RE: [texasems-L]

February 12, 2008

We are so very sorry for the loss of Mr. O'Neal. Please tell his family that

his EMS family will be thinking of them.

Jane Dinsmore

To: texasems-l@...: pwilliams@...: Tue, 12 Feb 2008

21:32:48 -0600Subject:

We are saddened to learn that Paramedic " Rick " Hunter O'Neal,60, of

Waco, passed away Saturday, Feb. 9, 2008,. A memorial servicewill be 2 p.m.

Wednesday at the Bridge City Fire Department in BridgeCity, Texas. Burial will

be at the Orange Grove Grace Land Cemetery inLake , La. He was a

paramedic for the Former Orange CountyAmbulance Service, Acadian Ambulance

Service and Hillcrest Hospital.Please keep his family in your thoughts and

prayers.PolliPolli , RN/LP pwilliams@...

February 12, 2008

Losses to one in EMS are a loss to all in EMS.

Condolences to all that knew him

LNM

Sent via BlackBerry by AT & T

We are saddened to learn that Paramedic " Rick " Hunter O'Neal,60, of

Waco, passed away Saturday, Feb. 9, 2008,. A memorial servicewill be 2 p.m.

Wednesday at the Bridge City Fire Department in BridgeCity, Texas. Burial will

be at the Orange Grove Grace Land Cemetery inLake , La. He was a

paramedic for the Former Orange CountyAmbulance Service, Acadian Ambulance

Service and Hillcrest Hospital.Please keep his family in your thoughts and

prayers.PolliPolli , RN/LP pwilliams@...

February 12, 2008

Sent via BlackBerry by AT & T

We are saddened to learn that Paramedic " Rick " Hunter O'Neal,60, of

Waco, passed away Saturday, Feb. 9, 2008,. A memorial servicewill be 2 p.m.

Wednesday at the Bridge City Fire Department in BridgeCity, Texas. Burial will

be at the Orange Grove Grace Land Cemetery inLake , La. He was a

paramedic for the Former Orange CountyAmbulance Service, Acadian Ambulance

Service and Hillcrest Hospital.Please keep his family in your thoughts and

prayers.PolliPolli , RN/LP pwilliams@...

March 30, 2008

The Texas Legislature is not about to levy a tax on automobile accidents, and

if it did, it certainly would not earmark it for EMS use. We have had some

trauma funding through taxes on fines that are always in jeopardy.

In short, Texas has no EMS constituency with any legislative clout. Funding

for Texas EMS has been relentlessly cut every legislative session in the last

10 years or more.

And, I surely would not want the DPS to be responsible for medic helicopters

anymore than I would want us to be responsible for traffic enforcement on the

interstate.

It is quite apparent to everyone except the persons who have an interest in

perpetuating their little kingdoms that the system is not cost effective, nor

is it medically effective.

Gene G.

>

> This was not a post to blast anyone. It is the over use of medevacs, not the

> need the concern many.

> I have been to Texas several times and I was amazed by the rural areas and I

> fell in love with the state because of the rural aspect. I can see where

> Texas has a need for medivacs, but the calls must be prioritized.

> I wouldn't go as far as saying your governor is to cheap to fund

> helicopters. You all have a General Assembly that makes the laws. land's

funding for

> the choppers comes from our Tag (vehicle registration) fees. It is called

> the EMSOF, Emergency Medical Services Operations Fund. Would the citizens of

> the Lonestar state be willing to pay $5 or $10 more dollars annually for

> registering their vehicles. I don't have a problem paying a user fee. MSP

doesn't

> charge anyone for transports, even visitors get a free ride. I do have a

> problem with someone calling the helicopters because it looks cool when we

shut

> down the highway.

> Voice your opinion and vote.

> Thanks again.

> Larry

>

> ____________ ________ ________ ________ ________ ________

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March 30, 2008

Larry;

Why don't some of you people show in Texas how to get a helicopter for areas

such as Presidio,Candelaria,Lajitas,and Redford. We sometimes have a hard time

getting them to come south of Highway 90 in our area.We get snakebites and a lot

of trauma to boot.Why don't you people think of lives saved instead of the

bottom line. I'd like a way to get us bird like that in Texas. Our governor is

too cheap fund EMS,let alone a chopper

Rabbiems

Look at beating up on our Medevacs in land. I must say that I have to

agree with him on this one as usual. Where did they catch you? In Baltimore at

JEMS? --

Larry W. Dodd, M.S., NREMT-P

Salisbury, land

lwd7734@...------------------------------------------

http://www.hometownannapolis.com/cgi-bin/read/2008/03_30-12/TOP Half of medevac

patients are not seriously injured

" see link for pic " W. Gillespie - The CapitalLocal and state workers prepare

for a flight from a recent accident scene. The Capital discovered that about

half of medevac patients in recent years are not seriously injured and are

released within 24 hours.By EARL KELLY, Staff WriterPublished March 30, 2008

When an Anne Arundel landscaper was caught in a stump grinder and a young woman

was thrown headfirst through her car windshield, their lives were saved by

land State Police medevac helicopters and the University of land Shock

Trauma Center.The system - considered by many the best medevac and trauma

treatment system in the nation - was designed precisely for their types of

massive, life-threatening injuries.

