New Ambulance Services Payment schedule

[Ken Lawson-Williams <Macgyver@FlightMedicMail.com>]

I don't know if anyone here has had the time to look at this, (the original (PDF) can be downloaded from the JEMS website) but something struck me as odd and I'm wondering if anyone can help me figure it out. 

As I read it, an air transport gets paid the same (+mileage and rural cost adjustment) no matter what the level of care delivered (unlike ground). So what is to stop a program from reducing a crew to 1 (unless 2 are obviously or likely to be needed), or to scale back on the care offerred and use EMT-B or EMT-I with (I hope) appropriate flight physiology etc training?. 

Nothing I have read requires 2 attendants, and the level of care (especially for transfers) can be determined at the time of booking (I know, not true, but a manager could claim that hospitals never lie), and a single EMT-B could be sent - provided the probable (I know, murphy ALWAYS strikes . . . but again I'm looking at what-if's and poor management or programs heavily financially hit by the new rules) course of care during the transport was wiythin his scope.

Yeah, EMTLA again. But as already stated, it has more to do with the ongoing level of care REQUIRED and PROVIDED by/to the patient than the titles of the crew.

Also - there is no "wilderness" cost adjustment. So operators (primarily fixedwing) who might choose to scale back to single engine (ie: PC-12) to save on fuel in southern areas with lots of strips within gliding range of 25000 feet cannot safely do so in areas like Alaska and Hawii where there are often NO strips within gliding range, thus requiring twin engine birds. Thus they will be financially very hard hit as fuel costs have been specifically excluded from the adjustment for location - the Govt will rely instead on the overall consumer price index changes due to inflation. Not often close to the inflation in Aviation!!

Just food for thought.

Fly Safe. KLW

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