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Lifeguard: An alternative method for aeromedical helicopter finance
Progran~ Profile
Lifeguard: An Alternative Method for Aeromedical Helicopter Finance by Craig L. Manly
Pendleton Fire Department EMT's provide service for both ambulance and helicopter, each stationed at the Fire Department.
Lifeguard Medical Transport is a non-profit air ambulance corporation based in Pendleton, Oregon. Lifeguard serves the eastern O r e g o n and southeast Washington area, providing helicopter and fixed wing ambulance service similar in structure and operation to hospital-sponsored services t h r o u g h o u t the country. It is one of the few successful dedicated helicopter services which does not rely on the hospital for financial support. As such, it is incomparable 14
HOSPITAL AVIATION, JANUARY 1985
with other aeromedical operations in the United States today. In the marketing and administration of hospital-based air ambulance programs, there seems to be a natural evolution from concept to i m p l e m e n t a t i o n and on t h r o u g h maturity. Usually within the hospital there is a champion, a flag carrier, developing the r u d i m e n t a r y stages of the program. He or she p r o m o t e s and attempts to popularize the helicopter idea to the hospital governing body.
This person often is a physician a n d usually serves as the e m e r g e n c y r o o m doctor. Typically there is strong inter-city or inter-county hospital rivalry. The c h a m p i o n k n o w s the occupancy rate of his hospital is d o w n and the competing hospital has just hired a new n e u r o s u r g e o n and is b u y i n g n e w equipment. At this point the idea of a helicopter, with all of its mystique and charisma, is a logical counter p u n c h . In the final stages of hospital
Program a p p r o v a l the hospital administrator m a y be the last p e r s o n to look at the helicopter decision logically a n d with little bias. After all the preliminary h o o p l a of feasibility studies, certificate of n e e d a n d hospital approval, the a d m i n i s t r a t o r decides to go with the p r o g r a m . If the p r o g r a m is a success, t h e n all are h a p p y . If the helicopter p r o v e s to be a financial b u r d e n , the p r o g r a m m a y continue to operate u n d e r the w o e s a n d i n n u e n d o e s of " w e s h o u l d n e v e r h a v e
...
gaining m o m e n t u m a n d popularity. At the e n d of the trial period it was obvious that patient r e v e n u e could not s u p p o r t a helicopter air a m b u l a n c e service on our p o p u l a t i o n base. It w a s also obvious no hospital in the region w a s large e n o u g h to carry the financial obligation of a helicopter, nevertheless, the Fire D e p a r t m e n t h a d s h o w n the service w a s n e e d e d . Therefore, a c a m p a i g n was l a u n c h e d b y the P e n d l e t o n Fire D e p a r t m e n t to gather s u p p o r t for a
The Lifeguard h e l i c o p t e r is a w e l c o m e sight when it appears at a remote recreational accident,
gotten into this." a far different scenerio u n f o l d e d in n o r t h e a s t Oregon, however. The citizens of P e n d l e t o n , O r e g o n or, m o r e correctly, Umatilla C o u n t y , felt the n e e d for a helicopter ambulance. Ron Campbell, Fire Marshall for P e n d l e t o n Fire D e p a r t m e n t , s p e a r h e a d e d the m o v e m e n t for the helicopter p r o g r a m . After r e v i e w i n g resources a n d possible alternatives, it was decided to operate out of the city of P e n d l e t o n Fire D e p a r t m e n t a n d to staff the p r o g r a m with existing fire d e p a r t m e n t EMT's. Lifeguard started out in June of 1981 as an a g r e e m e n t with the current helicopter contractor a n d the P e n d l e t o n Fire D e p a r t m e n t . The a g r e e m e n t w a s to operate a medically c o n f i g u r e d helicopter by the h o u r for a sixty day trial period. Lifeguard s a v e d several lives d u r i n g that period,
Profile
e v e r y o n e contributed, i.e., EMT's, c o m p e t i n g hospitals, local business, etc. 100 % of the tax levy goes for the helicopter contract. 30 % of patient r e v e n u e goes to St. A n t h o n y ' s for billing a n d 65 % of patient r e v e n u e goes to the helicopter contractor. This leaves 5 % for Lifeguard to use for office space, marketing, etc. Lifeguard is a n o n - p r o f i t corporation a n d it is s t r u c t u r e d to m e e t its financial c o m m i t m e n t s a n d not h a v e large s u m s of m o n e y in the bank.