But in recent years, about half the patients transported by state police

helicopters to a trauma center are not seriously injured; they are treated for

nonlife-threatening injuries and released within 24 hours.

That has raised questions about whether the more than $20 million a year

taxpayers spend to keep the choppers flying so frequently is necessary or if

it's being used to bolster billing at the trauma center.

land is the only jurisdiction in the country where a state agency - the

state police - runs a comprehensive statewide medevac system financed by the

public. Other states rely on hospital-based commercial operators that bill

patients and their insurance companies. When patients don't have the resources,

the medevac operators swallow the expense.

A typical medevac bill runs about $10,000, sources said, depending on travel

distance and the geographic market.

The land State Police Department never bills for medevac flights, though

patients treated at trauma hospitals and the University of land Shock Trauma

Center do pay for their medical care.

" When you get a helicopter ride from us, you are not going to get a bill, you

ride free, " said Maj. A.M. Mc, commander of the land State Police

Aviation Command. " You get a ride in some other states with private companies,

you are going to pay, you are going to get a bill for $6,000 or more. "

The $20 million a year it costs to keep the choppers flying doesn't include the

roughly $139 million the state is looking to spend to replace its aging fleet of

12 Eurocopter Dauphin helicopters. (Some experts say the purchase price

ultimately will be closer to $200 million.)

The annual operating costs come mainly from a $13.50 registration fee charged

for each motor vehicle in the state, but state officials say this fund is

heading into the red and the fee may need to be increased in as little as four

years.Medevac experts said they can't think of a state where the public treasury

subsidizes medevac flights, though in some states, such as Florida, a few local

fire departments run air ambulance services. In New Jersey, the state police run

only two helicopters and the bulk of medevac missions are flown by commercial

operators and hospitals.

Some critics say land should follow these states' example and privatize

services, but the argument never gets off the ground.

Several members of the General Assembly said lawmakers get so much pressure from

state police and the group that oversees trauma care, the land Institute for

Emergency Medical Services Systems, that it's impossible to have an open

discussion about major changes to the existing system.

" We have some concerns about the system, and the public needs to know, " said

Sen. iel Exum, D-Prince 's, who sponsored a bill four years ago to

establish a medevac privatization pilot program.

" But we aren't even able to talk about it, " Mr. Exum said of the intense

lobbying pressure. " They (state police and the land Institute for Emergency

Medical Services) call all the little people back home, the firefighters and the

paramedics, and tell them we are trying to dismantle the system, and they come

running. " Mr. Exum said.

" The people who are running the program think it is their program, and they

don't want to recognize that it belongs to the people, " Mr. Exum said.

When told about lawmakers' perceptions, land State Police Secretary Col.

Terrence B. Sheridan laughed and said it was news to him.

" I have never heard that before and I don't know of any leader who has been

leaned on, " he said.

" If (a private person) out there wants to speak out on their own position, I

can't control that, " Col. Sheridan said.

Shock Trauma Center

land is the only state in the nation with a hospital - University of

land Shock Trauma Center - dedicated entirely to treating adult trauma

patients, according to Spearman, the center's vice president.

Besides the University of land Shock Trauma Center, there are eight other

hospitals around the state with trauma units, and still other hospitals that

specialize in areas of care such as eye injuries and burns.

Not counting these other hospitals, keeping the University of land Shock

Trauma Center's doors opens costs about $185 million a year, most of which is

paid for by patients and their insurance companies.

" It saves lives, no question about it, " Del. Bob Costa, a Republican from Deale,

said of the helicopter-hospital system.

But Mr. Costa, a career paramedic, said he agrees with the pilots, paramedics

and doctors who say the system is overused.

" It is a huge source of income, " said Mr. Costa, who explained that patients

with minor injuries help pay the hospital system's operating expenses.

The heads of the state trauma system say that treating people with minor

injuries is inevitable.

Patients cannot be screened properly until they have undergone a battery of

sophisticated tests, according to these officials, and those tests must be done

in a trauma center.

