Is Lake County Response-Able?
Part Two: “Incoming” – Air Medical Services
The sound of motor blades across the highest of skies always gets your attention if you live in Leadville Today. It’s usually one of two types of helicopters: military or medical. Most locals can audibly tell the difference.
The Army’s twin-engine, tandem rotor Chinook’s echo is distinctly dominant, usually heard following the mighty Arkansas River as part of regular training exercises and routine patrols. Last February LT readers may recall the visit from a pair of Ospreys that rattled old house windows when the two military copters refueled at the Leadville Airport (LXV).
What happens in the skies above Leadville is more relevant than ever, especially when it comes to air medical services. In Part One of LT’s “Incoming” series the three private air medical services companies had an opportunity to share with residents the services they provide, to tell their story. In addition, LT inquired about their interaction with local emergency responders. What was the protocol? Who makes the call for a medical airlift? Have they seen an increase in calls?
In Part Two of “Incoming,” LT shares not only those findings but also the responses to several media inquiries made to the locally tax-based organizations and facilities charged to coordinate with these companies, including Lake County Search and Rescue (LCSAR) and St. Vincent Health (SVH) and the Leadville/Lake County Airport (LVXX).
In short, the good news is that Lake County is well-covered and well-cared for in Central Colorado. However, there are some discoveries worth sharing, some good, some not-so-good. These findings are not to cast blame but rather shine the light on some areas that could use some. Perhaps there are readers who can offer assistance as all of these entities rely quite heavily on volunteers to get the job done.
Look, Up in the Sky
Whenever there is an unusual flight pattern in the skies, people take notice. So on June 5 when a helicopter appeared to be making an unexpected landing in the Mosquito Mountain Range located to the east of Leadville, it got people’s attention. And most sky-watchers knew it was not one of the utility copters which had been routinely dropping in supplies to land crews working on a utility upgrade in that area. People knew it was a medical air evac copter and its presence is the kind of thing that will make phones ring.
Fortunately, the aircraft was part of a training exercise. LCSAR’s Board Secretary Becky Young explained the unusual flight pattern after repeated inquiries to the aircraft’s company (REACH) went unanswered. See something, say something, right? Ask questions and answers should follow. So thank you LCSAR:
Like most Colorado SAR teams, LCSAR participates in the Lift Ticket Program. The three medical helicopter agencies operating in Colorado (Reach, Flight For Life, and Classic Air) all participate in this unique program. It allows SAR teams to utilize medical helicopters for non-medical assistance free of charge to teams and subjects. The 3 medical helicopter agencies each hold an annual Lift Ticket Training for teams, where members learn how to safely work with the helicopter and crew. Each member receives their flight card after completing the training, which then certifies that they are trained to ride in, or work around, a helicopter. Each helicopter agency offers its own lift ticket training and cards (the training and cards are agency-specific; you cannot use a Reach card to ride on a Flight For Life helicopter, for example), and these trainings are free. So, to specifically answer your funding question about the training session with Reach, the training was free. Furthermore, the Reach training was for LCSAR members and was facilitated by the Flight Crew in service that day. LCSAR will host 2 more Lift Ticket training next week, one for Classic Air and one for Flight For Life.
And sure enough on June 19, the Classic Team landed in an open field adjacent to the LCSAR Cache Building at the tail end of East 10th Street, creating a rotor blade of dust and dirt to nearby residents. This is the new reality. That life-saving bird will likely come to you. And this group of dedicated, trained volunteers are ready, they are Response-Able! #goodtoknow
Living Up to the Narrative: A New Day
The helipad at St. Vincent Hospital officially shut down in August 2019, marking two years this month. At that point, the official interfacility transport location was re-established at the Leadville/Lake County Airport. which until just recently had a management gap of more than 12 months through a global pandemic and was (successfully) being run by an 18-year-old Leadville student. But it turns out that doesn’t really matter when it comes to air medical services. So while recently appointed airport staff is defining new priorities, while a medical air evacuation plan and defined extraction point have not been officially established, the truth is it’s mattering less all the time.
At that point, Leadville’s local emergency model became a “stabilize and transport” operation as patients in need of more critical care were part of the interfacility transports systems. That looks a bit different in Leadville Today; not better or worse, just different. It’s also important information in today’s narrative regarding emergency services for residents and visitors.
When it comes to air-evacuations in Leadville, Flight for Life’s last flight from St. Vincent Hospital’s helipad was on August 14, 2019. It was the last (official) flight out. But that doesn’t mean that FFL crews aren’t just as busy in Lake County. In fact, the same crew operates both the air and land transports because there are times when the aircraft is grounded due to weather.