The wide-open spaces o f eastern Oregon are served best by helicopter, and P e n d l e t o n ' s Lifeguard fills the bill.
tax levy to o p e r a t e the helicopter. The g o v e r n i n g b o d y of Umatilla C o u n t y is a b o a r d of three c o m m i s s i o n e r s . The c o m m i s s i o n e r s h a d strong feelings concerning the helicopter. T h e y were c o n v i n c e d the helicopter w a s a frill a n d not n e e d e d during this d e p r e s s e d e c o n o m y . A list of p r e s s i n g c o u n t y affairs required attention a n d the c o m m i s s i o n e r s could only p u t t h e m in order, a d d r e s s i n g t h e m one at a time. Naturally, the helicopter was low on the list. The c o m m i s s i o n e r s allowed the levy to be placed on the ballot, d e t a c h e d f r o m the c o u n t y ' s a n n u a l budget. The voters p a s s e d the issue by an o v e r w h e l m i n g 80 percent a n d established a levy s u p p o r t i n g the helicopter p r o g r a m . The levy is for three years. L i f e g u a r d ' s t r a n s p o r t charge is a $200 lift off fee a n d $4.50 per mile. The b e a u t y of the p r o g r a m is that
W h e n on duty, EMT's stand b y for fire calls, a m b u l a n c e calls a n d a n y r e s p o n s e n e e d e d for the helicopter. G e n e r o u s l y , in their off time, t h e y w e n t to various t o w n s p r o m o t i n g the helicopter. At this point, the p r o g r a m is healthy a n d is increasing its service. Plans are b e i n g m a d e to incorporate other counties in our service area for a d d e d financial s u p p o r t . The other counties in the region a p p e a r to h a v e the s a m e degree of high interest in the helicopter p r o g r a m . Most people in eastern O r e g o n feel the helicopter a m b u l a n c e is a n o t h e r form of health insurance a n d the m o n e y for s u p p o r t is a g o o d i n v e s t m e n t . This is truly a p r o g r a m for the p e o p l e a n d s u p p o r t e d by the people. A n y p e r s o n in our service area can pick u p the t e l e p h o n e a n d call Lifeguard. Lifeguard will be airborne in five m i n u t e s to a n s w e r the call. HOSPITAL AVIATION, JANUARY 1985 15
S h o u l d the helicopter not be n e e d e d u p o n arrival at the scene, there is no charge to the caller. The cancellation rate is usually small for Lifeguard. The a d v a n t a g e of leaving the option for a n y o n e to call has not b e e n abused. Our d o c u m e n t a t i o n shows that no insurance carrier has refused p a y m e n t due to the call being inappropriate. Lifeguard does not bill for DOA's which, by contract, is the b u r d e n of the helicopter contractor. M a n y scene flights are in conjunction with an ambulance e n r o u t e or at the scene. Lifeguard has t r a n s p o r t e d in almost e v e r y circumstance w h e n called, D O A being the exception. The majority of calls for on-scene flights have b e e n lumber related accidents, car accidents, or farming injuries. During our last fiscal year, July 1, 1983 t h r o u g h June 30, 1984, the Lifeguard helicopter t r a n s p o r t e d 219 patients. During that period 34% of the flights were scene flights. Lifeguard was unable to r e s p o n d to 32 calls, 19 flights were cancelled because of the weather. The r e m a i n d e r of the missed call r e s p o n s e s was due to the fact that the helicopter was already on call. Our average one way distance is 75 miles. Helicopter service is p r o v i d e d by Rambling Rotors of L a G r a n d e , Oregon. Our fixed wing service has b e e n in effect for nine m o n t h s and we are currently averaging 14 flights a m o n t h . St. Mary's Hospital of Walla Walla, W a s h i n g t o n carries the financial b u r d e n for the fixed wing and does the patient billing. The fixed wing is based in Walla Walla, Washington, and is o p e r a t e d by Sun West Aviation of Ogden, Utah. St. Mary's e n t e r e d into this a g r e e m e n t with Lifeguard as a form of s u p p o r t or contribution for a complete air a m b u l a n c e program. You see, e v e r y o n e pitched in and gave what they could. As I stated earlier, Lifeguard is incomparable with any other helicopter ambulance service in the United States. Where else have the people rallied, b y p a s s e d the existing g o v e r n m e n t , and written in s u p p o r t for a helicopter program? T h a n k s to our public s u p p o r t in the American tradition, we have a helicopter air ambulance service. Equally important, the service has a positive future.
