Washington County Commissioners agreed to move forward with a new air ambulance service provider at their meeting today (Tuesday), although not unanimously.

EMS Director Kevin Deramus details the changes between the county's current air ambulance agreement with REACH Air Medical Services and the new one with Metro Aviation at Tuesday's Washington County Commissioners meeting.

Commissioners voted 3-1 to enter into a three-year agreement with Louisiana-based Metro Aviation, beginning June 1st.  Commissioner Joy Fuchs voted against the measure.

EMS Director Kevin Deramus said Metro was chosen based on four major factors, those being “commitment to safety, quality and customer service,” “caps on price escalation,” a “strong equity position” and a “commitment to minimizing aircraft downtime.”

Deramus said a primary change from the county’s current agreement with REACH Air Medical Services, which will terminate on June 27th, is that the county will receive all revenue from insurance providers.



Celeste Dickschat (front), district clerk for Washington Soil and Water Conservation District #348, holds a proclamation issued by Washington County Commissioners on Tuesday that proclaims April 24th to May 1st as Soil and Water Stewardship Week.

Fuchs said her concern lies with the amount that the county will have to pay Metro on a month-by-month basis, versus the fact that expenses under the county’s previous agreement were reimbursed by REACH.  According to the agreement, the county will pay Metro a fixed monthly sum of $170,883 for “the provision, maintenance and operation of the aircraft,” plus a per hour flight time fee of $1,200.  She said there are a lot of unknowns and is not certain whether the money from insurance will be enough to cover the program.  She added, however, that she hopes she is wrong and that the agreement ends up being beneficial.

Deramus said the county does have a 90-day out clause in case expenses from the new agreement prove to be too expensive.



Commissioner Candice Bullock said the county evaluated best- and worst-case scenarios based on current data, which indicates a trend of growth and rising medical calls year over year.  She said at the end of the day, regardless of if “worst-case scenario numbers” come true, this program will still save hundreds of constituents tens of thousands of dollars from their medical provider.

Currently, Metro operates over 140 aircraft and over 40 medical bases in the country.  Deramus said the county has visited two of Metro’s programs in Texas, those being Cooks Children’s Transport and the University of Texas at Tyler.

Deramus said the goal of Washington County’s air medical program has been to move to a “traditional model” where the county employs the medical personnel, while the company provides the pilots and flight crew.  According to Deramus, REACH desired to have nurses remain as REACH employees during the program’s initial build-out, eventually desiring both nurses and paramedics, where the program currently sits.

The new agreement will also allow the county to perform its own agency billing for operations as a government taxing entity, giving it the ability to waive co-pays for air transports as it does for ground EMS patients, while also meaning the county would no longer have to pay a subscription fee to AirMedCare Network.  Deramus said the county outsourced billing for ground EMS in 2006, and is currently serviced by a company named EMS|MC.  The company presently collects over $2.7 million in revenue annually for Washington County EMS on the ground, and has experience billing for air.

(Editor's note: A copy of the aircraft operating agreement as included with the meeting's agenda packet was previously linked in the article, but has been removed at the request of EMS Director Kevin Deramus on the behalf of Metro Aviation, citing the presence of proprietary information within the contract.)

Also at today's meeting, commissioners:

  • Purchased recording software from NICE for E-911 to include installation, training and the first year of maintenance funded through a line item transfer. The purchase is for $21,728, with an additional cost of $7,355 for each of the next four years for maintenance.
  • Approved a right of way permit application for the Blue Bell Fun Run/Run for the Youth of Washington County, taking place April 2nd.
  • Rejected the transfer of a 2012 Ford F-150 from Engineering and Development Services to EMS, due to incorrect wording on the meeting agenda. Deramus explained that the agenda says the truck is being transferred to EMS, but is actually meant for the Office of Emergency Management.
  • Proclaimed April 24th to May 1st as Soil and Water Stewardship Week.
  • Approved a formal notice from Magnolia Oil & Gas Operating, LLC for a gas line, oil and water line road bore on Moye Road in Precinct 4.
  • Approved a 60 day extension of 20.5 excess vacation hours for Peggy Diggs with the district clerk’s office.
What’s your Reaction?