" We have said as a medical society 'We will overtriage, we will bring people

here who don't need to be here, rather than miss someone,' " said Dr. M.

Scalea, physician-in-chief at shock trauma center.

Shock trauma's Mr. Spearman said, " Your aorta could separate and it won't show

itself for two hours. But the moment it does choose to reveal itself, you are

dead within two minutes. "

Overkill

" It is overkill, " Dr. Bledsoe, a Dallas resident who writes about trauma

medicine nationwide, said of the land medevac-trauma center system.

Now a professor at the University of Nevada Medical School in Las Vegas, Dr.

Bledsoe taught until recently at Washington University Medical School in

Washington, D.C.

He said shock trauma care and medevac helicopters swept the medical world off

its feet about three decades ago, but the movement was " based on emotion and not

on science. "

" It started in land and Connecticut, " Dr. Bledsoe said. " It was a good idea,

but the situation just got crazy - the majority of patients transported by

helicopter don't benefit from it. "

A doctor who helped develop the land system, Dr. Clayton H. Shatney, said

the shock trauma center and state police helicopters were designed to be

overused.

Dr. Shatney worked with the center's founder, Dr. R Cowley, and taught

medicine at the University of land between 1979 and 1982. He went on to help

establish a trauma center in ville, Fla. and to teach trauma medicine in

California.

" Cowley wanted to keep shock trauma center full - the helicopters would fly over

(lower-level but adequate) hospitals and bring patients to shock trauma center, "

Dr. Shatney, now retired, said of the land system.

" Part of it is finance, " Dr. Shatney said. " If you can bring a steady stream of

(slightly injured) patients into the trauma center, it helps offset the care in

ICU, which is truly expensive. "

Dr. Shatney has studied the use of medevac helicopters in California, studying

transportation times and types of injuries, and concluded that only 23 percent

of patients benefitted from being flown.

He said he thought a study of land's helicopter and trauma care system would

produce similar results.

As for the cost of treating a minor injury (such as a broken arm) at a trauma

center, versus the cost of care at a community hospital such as Anne Arundel

Medical Center, Dr. Shatney said he has never been able to compute the

difference, but estimated it at " three to five times as much. "

After trying to conduct an analysis for The Capital, the state Health Services

Cost Review Commission concluded there are too many variables to compare the

cost of care at the two types of hospitals.

Dr. Shatney said trauma centers and helicopters are overused because the public

likes to believe these tools can work magic.

When asked if his report on overuse of helicopters in California resulted in a

decrease in the number of flights, he said, " Hell, no. "

Costly system

" What I like about the state program is whether you are the homeless man

crossing Interstate 95 or Trump, whose limo crashes on I-95, you will get

treated by MSP, " said veteran state police pilot Bill " Nitro " Bernard. " We build

stadiums for millionaires to play ball in, so why shouldn't we do this? "

But keeping helicopters flying is an expensive proposition.

It costs between $1,500 and $2,000 an hour to operate one of these helicopters,

medevac experts said, and that does not include fixed costs such as renting

hangars and paying crews. Just the fuel for one of the twin-engine land

State Police helicopters costs upwards of $400 an hour, state police officials

said.

Everything about a helicopter has to be made according to high - and costly -

standards. The Dauphin's engines weigh only about 300 pounds each, but produce

roughly 800 horsepower apiece. The four rotor blades weigh only 90 pounds each,

but together they hold the 9,000 pound helicopter in the air and transport

patients and crew at well over 150 mph. Replacing the four rotor blades costs

more than $400,000.

State police received a big vote of confidence last fall when the General

Assembly earmarked $110 million in sales taxes to go toward replacing the

existing helicopter fleet.

Lawmakers agreed to the expense during a special legislative session called to

address a budget shortfall by raising taxes and cutting spending.

State audit

There have been claims of mismanagement in the land State Police Aviation

Command. The General Assembly's Joint Audit Committee, which consists of 10

senators and 10 delegates, has asked the nonpartisan Department of Legislative

Services to audit the unit's operations.

The audit is to determine if state helicopters are used frivolously or " beyond

operational purposes, " Department of Legislative Services Chief Auditor Bruce A.

Myers said, and to see if patients are transported in a timely manner.

While Mr. Myers declined to discuss his findings so far, a pilot's personal

notes obtained by The Capital show that state police helicopters sometimes are

used for missions that have little or nothing to do with saving lives or

protecting the public.

