The addition of a second helicopter ambulance service in Benton and Washington counties will require more coordination among emergency services and could complicate residents’ plans regarding membership programs, officials say.
On March 1 5, Mercy Northwest Arkansas in Rogers joined Northwest Arkansas Medical Center-Springdale as the second area hospital to provide a home base for an air ambulance. Each hospital has a dedicated helicopter operated by an outside company, along with a helipad and quarters for their respective on-call flight crews.
Mercy Medflight is part of a joint venture between the Rogers hospital in Benton County and Air Methods Corp. of Englewood, Colo., a publicly traded company. Air Evac Lifeteam, the brand for a service operated by Missouri-based Air Evac EMS Inc., has served Northwest Arkansas from its base at Northwest Medical Center-Springdale since May 1991.
Julie Heavrin, Air Evac’s public-relations manager, said the Northwest Arkansas community will benefit from having two air ambulance providers.
“That area is growing dramatically,” she said.
Those familiar with the way helicopter ambulances are dispatched said it’s usually the call of a ground ambulance crew at an emergency scene as to whether a helicopter is needed. The ground crew determines whether the helicopter is medically necessary, weighing factors such as whether it is needed to save life or limb or prevent permanent disability.
Jeff Tabor, program director for the statewide Trauma-Comm, said that paramedics or other emergency medical technicians make the decision to call for air support “99.9 percent of the time.” TraumaComm is the nickname for the Arkansas Trauma Communications Center in Little Rock, which began coordinating emergency room traffic for the state’s new trauma system in January 2011.
The system’s call center aims to route ambulances to the nearest hospital that has the best capabilities to treat the patient at the time. But it usually leaves the dispatching of ground ambulances as well as the option of calling a chopper up to local 911 centers, rural fire departments, or other dispatching agencies, Tabor said.
“The only thing we may do - if we recommend a hospital that is quite some distance, we may ask the ground crew: ‘Do you want to rendezvous with a helicopter somewhere along the way?’” Tabor said.
Benton County’s 911 center is writing protocol to guide dispatchers’ decisions about whether to call Air Evac or the new Mercy Medflight service.
“Those are currently some things we are working through,” said Marshal R. Watson, Benton County’s administrator of public safety. “One of the issues we face is, we are obligated to send the closest appropriate unit.”
As part of this, his Public Safety Division has divided the county into “response zones,” he said. “What we’re working on now is who will constitute the first-out unit for specific portions of the county.”
Each zone would be assigned one of the two helicopter services, based on factors such as proximity. If the first service couldn’t respond, the second service would be contacted, Watson said. If both were tied up, choppers based in places such as Branson, Springfield, Mo., Joplin, Mo., or Tahlequah, Okla., could be next.
“These two providers pretty well saturate what we call the ‘four-corners’ area,” Watson said of Air Evac and Air Methods and the states of Arkansas, Missouri, Oklahoma and Kansas.
PREVIOUS PROTOCOLS
It’s not the area’s first time having two air ambulance providers.
In May 2005, EagleMed, a helicopter ambulance service out of Wichita, Kan., set up base at the Bentonville Municipal Airport, prompting the same rewriting of dispatch protocol.
Watson estimated that EagleMed left the area roughly a year after it arrived.
“We certainly are looking at the maps we utilized when EagleMed came in,” Watson said. “It does lay some preliminary groundwork for us.”
Until the protocol is completed, Benton County will have its crews choose an air service for dispatching.
“Based on the nature of the call, our dispatchers do have the ability to go ahead and contact an aeromedical provider to put them on standby,” Watson said.
The trauma system’s Tabor said that although anyone could call for a helicopter ambulance - the patient’s companion, a passer-by, or police - he recommends calling 911 in any emergency.
Weather conditions, mechanical problems or involvement in another emergency case all could mean a helicopter is delayed or unavailable. A ground ambulance crewcan begin stabilizing a patient and is better equipped to decide whether air support is needed, Tabor said.
Coordination is important generally because there is overlap in the service areas of air ambulance services, and there are numerous helicopters based throughout Arkansas and nearby states.
Air Methods will go “anywhere from a 75- to 150-mile radius from the [Rogers] base,” said Matt Kasten, an official with the company, after the March 15 event in which Mercy announced its new service.
For Northwest Arkansas, Mercy-Springfield in Missouri, roughly 100 miles to the north, is the nearest Level 1 trauma center participating in Arkansas’ statewide trauma system. Kasten puts the low end of the range on his estimate because “there’s such a saturation of air helicopters now” in the multistate region.
Air Evac’s Springdale base is a half-hour flight away from points that include the Harrison area, Barling in the Fort Smith area, the Joplin area of Missouri and Locust Grove, Okla., according to a radius map on its website.
MEMBERSHIP MATTERS
With overlapping services, area residents can find the solicitations for air ambulances’ annual memberships confusing, particularly where they’ve been used to having just one service available, the emergency officials said.
The helicopter services sell the memberships to individuals, families, businesses and schools at varying rates. The memberships generally cover whatever cost an individual’s insurance doesn’t cover.
Both services recommend checking with insurance carriers to see what percentage of a flight’s costs a policy will cover, and to keep in mind that even if the policy reads “100 percent coverage,” this applies only to the amount the insurer agrees was medically warranted.
“Just because you have a membership does not mean you’re not going to get a bill,” Tabor said. If the insurer deems the flight itself was medically unnecessary, “you’re going to get the whole bill.”
Tabor suggested that anyone considering a membership weigh it carefully.
In markets with more than one provider, he said: “What if the other one, the one you have a membership for, is out on a call? The other one is not going to honor it.”
Laws and regulations prevent one service from honoring another’s membership, Air Methods’ Kasten and Air Evac’s Heavrin said.
The expense of an air ambulance is an incentive to buy a membership, even though the chances of ever needing one are slim.
“Oh, thousands,” Tabor said when asked what a flight typically costs. “I would say $12,000, being a very low number, to $25,000.”
Heavrin estimated the cost at about $20,000, adding that many variables affect cost, including distance and time traveled.
Ideally, the ground crew, dispatchers and the service itself will try to limit flights to those truly in need, Tabor said.
Heavrin said she hopes dispatchers will consider patients’ memberships with both Air Evac and Air Methods whenever possible.
“I think it’s important for all the emergency services to keep one thing in mind: The best interests of the patient,” she said. “Whether that’s life-saving care, or financial.”
Northwest Arkansas, Pages 7 on 03/25/2013