Lois Henry

Saturday, Apr 19 2014 08:00 PM

LOIS HENRY: County hides behind patient privacy to avoid transparency

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    Californian columnist Lois Henry

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By Lois Henry

This should come as no surprise, but I completely disagree with Kern County’s decision not to release ambulance response times for a particular incident last month in the Kern River Canyon.

And, actually, I never even asked for the information. It was a fellow journalist, Gunnar Kuepper, who runs an online paper called GBU Mountain News out of Frazier Park. But I immediately became concerned that the county’s response to Kuepper would become its response to all media inquiries about ambulance response times.

Ambulance performance is a basic public safety concern. Information about response times should be made readily available to the public.

The county claims releasing that information could compromise patient confidentiality. Poppy cock. That’s just another thin excuse by county bureaucrats to keep the public out of its own business, which seems to be SOP in Kern.

Here’s the background.

Kuepper, who is a former paramedic and longtime emergency management professional from Southern California, became very interested in a rescue in the Kern River Canyon that happened the night of March 28.

A woman jumped out of a moving car and plunged 75 feet down the side of the canyon. Kern County Fire and Sheriff’s crews worked together (kudos for that, by the way) to reach the woman, who was said to be seriously injured.

A Hall ambulance was dispatched but couldn’t make it up to the site, which was near Richbar about six miles inside the canyon. So crews hoisted the woman out using the Sheriff’s helicopter and flew her to the mouth of the canyon to the waiting ambulance, which then drove her on to Kern Medical Center.

I happened to be working the “cop shift” the day after the rescue and wrote the story for the paper, and I included the woman’s name, Blanca Pena.
That’s absolutely public information. This was an accident on a public road that required a lot of public expense, including shutting down Highway 178 for a couple of hours. You don’t get to be anonymous in situations like that.

The incident caught Kuepper’s attention. He wondered why on earth the Sheriff’s helicopter didn’t just fly Pena to KMC. Seemed to him that would have been the shortest travel time, which would have been in the best interest of the patient, according to his many years of training and experience.

That’s an excellent question. And it brings up a very curious policy by EMS that restricts the fire and sheriff’s departments from flying patients directly to hospitals without first going through a bunch of rigamarole including getting the OK from the incident commander, the highest ranking medical person on scene (typically a paramedic with the ambulance company) and whoever is on-call at EMS.

The default is to favor ground transportation. Even in potentially dicey situations. (That’s a story for another time.)

Anyway, Kuepper called EMS and asked for information, including how long it took Hall to get to the scene and how long it took for the ambulance to get to KMC.

He got nothing from EMS but eventually did get a letter from the office of the Kern County Counsel on April 15 saying the county would not give up ambulance times because they related to a specific patient.

County Counsel said all the information Kuepper was seeking, including ambulance response and travel times, was collected on a “patient care report” generated by Hall’s and, as such, was confidential.

OK, yes, the care report is not releasable. I get that.

But response times must be reported by Hall’s to EMS on a monthly and sometimes daily basis, according to EMS’ policies. That information is kept in a database and is, and has been, releasable to the media.

I know, because this newspaper got a month’s worth of exactly such response times back in 2007 from the EMS database.

Location information was stripped out to protect patient confidentiality. But otherwise, date, time of call, time at the scene and other information was readily available. That easily could have been given to Kuepper.

When I pointed that out, Chief Deputy County Counsel Karen Barnes said no, because Kuepper was asking for response times for a specific patient. Actually, his exact request was for information regarding “the so called Canyon Incident on March 28, 2014 at 8:40 p.m., six miles East in Kern Canyon Highway 178.”

No mention of the patient.

But Kern’s denial wasn’t limited to the patient care report issue.

County Counsel also denied Kuepper based on medical privacy laws. Specifically, County Counsel cited California Civil Code 56.05 (j) which defines “individually identifiable” information as a number of things including “information that alone or in combination with other publicly available information reveals the individual’s identity.”

“Kuepper had some information related to this patient,” Barnes said. If the county also gave him ambulance response times then he could “connect the dots to that patient and that’s where the breach comes.”

Clearly, the patient’s name had already been made public and the law does say you can’t give out information that could be used to connect those dots.

But, frankly, what Kuepper knew, or didn’t know, about the patient isn’t a concern of the county’s.

“It appears Kern is being hyper technical,” said First Amendment attorney Thomas Burke. “They’re trying to get inside the journalistic process and assuming they know what you know. They’re being overly cautious and the law doesn’t require that.”

The questions in Kuepper’s letter were basic public safety questions. That exact information had been released in the past. The county should just have given the basic information and been done with it.

Not to mention, said Jim Ewert, an attorney for the California Newspaper Publisher’s Association, the California Constitution requires agencies to construe laws broadly when it increases the public’s access to information and narrowly when it limits rights of access.

Beyond all that, the Board of Supervisors promised back in 2007 that ambulance response times — long a bone of contention in rural Kern County  — would be accessible to the public.

That’s when a new county ordinance was passed giving ambulance companies geographic monopolies by carving the county up into service areas.
Citizens were concerned these monopolies would be a disincentive for prompt service, so the board required companies to report response times to EMS. If ambulance companies don’t hit certain response time targets 90 percent of the time, their contracts can be revoked.  Personally, I think the time and mileage it took to get the patient to the hospital should be reported as well. But no one ever asks me.

To make it all transparent, Supes decreed that information would also be publicly available. Absolutely, agreed former Emergency Medical Services (EMS) Director Ross Elliot. Monthly performance reports would be posted on EMS’ website.

Pshhhhh.

Those reports give the public almost zero information.

They are check box forms that EMS fills out saying whether the company filed timely reports, or met response time standards. Just “met” or “not met.” No further information. Some transparency. You have to ask for the underlying data bases to see the actual response times, call by call. Which is what the paper asked for, and received, back in 2007. And it’s exactly what Kuepper should have gotten as well.

“It was frustrating,” Kuepper told me in his thick German accent. “But we Germans, you know how we are, that just encourages us even more to get the information.”

Viel Glück, meine Brüder.

Opinions expressed in this column are those of Lois Henry, not The Bakersfield Californian. Her  column appears Wednesdays and Sundays. Comment here, call her at 395-7373 or e-mail lhenry@bakersfield.com

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