" Trooper 8 (the helicopter based in Montgomery County) overflew the (accident)

scene and the mission was given to Trooper 2 (from s Air Force Base), who

transported a Priority 1 intubated patient. Why? Trooper 8 was dedicated to a

demo at the hangar for 13 kindergartners, " the pilot's notes stated.

Another time this pilot wrote, " After being out of service for three days due to

aircraft maintenance and inspections, Trooper 8's first mission was to attend a

dinner party demonstration at the Elkridge Furnace Inn. "

Auditors have had a difficult time getting documents from the land State

Police Department, according to some members of the General Assembly, but Mr.

Myers said the audit will be completed by early summer.

The report will not look at whether state police transport too many patients who

have only minor injuries.

Standard of care

Commercial medevac operators say they not only would save taxpayers money, but

would provide better service.

Under state licensing requirements, state police helicopters are required to

carry only a pilot and one flight paramedic, while commercial operators must

carry a pilot and two medical providers, typically a paramedic and a registered

nurse.

Currently, when a patient's condition necessitates a second caregiver, the state

police flight paramedic will recruit a member of the local ground crew at the

accident scene, who may be a professional or a volunteer.

Critics of the current system also stress that response time would not suffer

because of privatization.

" If you had eight commercial helicopters in the same eight places MSP has

helicopters, you would have the very same function, " said Ed Rupert, vice

president of Colorado-based Air Methods Inc.

Air Methods is publicly traded and is the world's largest air ambulance service

with 345 helicopters and 20 airplanes. Mr. Rupert's office is on Kent Island,

and he is responsible for operations in an area that extends from Virginia to

New England, and from Delaware to Michigan. But, Mr. Rupert said, Air Methods

does not base helicopters in land.

Commercial medevac operators do fly missions in land, mainly transferring

patients between hospitals.

These helicopters are almost never called to accident scenes.

Under state guidelines, if a state police helicopter is within 25 minutes'

flight time from a trauma scene and a privately-owned medevac is 10 minutes

away, the state chopper gets the call - and that call comes from the land

State Police dispatcher working out of the land Institute for Emergency

Medical Services Systems building in Baltimore.

" We're usually on the L(anding) Z(one) and waiting for the patient, " said

Trooper First Class , a flight paramedic stationed at the

State Airport hangar east of Baltimore.

He gave the following example of a typical call: " We have a 20-minute flight

time to Cecil County, and (by the time I get there) I still have to wait for the

ground crew to complete the extrication. "

Dr. Bass, executive director of the land Institute for Emergency

Medical Services Systems, said the average state police response time is about

18 minutes, and the flight time from the accident scene to a trauma center is 11

minutes.

" There is no other state I know of that can say they have an 18 minute response

time statewide, " Dr. Bass said. " I don't think there is any other state that

does it as well as we do. "

Mr. Rupert countered that the state's goal of getting patients to the hospital

as fast as possible does not jibe with the practice of giving state police

helicopters priority over the closest helicopter.

" You either need the closest helicopter or you don't need a helicopter, and if

you don't need a helicopter, then why are you being flown? " said Mr. Rupert, who

is a registered nurse.

He has supporters in the General Assembly.

" I really believe it would be cost-effective for the people of land if we

were to privatize the system, " said Sen. Astle, an polis Democrat and

retired medevac helicopter pilot.

Mr. Astle flew for MedStar, a non-profit corporation that operates hospitals and

medevac transportation systems.

Mr. Astle emphasized that he's not trying to line his own pockets by supporting

privatization.

" I no longer have a dog in the fight, " he said.

It may never be known whether commercial operators' claims - an ability to

transport patients competently without costing taxpayers - have merit, because

not many lawmakers are listening.

Sen. Ed DeGrange Sr., a Democrat who represents the Glen Burnie area and serves

on the powerful Budget and Taxation Committee, for example, said the issue of

privatization surfaces from time to time, and he always opposes it.

" Am I going to be relying on a private carrier who may not put the resources

into it? " he said. " They are in it to make money, and what happens if they don't

make money and leave? "

Gag order

" You are about to get your wrists slapped, " Mr. Costa said of anyone who dares

ask whether state police helicopters and the University of land Shock Trauma

Center are being used unwisely.

Sen. E.J. Pipkin, an Eastern Shore Republican, has supported privatizing the

helicopter system in the past, but got nowhere.

This year, he introduced a bill to allow private helicopter companies to be

compensated by the state for transporting a very small handful of patients -

about 20 a year - from accident scenes to trauma centers. The charges would

total less than $200,000 and would come out of the roughly $54 million yearly

fund that supports state police helicopter operations and other emergency

medical services.

State officials, some from the land Institute for Emergency Medical Services

Systems, recently testified that the bill would undermine the entire state

emergency medical system.

