By Jim Johnson
The Monterey County Herald
MONTEREY, Calif. — Emergency trauma helicopter service in Monterey County could go out to competitive bid at the beginning of next year, county Emergency Medical Services Agency Director Tom Lynch said Tuesday.
Lynch said the agency’s staff is preparing to carry out a full review of the air ambulance service, which is mostly provided by nonprofit CalStar, and to issue a request for proposals to potential providers in the next six months.
Both actions would be allowed under a new county EMS ordinance being considered by the Board of Supervisors, as well as a newly adopted EMS Plan, Lynch said. The ordinance, which the board considered Tuesday and is scheduled to consider again in two weeks, allows the county to set up an “exclusive operating area” for air ambulance service and open it up to bid.
“Essentially, we have a monopoly on emergency air transport service in Monterey County,” Lynch said, adding that a request for proposals would allow the county to “ensure that its citizens have the best quality and most cost-effective” service.
For years, CalStar has provided the bulk of all emergency air transport service in the county, flying auto accident, shooting and heart attack victims, among others, to San Jose area trauma centers.
Last year, the firm responded to 827 requests for transport, though only 373 of those were actually transported, and to 260 transports from a trauma scene. By comparison, Stanford-based Lifeflight and the Paso Robles-based California Highway Patrol helicopter each conducted 14 trauma scene transports in 2008.
Only about 30 percent of all patients transported by helicopter end up requiring an emergency operation or intensive care, Lynch said, though he noted that studies indicate the national average is about the same.
Two-thirds of the patients are either treated in an emergency room and released or end up in a hospital bed.
Lynch said he believes CalStar’s rates are higher than those of other ambulance companies in the state, though he said he doesn’t know for sure because CalStar treats its rate information as proprietary. CalStar, which has a base at Salinas Municipal Airport, charges about $25,000 for transport from Salinas to San Jose.
Supervisor Dave Potter, who has noted complaints about CalStar’s charges and a recent “proliferation of emergency flights,” asked Lynch on Tuesday when a report on air transport rates and transport frequency would be available. Lynch said a report would begin after passage of the new EMS ordinance.
Though CalStar has been operating in the county for years, Lynch said, there is no apparent record of a formal contract. When the EMS Agency reviewed a strategic plan that included a request for proposals for a new air ambulance, Lynch said CalStar informed him they already had a contract with the county. CalStar has yet to produce such an agreement.
Lynch said the EMS Agency is looking at establishing a trauma center at a local hospital, which would vastly reduce air transport costs, but that could take some time because none of them are equipped for such service. Trauma centers are not regarded as moneymakers.
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