County Commission says it will consider joining program to cover residents’ out-of-pocket air medical transport expenses

by Debora Nicoll | June 25, 2021
6 min read

For an annual cost of only $23,592 to Sierra County government, any county resident suffering a medical emergency that requires an air lift to a hospital would have all out-of-pocket transport expenses covered, the county commission learned at its June 15 meeting.

air medical transport and technicians
Source: PHI Air Medical

The coverage would be provided by PHI Air Medical, a national air ambulance company, through its PHI Cares countywide membership program, according to PHI sales representative Jillian Manley, who made a presentation on this service at the meeting.

Brian Coutts, PHI Cares director, confirmed that the program would eliminate all out-of-pocket costs associated with air medical transport for county residents, including Medicare participants. “We will bill their insurance or responsible third parties and accept this as payment in full,” Coutts said in an email to the Sun.

As with all aspects of medicine in the United States, the costs of air medical transport have skyrocketed. In New Mexico, with its large rural population and single Level 1 trauma hospital (UNM Hospital in Albuquerque), a physical health emergency can have a big impact on an individual’s financial health, as well.

A 2019 article in the Santa Fe New Mexican provided the latest available information about the average cost of air ambulance transport in New Mexico, citing 2017 statistics supplied by the state superintendent of insurance. Transport costs rose to nearly $46,000 in 2015 from about $14,000 in 2006. After insurance companies covered their portions of transport costs, an average of nearly $27,000, as of 2015, was left for patients to pay.

PHI Cares county membership plan costs $8 annually per household and places no limit on the number of service calls. Manley estimated the number of Sierra County households that would be covered at 2,949.

The sole question from the commission addressed to Manley came from Chairperson Jim Paxon, who asked her to confirm that the cost to the county would be $23,592. With that price reiterated, Paxon informed Manley that the commission would consider the proposal.

Contacted later, Acting Sierra County Manager Serena Bartoo told the Sun that the Sierra County commission will not take the proposal into consideration because Sierra Vista already has established medical air evacuation contracts. “It’s a hospital thing,” Bartoo said, assigning Sierra Vista responsibility for medical transport services.

Sierra Vista Hospital CEO Eric Stokes told the Sun he was not aware of the PHI Air Medical proposal. To his knowledge, the hospital does not have an exclusive contract with any medical air transport company. The hospital, which has a helipad, “provides a safe environment” for the air transport of patients, but the payment for transport services is between the patient and the transport company. Stokes told the Sun that he is willing to look into or discuss with the county commission any issue that might enhance medical services available to county residents.

If Sierra County government were to enroll in PHI’s Cares, local residents would be served by one of four PHI Air Medical bases located within 200 miles of here. Three are in New Mexico (in Socorro, Albuquerque and Grants) and one is in Safford, Arizona. All told, the company operates out of more than 65 bases around the United States, its website states.

Manley described the company’s air ambulances as being essentially “flying ICUs (intensive care units)” since each base is staffed by a paramedic, a nurse, a pilot and a medical director, enabling PHI to treat patients while enroute to a hospital.

Sierra Countians who suffered a medical emergency requiring air transport to a hospital while in an adjacent county (Socorro, Catron, Grant, Luna, Doña Ana, Otero or Lincoln) would be covered under the county plan. Even county residents without health care insurance would be included. In addition to covering all family members, up to three non-relatives living in a household would also receive the benefit, according to Coutts.

Coutts explained how the program would work for a Sierra County resident if the county were to subscribe. In a medical emergency, the resident would call 911 and, if possible, inform the dispatcher of membership in PHI Cares. The 911 operators are trained to determine if a helicopter is needed, in which case the dispatcher would contact PHI Air Medical and coordinate with the local EMS to identify the safest and best pick-up location. In some cases, the local EMS would transport the patient to a heliport by ambulance. If required, PHI can land locally in a cleared area. Air medical response times can vary, but dispatch is typically within minutes and can often reach patients in remote rural areas faster than ground ambulance, Coutts said.

The Sun also spoke to county managers in Harding County (Jennifer Baca) and in Union County (Brandy Thompson), where PHI Air Medical county-wide programs have been in effect for about a year.

These counties have lower populations than Sierra. Harding has 441 residents spread over 2,126 square miles. Union is larger with 4,133 residents spread over 3,831 square miles. In comparison, Sierra County has a population of 11,031 over 4,236 square miles. However, half of Sierra county’s population lives in either Truth or Consequences or Elephant Butte, so the rural population of Sierra is comparable in density to that of Union County.

Both Harding’s Baca and Union’s Thompson have found that membership in PHI Cares has been good for their counties. 

Baca told the Sun that a number of Harding County residents thanked their commissioners for joining the program and that it has been already used several times. While Baca did not have any information on the experience of those patients, she knew of any individual, airlifted before the program went into place, who was “still paying off their deductibles of $35,000 to $40,000.”

