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The Honolulu Advertiser
Posted on: Monday, June 12, 2006

Deadline looms on medevac flight service

By Peter Boylan
Advertiser Staff Writer

With less than a month to go before the Hawai'i Army National Guard is scheduled to stop flying emergency medical flights on O'ahu, the state still has not found a permanent solution and remains in discussions to extend the temporary Guard flights.

O'ahu has been without 24-hour emergency medical flight coverage since March 31, after a 30-year agreement with an Army unit based at Schofield ended because of active-duty needs in Iraq. In a temporary setup, seven National Guard helicopters began providing the service May 1, but a permanent contract with another provider has yet to be secured, according to state officials.

The temporary agreement with the Guard is set to expire July 1.

The Guard has flown four missions and transported five patients since May 1, said Col. Steve Logan, a former Honolulu Police Department lieutenant who is the aviation program director for the Guard. The military flights, previously provided by the Army's 25th Infantry Division, numbered about 200 a year during the past 30 years.

In January, the Army notified the city and state that the Military Assistance to Safety and Traffic, or MAST, service would be suspended through at least October 2007. State officials are hoping a private company will step forward and bid to take over the flights permanently.

All 12 Black Hawk helicopters with Charlie Company of the 25th Infantry Division's combat aviation brigade, along with 85 to 100 soldiers, are deploying to Iraq this summer.

Approving an application from a private air ambulance service can take up to three months, and the state has not received any new applications since 1999. The military is handling the procurement process.

An emergency provision that allows for a speeded-up application process can be put into motion, but any company that passes state muster also would have to seek approval from the Federal Aviation Administration.

"We believe one or more private companies have responded to the military's procurement notice for services," said Janice Okubo, spokeswoman for the state Department of Health. "DOH has also received proposals, but we are not procuring services at this time.

"The National Guard has been able to provide sufficient emergency air support services for Honolulu since the deployment of the MAST, and we are very grateful for their help. We are in discussions with (the Department of Defense), and an extension of the current agreement with the National Guard to provide medevac services is a possible option."

HARDSHIP FOR CREW

Guard officials say that providing the service is a hardship for members of the unit, which is based at Lyman Field in Hilo, Hawai'i, but now is housed temporarily at Wheeler Army Airfield. Crew members have been away from their families for more than 60 days, Logan said, but some are able to fly back on off days.

Among the changes created by the departure of the Schofield helicopters is the amount of coverage. Currently, the Guard unit conducting the flights has the resources to work only from 11 a.m. until 11 p.m. daily, the critical period according to city and state officials.

Also, the Black Hawks used by the Guard are configured for combat missions and cannot carry the payload the Army helicopters could.

Without air support, city officials said the city's 18 ambulances and their crews would shuffle around O'ahu to provide coverage for areas left exposed by emergencies, a practice that occurs now to a much smaller degree.

Patty Dukes, head of the city's Emergency Medical Services, said paramedics simply have to get geared up and go faster. She said she is grateful that no mass casualty incident has occurred in a rural spot but said the public should not be alarmed by the 12 hours a day when air support is unavailable.

"People should not think we're not able to handle any situation," she said.

'LIFE AND DEATH' ISSUE

While officials work to address the issue of a permanent provider, the medical director at the state's only trauma center, and a lawmaker who represents rural O'ahu, say it is critical that 24-hour emergency medical flights are restored on O'ahu.

"It is a concern. We had someone from Kahuku who took 45 minutes to get here because the helicopter wasn't flying at that time. Luckily, the patient was OK, but in other circumstances he might not have come out so well," said Dr. Hao Chih Ho, director of trauma service at The Queen's Medical Center.

"For someone who is very seriously injured who has ongoing bleeding, the 15-20 minutes (difference in flight and drive time) could be the difference, especially if rush hour happens and you have a car crash. Twenty-four-hour-a-day service would be the best."

Sen. Clayton Hee, D-23rd (Kane'ohe, Kahuku), who is running for Congress, said the issue has concerned him since his days as a lawmaker on Moloka'i. Hee said he saw sick people go without treatment because of the scarcity of medical flights from the Neighbor Island at the time. Now that issue has moved to O'ahu, he said.

"In my opinion, it is incumbent on the state Department of Health to procure service, because the times when this service is required are times when it is a matter of life and death," he said.

Reach Peter Boylan at pboylan@honoluluadvertiser.com.