  1. Has the public ever been advised of the flight counts per month? When Reach started up it seemed they were daily patient flights. When the county started looking at another provider the flights dropped. EMS makes the call for assistance so are the patients suddenly not Ill or is the county punishing Reach because they put their foot down when they could not be reimbursed by insurance for flying non flight worthy patients. I bet if the monthly numbers were published a drop in flights corresponds with EMS notice of changes of the air provider. If you don’t let Director Deramus have his way he will tweak the rules in his favor. Commissioners stand up for the citizens.

  2. I don’t know Kevin Deramus personally, but everything I’ve come to learn about him is the complete opposite of what I am reading. Our family participates in their ACP program and have been in it for several years now. If you don’t know what it is or about; you do the homework and find out. EMS is in our home twice a week assisting us and before you accuse us of draining county services; we donate to the EMS because of our appreciation. I have learned from the employees themselves what kind of man Kevin is. They have a deep appreciation for this innovative man. He’s constantly planning and looking to the future for his people; more importantly to the people of Washington County. If your child, grandchild, or spouse is in an accident in a remote part of the county; the helicopter will take your loved one either direction for the best care. I’ve come to know some of these men and women personally, they are some of the finest people I’ve met. When your loved one is sick, possibly dying, don’t you want the finest people taking care of them? I do. In fact our grandson’s were in an accident and EMS did respond. In spite of their young ages, they were treated with respect and dignity. Come on folks, everyone knows this isn’t Houston. Washington County is growing, in spite of the heel digging we have to grow with it. The helicopter serves surrounding areas. They don’t sit and wait for accidents to happen just in Washington County. I’m proud knowing it serves our surrounding neighbors. Kevin, I’ve come to know, is a man of deep faith. Maybe that doesn’t concern you, but it does me. He is a man with principals and I’m proud he’s in control of ALL our care. Get to know these folks before hiding behind your words. Go take a tour. Find out everything they do. Maybe invest your money into their programs. Your money could very well serve you.

  3. “plus a per hour flight time fee of $1,200″…..you really need to read the operating agreement. Flight time is not actually “flight” time….but rather is defined by anytime the rotors are in motion. This includes time accumulated for rotor motion time during maintenance, relocation, refueling, & training. So there’s a fixed cost of $170,000/ month for maintenance plus $1200/hr anytime they turn the key to the ON position regardless of the degree of service that is rendered from that ON position. That’s going to add up to some really big bucks.

  4. How about the county build a 24hr clinic that a citizen can walk into with the 2million+ a year would be a good start

  5. It is going to be a sad and costly mistake to the residents of Washington County when commissioner Fuchs retires. She seems to be the only one with common sense and looks out for us citizens., seems like all the others are “YES” people. Wake up commissioners.

  6. My sister n law is a life flight nurse. Don’t they come here when necessary? We have how many EMS vehicles? We are not Houston and the residents aren’t “the bank.” Stop spending and learn to say NO. You have been the worst representation for Brenham.

  7. After reading the current posts I realized there was little I could reasonably add. However, I would like to add that I would counsel caution as it seems that history would dictate that the powers that be have no qualms about squandering our money.

  8. Why does Washington County need to spend this money on this service? We just don’t have to have an air service for a county this size. It would be nice yes but affordable no. Stop wasting our money is that so hard to do? Property taxes for our homes should be lower not higher, insurance companies will not pay for this service it will be subsidized by tax payers. Thank you Joy for your common sense. The rest of our county commissioners wake up you are being manipulated.

  9. It’s really crazy that Deramus has been able to confuse so many people on the Commission with the information he has given them. You know that information is all available to do research on. I haven’t read it but I’m pretty sure the reason he has been able to confuse or manipulate the commissioners into voting for these items all at one time might be because there is information in there that makes sense for the growth and safety of the community. I’m guessing there are not personal vendettas in any of the posts that always call him out. I would think you might equally call out the commissioner’s who are the ones that actually vote to accept these things. Go present all of your information on why this is wrong and change their minds. I’m just super confused as to why Deramus isn’t hammered by the commission the way he is by a handful in the KWHI comment section.

