WASHINGTON CO. PARTING WAYS WITH AIR MEDICAL PROVIDER; HELICOPTER PROGRAM WILL CONTINUE
Washington County is moving in a different direction with its integrated air ambulance program.
Commissioners voted unanimously this (Tuesday) morning to proceed with a 90 day termination agreement with its current air medical provider, REACH Air Medical Services. The agreement, which was entered into in November 2019, will end effective June 13th.
EMS Director Kevin Deramus said the county believes that with a different provider, it can both increase the amount of time the aircraft is available and shrink the cost going into the county’s air medical subscription program with AirMedCare Network.
Deramus said in 2021, the county’s aircraft was available 77 percent of the time and out of service for 23 percent, compared to the industry standard of 98 percent availability. Commissioner Candice Bullock noted that when the aircraft is down, constituents in need of air transport have to use a different provider that does not include the benefits of Washington County EMS’ air medical program, which Deramus said can lead to additional costs for the patient.
According to a release provided from County Judge John Durrenberger after the meeting, the county’s goal has always been to migrate the air medical billing operations into the county’s revenue recovery operations, and it feels now is the time to do it. Performing this action, according to the release, will eliminate the need for the county to continue funding the subscription program’s annual cost of approximately $135,000. The release further stated that as the county performs its own agency billing for the operations as a government entity, it is able to waive co-pays as it does for ground EMS patients.
Full press release from Washington County Judge John Durrenberger:
The Commissioner Court of Washington County has decided to execute section 5.1 of the current agreement between REACH Air Medical and Washington County for integrated air ambulance operations. This section describes a 90 day termination agreement that either party may opt to use. Washington County believes it's in the best interest of the citizens, agencies, and future program direction that we take advantage of this opportunity and make the needed directional changes to better provide service to the Washington County residents.
First and foremost the air medical program has been widely successful with its primary mission of providing air ambulance lifesaving operations to our citizens, visitors and neighbors. This will only continue to improve with these upcoming changes. The program is not going anywhere and will remain a functioning part of the public safety EMS agency in Washington County. We believe the redirection is required to increase aircraft availability, decrease out of service time, and reduce the need for the county subscription program to Air Med Care Network. It has always been our goal to migrate the air medical billing operations into our revenue recovery operations at some point and we believe now is the time. In doing so it will eliminate the need for us to continue to fund the subscription program annual cost of approximately $135,000. As we perform our own county agency billing for the operations, [as] a government entity we are able to wave those co-pays amounts just as we are doing on the ground transportations of EMS patients.
Also at today’s meeting, the court:
- Approved $6,969,658 of American Rescue Plan Act (ARPA) funds to be designated as loss revenue. County Judge John Durrenberger said before the meeting that counties have the option to declare ARPA funds as loss revenue if they receive less than $10 million. He said doing so allows the county to use the money for a wider variety of purposes, while still abiding by federal guidelines for spending the funds. He said the county intends to focus on using the funding for “long-term infrastructure projects” and “for the benefit of the taxpayer.”
- Approved the extension of a contractor agreement between the county and Revenue Optimization Solutions, LLC to serve as EMS’ consultant for the Texas Ambulance Supplemental Payment Program (TASPP).
If you think tossing out REACH air medical and trying another vendor will fix this program, you will learn soon. And you will never find another vendor who will offer firefighting, SAR, or hoist capability.
The recent drama surrounding this program is well known to the helicopter EMS community. As a previous poster had already said, good luck to the new flight crews. If you can find any.
Wondering if this calls for an FBI investigation
Kat, I’m not sure about an FBI investigation. But, a call to the state attorney general may be in order. The business was not publically announced on the agenda of the Commissioner’s Court as required by the Texas Open Meetings Act. At the most, the business should only have been discussed to the point of putting it on a future agenda. This is an example of why the open meetings act was put in place.
Unfortunately I fear the consequences of the county being solely responsible for Helicopter EMS Operations.
The EMS Director has extreme expectations and has previously encouraged and accepted dangerous behaviors. The only risk mitigation in Washington County was REACH. Their very high standards which are industry proven and best practice prevented any adverse outcomes or incidents.
If only the Director and Commissioners weren’t so short sighted. I pray that the future of Washington County HEMS doesn’t become a terrifying aviation disaster and statistic, simply because the Director didn’t get his own way.
DD, I think you might be on to something. Such as discovered in casual conversations with current and former staff of WashCo Air1. The reason for the safety stand down was based on the actions of Mr Duramus. The exit letters from an experienced RN and another from a long time pilot to REACH was the current climate was toxic and all point to Mr Duramus. One even mentions a crash was imminent under current circumstances. After the safety stand down Mr Duramus was asked by REACH to no longer have direct contact to the medical crews due to his past unsafe actions. Now the Judge wants to put him in charge of the county program.
