Washington County’s EMS Director says the recently approved air ambulance agreement with METRO Aviation is performing well.

EMS Director Kevin Deramus provides an update to Washington County Commissioners on Tuesday about the EMS department's air ambulance agreement with METRO Aviation.

Kevin Deramus, who provided the EMS department’s monthly report to county commissioners today (Tuesday), said the number of helicopter flights run through the first quarter of the agreement, from June to August, is 75 transports.  That total aligns with projection models run by the county of at least 300 transports per year, with other models showing 360 and 420 annual transports.

Deramus said while it is still too early at this point to truly compare revenue versus cost for the agreement, revenue is better than expected through the first three months and is a positive early indicator thus far.  He explained that of the 75 patients transported, 72 percent of them had private insurance, which pays more than Medicaid.  In comparison, 40 percent of ground ambulance transports have private insurance.

A main difference between the agreement with the county’s current provider versus the one it had with REACH Air Medical Services is that the county receives all revenue from insurance providers.  The court approved the new agreement in March with a start date of June.

Deramus also said reasonable rates make the county more favorable when going through the Independent Dispute Resolution (IDR) process.  The IDR system is part of the No Surprises Act, which became effective January 1st and settles billing disputes with insurance providers.  Deramus said if an insurance company refuses to pay a certain amount, the county can take them to an IDR board, who determines what a provider would pay for services.  He said since the county is operating with reasonable rates, the board is more likely to side with the county and ensure the insurance company makes payment.

Deramus said more data and trends will likely become available to review as the helicopter program continues over the coming months and years.

Also of note in Deramus’ report to commissioners was that the EMS department is fully staffed for the first time since late 2018 or 2019.

At today’s meeting, commissioners:

  • Approved the purchase of a 2022 Ford F-150 crew cab for the office of emergency management. The purchase is from Appel Ford for $53,873.
  • Approved an oil and gas development permit from Magnolia Oil & Gas Operating, LLC with a site location of Schoenemann Road in Precinct 4.
  • Received reports from the sheriff’s office, E-911 and veterans service officer.


  1. You are correct!
    A lot of people don’t realize that tax dollars are really the “main difference between the agreement with the county’s current provider versus the one it had with REACH Air Medical Services”. This is costing taxpayers since REACH was run off/out. I agree, there needs to be more transparency. There is a lot of missing information it seems. Someone is leaving it out. Thanks for mentioning the lake Somerville plans too, I had no idea. $100,000 per month could fund a lot of ground units.

  2. I guess we the taxpayers are excluded from this “No Surprises Act” because we seem to be getting more and more surprises from EMS. It would appear that someone is on a power trip, and money equals power, even if it’s taxpayer money. Just speculating but, before you know it he’s probably going to try and get a county wide Emergency Service District (ESD) put together to collect more taxes from county residence for EMS services, watch and see. Of course, the taxpayers would have to vote for this. None the less, there is some shady business going on here. There seems to be no transparency. Did y’all notice there was not a number of ground transports attached to that “40% by ground transport have private insurance”. Are you kidding me? What is he counting? How about making it apples to apples? Helicopters don’t make routine EMS calls to the nursing and rehab facilities. Stop trying to fool the citizens of this county! He’s not giving us the true numbers, these are manipulating and misleading if anything, which seems to be a trend. You know, Local Volunteer Fire Department asked to form ESD’s years ago to help fund their services and were told no by the commissioners court because it was additional taxes. Now EMS seems to have a blank check backed by tax dollars. What gives?

    1. Anyone remember the 7 million in ARPA funds the county wrote off as a loss right before the REACH contract termination to be used for “other long-term projects?” Well this is it. They are floating this program with ARPA money until they can hopefully find a way to recoup the cost.

      They went from $138,000/yr to ~$200,000/month. When they burn through the ARPA money, no doubt they will have to subsidize it. With No Surprise Billing Act, the fact they aren’t CAMTS accredited, and their charting software is not designed for critical care billing, and insurance companies will refuse to pay out low acuity (unnecessary flights), it’s difficult to see how this will be a revenue generating mechanism that he claims it will be.

