Tuesday, July 12, 2016

SouthSTAR: South Jersey air medical service grounded -The Kathryn Report



Penny Morey said her first granddaughter wouldn't be alive without SouthSTAR, the publicly funded, state-run ambulance service that has long served South Jersey.

In July 2005, Morey's granddaughter Jasmin was born with pneumothorax, a lung condition. When she was just three days old her lung collapsed.

Paramedics from SouthSTAR were summoned to South Jersey Regional Medical Center in Vineland to airlift Jasmin to the Children's Hospital of Philadelphia. Doctors put her chances of survival at just 10 percent.

"The staff was so amazing," Morey recalled. "They told me and my daughter what they would have to do to prepare her. They let us be right there to watch and to comfort us. If it wasn't for the flight my first granddaughter would have never made it."

Eleven years later, Jasmin is doing "amazing," Morey said.

It is a different story for SouthSTAR .

After responding to traumatic crash scenes and airlifting patients between hospitals for nearly three decades, the service is no longer in the air. Facing rising competition from private companies that have flooded the market in recent years, Virtua, the healthcare system that provided the medical crew for the helicopter, opted not to reapply for a state grant that funds the service. SouthSTAR has been grounded since July 1.

That means, for the first time since 1988, southern New Jersey, including Ocean County, does not have a state-run air medical service and will instead rely on private companies, which typically charge patients tens of thousands of dollars. SouthSTAR was free to those needing its services.

'No longer sustainable'

SouthSTAR and all local medical helicopter services are summoned by EMS crews on the ground at an accident scene when a patient is in dire need of medical care and ground transportation to a hospital would be too slow. They are also called to hospitals when patients need to be airlifted to larger facilities for urgent care. The SouthSTAR crew consisted of paramedics and nurses from Virtua and was piloted by the state police, which owned and operated the helicopter.

The Department of Health and Senior Services searched for another provider to take over SouthSTAR, but received no response, according to agency spokeswoman Dawn Thomas. She said the agency is currently "evaluating its options," as to what the future of the service will be, but said "no determination has been made to end the service."

Thomas said South Jersey "should receive sufficient coverage" from the other air medical services that continue to operate there.

Capt. Stephen Jones, a spokesman for the State Police, said its sister service NorthSTAR will remain in operation in northern New Jersey, including Monmouth County, and said the department is "proud" of the record SouthSTAR established.

"It is a service that we have performed extraordinary well with reliable service and a perfect safety record.  I think it's yet to be determined how this is all going to turn out," he said.

The service was funded in part through a $3 surcharge on every vehicle registration in the state. Despite the millions in public money generated by those fees, Virtua said plummeting call volume rendered SouthSTAR unsustainable.

Thomas declined to comment on what would happen to the money raised through Motor Vehicle Commission fees.

The state legislature voted to create the air ambulance program, known as JEMSTAR, in 1986, authorizing the creation of NorthSTAR, which would respond to calls in the northern half of the state, and SouthSTAR in the south. For nearly two decades, they were the only licensed air medical services in New Jersey.

Since DHSS began licensing private air medical companies in 2006, SouthSTAR's flights have fallen from an average of 75 a month to an average of just 20 a month in 2015 and 14 a month in the first quarter of 2016, according to Virtua. In the entire month of February, only 35 percent of the critical flight crew had contact with a patient, the company said.

"Therefore, after careful analysis and review, we determined that the significant decline in SouthSTAR’s flight volume makes the program no longer sustainable," the company said in a statement.

It was devastating news for six-year veteran SouthSTAR flight nurse Richard Harris.

"It was honestly without a doubt the best job I ever had," he said.  "Everybody, we all worked well together as a team and we were really able to provide a necessary service to the people of South Jersey. I think we helped to save a lot of lives and I like to think that we made a difference."

Harris said he was "upset and a little bit angry" when he found out in early April that Virtua did not plan to reapply for funding, essentially putting SouthSTAR out of service at least temporarily.

Rising Competition

The decision culminates a protracted battle between Virtua and private air medical companies for control of South Jersey's skies. When private companies were first licensed in 2006 to airlift patients from accident scenes and between hospitals, state-run services were still given priority.

Advocates of private companies complained that the preferred treatment of NorthSTAR and SouthSTAR led to slower response times in life-and-death situations where even a few minutes can make an enormous difference. As a result, in 2010 DHSS changed its guidelines to rule that the helicopter that is closest to the scene, regardless of who owns it, will respond.

The decisions opened the door for six private companies that have dramatically increased operations in South Jersey over the last decade. They include Monmouth Ocean Healthcare Cooperative, AtlantiCare Regional Medical Center,  Hospital of the University of Pennsylvania, which operates out of Atlantic City, Thomas Jefferson University Hospital and Cooper University Hospital.

Harris said SouthSTAR was "squeezed out" by these private companies.

"It's big business," he said. "My concern is that they are profit-driven and I don't think they represent the citizens of the state the way NorthSTAR and SouthSTAR did."

In 2011, Virtua filed a motion against the DHSS asking a court to block Atlantic Health from basing a medical helicopter in Millville alleging that there was not enough oversight of medical personnel from private companies and warning that SouthSTAR wouldn't be able retain its quality if it continued to receive fewer dispatches. The State Superior Court's Appellate Division later upheld the license.

Toms River EMS Director Paul Daley said helicopter response time had not been reduced in the township despite the claims of private companies. He added that crews hadn't noticed a difference in quality of care between SouthSTAR and other services.

Daley said SouthSTAR is "a lot less costly than" private services, though he wasn't sure about exact costs.

"The private companies, they have to make their money," he said.

The cost difference between state-run and private medevac services can be steep. Federal Aviation Administration restrictions currently bar patients from being charged anything for a state-run air medical service.  Costs charged by private companies were hard to attain, but a March report from ABC News found that they exceed $40,000 a flight throughout the country. Multiple private services did not return a request for comment.

End of an era

Harris flew his last SouthSTAR mission June 30 and since began work at Robert Wood Johnson University Medical Center. He said other former crew members remained with Virtua and were transferred to ground jobs at medical facilities owned by the company.

He said his disappointment lies primarily with state government, which he says licensed private companies without regard for the impact it would have on SouthSTAR,

"I am disappointed with the way the state handled the whole thing, I kind of feel like our state doesn't necessarily believe in the program," Harris said. "What upsets me the most is that we were all paying to provide a service that the people of South Jersey are now not getting."

Daley said the move reflected the business mentality that has permeated the EMS industry.

"It's just said to see them go. They provided a great service to the residents of Ocean County," he said of SouthSTAR.  "It's unfortunate, but it's a business like anything else. I understand it. Do we like it? No."

For Morey, the news led to an emotional phone call with her daughter.

"We just cried knowing that someone else might not be as lucky as we were," she said.

Original article can be found here:   http://www.app.com

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