Also it should be asked why have the standards once outline by Mr Duramus as minimum patient care for air medical transport are no longer important. As a working committee member to the Brazos Valley Regional Advisory Council Mr Duramus once outline and push the issue that Air Medical Providers must be credentialed such as CAMTS to provide RAC coverage. However to gain the desperate control he desires those are not important to him anymore. The current behind the scene plan is to fly the county Operations with two paramedics not paramedic with a RN. Is this because of the EXTREME turn over Mr Duramus has caused or is it he has now found such far superior way of managing your health care? We can all brace for the defense of RNs are too hard to find; but if so how does REACH continue to find replacements for the ones fleeing Mr Duramus? My guess it is the RN market simply gives them the ability to leave a toxic program. It may also interesting to see how the use for air medical declined once Mr Duramus lost control of the medical staff. Did patients just stop needing air transport or did the ego?
In all, the comments here warn the county of the potential but will once again be buried by timing and political play.
Unless the community and media Big and Small actually care to find the truth not just statical rhetoric things will never change.
How peculiar. Last month, after the Commissioner’s Court session and subsequent subscription plan renewal, the statement was “The county pays $131,078 annually for the membership plan. The cost is reimbursed by REACH Air Medical Services.” This month, the cost is is now $135,000 annually, the county is paying for it, and apparently simply cannot justify the cost.
But, what cost is that exactly again? Let’s review.
The cost of the helicopter, fuel, maintenance, and rent for hanger space is funded completely by REACH.
The payroll costs of pilots, mechanics, and clinical staff, also funded completely by REACH.
In essence, the county, at no cost to itself (or some cost to itself, depending on which fact is more convenient at the time), has been supplied with a complete Air Medical program with national resources, with growing local capabilities for wild-land fire suppression and search and rescue abilities including hoisting. If you’re re-reading that looking for the bad deal for the county, you’re probably not alone.
Even if the reported 77% in-service rate is true, )which by now we’ve learned that facts and figures are fluid in Washington County), an astute observer would note that it’s still 77% more Air Medical capability than was present previously, all at little or no cost to the county.
So now the question is why the change? If it not due to cost, what could it be? Surely not leadership, as Washington County has been the source of all local leadership, at least until that unfortunate safety stand down that is mysteriously missing from all press releases. Speaking of cost, what is the cost of the as yet unannounced program that is to follow? Will whatever vendor is to follow pay the county for all the above, and then a gratuity on top? That’s the only formula for a better deal. Will there still be fire suppression and search and rescue capabilities, such features that were vitally important to the program’s inception only two short years ago? Why was the vote to terminate the contract not published on the agenda for the Commissioner’s Court? Things done in the dark are done so for a reason, as they would not stand the light of day. Surely, something as small as personal pride couldn’t possibly the impetus for all of this change, could it? These are just the beginning of questions we should be asking, dear tax payers of Washington County.
The 77% in service time ( 23% out of service) for the entire year would seem pretty unbelievable. Any air care provider makes their revenue on being available to transport patients. This would equate to nearly 90 days of nonavailable time. If the aircraft was not available to take a patient, it would seem prudent to provide a spare aircraft to continue the service and subsequently earn revenue. I believe Reach Air Medical has been in the business long enough to have figured out this fairly simple model. With this in mind, it would seem Mr. Deramus has been able to throw something at the wall and get it to stick. Whatever the motivation, I don’t see this as a win for the county. Only the ego of one individual.
Wondering Why
Kevin Deramus quoted in 2021 the poor percentages that Reach wasn’t doing their job and Candice Bullock “noted” other air transports have to be used that does not include EMS air medical program and “can” lead to additional cost to the patients. My wondering is with thes unbelievable high percentages is to ask why EMS DIRECTOR Kevin Deramus let these percentages get to be his quotes? Plus why didn’t EMS Director Deramus, judge John Durrenberger and other county adminstration or (as the county preforms does it’s own agency in billing for operations as a government entity) SUE REACH that costing possibly patients lives and money more than anything for so long? Or is there reasons for the government of the Air medical transport department to not get involved and check the facts? Just wondering ?
Industry standard of 98% seems a little high. Especially considering weather factors and for a base with only one helicopter.
I’d like to see where those numbers come from. A lot of numbers that get thrown around as “industry standard” by the EMS director don’t seem to line up…
I’m pretty sure… if it looks like a skunk, raises it’s tail like a skunk, and smells like a skunk……..it’s a skunk!!
As I Said a year and half ago free. Nothing is free but Prect 1 still voted for the incumbent !!!!
The EMS Director is just mad at Reach because he wanted them to do some dangerous stuff and Reach told him to pound sand! It got so bad Reach put the base on a 2 week safety stand down to force him to chill.
So now he’s acting like a child and forcing them out. Good luck to the new flight crews
Sorry but no. I’ve been flying helicopters for over 36 years and I fly in another state and Reach Air Medical is a SOLID company!
It’s true that sometimes helicopters break but at least they are finding the problems on the ground and not in flight.
This is not a Reach Air Medical problem! This is the EMS director asking them to do things that shouldn’t be done. Wish we could hear Reach Air Medical side of this story.
Maybe our local news sources can follow up with Reach and find out what is really going on…
Maybe ask some former employees. There seems to be a lot of them, ALL starting the EMS Director issues.