“They respond to St. Vincent’s fairly often,” explains Kathy Mayer, FFL Program Director. The primary reason is patient acuity either stemming from a medical condition or in some cases their weight makes them an air-evac risky. Regardless of the reason, the gap gets narrower all the time as medical air services step up their practice with equipment and management of medications particularly blood transfusions in transports.
But if a flight is necessary, the big orange motor-bird is Lake County’s first choice simply because of the long-standing relationship with the local community and its proximity, operating just over the hill out at St. Anthony’s in Frisco. It’s also the most recognizable aircraft against the bright blue sky. And who can forget those pretty dramatic landings on the big red cross located at the hospital in the middle of the city center? So with the advancement of medical aircraft, is an official hospital helipad even relevant anymore?
“It happens more often than you think,” explains Chad Bowdre, Director of Customer Relations for Classic Air Medical regarding their operations across Colorado, “that there’s some impediment to using the hospital helipad: ‘Oh, you need to land in the grass next to the helipad at the hospital, or you need to go to the airport or vice versa.’ There are consistent logistical challenges for all sorts of reasons and that’s one of the things that we’re (Classic) quite good at.”
There has been at least one documented record of an emergency-room air-transport pick-up since the facility’s helipad officially closed on August 20, 2019. However, since then, the protocol has changed and the Leadville Airport became that official interfacility transport designation. How has it been going for the past two years as needs have increased for Lake County and the world has been undergoing a global pandemic putting extra strain on the medical community? For Flight For Life crews, the established facility has been working just fine, now two years into a re-designation that was supposed to be a “temporary situation.”
“We’ve been going out of the airport for a while now,” stated Mayer (FFL). “And we are happy to do so as long as it takes. The ambulance has been great about meeting us up there and getting patients out. It’s not really a big deal, it does lengthen the transport by a little bit. It’s a pretty well-oiled system right now.” #goodtoknow
But for Lake County taxpayers it does matter. While there is no documented evidence of a new helipad planned at the new medical facility, not on their website, not on their social media platforms, two separate emergency responders confirmed reports of hospital management discussing plans of a fully-heated, supped up helipad at the new medical facility. So LT reached out to SVH’s Chief Branding Officer Karen Onderdonk for comment:
“When we began construction on the new hospital our helipad closed temporarily. The air-transport companies then began to fly into Lake County Airport. If a patient at SVH needs air-medical transport for a higher level of care, our ambulance transports them to the airport to meet the helicopter after they have been stabilized in the ER. We will reopen the helipad at SVH once the construction is completed. Which we hope is later this summer we have experienced delays related to the pandemic, such as supply chain and workforce.”
But no plan, no sketch, no engineering design of a new helipad has been presented, to date. When it is, it will be added to this report. But for now, two years into what hospital officials stated would be a “temporary situation,” most medical personnel know the drill: transports are out of the airport. And by all accounts, that component of the medical transport system is working. It is fully intact, and reliable. In fact, Mayer, among others, made specific mention of SVH’s ambulance director Jeremiah Grantum, describing him as a “take-hold, dedicated person.” #goodtoknow
So the last place before liftoff is LXV. Was the airport staff ready to answer a series of simple questions, concerning their protocol as the interfacility transport designation? Did they have a dedicated area similar to the former helipad which was left to go dormant during the most recent runway upgrade? How do they clear the area of snow and ice during winter months so that both ground and air trasnports have a clear easily accessible pathway? It was another “no response,” the second weak link in the medical air services chain.
But, it turns out, it doesn’t matter. In fact, the three private companies are prepared to extract patients from pretty much anywhere. And since the Leadville/Lake County airport does not maintain a 24-hour staffed tower, pilots have regular protocols in place about letting air traffic know they are coming in for a transport. Medevac staff notifies Lake County Dispatch to see if the area is clear and if it’s plowed that’s great, but helicopters can pretty much clear their own landing strip from their rotor blade wash.
In full disclosure, this county-run facility has seen a high rate of staff turnover even during its most aggressive upgrades in recent years. However, there was no response from the new manager, and a quick check of the airport’s social platforms displays different priorities for the recently appointed staff. But as the airport team focuses on re-branding as the Leadville Air Center, there still is no designated medical helipad in place, no protocols. If that information is made available, it will be added to this report and it will be #goodtoknow.
Who Makes the Call?
