, but it appears to be concern about job security and preservation of benefits. Since North Las Vegas is going broke, and other fire districts are hamstrung with labor costs they can't afford, it makes perfect sense to look at more cost effective ways to deal with medical emergencies.

  9. It is also interesting that the private ambulances are not authorized the equipment used to change the traffic lights like the fire department. How does that affect the response times? If private services are being authorized by local government, then they should have the same access to traffic control devices the fire department uses.

  10. I'm trying to remain objective but I must admit the word union brings to mind a variety of unsavory images, and prejudices my initial response. If these unions didn't have a history of questionable actions, we wouldn't have to fight for objectivity.

    Firefighters (and public sector employees in general) are saddled with the negative images of their unions as well as any they may have earned on their own. It's difficult to think well of folks who reportedly work half as long for twice the pay as those they serve while demanding more and using tactics that smack of threats and intimidation. Seeming indifference to the ability of the taxpayers and employers to pay more is hard to swallow, especially in times like these.

    It would be much nicer if the only image that came to mind was the brave neighbor risking his life to protect our citizens and communities rather than memories of union threats and intimidation. Constant reminders like the subject of this piece cause many to see a mercenary like approach making that hard.

    I would like a different perspective, maybe my expectations are unrealistic. If the truth is not what we are seeing, the firefighters themselves need to cause it to change. It seems firefighter unions control their members rather than the opposite and as long as unions continue to act in an objectionable manner with firefighter approval, tacit or otherwise, the future will likely find us at odds and motives suspect.

    I'm willing to listen but as of now I need a reason. That reason should come from the folks doing the job not those who couldn't win a popularity contest if it were rigged.

  11. Tick,
    I agree that it may be a close call, whether there's a breach of patient privacy in connecting the type of call with a specific residential address. This is where attorneys come in. :-)

  12. interesting that whenever I see a private ambulance company I also see a municipal ambulance there (example...at the bus stop at Flamingo and Maryland - Southwest was already there and the county showed up several minutes after)....either turn the responses over to municipal services or private services, but this double response is a waste of resources.