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.

Rural/Metro offered its 911 services to the Sheriff's Office back in August 1990 so that MCSO could concentrate on police work. Apparently, then-sheriff Tom Agnos jumped at the opportunity, because the deal was in place three days later. In a letter to the sheriff dated September 27, 1990, Rural/Metro vice president Robert Edwards wrote, "Effective August 10, 1990, Rural/Metro Fire Department relieved MCSO of the burden and began acting as County-wide dispatching control center for all fire and EMS activity throughout unincorporated areas of Maricopa County and/or any area served by MCSO, excluding fire districts under the dispatch authority of another agency."

The letter from Edwards was the only apparent record of the agreement between Rural/Metro and MCSO for nearly four years, and the current sheriff's administration was apparently unaware of the oversight until the DHS investigation. To date, no contract has been drawn up between Rural/Metro and MCSO. Between its Scottsdale and county responsibilities, Rural/Metro likes to boast that it handles 70,000 to 80,000 911 calls a year. And although those calls may be for fires or rattlesnakes in the backyard, one can assume that a healthy percentage is for emergency medical treatment.

With calls coming from unincorporated county areas, Rural/Metro is supposed to "take the responsibility for finding the closest appropriate agency to respond to all fire/ambulance-related situations, including those that fall outside of our current service area," as Edwards promised in his 1990 letter.

In reality, Rural/Metro executives and dispatchers make it clear to the other companies that it is the other companies' responsibility to monitor the radio broadcasts for 911 dispatches and inform Rural when they have ambulances closer than Rural's own.

"They tell us they don't know where our units are," says Bob Ramsey of Southwest Ambulance. "If it's in our area, they should call us."
In a report dated June 26, 1994, DHS investigator McDonald cited 14 instances between March 10 and June 10, 1994, in which Rural/Metro dispatchers had either sent their own ambulances to calls when other companies had closer units or had failed to notify closer paramedics that 911 calls had been received from their areas. Most of the incidents took place in the west Valley, but some were as far east as Mesa.

In August and September of that year, McDonald reported on further complaints, and, by October, in a letter to the Sheriff's Office, he referred to 20 incidents in which Rural/Metro had dispatched its own ambulances in the west Valley without consulting AmEvac to see if it had closer units.

Even though the 1990 letter from Rural/Metro had assured the sheriff that Rural would send the closest appropriate ambulance, McDonald wrote in his report, "Rural/Metro does not observe this practice, but instead places the burden on the competitive ambulance companies to notify Rural/Metro of the location of an available ambulance each time emergency call service is broadcast. Rural/Metro exacerbates the situation by occasionally 'prealerting' AMT and Rural/Metro fire/ambulance units on radio frequencies with certain 'PL' tones (designed in part to limit access to the transmissions) . . ."

Nor can any competitor be sure exactly how close Rural and AMT ambulances are to any given call.

"Additionally," McDonald wrote, "Rural/Metro does not always verify or announce on dispatch frequencies, the specific location of either responding or available AMT-Rural/Metro units. [ . . . ] It also made this investigation more difficult, as there was no written record of the location of the starting point for responding AMT and Rural/Metro units."
He cited specific examples: On May 14, 1994, according to McDonald's investigation, employees of AmEvac, which has since been bought out by Southwest Ambulance, were sitting in their station on Litchfield Road in the west Valley when an AMT ambulance screamed past the station, Code 3, with lights flashing and siren wailing.

Since it had to pass the station house, the AMT ambulance clearly was farther from the call than AmEvac. Yet there was no dispatch broadcast over the open radio frequencies so that AmEvac could state its own position. There was no record that the call had ever occurred.

Later, when McDonald questioned Rural/Metro executives about the incident, one of them quipped, "How do you know [the ambulance drivers] weren't going to McDonald's?"

"Code 3?" the investigator fired back.
On May 24, 1994, near Mesa, two Rural/Metro emergency vehicles passed a station owned by PMT, another private ambulance company, on their way to the home of an elderly man who had suffered a heart attack. PMT paramedics heard the call, and advised of their position, but they were told not to respond. There was another AMT ambulance closer--but it got lost. Rural/Metro dispatched one more of its own units as back-up, even though the PMT ambulances were miles closer.

(The PMT executive who filed complaints with DHS against Rural/Metro, Tom Melton, has since been hired by Rural/Metro.)

McDonald also listed a number of 911 irregularities in the tiny town of Wittmann, northwest of Phoenix on the way to Wickenburg.

Wittmann has no ambulance company, and relies on Rural/Metro ambulances 20 minutes away in Sun City. But Wittmann's volunteer fire department has trained paramedics, who are supposed to be the first response to medical emergencies in their town while waiting for the ambulances to come their considerable distance. Then, if the Rural/Metro ambulance transports the victim to the hospital, Rural collects the fee.

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