According to Baca, Harding County has two designated heliports, one in Mosquero and the other in Roy, but that an airlift can take place if a 100 by 100 foot area is cleared. After joining the Cares program, the county has obtained legislative funding to improve the Roy heliport.

Likewise, Thompson said that having membership in the program has been “great, especially through the pandemic.” The hospital in that county was a spoke in the “spoke and hub” group of hospitals that accepted COVID-19 patients and a number of Union County patients were transported to a hospital in Amarillo. Thompson told the Sun that a person involved in a ranch accident who was airlifted to medical help later thanked the commission for having the program. Thompson said that the Union County Commission will renew its membership in the program as long as funds are available, and they have already budgeted for membership in the upcoming fiscal year.

If Sierra County, on the other hand, decides not to participate, private citizens may enroll in PHI Cares at an annual membership rate of $60 for households with health care insurance or $40 for an insuredindividual. The rate for uninsured households or individuals is $100.

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Debora Nicoll covers the Sierra County Commission for the Sun.

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HAVE YOU SEEN?

Understanding New Mexico's proposed new social studies standards for K-12 students

“The primary purpose of social studies is to help young people develop the ability to make informed and reasoned decisions for the public good as citizens of a culturally diverse, democratic society in an interdependent world.”
—National Council for the Social Studies 

Reader Michael L. Hayes of Las Cruces commented: What impresses me is that both the proposed standards and some of the criticisms of them are equally grotesque. I make this bold statement on the basis of my experience as a peripatetic high school and college English teacher for 45 years in many states with many students differing in race, religion, gender and socioeconomic background, and as a civic activist (PTA) in public education (My career, however, was as an independent consultant mainly in defense, energy and the environment.)

The proposed social studies standards are conceptually and instructionally flawed. For starters, a “performance standard” is not a standard at all; it is a task. Asking someone to explain something is not unlike asking someone to water the lawn. Nothing measures the performance, but without a measure, there is no standard. The teacher’s subjective judgment will be all that matters, and almost anything will count as satisfying a “performance standard,” even just trying. Students will be left to wonder “what is on the teacher’s mind?” or “have I sucked up enough.”

Four other quick criticisms of the performance standards. One, they are nearly unintelligible because they are written in jargon. PED’s use of jargon in a document intended for the public is worrisome. Bureaucrats often use jargon to confuse or conceal something uninformed, wrong or unworthy. As a result, most parents, some school board members and more than a few teachers do not understand them.

Two, the performance standards are so vague that they fail to define the education which teachers are supposed to teach, students are supposed to learn, and parents are supposed to understand. PED does not define words like “explain” or “describe” so that teachers can apply “standards” consistently and fairly. The standards do not indicate what teachers are supposed to know in order to teach or specify what students are supposed to learn. Supervisors cannot know whether teachers are teaching social studies well or poorly. The standards are so vague that the public, especially parents or guardians, cannot know the content of public education.

Three, many performance standards are simply unrealistic, especially at grade level. Under “Ethnic, Cultural and Identity Performance Standards”; then under “Diversity and Identity”; then under “Kindergarten,” one such standard is: “Identify how their family does things both the same as and different from how other people do things.” Do six-year-olds know how other people do things? Do they know whether these things are relevant to diversity and identity? Or another standard: “Describe their family history, culture, and past to current contributions of people in their main identity groups.” (A proficient writer would have hyphenated the compound adjective to avoid confusing the reader.) Do six-year-olds know so much about these things in relation to their “identity group”? Since teachers obviously do not teach them about these other people and have not taught them about these groups, why are these and similar items in the curriculum; or do teachers assign them to go home and collect this information?

Point four follows from “three”; some information relevant to some performance measures requires a disclosure of personal or family matters. The younger the students, the easier it is for teachers to invade their privacy and not only their privacy, but also the privacy of their parents or guardians, or neighbors, who may never be aware of these disclosures or not become aware of them until afterward. PED has no right to design a curriculum which requires teachers to ask students for information about themselves, parents or guardians, or neighbors, or puts teachers on the spot if the disclosures reveal criminal conduct. (Bill says Jeff’s father plays games in bed with his daughter. Lila says Angelo’s mother gives herself shots in the arm.) Since teacher-student communications have no legal protection to ensure privacy, those disclosures may become public accidentally or deliberately. The effect of these proposal standards is to turn New Mexico schools and teachers into investigative agents of the state and students into little informants or spies.

This PED proposal for social studies standards is a travesty of education despite its appeals to purportedly enlightened principles. It constitutes a clear and present danger to individual liberty and civil liberties. It should be repudiated; its development, investigated; its PED perpetrators, dismissed. No state curriculum should encourage or require the disclosure of private personal information.