  10. I can only pray that the residents of Washington County will stand up for themselves and push back on this measure. It is unnecessary and has nothing, absolutely nothing, to do with improving the safety or clinical outcomes of the residents. This is exclusively about feeding an ego that has an ever expanding appetite for power and control. This measure took the county from a $135,000/yr commitment to protect the financial interests of the residents while providing them nationally recognized and accredited air medical transport to a $2,136,996/yr commitment(and that is if the aircraft never files and accrues the additional $1200/hr flight time cost) that does not protect the financial interests of the residents and lowers the level of care they will receive. Additionally, there is no data to suggest financial recuperation is even possible considering the lack of CAMTS accreditation. Is he suggesting to simply increase the revenue potential by flying more patients through internal mandate? Seems like fraud to me. Ever hear of medical necessity? If not, you should look into it. Furthermore, there may have been a case to be made for Fire Fighting capability, but there is no case for search and rescue by this program. The ground EMS has a more than capable rescue capability and the environments do not necessitate helicopter rescue capability. It is nothing more than ego driven pipe dream of Deramus, solely funded by the residents of the county.

    If at any point, the truth about the behaviors of those involved in the Washington County air program from inception was known to the general public, Kevin would no longer be associated with the County in any way. I pray you will look deeper and demand truth from you elected officials. How it has not come out yet is almost as concerning as leaving Kevin in a position to continue this outlandish venture.

  11. I too have a hard time believing that our county would benefit from being charged $170K monthly for this service model. And why is it necessary to transport virtually every accident victim by helicopter? It seems the “build it and they will come” mantra is true here. Talk about a huge medical expense for county residents. Thank you TL for providing more information for citizens to consider.

  12. Dear Washington County residents,

    I would be very concerned with your money being invested into this “new” program. Over $3,000,000 per year of county funding is being committed into this program.

    This will be a failure, let me tell you why.

    Director Deramus is planning to staff this with 8 paramedics from the already understaffed Washington County EMS ground system. The dual paramedic staffing model is not best practice and does not meet the National standard of aeromedical retrieval or Helicopter EMS (HEMS)

    The regional medical advisory committee does not support this staffing model, nor do the regional hospitals. Washington County residents will eventually be flown by Commission on Accreditation of Medical Transport (CAMTS) programs and see huge bills being in the tens of thousands.

    The paramedics do not have the in hospital critical care experience that flight nurses bring to HEMS. Further to this, the majority the paramedics on this doomed program have zero flight paramedic experience. This will unfortunately impact the clinical care county residents will receive.

    This money should be invested into other public safety programs and not a pie in the sky idea that Director Deramus has of saving the world. Stick to improving the efficiency of the current EMS system and use the money to increase the Full Time Equivalent (FTE) poisons on ground EMS. The current staff are drowning so looking after them first.

    The county should stay with the current program which has little financial risk. This change is purely Director Deramus pulling power as his unsafe practices were compromising the safety of flight crews and residents of the county. His control over the current program was revoked and this is now the “revenge” of the Deramus.

    Please write and call your commissioners and pled not to spend over $3,000,000 annually on this financial burden. Ask why Director Deramus is now cowboying this new program and not following best practice!

    1. Totally agree with TL on every one of his comments. I think this is just another “yea” vote from commissioners that are not educated on this issue. Let me emphasize that ground EMS and nurses are not educated for what flight crews must contend with. This has all the red flags of “FAILURE and Disaster” waiting to happen !

    2. If these points are all true and I have no reason to not think so until I do my own research, why is Mr.Deramus being allowed to do this. I’m sure the EMS staff is probably stretched to their limits and do not have all the experience needed for this program. Maybe if Mr.Deramus had to put his life in these peoples hands which I guess he in some way is he may see things a little differently! Also if this come to fruition and ends up costing the taxpayers this unreal sum of money and it fails, all of the commissioners that voted for this and Mr. Deramus should be terminated immediately without a doubt! It jus seems that when he(Mr.Deramus) doesn’t ghetto his way as with the previous program he stomps his feet and the commissioners appease him by doing something that appears to not a good fit.

      1. This is one of those with a personal vendetta people right here. Call out the commissioners or tell us what the real reason is why you don’t like Deramus. I would love to hear both sides of this but I know Deramus isn’t able to give the opposite side. Ghetto his way to the top? Really?

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