" The power down here from the land Institute for Emergency Medical Services

Systems and the state police is just incredible, " said Nash, Mr. Pipkin's

chief of staff.

The pressure on lawmakers comes from the local firefighters and paramedics back

home.

The land State Police Department and the land Institute for Emergency

Medical Services Systems control to a large degree the grants that go to local

fire departments for emergency equipment, and anytime state police sound the

alarm, the local emergency medical providers come to polis.

Local paramedics who were questioned did not want to talk for the record, saying

their unit could be denied grants for new equipment.

In polis, state police medevacs seem to fly under the political radar:

conservatives support the police and aren't eager to cut their budgets, while

liberals like that the idea that medevac flights are financed by the state and

not billed to the patient.

The commercial medevac industry's chief lobbyist in polis, attorney Bryson

Popham, said his clients have given up, and he didn't even get his " helicopter "

files out of storage this session.

Mr. Rupert, of Air Methods, said his company has abandoned hope that anything

will ever change.

" The state police are the most powerful lobby in the state - they provide

security for the governor, the Speaker of the House, and the President of the

Senate, " he said. " I don't think anything is going to change in my lifetime. "

--

Note: Story printed under headline " Emergency overkill? "

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March 30, 2008

It's funny to me that people are making issues about things like this yet

you don't hear a word about BS such as Congressional Hearings on freakin

steroid use in professional sports or the fact that Exxon is making over $14

Billion in profit EVERY quarter yet we are the ones suffering. We need to

start a new way of thinking. We need to make some laws that only allow

professional sports figures to be paid based on their years of experience

and make that salary across the board. We could make a new law that says

elected politicians only get paid based on performance! If what this

article says is true it appears that there is a flaw in the system, either

the ground providers need more or recurrent education regarding appropriate

utilization of air transport and they should be charging for their services

(at least bill insurance). I wonder what percentage of MSP's missions are

EMS vs. LE?

Just my 2 cents!!!!

Lee

From: texasems-l [mailto:texasems-l ] On

Behalf Of lwd7734@...

Sent: Sunday, March 30, 2008 9:05 PM

To: texasems-l

Subject: RE:

This was not a post to blast anyone. It is the over use of medevacs, not the

need the concern many.

I have been to Texas several times and I was amazed by the rural areas and I

fell in love with the state because of the rural aspect. I can see where

Texas has a need for medivacs, but the calls must be prioritized.

I wouldn't go as far as saying your governor is to cheap to fund

helicopters. You all have a General Assembly that makes the laws. land's

funding for the choppers comes from our Tag (vehicle registration) fees. It

is called the EMSOF, Emergency Medical Services Operations Fund. Would the

citizens of the Lonestar state be willing to pay $5 or $10 more dollars

annually for registering their vehicles. I don't have a problem paying a

user fee. MSP doesn't charge anyone for transports, even visitors get a free

ride. I do have a problem with someone calling the helicopters because it

looks cool when we shut down the highway.

Voice your opinion and vote.

Thanks again.

Larry

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March 30, 2008

Larry;

What is $5 or $10 in a fee. Better yet,those ticketed for traffic violations or

DUI should help out to since they contribute to the problem of trauma,Bottom

line,Texas needs to fund its far west region better for EMS and provide

resources unique to our needs Rabbiems

RE:

This was not a post to blast anyone. It is the over use of medevacs, not the

need the concern many.

I have been to Texas several times and I was amazed by the rural areas and I

fell in love with the state because of the rural aspect. I can see where Texas

has a need for medivacs, but the calls must be prioritized.

I wouldn't go as far as saying your governor is to cheap to fund helicopters.

You all have a General Assembly that makes the laws. land's funding for the

choppers comes from our Tag (vehicle registration) fees. It is called the EMSOF,

Emergency Medical Services Operations Fund. Would the citizens of the Lonestar

state be willing to pay $5 or $10 more dollars annually for registering their

vehicles. I don't have a problem paying a user fee. MSP doesn't charge anyone

for transports, even visitors get a free ride. I do have a problem with someone

calling the helicopters because it looks cool when we shut down the highway.

Voice your opinion and vote.

Thanks again.

Larry

__________________________________________________________

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March 31, 2008

There is a fee in place. It is added to anyone who gets certain types of traffic

tickets. Like no ins. DUI, speeding. It costs about $230 a year for 3 years ( If

I am right on that figure not too sure though but it is close ) It was put

inplace by the State four years back. the money is to be divided between the

varius EMS systems in the RAC that the ticket was issued in.

" rabbiems@... " wrote: Larry;