Craig Manley is Executive Director for Lifeguard in Pendleton, Oregon. 16 HOSPITAL AVIATION, JANUARY 1985
Lifeguard: An Alternative Method for Aeromedical Helicopter Finance by Craig L. Manly
Pendleton Fire Department EMT's provide service for both ambulance and helicopter, each stationed at the Fire Department.
Lifeguard Medical Transport is a non-profit air ambulance corporation based in Pendleton, Oregon. Lifeguard serves the eastern O r e g o n and southeast Washington area, providing helicopter and fixed wing ambulance service similar in structure and operation to hospital-sponsored services t h r o u g h o u t the country. It is one of the few successful dedicated helicopter services which does not rely on the hospital for financial support. As such, it is incomparable 14
HOSPITAL AVIATION, JANUARY 1985
with other aeromedical operations in the United States today. In the marketing and administration of hospital-based air ambulance programs, there seems to be a natural evolution from concept to i m p l e m e n t a t i o n and on t h r o u g h maturity. Usually within the hospital there is a champion, a flag carrier, developing the r u d i m e n t a r y stages of the program. He or she p r o m o t e s and attempts to popularize the helicopter idea to the hospital governing body.
This person often is a physician a n d usually serves as the e m e r g e n c y r o o m doctor. Typically there is strong inter-city or inter-county hospital rivalry. The c h a m p i o n k n o w s the occupancy rate of his hospital is d o w n and the competing hospital has just hired a new n e u r o s u r g e o n and is b u y i n g n e w equipment. At this point the idea of a helicopter, with all of its mystique and charisma, is a logical counter p u n c h . In the final stages of hospital
Program a p p r o v a l the hospital administrator m a y be the last p e r s o n to look at the helicopter decision logically a n d with little bias. After all the preliminary h o o p l a of feasibility studies, certificate of n e e d a n d hospital approval, the a d m i n i s t r a t o r decides to go with the p r o g r a m . If the p r o g r a m is a success, t h e n all are h a p p y . If the helicopter p r o v e s to be a financial b u r d e n , the p r o g r a m m a y continue to operate u n d e r the w o e s a n d i n n u e n d o e s of " w e s h o u l d n e v e r h a v e
...
gaining m o m e n t u m a n d popularity. At the e n d of the trial period it was obvious that patient r e v e n u e could not s u p p o r t a helicopter air a m b u l a n c e service on our p o p u l a t i o n base. It w a s also obvious no hospital in the region w a s large e n o u g h to carry the financial obligation of a helicopter, nevertheless, the Fire D e p a r t m e n t h a d s h o w n the service w a s n e e d e d . Therefore, a c a m p a i g n was l a u n c h e d b y the P e n d l e t o n Fire D e p a r t m e n t to gather s u p p o r t for a
The Lifeguard h e l i c o p t e r is a w e l c o m e sight when it appears at a remote recreational accident,
gotten into this." a far different scenerio u n f o l d e d in n o r t h e a s t Oregon, however. The citizens of P e n d l e t o n , O r e g o n or, m o r e correctly, Umatilla C o u n t y , felt the n e e d for a helicopter ambulance. Ron Campbell, Fire Marshall for P e n d l e t o n Fire D e p a r t m e n t , s p e a r h e a d e d the m o v e m e n t for the helicopter p r o g r a m . After r e v i e w i n g resources a n d possible alternatives, it was decided to operate out of the city of P e n d l e t o n Fire D e p a r t m e n t a n d to staff the p r o g r a m with existing fire d e p a r t m e n t EMT's. Lifeguard started out in June of 1981 as an a g r e e m e n t with the current helicopter contractor a n d the P e n d l e t o n Fire D e p a r t m e n t . The a g r e e m e n t w a s to operate a medically c o n f i g u r e d helicopter by the h o u r for a sixty day trial period. Lifeguard s a v e d several lives d u r i n g that period,
Profile
e v e r y o n e contributed, i.e., EMT's, c o m p e t i n g hospitals, local business, etc. 100 % of the tax levy goes for the helicopter contract. 30 % of patient r e v e n u e goes to St. A n t h o n y ' s for billing a n d 65 % of patient r e v e n u e goes to the helicopter contractor. This leaves 5 % for Lifeguard to use for office space, marketing, etc. Lifeguard is a n o n - p r o f i t corporation a n d it is s t r u c t u r e d to m e e t its financial c o m m i t m e n t s a n d not h a v e large s u m s of m o n e y in the bank.
