Ambulance Chases

If you need anemergency medical vehicle, just hope you're in the right partof Maricopa County. If you're not, questionable dispatching practices could prove hazardous to your health.

At 8:30 on the evening of October 4, 1994, Rebecca haro, lead paramedic for Samaritan AmEvac, and her partner were parked in their ambulance near 83rd Avenue and Glendale. . A call came over the radio: A man had been injured in a fight just blocks away.

All 911 fire and ambulance calls in unincorporated areas of Maricopa County, such as the neighborhood they were parked in, are dispatched by Rural/Metro Corporation, the Scottsdale-based private fire department. Although Rural/Metro is supposed to send the closest appropriate ambulance, in this instance, the dispatcher sent a unit from AMT, an ambulance company owned by Rural/Metro.

Haro knew that ambulance would have to come from Sun City, a few miles to the northwest, and farther from the call than she was, and so she got on the radio to set the record straight.

"We advised Rural/Metro's dispatch what our location was, and they proceeded to tell us to disregard because they had a closer ambulance," Haro recalls. She didn't believe it.

"So we drove normal traffic-type driving--no lights, no siren, obeying the speed limits, not running red lights--and parked on the corner where the call was being dispatched to," she continues. "We advised their dispatch a couple of different times that 'we are here, we are close.' But we were told that there was this other ambulance responding."
Haro and her partner waited three to five minutes before the AMT ambulance arrived. They had a video camera with them, and so Haro's partner taped the event: With the dispatcher's voice in the background, the AMT ambulance--the one allegedly closest to the call--flashed by. A digital read-out on-screen logged the date and time.

Haro turned over the tape to an investigator for the Arizona Department of Health Services, the state agency that oversees ambulance operations.

Haro's video moment was not an isolated incident. The DHS investigator, William McDonald, had a growing file. McDonald spent the summer of 1994 looking into allegations that Rural/Metro was using its 911 authority to give itself an edge in the wildly competitive ambulance business--while gambling with the health of the heart-attack and auto-wreck victims to whom it was dispatching ambulances.

McDonald, a retired New York police captain, refused to speak to New Times, as did his superiors at DHS, all under the direct orders of the department's director, Dr. Jack Dillenberg.

But McDonald's investigation reports, obtained under the Arizona Public Records Law, speak for him. The reports allege that:

Rural/Metro frequently sent its own ambulances or those of its subsidiary, AMT (which has since been absorbed into the parent company), even when other ambulance companies had vehicles closer to the victim.

Rural/Metro dispatchers would sometimes "prealert" their paramedics. They would warn them over private radio frequencies that a call had come in to the dispatch center, giving paramedics time to get closer to the emergency location before the dispatcher would officially dispatch them over the open radio frequencies. Rural/Metro and AMT ambulances would misrepresent their true locations so that they would appear to be the closest unit to the call.

Rural/Metro would frequently respond outside of its own approved zones, putting its own profits above lifesaving, even in instances where profits were not endangered. This is in violation of Arizona statutes and DHS regulations. Rural/Metro's handling of 911 calls is based on little more than a handshake deal with the Maricopa County Sheriff's Office, with no contract formalizing what is and isn't proper and who bears responsibility--and liability--for any mistakes.

Since McDonald started asking questions, the Sheriff's Office has been scrambling to figure out the liability issues uncovered by that investigation, whether it wants to force Rural/Metro into a contract, train its own dispatchers or take its 911 business elsewhere.

If Rural/Metro were found guilty of McDonald's allegations, it could be fined or censured. But this being Arizona, the business state, the DHS investigation mysteriously dried up last January.The ambulance business as usual.

Within recent memory, the ambulance business was cutthroat, with companies racing each other to the scene of an accident to "scoop and run." Many ambulances carried credit-card machines so paramedics could demand payment before transporting the victim to the hospital.

Each ambulance company, private or municipal, operates within a DHS-prescribed-and-regulated zone called a CON, or Certificate of Necessity. But the various CONs overlap, and on-the-scene squabbles still occur.

To avoid such misunderstandings, some municipalities have entered into sole-provider contracts with ambulance operations. The City of Phoenix, for example, has an exclusive arrangement with its own fire department. Glendale contracts with Southwest Ambulance, and Scottsdale with Rural/Metro.

Most emergency and fire calls in the urban Phoenix area are routed through a centralized 911 system that automatically dispatches the closest fire truck or ambulance to your home, regardless of city boundaries.

Scottsdale fire and ambulance calls go directly from the Scottsdale police to Rural/Metro. Calls from anywhere else in the county, including all 911 calls placed from cellular phones, ring at the downtown Phoenix dispatch center of the Maricopa County Sheriff's Office. As soon as MCSO operators hear the words "fire" or "accident," they can hit a button that transfers the call to Rural/Metro's alarm room in Scottsdale.

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