University of Vermont Medical Center Argues Air Ambulance Proposal Doesn't Need Review

The University of Vermont Medical Center wants to bypass state regulators as it seeks to expand air ambulance service.

The hospital on December 14 sent a letter to the Green Mountain Care Board arguing that its proposal should not trigger a permit review. The letter specifically seeks a "non-jurisdictional" ruling from the board to affirm that it agrees with the hospital's interpretation of the law.

The board has not responded or discussed the request but will do so within 30 days, board spokesman Conor Kennedy said Tuesday.

Under the proposal, a medical helicopter would be permanently based in the Burlington area for the first time. UVM flight nurses, paramedics and a physician would staff the air ambulance under an expanded agreement with the Dartmouth-Hitchcock Advanced Response Team (DHART).

The operation already flies to the hospital helipad off East Avenue but does not keep a helicopter there or at the Burlington International Airport. It instead is based at the Dartmouth-Hitchcock medical center in Lebanon, N.H. 

UVM hospital execs, meanwhile, want more air rescue capacity to serve patients in its growing six-hospital network across Vermont and New York. The three-hour drive from Massena, N.Y., to Burlington would take about 35 minutes via helicopter, for example.

Burlington attorney Tristram Coffin, writing to the GMCB on behalf of the UVM Medical Center, noted that DHART has continuously operated a Vermont air ambulance service for almost 20 years under a 1998 state permit.

The increase in service does not constitute a new health care project on its own and therefore does not trigger a certificate of need review with the state, Coffin contended. 

He also argued that recent case law suggests the expansion might be exempt from a new review under a federal preemption provision of the Airline Deregulation Act.

The letter outlines only limited details about the expansion with DHART, which would manage and bill for the additional service. DHART would also be responsible for ensuring the aircraft is properly provisioned.

The UVM flight crew would be under contract with DHART. It's unclear what the costs per hour would be. No financials are included in the letter. 

UVM Medical Center executives declined to comment Tuesday.  

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