body-worn cameras
A concise guide to understanding consent, privacy, and policy considerations for body-worn camera use in the fire service.
U.S. guidance only – Canadian information coming soon.
The use of body-worn cameras, dash cams, and cellphone video in EMS settings raises significant legal, ethical, and operational considerations that departments must address.
Adding complexity, state consent laws vary widely – some require all parties to consent to audio recording, while others allow one-party consent.
In this landscape, clear and comprehensive departmental standard operating procedures are essential to ensure legal compliance, safeguard patient rights, and maintain public trust.
HIPAA plays a central role in this conversation, strictly governing patient privacy and limiting how protected health information can be recorded, stored, and shared.
legal considerations
hippa & privacy best practices
Body-worn camera (BWC) recordings with identifiable patient data are considered protected health information (PHI) under HIPAA. EMS agencies must comply with federal regulations for the secure collection, storage, and use of these recordings. Key requirements:
- Use BWC recordings only for QA/QI, protocol review, and training — no patient consent needed under HIPAA.
- Execute business associate agreements (BAAs) with any vendor storing BWC footage.
- Encrypt recordings at rest and in transit; ensure secure deletion when destroyed.
- Implement strict access control, audit logging, and remote wipe functionality for BWC devices.
- Train all personnel on breach protocols, legal limits, and HIPAA compliance expectations.
State Consent & Open Records Laws
Consent laws for recording vary by state. Most are one-party consent states (including Louisiana, example below), but some require all parties to consent. Additionally, EMS providers may be subject to their state’s public/open records laws (FOIA/ORL). Key points:
- In private settings, allow discretion to disable BWCs (e.g., bathrooms, during disrobing). Define this in policy.
- Clarify when BWC footage is subject to disclosure under state FOIA laws.
- HIPAA allows disclosure only if state law mandates it — not if it simply permits it.
- Establish SOPs for redacting, handling, and responding to public record requests.
state-by-state recording consent laws
| State | Consent Type | Summary Notes |
| Alabama | One-party | Standard public/private boundaries |
| Alaska | One-party | No secret filming in private spaces |
| Arizona | One-party | Same as federal; privacy expected in homes |
| Arkansas | One-party | Caution in private dwellings |
| California | All-party | Consent required; private areas restricted |
| Colorado | One-party | Consent not needed in public spaces |
| Connecticut | One-party (in-person), all-party (electronic) | Context-dependent |
| Delaware | All-party | Private conversations require consent |
| Florida | All-party | Strict on all recordings |
| Georgia | One-party | Applies only if participant in conversation |
| Hawaii | One-party | All-party in private homes |
| Idaho | One-party | Standard practice |
| Illinois | All-party | Electronic conversations protected |
| Indiana | One-party | Public recordings allowed |
| Iowa | One-party | As long as participant is informed |
| Kansas | One-party | General compliance with federal standards |
| Kentucky | One-party | Private spaces caution |
| Louisiana | One-party | Home video needs care |
| Maine | One-party | Same as federal |
| Maryland | All-party | Strict recording laws |
| Massachusetts | All-party | Secret recordings banned |
| Michigan | All-party | Wiretap law includes hidden cameras |
| Minnesota | One-party | Standard video/audio rules |
| Mississippi | One-party | Recording in private homes discouraged |
| Missouri | One-party | State aligned with federal policy |
| Montana | All-party | Private consent required |
| Nebraska | One-party | General federal alignment |
| Nevada | All-party | Restricts hidden video/audio |
| New Hampshire | All-party | Strict consent rules |
| New Jersey | One-party | Normal expectations of privacy apply |
| New Mexico | One-party | No filming inside homes without notice |
| New York | One-party | Home video not restricted unless hidden |
| North Carolina | One-party | Standard restrictions apply |
| North Dakota | One-party | As long as participant is aware |
| Ohio | One-party | Broadly permissive |
| Oklahoma | One-party | Caution for indoor spaces |
| Oregon | All-party (in-person) | Complex; verify case-by-case |
| Pennsylvania | All-party | Strict limits on audio/video |
| Rhode Island | One-party | Recording allowed with participant notice |
| South Carolina | One-party | Home settings require discretion |
| South Dakota | One-party | Mirrors federal limits |
| Tennessee | One-party | No extra state restrictions |
| Texas | One-party | Private settings require caution |
| Utah | One-party | Recording is legal when part of conversation |
| Vermont | One-party | No specific statute; follow federal |
| Virginia | One-party | Home/clinical privacy assumed |
| Washington | All-party | Strictest state rules |
| West Virginia | One-party | Standard use permitted |
| Wisconsin | One-party | General privacy law applies |
| Wyoming | One-party | Aligns with federal rules |
Example: Retention Requirements & Legal Opinion
Per a legal opinion from Louisiana Department of Health (David McCay, 9/15/2022), EMS BWC footage does not qualify as a “hospital record” and is not subject to the 10-year retention requirement under La. R.S. 40:2144. Highlights:
- EMS agencies are not considered healthcare providers under La. R.S. 40:2144 or 40:1165.1.
- BWC recordings are generally used for QA/QI, internal training, and peer review, not clinical documentation.
- Agencies should classify BWC recordings as operational, not medical records, to avoid unnecessary retention obligations.
- Default retention period should be 90 days, unless flagged for legal hold, training, complaint, or investigation.
additional legal resources
IAFF: Use of Body-Worn Cameras
NEMSIS: EMS Body-Worn Camera Quickstart Guide: Legal Considerations for EMS Agencies
HIPPA Guidance
department sops & safe-use examples
Some EMS agencies have piloted or adopted standard operating procedures (SOPs) for video device use, often aimed at quality assurance, legal defense, or operational training.
Effective policies place strict limits on recording in sensitive situations, such as when patients are disrobed or inside private residences, and they clearly define how footage is stored, accessed, and used.
Well-designed SOPs also help reduce HIPAA risk and reinforce appropriate personnel boundaries. Here is a general guide on getting started, a sample BWC SOP to use, and examples of how others have implemented SOPs for BWCs:
- New Orleans EMS Pilot BWC Program:
- Used for training/QA. Not included in medical records.
- Prohibited use in private residences unless justified.
- Cypress Creek EMS (Texas):
- Policy enforced BWC activation in public/transport settings.
- Recording banned in bathrooms or when patients disrobe.
- Partnered with HIPAA-compliant storage vendor.
- North Channel EMS:
- Focused on cardiac arrest, RSI, and trauma review.
- BWC required upon arrival, deactivated before ED entry.
- QA trigger extends retention window.
- American Medical Response (AMR):
- Uses dash cams primarily for driver safety and scene review.
- SOP includes auto-recording during driving and manual triggers during patient care.
case studies & media coverage
Real-life legal cases and media coverage offer valuable insight into the risks and benefits of using video in EMS.
In some instances, EMS video footage has supported both prosecution and defense in legal proceedings. However, mishandling recordings or capturing video in inappropriate settings can lead to HIPAA violations, public backlash, and potential civil liability.
- Iowa – Fatal Medication Error
In August 2023, a Sioux City paramedic allegedly administered the wrong drug — rocuronium instead of ketamine — which paralyzed the patient and led to their death. A federal lawsuit followed, and the medic was criminally charged with involuntary manslaughter. Read More - Illinois – Paramedics Charged with First‑Degree Murder
In December 2022, EMS workers responding to a 911 call strapped Earl Moore Jr. face-down to a stretcher. He died from positional asphyxia. Prosecutors charged both responders with first-degree murder in January 2023. Bodycam footage was central to the case. Read More Watch Video