It’s great to have choices, especially if you live in a small, remote community like Leadville. Having three air medical services that operate in Lake County is a big advantage, but how is it determined which transport company to use? In most instances, it’s “who can get there the fastest?” And “who can handle the situation?” For example, if you have a high-risk OBGYN, Classic has such a team available. According to Chad Bowdre, Director of Customer Relations for Classic Air Medical, each county seems to have different protocols, some use rotation if they have more than one server available.
LT’s discovery found that each hospital makes its own determination. And if it’s a Search and Rescue situation, they have the ability to call in their choice of air-vac, generally determined by the incident commander in charge and the patient’s status. All-in-all the spirit of cooperation and coordination seemed to be full-circle between the private and public sectors. #goodtoknow.
What’s All This Gonna Cost Me?
One of the top concerns for any medical services are fees, now add a helicopter and top-notch onboard medical crew and a patient’s got to ask – what’s all this going to cost me?
“Like all SAR teams in Colorado, we sometimes utilize Medical helicopter agencies for non-medical assistance, such as aerial searches, and for insertion of members and/or equipment into difficult to access locations. These are services all the medical helicopter agencies (Reach, Flight for Life, and Classic Air) agree to provide to SAR teams free-of-charge under certain circumstances through the Lift Ticket Program,” explains Board Secretary Becky Young for Lake County Search and Rescue which still operates under the purview of the Lake County Sheriff Office. “LCSAR utilized medical helicopters 4 times for severely injured patients in 2020, and utilized a medical helicopter for non-medical assistance 6 times in 2020. So far in 2021, LCSAR has not utilized a medical helicopter for any mission support or medical evacuation (June 2021).”
Young added that SAR’s use of medical helicopters for non-medical assistance is still free to subjects. Some subjects ask if they will have to pay for the helicopter that inserted the SAR personnel that then completed the rescue. The answer is no, the rescue is always free, even if a helicopter is used to insert members into the area or to complete aerial searches.
“However,” she further explains, “if a patient requires a medical helicopter for a medical evacuation, then that service is billed to their health insurance by the helicopter agency just like an ambulance or ER visit.”
It’s not too different on the private side either: “Insurance or patient preference does not come into play in high country air rescue,” a reassuring statement from Classic’s PR guy. In fact, Classic was quite forthcoming, stating that the average out-of-pocket cost for their customers is $200.
Going By The Books On This One
Speaking of money, one of the discoveries LT made during its inquiries was that LCSAR’S non-profit status is currently reported as “non-compliant.” Here is the organization’s explanation of a sticky tax situation it finds itself in with the Colorado Secretary of State’s Office.
“This is due to a tax mistake in 2020. We have completed the relevant paperwork to get our non-profit status reinstated and are now waiting on the IRS to process that paperwork. As I’m sure you know, the IRS isn’t known as the speediest agency. We have disclosed this information to all would-be donors and are currently not accepting unsolicited donations until our status is reinstated. It was an unfortunate mistake, but an understandable one given that we’re all volunteers doing our best to run this volunteer agency while working full time jobs. We’ve since hired an accountant to manage our taxes.”
Follow-up: Unfortunately, on June 30, 2021 the Colorado Secretary of State’s office issued the following failure notice. “LAKE COUNTY SEARCH AND RESCUE INC. – 20031054892, has become Delinquent for failure to file its Periodic Report.” While there’s little doubt that life-saving volunteers willing to heed the call in the middle of the night supersedes an IRS speedbump, it’s also good stewardship to maintain the integrity of an organization and the community it represents. And it’s not the only Lake County non-profit that looks untidy, unkept on the back end.
Up, Up, and Away
“It was like that scene from Willie Wonka” described one resident who years ago was flown out during a high-risk delivery. “I looked down on Leadville as we flew off into the wild blue yonder!” And while most air-evac patients don’t remember their life-saving flight quite like that, they know that the trip likely saved their life.
As Lake County heads into its busiest month its #goodtoknow that this small, remote community is well-covered on all fronts with dedicated, caring medical staff and volunteers. Something to think about when you hear the whirl of that rotor blade against a crisp Leadville sky.
“I mean sometimes someone is having the worst day ever and the closest aircraft is out on another flight or doing something somewhere else,” concludes Chad Bowdre, Director of Customer Relations for Classic Air Medical, “but be assured that you’ll be well taken care of no matter which colored aircraft is coming for you.”
And if you live in Leadville Today, that’s #goodtoknow!
Kathy Bedell © Leadville Today
Colorado Journalist Kathy Bedell owns The Great Pumpkin, a digital media company located in Leadville, Colorado which owns Leadville Today and Saguache Today. She may be reached at firstname.lastname@example.org.