Private medevac copters hit skies

topic posted Wed, April 26, 2006 - 6:26 PM by  Rip............

More expensive services boosting flights provided by State Police

Wednesday, April 26, 2006
BY RALPH R. ORTEGA, Star-Ledger Staff

For two decades, the only medevac helicopters in New Jersey skies were
run by the State Police, and the service was partially funded by motor
vehicle surcharges.

But in the past year, three private hospital medevac programs have
flight, lifting patients from highway accident scenes and other
emergencies and transporting them to the state's trauma centers.

And while the last thing someone in a life-threatening situation may be
thinking about is money, there comes a time when the bill comes due.
state charges a flat rate of $1,337 per call. The private helicopter
services can charge thousands more.

"This is about saving lives, but it's also about making money," said
Matt Topper, an air medical transport operator who sued the state two
years ago for the right to fly in New Jersey and paved the way for the
licensing of in-state commercial medevac programs.

The state issued the first private license to Atlantic City Medical
Center and its affiliates (University Medevac) last July, and the
in February to Morristown Memorial Hospital (PHI) and its partners,
Overlook Hospital in Summit and Mountainside Hospital in Montclair.

The third, Monmouth-Ocean Hospital Service Corp., (PHI also) received a
final inspection for its license from the state on April 6.

The commercial operators answer to state health officials, who jointly
run the state medevac program with the State Police, who make about
1,600 runs a year.


The state's medevac program was created by the Legislature in 1988 in
response to a growing need for quick transportation from the state's
highway and emerging suburban population centers to the trauma centers.

For years, state officials relied almost exclusively on the State
medevac program, which runs a helicopter out of Bedminster in Somerset
County, and one out of Voorhees in Camden County.

"They were handling all the calls, and needs of the state," Assistant
State Health Commissioner David Gruber said.

The only commercial services that had been licensed to work in New
Jersey were from out of state. Under mutual-aid agreements, services
from Pennsylvania and Delaware responded to calls when State Police
medevac helicopters were unavailable, or when the commercial services
could respond faster to far west and southern parts of the state.

Topper, owner of Air Ambulance Express at Trenton-Mercer Airport, and
which uses only planes, said he discovered a double standard in the
state's policies when he applied for a license to fly helicopters in
April 2004.

State health officials turned down Topper, he said, because no system
was in place to license New Jersey-based air ambulances. "At that point
we were not accepting outside air ambulance services," Gruber said.

"They had locked out anybody who wanted to do it in-state, to protect
their own interests," said Topper. He sued the state a month later.

The case spent a year in state appellate court and concluded when state
officials drafted new regulations for licensing New Jersey-based air

The state required commercial operators to be affiliated with a
state-certified "Mobile Intensive Care Unit," which provide
pre-hospital, advanced life support care, and to be affiliated New
Jersey trauma centers.

Topper could not meet those requirements and withdrew his application
after his partners backed out. "We missed a tremendous opportunity,"
Topper said.


Rates for private air transport are determined by insurance contracts,
or by the federal government for Medicare and Medicaid patients. Vince
Robbins, president and chief of operations at MONOC, which began flying
emergency calls out of Trenton-Mercer Airport, estimated the average
private air ambulance service bill to uninsured patients was about

Robbins said MONOC was sensitive to billing rates, especially with
patients who cannot pay.

"They're the ones we try to be careful about, because we know they
have the money to pay some of these charges," he said. "When patients
work with us, and can identify they have financial problems, we
dramatically reduce the bill."

Abigail Meisel, a spokeswoman for Morristown Memorial Hospital, would
not release billing information, but in an e-mail said: "We transport
people regardless of their ability to pay. We do not release a specific
number because we would never want anyone who needed the service to
refuse it based on cost."

State officials, meanwhile, have no plans to cut the State Police
service now that private carriers are allowed, Gruber said. In fact, it
plans to expand.

The program has had of a spotless safety record and is "well below what
any commercial service charges," said Gruber. "We believe we owe the
service to the people of New Jersey."

The state program serves 1,600 patients annually, according to state
budget records, and spent $5.7 million last year on salaries, fuel and
other costs.

A $1 surcharge on 7.4 million state motor vehicle registrations had
funded the program since the early 1990s. In July, the motor vehicle
surcharges will increase to $3 to give the program its first-ever
The increased funding will cover maintenance and the proposed purchase
of five new twin engine aircraft, according to State Police.

State officials also warned against giving up control of the program,
describing "air wars" in Pennsylvania between competing air ambulances
that race each other to calls.

The National Transportation Safety Board in January had also seen a
spike in air ambulance accidents due to a lack of training and some
safety oversights. New Jersey officials decide who gets the call based
on proximity and availability.

MONOC's helicopter and flight crew is supplied by an outside
PHI of Louisiana, which runs a risk assessment before each flight
addressing the federal concerns, said lead pilot Al Kasakowski. PHI is
also used by Morristown Memorial.

Kasakowski insisted there was no competition with other services, or
rivalry with the state. "We're here to serve the community, that's the
bottom line," he said.

Capt. Albert Della Fave, a State Police spokesman, welcomed the support
of the commercial operators.

"In cases where we need the help it's good to have them there," Della
Fave said. "When it comes to saving lives, whether it's our ship, or
someone else's, getting people to the hospital within that critical
window is what's important."

Ralph R. Ortega may be reached at or (908)
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