Sunday, August 18, 2013

Sheriff ponders air ambulance service: Citrus County, Florida

Citrus County officials are exploring the idea of providing an air medical transport service by converting the sheriff’s office’s 2006 helicopter so it could fly patients to trauma hospitals.

The idea, they say, is twofold:

+ One, it would significantly reduce the exorbitant cost patients are saddled with when they are flown by private air services to trauma hospitals in Tampa or Gainesville.

+ Two, a Citrus County service could be a revenue source for the county.

Sheriff Jeff Dawsy said talks are in the early stage.

“There are no estimates of costs yet,” he said. “All I’m doing is going out and asking questions.”

Last month, Dawsy and his two top fire commanders, along with County Administrator Brad Thorpe, County Attorney Richard Wesch and commission Chairman Joe Meek, spent parts of three days with officials in Broward County reviewing their medical flight program.

Dawsy said he will make a similar trip to Volusia County, which also offers medical air transports through its sheriff’s helicopters.

Meek said he, Thorpe and Wesch accompanied Dawsy on the Broward trip to see how the program could work first-hand.

“The potential is very big,” Meek said. “Now it’s up to us to do the due diligence.”

Nature Coast EMS Chief Executive Officer Mike Hall said his agency is looking to partner with the sheriff’s office, should the program be implemented.

“We’re not-for-profit, the sheriff is not-for-profit. We can partner together,” Hall said. “We can do it more economically if it’s locally controlled.”

Private service fees ‘astronomical’

Dawsy said he got the idea after reading a 2012 Chronicle story about parents stuck with a $17,000 bill from a medical air company for flying their son to a trauma center.

“It was an astronomical rate. I wondered if I could do it cheaper,” he said.

Most medical flights in the region are provided by Colorado-based Air Methods Corp., which partners with trauma centers that provide air transport service, such as Tampa General Hospital and Shands Hospital in Gainesville.

The flights are not inexpensive. Hall said Air Methods’ charges can exceed $20,000, with insurance covering about $5,000.

A Google search for Air Methods found news stories across the country of families charged thousands of dollars for medical flights. In nearly every instance — including the Citrus County case — Air Methods and the patient’s family settled for a much lower amount or the portion not covered by insurance was eliminated entirely.

About 25 to 30 patients are flown from Citrus County each month to trauma hospitals, Dawsy said. Some are transfers from Citrus Memorial Health System or Seven Rivers Regional Medical Center. Others are victims of traffic accidents or assaults, with head injuries, concussions or internal injuries.

Hall said that, regardless of which hospital the helicopter is affiliated with, patients in most cases are flown to the closest trauma center. For years, that meant Gainesville or Tampa. In the past two years, trauma centers have opened at Bayonet Point in Hudson and at Ocala Regional Medical Center.

From 2001-08, Aeromed, out of Tampa General, stationed a helicopter and full-time flight crew at the Inverness Airport. In 2008 the company, citing the need for additional flights, moved its operation to Wildwood.

Hall said he believes Aeromed is leaving Wildwood, as well.

That makes a Citrus County medical flight program even more practical, he said.

“I think we can do it more cost-effectively,” he said. “We could provide better service at a better cost.”

Helicopter would have dual purpose

Because the sheriff’s helicopter, purchased in 2006 at a cost of $2.4 million, would still be used for law enforcement duties, paramedics and sheriff’s flight personnel would be cross-trained, Dawsy and Hall said.

Getting the helicopter retrofitted to fly as an air ambulance — or leasing another helicopter altogether — is another story.

“We’ve got to figure out how much it costs to get a helicopter ready,” Hall said. “That’s the biggest expense to this whole thing.”

Dawsy said he hasn’t begun the task of determining that cost because he is still exploring the idea in general.

Then there’s another, broader, matter. Dawsy wants to make sure the medical transport doesn’t take away his helicopter’s initial purpose: Law enforcement.

“That’s one of the things I’m still toying with,” he said.

A medical transport would not leave the county without a helicopter. Dawsy’s backup is a Vietnam-era helicopter that could fly at a moment’s notice.

Dawsy learned from the Broward trip that the sheriff’s helicopter is large enough to accompany a medical retrofit.

But he also said the Broward situation is much different. Broward has three trauma centers in-county — Citrus has none — and the Broward sheriff’s office has five helicopters.

Coincidentally, Broward is also the county that gave Dawsy the prototype for bringing fire services from the county commission to under his control.

Dawsy said he hopes to have a decision by the end of the year whether to move forward with the helicopter plan.

“We’re being very methodical about it,” he said.

Meek said he sees the program significantly reducing patient costs while providing a revenue source for the county.

“It’s up in the air right now,” he said. “If there’s any potential to offset some costs and at the same time lower the cost for people who need it, it’s a no-brainer to see if it’ll work.”