Maryland State Police Aviation Command:
Scare Tactics and False Claims on the Nightly News!!

During a recent (28 November 2007) airing of the WBAL TV 11 I-Team investigative report: Closest Medical Helicopter Not Always Called – high level officials within the Maryland State Police were interviewed and asked to defend the current Medevac system.

Myth #1:

I was aghast as I watched a high level state representative use false inaccuracies and scare tactics to publicly promote his department’s already excessive budget and additional monetary request (see SB 2 and HB 5 special session 2007, which grants the MSP Aviation Command an additional $110 million).

“FREE OF CHARGE” I find it personally offensive that MSPAC Major believes he can spend XXX million dollars of tax payer money each year for a system fraught with problems (performance, cost-overruns, safety) while telling the general public on the nightly news that his department provides services for FREE.

State Police Helicopter Operational and Capital Budget

As you can see from the breakdown on page one – providing the important service of air medical transport in the state of Maryland is anything but FREE. I am most concerned to see a state official who represents a department which has shown time and time again to have little regard for the public’s scarce tax dollars that his multi-million operation is FREE on the evening news.

Numerous Office of Legislative Audit Reports (OLA) have shown that the State Police is insensitive to public concerns about “accountability” and unscrupulous handling of the Taxpayers Funds and their Medevac statistics reporting. In one of several OLA state police audit reports, “… we concluded that DSP’s fiscal accounting and compliance was unsatisfactory”, (OLA reference dates: June 2004, July 2005, January 2007 and February 2007).

Myth # 2.

Again, I’m left perplexed by the Major’s position on this. I can’t understand how the state of Maryland spends more public funds on its air medical system then any state in the nation- yet we can’t afford to comply with the national benchmark for “standard of care”. The vast majority of air medical programs throughout this country utilize two high level care providers in the air craft. The work load and intensity of caring for the critically ill demands the additional care provider. Common sense dictates that pulling a random field provider from the scene is a poor substitute for trained, skilled providers. Not only does this policy put the patient transported in the helicopter at a disadvantage – it also exposes the community (which is now short 1 EMS field provider) to less pre-hospital coverage, and the vulnerabilities associated with that.

I find it curious to learn that most states which do not spend millions upon millions of dollars on their medevac system do not have to contend with this vulnerability.

In a Department of Legislative Services (DLS) Policy Analysis of the FY 2007 Maryland Executive Budget, 2006 the Analyst for DLS stated … … “The Commission on Accreditation of Medical Transport Systems (CAMTS) providers accreditation standards that are generally accepted as the national standard for aeromedical transport programs. Maryland regulations require that commercial air ambulance services seeking licensure in Maryland must be CAMTS-accredited. However, though the State Police Aviation Command itself is not CAMTS accredited because one critical component of accreditation is having two medical care providers on each aircraft.

Additional quotes to the issue of “Single Provider Medical Care”:

• “Based on our mission profile,...“ . We do not handle Critical Care Missions as our scope of practice is ALS”, . Source, MSPAC.
  
  “the existing manner in which we pick up a second provider from the scene is adequate but you are never certain of the abilities of the ‘off-scene’ provider.” Source MSPAC
• “...ground personnel, ., they are not properly equipped with safety equipment and are not always comfortable operating in the HAS.” Source: DLS.

Myth # 3.

25 minutes away! Critically ill! Do you really need to Medevac the Patient?

• How does this policy benefit the patient (ie…the citizens of MD who pay for this service). It would seem to me that if I or my loved one were in a life-threatening situation warranting helicopter medical care – I would like to be sure we receive the closest aircraft. No time wasting would be acceptable (25 minutes or 5 minutes!!!)
• The Trauma Surgeon’s have repeatedly told us that “time is our enemy in Trauma Care”. If that is truly the case – then 25 extra minutes surely can’t be helping anyone.
• The Governor’s EMS Board Medevac Response Time Reliability guidelines state “providing a 20- minute response to any scene in Maryland.” Personally – I think 20 min is too long – however, I find most disturbing that now the trend has gone in the wrong direction and we are talking 25 minutes!!! Clearly, the policy makers are not complying with the Trauma Surgeon’s message.
• 63.6% of Trauma Patients flown by the MSPAC with Nonlife-threatening injuries, statistics could be higher? Source: MSPAC outdated study in the Journal of trauma June 2006. “Studies have several limitations and risk for selection bias”. Is this good use of our “FREE/Multi-Million Dollar” state resources?
• 59.91% of patients discharge from the shock trauma center within 48 hours, ground and air transports, are the truly trauma patients? Source: FY 2006 UMMS submission to the Maryland Health Services Cost Review Commission.

The Governor’s Executive Director for Maryland Institute for Emergency medical services System (MIEMSS) is quoted in the WBAL TV 11 News I-Team Report “I would argue that the system is working very well,” “System working very well”: Not SO! It would appear as though the Maryland air medical transport system has failed to evolve throughout the years to incorporate and benefit from marked efficiency improvements within the air medical transport industry at large. This has left Maryland with a costly, inefficient, and less qualified system in comparison to what is available to other states throughout the nation.

Maryland’s EMS Response Systems: A System of a Larger Problem:

“THROUGHOUT HISTORY, IT HAS BEEN THE INACTION OF THOSE WHO COULD HAVE ACTED; THE INDIFERENCE OF THOSE WHO SHOULD HAVE KNOWN BETTER; THE SILENCE OF THE VOICE OF JUSTICE WHEN IT MATTERED MOST; THAT HAS MADE IT POSSIBLE FOR EVIL TO TRIUM”.

Respectfully Submitted,

Dick Johnson

CC: Governor Martin O’Malley
President of the Senate, Thomas V. Mike Miller, Jr.
Speaker of the House, Michael E. Busch
Legislative Committee Chairs
Members of the General Assembly
www.medevacmdsurcharge.com.