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Stockton, Calif. Ambulance Contract Changes in Question

STOCKTON, CALIF. -- Complaints about response to medical emergencies are at the heart of the latest legal dispute between Stockton and San Joaquin County in the two years since the county entered into a new contract to provide ambulance services.

One side says public disclosure of professional complaints means more public accountability, and the other argues information -- particularly medical information -- can be kept confidential if doing so allows the candid reviews necessary to provide top emergency medical care countywide.

The integrity of a county program to improve emergency medical services is in jeopardy without the confidentiality that makes participation in such a program possible, according to court documents and county officials.

The city counters that confidentiality protects the county from disclosing information embarrassing to the county and its ambulance contractor.

Both sides claim state law and the interest of the public back their arguments.

This issue began in December, when county officials discovered the firefighters union had posted a log of complaints and other information on the Internet.

The union obtained the information by filing a California Public Records Act request with Stockton for a log of unusual-occurrence reports. Public documents must be provided unless state law prevents their disclosure, according to Stockton's argument in court documents. The county's authority over emergency medical services does not give it the right to create new exemptions, the argument continues.

"Certainly that doesn't trump state law," City Attorney Ren Nosky said in an interview. "We don't believe the information at issue can be protected."

In court documents, the county argues public records law doesn't require a specific exemption and says withholding the information would be in line with existing exemptions involving medical records.

The city has the authority not to disclose the requested information, Assistant County Counsel Mark Myles said.

The county is concerned about the disclosure of protected information, and it wants to keep viable a program to improve public safety in the county, he said.

Confidentiality allows emergency medical providers to participate freely in the Continuous Quality Improvement program, which evaluates mistakes and keeps them from happening again, county officials said. The county filed suit to prevent the city from releasing information to protect the process, Myles said. "That's how important we think this is," he said, "and critical to provide the best service for citizens."

That sentiment was reflected in court documents in statements signed by ambulance and fire officials, including a statement from a vice president from American Medical Response. AMR provides ambulance and dispatch services for much of the county. Its contract with the county began in May 2006, and separate lawsuits between Stockton and county -- and other cities and the county -- followed.

Dispute over disclosure of complaint information predates the 2008 lawsuit. Court documents include a September 2006 letter from Stockton Fire Chief Ron Hittle in favor of keeping the complaints available for public view. "We believe that the public safety system should be open and accountable," he wrote. "Our position is that anyone who serves the public should be accountable."

AMR reports its performance regularly to the county, and that information is readily available to the public, company spokesman Jason Sorrick said.

In 2007, the county civil grand jury found that AMR and the Stockton Fire Department used reports of unusual occurrences to build cases against each other. That grand jury also found that problems after the changeover in May 2006 were largely resolved, and county officials call the report a validation of the switch to AMR.

"(The grand jury) really gave us a clean bill of health," said Dan Burch, the county Emergency Services Agency administrator.

The new lawsuit is pending, although a judge signed an order last month that Stockton would contact the county if information in question is requested by the public.

The information on the union Web site came down months ago after union leaders received a letter from AMR's lawyers, said Dave Macedo, president of Stockton Professional Firefighters Local 456. An expensive lawsuit would not have been a good use of union funds, he said.

The complaints documented incidents of slow or incorrect response, he said.

"We're just trying to get the word out to the community that there are still issues," he said.

Contact reporter Zachary K. Johnson at (209) 546-8258 or zjohnson@recordnet.com

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