Over the last several months, a number of letters to the editor
and guest columnists have rendered opinions on the operation of our
local CALSTAR air ambulance service.
Over the last several months, a number of letters to the editor and guest columnists have rendered opinions on the operation of our local CALSTAR air ambulance service. Most recently, Gilroy City Councilman Bob Dillon wrote an excellent column addressing some of these issues, and inviting a response from CALSTAR.
As I have the honor to be the chief flight nurse for CALSTAR in this area, I appreciate the opportunity to shed some light on our service. To begin with, I should make clear that CALSTAR is a non-profit 501 (c)(3) community service organization, receiving no funding from taxpayer dollars. (I’ll talk more about our costs in a minute)
Who decides when to call CALSTAR?
It is widely recognized that seriously injured victims are best treated in specialty trauma centers, the nearest of which are in San Jose. All ground EMS personnel are trained to rapidly assess an accident victim to determine if they meet criteria for rapid helicopter transport to these trauma centers. The Santa Clara EMS Agency establishes these criteria with guidance from local trauma surgeons, hospital emergency room directors, ambulance providers and other interested parties. All EMS responders are required to follow these policies.
The overriding principle is the safety and best interests of the patient – recognizing that paramedics and EMS responders have to make quick decisions with limited resources in the field. (Imagine being roused in the middle of a dark, rainy night and expected to make life or death decisions on the side of a highway with traffic flying past just a few feet away. You have only your eyes, ears and experience to guide you – no x-rays, CT scans or other advanced diagnostic equipment that help physicians to make a definitive diagnosis in a hospital.)
As Councilman Dillon pointed out in his recent column, hidden injuries that seem initially minor may in fact turn out to be life threatening. This is seen most often with head and abdominal injuries. Therefore, the EMS system trains field personnel to err on the side of caution, requesting a helicopter if there is any suspicion of significant hidden injuries.
A recent study by Santa Cruz County revealed an 89 percent accuracy rate in this system – indicating that paramedics are very good at recognizing the potential severity of injuries. (This is significantly better than the national standard established by the American College of Surgeons)
Why does air ambulance transport cost so much?
As a community service organization, CALSTAR will always respond when requested, providing advanced medical care and rapid transport to anyone regardless of their ability to pay. We do charge for our services however, and, as you can imagine, it’s not inexpensive. (Councilman Dillon’s suggestion that we buy retired military helicopters would unfortunately not reduce our expense. Such aircraft are not suited for our mission due to their size and weight, and would cost millions to put into service. We select our aircraft to suit the mission profile we serve, and economy is one of many factors)
As I mentioned earlier, we receive no tax dollars – we are a “fee for service” operation, meaning those who utilize our service must pay for it. Most of our funding comes from patient’s insurance companies, although a sad fact of American health care is that these payments are steadily shrinking, leaving patients with a higher portion of their bill to pay. To help offset this difference and keep our helicopters available to more people, CALSTAR has developed a membership program. By buying a membership ($55 per year covers the entire family) local citizens can show support for CALSTAR and help keep us operating in this area.
In return, should a member ever need our service, CALSTAR will waive any portion of our bill that is not covered by insurance. This means members never pay more than their annual membership fee. This benefit also covers transfers between hospitals, and is honored by partner programs in several western states. (For details or more information, go to www.calstar.org, or call 1-888-207-5433)
We at CALSTAR appreciate the support the community has shown for our mission, and while we hope you never need us, please know that we are committed to continuing that mission. If I can be of service to you or if you have further questions, please email me at ds*****@*****ar.org