I am equally outraged by the comments of some of T or C’s school board members: Christine LaFont and Julianne Stroup, two white Christian women, who belong to one of the larger minorities in America and assume white and Christian privileges. In different terms but for essentially the same reason, both oppose an education which includes lessons about historical events and trends, and social movements and developments, of other minorities. They object to the proposal for the new social studies standards because of its emphasis on individual and group identities not white or Christian. I am not going to reply with specific objections; they are too numerous and too pointed.

Ms. LaFont urges: “It’s better to address what’s similar with all Americans. It’s not good to differentiate.” Ms. Stroup adds: “Our country is not a racist country. We have to teach to respect each other. We have civil rights laws that protect everyone from discrimination. We need to teach civics, love and respect. We need to teach how to be color blind.”

Their desires for unity and homogeneity, and for mutual respect, are a contradiction and an impossibility. Aside from a shared citizenship, which implies acceptance of the Constitution, the rule of law and equality under the law, little else defines Americans. We are additionally defined by our race, religion, national origin, etc. So mutual respect requires individuals to respect others different from themselves. Disrespect desires blacks, Jews or Palestinians to assimilate or to suppress or conceal racial, religious or national origin aspects of their identity. The only people who want erasure of nonwhite, non-Christian, non-American origin aspects of identity are bigots. Ms. LaFont and Ms. Stroud want standards which, by stressing similarities and eliding differences, desire the erasure of such aspects. What they want will result in a social studies curriculum that enables white, Christian, native-born children to grow up to be bigots and all others to be their victims. This would be the academic equivalent of ethnic cleansing.

H.E.L.P.

This postmortem of a case involving a 75-year-old women who went missing from her home in Hillsboro last September sheds light on the bounds of law enforcement’s capacity to respond, especially in large rural jurisdictions such as Sierra County, and underscores the critical role the public, as well as concerned family and friends, can play in assisting a missing person’s search.

Reader Jane Debrott of Hillsboro commented: Thank you for your article on the tragic loss of Betsey. I am a resident of Hillsboro, a friend of Rick and Betsey, and a member of H.E.L.P. The thing that most distresses me now, is the emphasis on Rick’s mis-naming of the color of their car. I fear that this fact will cause Rick to feel that if he had only gotten the facts right, Betsey may have been rescued before it was too late. The incident was a series of unavoidable events, out of everyone’s control, and we will never know what place the correct color of her car may have had in the outcome. It breaks my heart to think that Rick has had one more thing added to his “what ifs” concerning this incident.

Diana Tittle responded: Dear Jane, the Sun undertook this investigation at the request of a Hillsboro resident concerned about the town’s inability to mount a prompt, coordinated response to the disappearance of a neighbor. From the beginning, I shared your concern about how our findings might affect Betsy’s family and friends. After I completed my research and began writing, I weighed each detail I eventually chose to include against my desire to cause no pain and the public’s right to know about the strengths and limitations of law enforcement’s response and the public’s need to know about how to be of meaningful assistance.

There was information I withheld about the state police investigation and the recovery. But I decided to include the issue of the car’s color because the individuals who spotted Betsy’s car emphasized how its color had been key to their identification of it as the vehicle described in Betsy’s Silver Alert. Because the misinformation was corrected within a couple of hours, I also included in this story the following editorial comment meant to put the error in perspective: “The fact that law enforcement throughout the state was on the lookout in the crucial early hours after Betsy’s disappearance for an elderly woman driving a “light blue” instead of a “silver” Accord would, in retrospect, likely not have changed the outcome of the search” [emphasis added].

I would also point to the story’s overarching conclusion about the inadvisability of assigning blame for what happened: “In this case, a perfect storm of unfortunate circumstances, many of them beyond human control, hindered the search that it would fall to Hamilton’s department to lead.”

It is my hope that any pain caused by my reporting will eventually be outweighed by its contribution to a better community understanding of what it will take in the future to mount a successful missing person’s search in rural Sierra County.

1 thought on “County Commission says it will consider joining program to cover residents’ out-of-pocket air medical transport expenses”

  1. Dennis Dunnum

    This is an incredible deal! We moved here primarily because there was a hospital here. But our experience has been that this hospital is not equipped to handle any but the least serious ailments. We live near the hospital and the helipad and have been astounded at the number of people that have had to be airlifted to a more serious hospital. My partner and I have talked about it and decided it would take a very serious emergency to go to the hospital that is only a block away. We would sooner drive ourselves to Las Cruces than risk incurring a charge for airlift that would wipe out our entire life savings.

    This would definitely be a perfect example of government’s recognizing its social contract with its citizens. I would be perfectly willing to pay the county an extra $8 a year in taxes if they used it for something like this. It’s social insurance par excellence!

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