The wide-open spaces o f eastern Oregon are served best by helicopter, and P e n d l e t o n ' s Lifeguard fills the bill.
tax levy to o p e r a t e the helicopter. The g o v e r n i n g b o d y of Umatilla C o u n t y is a b o a r d of three c o m m i s s i o n e r s . The c o m m i s s i o n e r s h a d strong feelings concerning the helicopter. T h e y were c o n v i n c e d the helicopter w a s a frill a n d not n e e d e d during this d e p r e s s e d e c o n o m y . A list of p r e s s i n g c o u n t y affairs required attention a n d the c o m m i s s i o n e r s could only p u t t h e m in order, a d d r e s s i n g t h e m one at a time. Naturally, the helicopter was low on the list. The c o m m i s s i o n e r s allowed the levy to be placed on the ballot, d e t a c h e d f r o m the c o u n t y ' s a n n u a l budget. The voters p a s s e d the issue by an o v e r w h e l m i n g 80 percent a n d established a levy s u p p o r t i n g the helicopter p r o g r a m . The levy is for three years. L i f e g u a r d ' s t r a n s p o r t charge is a $200 lift off fee a n d $4.50 per mile. The b e a u t y of the p r o g r a m is that
W h e n on duty, EMT's stand b y for fire calls, a m b u l a n c e calls a n d a n y r e s p o n s e n e e d e d for the helicopter. G e n e r o u s l y , in their off time, t h e y w e n t to various t o w n s p r o m o t i n g the helicopter. At this point, the p r o g r a m is healthy a n d is increasing its service. Plans are b e i n g m a d e to incorporate other counties in our service area for a d d e d financial s u p p o r t . The other counties in the region a p p e a r to h a v e the s a m e degree of high interest in the helicopter p r o g r a m . Most people in eastern O r e g o n feel the helicopter a m b u l a n c e is a n o t h e r form of health insurance a n d the m o n e y for s u p p o r t is a g o o d i n v e s t m e n t . This is truly a p r o g r a m for the p e o p l e a n d s u p p o r t e d by the people. A n y p e r s o n in our service area can pick u p the t e l e p h o n e a n d call Lifeguard. Lifeguard will be airborne in five m i n u t e s to a n s w e r the call. HOSPITAL AVIATION, JANUARY 1985 15
S h o u l d the helicopter not be n e e d e d u p o n arrival at the scene, there is no charge to the caller. The cancellation rate is usually small for Lifeguard. The a d v a n t a g e of leaving the option for a n y o n e to call has not b e e n abused. Our d o c u m e n t a t i o n shows that no insurance carrier has refused p a y m e n t due to the call being inappropriate. Lifeguard does not bill for DOA's which, by contract, is the b u r d e n of the helicopter contractor. M a n y scene flights are in conjunction with an ambulance e n r o u t e or at the scene. Lifeguard has t r a n s p o r t e d in almost e v e r y circumstance w h e n called, D O A being the exception. The majority of calls for on-scene flights have b e e n lumber related accidents, car accidents, or farming injuries. During our last fiscal year, July 1, 1983 t h r o u g h June 30, 1984, the Lifeguard helicopter t r a n s p o r t e d 219 patients. During that period 34% of the flights were scene flights. Lifeguard was unable to r e s p o n d to 32 calls, 19 flights were cancelled because of the weather. The r e m a i n d e r of the missed call r e s p o n s e s was due to the fact that the helicopter was already on call. Our average one way distance is 75 miles. Helicopter service is p r o v i d e d by Rambling Rotors of L a G r a n d e , Oregon. Our fixed wing service has b e e n in effect for nine m o n t h s and we are currently averaging 14 flights a m o n t h . St. Mary's Hospital of Walla Walla, W a s h i n g t o n carries the financial b u r d e n for the fixed wing and does the patient billing. The fixed wing is based in Walla Walla, Washington, and is o p e r a t e d by Sun West Aviation of Ogden, Utah. St. Mary's e n t e r e d into this a g r e e m e n t with Lifeguard as a form of s u p p o r t or contribution for a complete air a m b u l a n c e program. You see, e v e r y o n e pitched in and gave what they could. As I stated earlier, Lifeguard is incomparable with any other helicopter ambulance service in the United States. Where else have the people rallied, b y p a s s e d the existing g o v e r n m e n t , and written in s u p p o r t for a helicopter program? T h a n k s to our public s u p p o r t in the American tradition, we have a helicopter air ambulance service. Equally important, the service has a positive future.
Craig Manley is Executive Director for Lifeguard in Pendleton, Oregon. 16 HOSPITAL AVIATION, JANUARY 1985