We Have to Treat Everyone

Flock ran an extended marketing campaign called “Expanding Your Healthcare Security Perimeter Beyond Four Walls.” In one webinar, a sales lead recommends adding fired and laid-off healthcare workers to the watchlist to be intercepted by security before receiving treatment.

Flock’s sales lead, David Ballard — now a “Solutions Consultant,” according to his LinkedIn page — describes how the system should be used:

Let’s say you have a domestic situation with a nurse and her husband has provided some type of threat and they’re separated. And the hospital administrator or the Flock administrator for that area can enter his tag into the Flock Safety LPR system. And it’s called a custom hot list. And what that will do is it will send you a text or an email and let you know, David Ballard just pulled on the area of this hospital. So what we can do then, we can move her to a safe location. We can lock doors. We can get our security team to push that way. We can call the police. So those seconds do matter. And that’s one of the big reasons for that hot list setting.

Ballard then continues to describe why that matters, and names what is fundamentally wrong about the picture he just painted:

You’ve got at-risk visitors, which like we’ve talked about were domestic disputes, at-risk patients. Because at the end of the day, we have to treat everyone. And we work with a lot of people in law enforcement that are in a mental crisis. And so we know that’s just a space we have to operate in, in the health care industry.

Habitual offenders, disgruntled and terminated employees.

Ballard didn’t go off-script by linking “terminated employees” to “habitual offenders.” It was right there on the slide behind him — official Flock marketing material titled “Proactive monitoring with real-time alerts,” which includes two mock push notifications. The first reads: “FLOCK ALERT: Custom Hot List Hit – Terminated Employee. Source: Parking Lot Entry. Camera: Entrance. Network: Hospital.” The second: “Custom Hot List Hit. LP #RUI6676. Terminated employee with active threat.” The slide visually equates “terminated” with “active threat.” There is no other datum on the badge.

The product has a “Hospital” network type, with the alert source pre-populated as “Parking Lot Entry.” This is not a thought experiment. It is what Flock built.

Ballard had discussed the policy with his Flock colleague, Jessica Barzee, the Sr. Demand Generation Manager hosting the call:

And that one, Jessica and I discussed this earlier about the terminated employees. These people have made a huge investment in their life. And if they’re terminated, we’re taking that away. And that’s affecting them for the rest of their life. So that’s very powerful, and people are very passionate about that.

The most common assailants of health care workers are patients…

He mentioned, in passing, “we have to treat everyone.” That includes a “Terminated Employee.” That’s not only a moral obligation, it’s a legal one. EMTALA (42 U.S.C. § 1395dd; 42 C.F.R. § 489.24) sets requirements for every Medicare-participating hospital with an emergency department: they must screen every patient, they must stabilize them, and they must transfer as appropriate.

This level of care is triggered as soon as a patient enters hospital grounds. It’s not conditioned on passing a security interview that potentially delays critical medical screening and care. If a “Terminated Employee” shows up at the “Parking Lot Entry” with chest pain and security blocks them from receiving care, that’s an EMTALA violation carrying severe penalties and liability.

What does that interception actually look like? Ballard walks the audience through the workflow:

So let’s say a disgruntled patient provides a threat. They’re going to commit an act of violence. So we can use the Flock Safety’s patented vehicle fingerprint search and identify the patient’s vehicle, or we can bring police into it, you know, do a report and they look up the tag and provide you with that tag and you can enter it. Then we add the license plate to our hot list.

That’s your custom hot list. You can choose who’s going to get that in your security teams, your administrative facility, because they want to know about it.

Then he names the action:

You receive an alert that the vehicle has entered the hospital campus. So if the vehicle returns, the security staff intercepts the suspect at entry.

The “suspect.”

The “Terminated Employee” at the “Parking Lot Entry” with chest pain or some other healthcare emergency? Someone who, in Ballard’s terms, is “very passionate” about having just lost “a huge investment in their life”?

If we suspect a mental health crisis — which would not be unreasonable under the circumstances — the hospital’s moral and legal duty isn’t for its security team to delay care by “intercept[ing] the suspect at entry.” It’s to provide healthcare. That laid-off employee may have provided that care for years before the budget was diverted to fund surveillance technology and security.

The watchlist isn’t limited to former employees.

He then suggests using Flock’s “non-resident” detection — a feature marketed primarily to its HOA customers — “that’s an evidence that we can use and push to our security team, create those hot lists and say, hey, we were cased by a car that looks suspicious.”

Let’s put it on a hot list for our team.

No reasonable suspicion. No expiration dates. No guidelines. No disclosures. You haven’t been to the hospital before and you look suspicious.

A public hospital, federally required to treat everyone, transformed into a privately curated watchlist enforced at the parking lot entrance. This is what Flock calls “objective evidence.”

Ballard describes the goal plainly: “solve crime, move crime, or prevent crime. I’d rather prevent it and move it than have to solve it.” Predictive policing. By hospital security. The “move it” clause is doing real work — applied to a fired nurse in active cancer treatment, it means she goes to a different cancer center, if one exists in her insurance network. Applied to a fired respiratory therapist in mental-health crisis, it means a longer drive to an inpatient bed in a state where beds are already rationed. The pitch: my customer is safe. The threat is over there now.

This webinar was originally posted in September 2023. It is still on Flock’s website. Its healthcare customers — of which there are many — continue to follow Ballard’s recommendations and are still adding “suspects” to custom hot lists based on vibes, interrupting patient care and exposing the hospital to legal liability.

Any hospital that has followed Flock’s deficient advice should immediately instruct its staff to remove all former employees from any “custom hot list.” It’s a facial EMTALA violation.

For every other category — habitual offenders, disgruntled patients, cars that “look suspicious” — the same architectural problem applies. The intercept blocks the screening. EMTALA does not allow that. Hospitals can learn this from compliance training, or they can learn it from federal court.

And that’s assuming the technology works perfectly. This week — three years after the webinar — 9News reports that incorrect Flock alerts are “not a one-off.” Among the affected: “a 76-year-old grandmother… repeatedly pulled over after data errors triggered inaccurate Flock camera alerts.”

In three years, how many patients have received delayed care, or have been “moved”, because of inaccurate alerts?

In Ballard’s words: “At the end of the day, we have to treat everyone.”

Let’s start now, before someone dies in the parking lot.

Full webinar, “Expanding Your Healthcare Security Perimeter Beyond Four Walls”