HAI Convention News

FAA HEMS Initiatives under Audit

 - February 22, 2014, 10:30 AM
The helicopter EMS industry and the FAA have been working together to improve safety.

Fresh pressure is being placed on the FAA to revise and finalize its 2010 notice of proposed rulemaking (NPRM) that would mandate the installation of helicopter terrain avoidance and warning systems (HTAWS) and radar altimeters on all U.S. emergency medical service (EMS) helicopters. The NPRM drew a firestorm of criticism from affected stakeholders for favoring high-cost solutions over less expensive, and some argued, more effective safety technology such as night-vision goggles (NVGs). Also criticized was what some see as the FAA’s slow approval process for related supplemental type certificates and field approvals. Nevertheless, over the last decade, the helicopter EMS (HEMS) industry and the FAA have been working together on a variety of voluntary and collaborative initiatives to improve HEMS safety, and there is some evidence that this approach is working as the number of HEMS accidents per 100,000 flight hours continues to decline in the U.S., even as the industry has rapidly grown from a handful of EMS helicopters in the early 1980s to nearly 1,000 today.

However, in part due to the nature of their flights and operating environments, the HEMS accident rate continues to be twice as high as that for other types of Part 135 operations. Last year U.S. Rep. Rick Larsen (D-Wash.), the ranking member of the House aviation subcommittee, asked the Department of Transportation’s inspector general to review the FAA’s progress in improving HEMS safety. The DOT commenced its audit last November with the stated objectives of evaluating the FAA’s progress in meeting requirements for HEMS operations cited in the FAA Modernization and Reform Act of 2012, and whether the FAA has implemented other actions to reduce the HEMS accident rate. As part of its inquiry, the DOT probe will undoubtedly examine the reasons for the delay of a final HEMS rule. The audit also comes a full three months before helicopter EMS operators are to make their first report to the FAA on number of flights and hours flown, data that ostensibly will be used to aid the FAA in promulgating further risk-mitigation strategies for the industry as mandated under the 2012 Act.

Meanwhile, the NTSB continues to recommend additional HEMS safety enhancements such as mandatory and recurring scenario-based simulator training for pilots. The nation’s largest HEMS operators already use simulator training to sharpen crew skills and avoid the two most common causes of fatal HEMS accidents: controlled flight into terrain and inadvertent flight into instrument meteorological conditions. In January, the NTSB placed helicopter safety on its 2014 “most-wanted list” and senior board members, including chairman Deborah Hersman, were expected to participate in a helicopter safety presentation here at Heli-Expo yesterday (February 24). Over the last decade, the NTSB has made more than 100 helicopter-specific safety recommendations.

Writing on the NTSB “Safety Compass” blog on January 24, board vice chairman Christopher Hart noted, “The NTSB believes that improving the safety of helicopter operations will require increased awareness among, and action by, key stakeholders such as the helicopter manufacturers, operators, training [providers] and regulatory agencies. In 2004, as a way to share industry best practices and coordinate industry responses to safety recommendations and requirements, the FAA and industry established the Helicopter Emergency Medical Services Safety Task Force. This effort led to many safety improvements, but ceased meeting shortly before the issuance of the FAA’s [2010] NPRM. Last week, I was pleased to attend a meeting in which stakeholders involved in the original HEMS Safety Task Force met to address delays in the issuance of the final rule and current helicopter industry safety initiatives.”

The NTSB has recommended that HEMS operators adopt safety management systems and that their aircraft be equipped with night-vision goggles, flight recorders and autopilots for single-pilot operations. None of these were addressed in the 2010 NPRM.


The quickest and cheapest way to increase EMS Air Ambulance safety is to require that all hospitals obtain their own Part 135 Air Carrier Certificate so they are liable to the FAA for rule violations and liable for crashes. I was fired as an Air Ambulance pilot for Carolinas Healthcare in Charlotte, NC because I objected to being scheduled to fly for 30 hours without a rest break even though the FAA rules required a rest break after 14 hours of being ON CALL and/or ON DUTY. The hospital saved money by not have to pay for the required number of pilots to ensure the FAA rest rules were in compliance. The hospital knew they were not repsonsible for FAA violations or crashes because the hospital was not the legal operator. Have you ever heard of an attorney allowing a non attorney to practice law without a law license by simply using the license of a licensed attorney? Can a pilot allow a non poilot to use their pilot's license? If not, then why is a hospital allowed to use the Part 135 certificate or license of another company? There have been efforts to force the FAA/DOT to rescind the Blanket Exemption that hospitals use to avoid having to obtain their own Part 135 Air Carrier Certificate and avoid FAA revocations and crash liability but the effort failed due to lobbying efforts by the hospitals. If you wanted to start charging patients for a flight on your aircraft, you would be required to obtain a Part 135 Certificate before charging patients for the flight. So why are hopsitals exempt from ontaining their own Part 135 certificte? Hospitals have no skin in the game by transferring the FAA compliance issues and crash liability to another company which drives up the cost of the medical flight and drives up the cost of Medicaid and Medicare and insurance coverage by having a middleman between the hospital and the patient. Why does American Airlines not simply use the Air CArrier Certificate of Southwest if the "model" hospitals use is so logical and cost efficient. Why not have one airline with an FAA Air Carrier Certificate and let all other airlines simply pay the one airline to use their certificate? The key word used to operate this scam is Operational Control. I was employed by the certificate holder, not Carolinas Healthcare, but Carolinas Healthcare was at all time in Operational Control of when and where I flew their aircraft. Hospitals would fly safer if they knew they would be sued for crashes and their FAA certificate revoked for safety violations. People don't take care of rental cars like they take care of their personal car. Hospitals do not care as much about safety since they do not have an Air Carrier license that can be revoked for safety violations such as the rest violations that I objected to that caused me to be fired from flying Carolinas Healthcare aircraft.    

Interesting article! We are puting together a database with all modifications available to comply with new FAA requirements (http://helicopterupgrades.com/reports.php?news_id=9). We will see what comes out at the end from the rulemaking processes FAA and EASA have put in place.

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