      When he speaks, it’s more important to listen to what isn’t said. You notice they didn’t articulate any specific figures…

      This only scratches the surface of that monster. If only someone would start shaking trees….

  3. We the taxpayers demand transparency in the cost of EMS service to the community be published. My taxes went up not down and if it’s because we are funding a Pie in the Sky copter service which is ten times more expensive to transport patients vs ground service I would like to know about it because it seems to me Kevin Deramus is the main reason my taxes go up if so he needs to be GONE with the Copter or maybe we drain the swamp here in Washington County.

  4. Don’t get me wrong, I’m in favor of a EMS helicopter, but someone is blowing some serious smoke and attaching “Life Safety” to it so they get what they want! Trust me, you attach “Life Safety” to it and it’s hard for anyone to argue against it! I myself have used this tactic! It works! If someone argues against it or questions it, they’re the “bad guy”. So, I guess I’ll be the “bad guy”.
    Other very nearby counties have had a helicopter for years. However, they contract with a private service, for much less. I’d bet PHI could provide the same service for less. You know since WCEMS can’t seem to get the certificates for Rescue and water drops/firefighting. It’s pretty much what our neighbors have next door! Except, they can’t send their helicopter on Texas Taskforce 1 calls all over the state.
    So one of my questions is, where is the part where it cost $100,000 A MONTH in Washington County tax dollars?!
    Who flips the bill for them to take off and
    land when no one is transported? Fuel isn’t cheap! Not to mention they’re going to have to train once they are able to do Rescues and water drops which will result in more fuel cost.
    My point, I don’t believe EMS is being upfront about everything. One minute it won’t cost tax payers and then all of a sudden we’re paying for it! Seems we got the old “”bait and switch” pulled on us.
    Commissioners, please explain to the tax payers of Washington County why Mr Deramus is going to WALLER county ESD’s, representing Washington County in uniform, looking for more calls!!! Washington County taxpayers are paying for it! So he’s looking to send Washington County’s helicopter to another county to cover the cost with insurance funding? Oh wait, it’s my understanding that that’s already happening! Please break down how many of the mentioned 75 transports were from Grimes county? See, that part is left out as well. Again and again, information is being left out!
    Something’s not right here!
    I believe in having air transport, but it seems we are funding something much bigger, like a new Helipad at lake Somerville and a new EMS station, with a EMS unit and a boat (Yes, WCEMS is currently trying to do this!). (Do the math, helicopter start up and flight from Old Washington to lake Somerville plus maybe 5 minutes for the 911 call taker to get info and dispatch them. You’re looking at at least 15 minutes. 15+ minutes without oxygen. Survival decreases, use the boat, I’m sorry it’s now a recovery, not a rescue).
    The commissioners and judge are being had!
    The Taxpayers of Washington County are not getting 100% transparency!
    Everyone needs to be asking deeper questions as to how and why this is being put on the backs of taxpayers and why the commissioners court is allowing it!
    Give us a helicopter that we can afford, that is guaranteed to be in Washington County when we the taxpayers need it!

    1. On top of what was just said, we need to ask why the county wants to cut money given to the volunteer fire departments in the county?

    2. I think the EMS needs to be under the elected Sheriff’s budget and he would decide what we need for Emergency Services. Kevin is a Paramedic at the most not elected but selected and this charade needs to come to a screeching halt. Stop digging in our pockets for things we don’t really need is that so hard to understand. Cutting the budget for our Volunteer firefighters really dumb.

      1. Did you know the county agreed to pay fire departments $112 per call to help with costs? And guess what they did not hold up there end of the deal and practically paid them $53 a call because they “maxed out” the $40,000 budget for a 6 month period. The commissioners brought up paid FF’s and were informed of the cost and said a $357,000 a year budget would not even cover one department to staff two people. FD has discussed an EFD (emergency fire district) but are concerned about Kevin getting involved and taking a majority of the funds (example: Robertson County). Time for people to start voicing their opinion at the commissioners court

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