The federal government, citing privacy concerns for patients, has informed the District that it can no longer operate a ride-along program that allows the public to observe medics at work on fire engines and ambulances.
The decision, the first of its kind, will likely have far-reaching consequences for municipal fire departments that allow journalists and elected officials, as well as the public, to oversee a critical taxpayer function.
The directive was issued Oct. 11 from the Office of Civil Rights Region 3, a division of the U.S. Department of Health and Human Services.
It asks the District to either scrap its ride-along program within 30 days or submit plans to alter the existing program. However, the language of the letter leaves little room for creating a program in compliance with privacy laws.
According to the letter, "disclosures of protected health information to persons other than health care providers, as would occur in the context of a ride-along program, would require an authorization of the individual or their personal representative."
The letter also states: "The fact that [the D.C. Fire and Emergency Medical Services Department] has no way of knowing in advance which individuals will be treated or transported effectively precludes obtaining prior authorization of disclosure."
An official with HHS could not discuss whether the letter was meant to set a national precedent, but said it was part of an investigation into whether the District violated the provisions of the Health Insurance Portability and Accountability Act.
The official said there are several exceptions to the act that allow patients' information to be disclosed without their consent, including oversight by a public health agency, for victims of domestic violence and disclosures to the courts.
He also said the ban did not apply to interns or trainees in the health care profession, but that the privacy rule contains no exceptions for elected officials or the public at large in an oversight capacity.
The official said that instead of issuing a mandate, the process of prohibiting ride-alongs is "complaint-driven" and that complaints can be filed by anyone, not just a patient.
The International Association of Fire Chiefs said it was not aware of other jurisdictions in which ride-alongs had been prohibited.
The decision stems from a complaint filed with the Office of Civil Rights about apparent privacy violations in a June 18 article in the Washington City Paper. The article had vignettes from a reporter's ride-along with the crew of Engine 10 in Northeast as they responded to a medical calls and included the names and medical conditions of several patients. Eric Wemple, editor of the City Paper, did not return a call seeking comment.
Fire department spokesman Alan Etter said the reporter got the names directly from the patients and that firefighters violated no privacy rules. He said the fire department's understanding of the letter is that it is in violation for allowing the reporter to have access.
Fire Chief Adrian H. Thompson said he is still analyzing the directive, but the program has recently been revamped and reconstituted based on the act's requirements.
