Report Reveals Half of Maryland Medevac Patients Are Not Seriously Injured

When an Anne Arundel landscaper was caught in a stump grinder and a young woman was thrown headfirst through her car windshield, their lives were saved by Maryland State Police medevac helicopters and the University of Maryland Shock Trauma Center.

The system - considered by many the best medevac and trauma treatment system in the nation - was designed precisely for their types of massive, life-threatening injuries.

But in recent years, about half the patients transported by state police helicopters to a trauma center are not seriously injured; they are treated for nonlife-threatening injuries and released within 24 hours.

That has raised questions about whether the more than $20 million a year taxpayers spend to keep the choppers flying so frequently is necessary or if it's being used to bolster billing at the trauma center.

Maryland is the only jurisdiction in the country where a state agency - the state police - runs a comprehensive statewide medevac system financed by the public. Other states rely on hospital-based commercial operators that bill patients and their insurance companies. When patients don't have the resources, the medevac operators swallow the expense.

A typical medevac bill runs about $10,000, sources said, depending on travel distance and the geographic market.

The Maryland State Police Department never bills for medevac flights, though patients treated at trauma hospitals and the University of Maryland Shock Trauma Center do pay for their medical care.

"When you get a helicopter ride from us, you are not going to get a bill, you ride free," said Maj. A.M. McAndrew, commander of the Maryland State Police Aviation Command. "You get a ride in some other states with private companies, you are going to pay, you are going to get a bill for $6,000 or more."

The $20 million a year it costs to keep the choppers flying doesn't include the roughly $139 million the state is looking to spend to replace its aging fleet of 12 Eurocopter Dauphin helicopters. (Some experts say the purchase price ultimately will be closer to $200 million.)

The annual operating costs come mainly from a $13.50 registration fee charged for each motor vehicle in the state, but state officials say this fund is heading into the red and the fee may need to be increased in as little as four years.Medevac experts said they can't think of a state where the public treasury subsidizes medevac flights, though in some states, such as Florida, a few local fire departments run air ambulance services. In New Jersey, the state police run only two helicopters and the bulk of medevac missions are flown by commercial operators and hospitals.

Some critics say Maryland should follow these states' example and privatize services, but the argument never gets off the ground.

Several members of the General Assembly said lawmakers get so much pressure from state police and the group that oversees trauma care, the Maryland Institute for Emergency Medical Services Systems, that it's impossible to have an open discussion about major changes to the existing system.

"We have some concerns about the system, and the public needs to know," said Sen. Nathaniel Exum, D-Prince George's, who sponsored a bill four years ago to establish a medevac privatization pilot program.

"But we aren't even able to talk about it," Mr. Exum said of the intense lobbying pressure. "They (state police and the Maryland Institute for Emergency Medical Services) call all the little people back home, the firefighters and the paramedics, and tell them we are trying to dismantle the system, and they come running." Mr. Exum said.

"The people who are running the program think it is their program, and they don't want to recognize that it belongs to the people," Mr. Exum said.

When told about lawmakers' perceptions, Maryland State Police Secretary Col. Terrence B. Sheridan laughed and said it was news to him.

"I have never heard that before and I don't know of any leader who has been leaned on," he said.