Cooperation between the two providers of emergency medical transport in San Juan County has become more difficult as of late.

The two providers, Airlift Northwest and Island Air Ambulance, both provide air transport for county patients, but island residents are wondering what is happening with the two entities and what exactly is the difference between them?

Transport

Airlift Northwest is the University of Washington-affiliated emergency medical transport that uses helicopters to fly critical-care patients directly to Seattle and Bellingham hospitals. The AirCare membership for transport by Airlift Northwest helicopter costs $79 a year in Washington.

Island Air Ambulance provides county residents and visitors with basic life support transport in an airplane between county airports and airports in Bellingham and Seattle. Today most patients requiring air medical transport from San Juan Island fly with Island Air Ambulance, according to Larry Wall, director of critical care transport for San Juan Island EMS. The service results in no out-of-pocket costs to residents of San Juan Island, Pearl Island, Brown Island, Henry Island, Stuart Island, Johns Island and Spieden Island, which are all part of the taxing district that supports San Juan Island EMS.

There are a number of differences in equipment and services available from each program, the primary one being that Airlift Northwest helicopters fly directly to hospitals with landing pads, while fixed-wing planes must land at airports.

Individual annual membership for those who live outside of the taxing district, like Orcas residents, is $45 a year and the family annual membership is $55.

Cutting ties

Airlift Northwest will not help to cover islanders using Island Air Ambulance.

Airlift Northwest announced it has terminated participation in the reciprocal payment program of the Association of Air Medical Membership Programs.

“Reciprocal payment” is a common arrangement among providers of emergency transport. For instance, if you had an AirCare membership and were transported by Island Air Ambulance, your out-of-pocket costs – over what your insurance paid – would have been covered by Airlift Northwest. That will no longer be the case for residents outside of the taxing district that supports San Juan Island EMS. Residents in that taxing district will also receive added benefits.

“A resident of San Juan Island Public Hospital District is covered for out-of-pocket expenses by the EMS Medevac [Air Ambulance] program no matter who does the transporting,” said San Juan EMS Chief Jim Cole.

The future

Airlift Northwest’s new plan is to negotiate payment plans directly with emergency transport providers, though apparently not with Island Air Ambulance.

Airlift Northwest claims the change became necessary partly because county residents are using Island Air Ambulance far more than Airlift Northwest.

“We cannot have reciprocity with Island Air Ambulance because we’re not communicating with Island Air Ambulance,” said Chris Martin, executive director of Airlift Northwest.

Martin said that San Juan Island EMS has decided to transport more patients using Island Air, rather than calling in an Airlift Northwest helicopter.

Airlift Northwest has about 3,700 San Juan County residents who pay to participate in its AirCare membership program.

San Juan Island EMS Medevac, who runs Island Air Ambulance, has recently begun signing up county residents for its similar program to offer emergency transport by airplane.

Cole says the membership is not being offered to residents of San Juan Island Hospital District 1 because their out-of-pocket costs are already covered by being part of the hospital district.

Martin said reduction in Airlift Northwest flights from San Juan County in recent years is evidence that San Juan Island EMS has relied less on Airlift Northwest helicopters and more on its own fixed-wing airplane and on the EMS emergency boat Guardian for transportation.

In 2011, Martin said, Airlift Northwest completed 552 missions to the county; in 2012, the number decreased to 370; so far in 2013, the number is 287.

Martin said that the reduced numbers are the result of decisions made by San Juan Island EMS.

Cole disagrees with that statement.

“All medical emergency transportation decisions are made on the basis of what’s best for the patient,” Cole said.

– Cali Bagby contributed to this story.