Jacob Nierenberg THE COLUMBIAN
After 40 Years, Life Flight Network Continues to Expand, Add Members
September 23, 2018
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  • If you’ve never seen a helicopter take off, it’s something to behold. No matter how many action movies you’ve watched, there’s a visceral thrill to seeing it in person: the high-pitched whine as the engine comes to life, the sharp stench of jet fuel, the sheer force of the wind kicked up by the rotor, ruining hairdos and making breathing impossible. And when the helicopter leaves the ground, it looks like a special effect.

    For Jodi Franzman, that never loses its thrill.

    “The first flight I went on, the adrenaline rush I got, that’s what did it,” she said. “I love it, and I still love it. I love coming to work, and I still get that excitement every time the rotor blades start spinning, and you smell that Jet A fuel, and you take off.”

    Franzman is 10 years into her career as a flight paramedic for Life Flight Network, the largest not-for-profit air ambulance service in the country. In that time, Life Flight has grown from only a handful of locations in Oregon to 25 bases with 550 employees across the Pacific Northwest. Franzman normally flies out of the base at the Southwest Washington Regional Airport in Kelso, but on Sept. 6 she paid a visit to Aurora, Ore., the site of Life Flight’s headquarters at Aurora State Airport.

    Since 1978, Life Flight has provided intensive care unit-quality medical attention to seriously ill or injured patients, within the cramped space of a helicopter. Patients can be transferred from one hospital to another or can be rescued from the scene of an emergency.

    When Life Flight began 40 years ago, it was named Emanuel Life Flight after its operator, Emanuel Hospital in Portland. At the time, Life Flight was only the fourth hospital-based air ambulance service in the country.

    “We just had the one helicopter,” said Regional Director Jacob Dalstra. “I think they did something in the neighborhood of 120, 150 flights that first year.”

    Emanuel Hospital became Legacy Emanuel Medical Center after a merger with Good Samaritan Hospital in 1989. Four years later, Life Flight dropped the “Emanuel” and assumed its current name after joining forces with Providence Health & Services’ Aircare program.

    Regulations, repairs

    When Franzman clocks in for work, she heads to the crew’s quarters on base. For the next 24 hours, she’ll work, eat and sleep in the space with her fellow clinicians and pilots on duty. (Per Federal Aviation Administration regulations, pilots have a 12-hour duty day.)

    When a call comes in, the crew has “about seven to eight minutes to get off the ground,” said Dalstra. Since weather conditions can affect takeoff, pilots check the weather constantly in between calls, and when one does come in, the crew grabs their gear and heads to the runway.

    With four crew members, a patient and whatever medications the paramedics bring aboard — narcotics, paralytics, saline solutions, and more — the helicopter can be a cramped space. The aircraft carries lighter, more-compact versions of a cardiac monitor and a ventilator among other medical equipment, tucking them away in hidden compartments.

    “These aircraft can only handle so much weight, so we have to pare down what we bring,” Franzman said.

    Depending on the location of the base, the crew may be flying in a single-engine helicopter or a twin-engine helicopter. Franzman said that single-engine and twin-engine helicopters are subject to different regulations. Single-engine helicopters are required to fly by visual flight rules, or VFR, meaning the pilot must be able to see where the helicopter is going. Twin-engine helicopters can fly under instrument flight rules, or IFR, allowing them to fly in more challenging weather conditions.

    The catch, Franzman said, was that IFR-flying aircraft must file flight plans with air traffic control and could only fly “from airport to airport.”

    “We can’t exactly IFR onto Mount St. Helens, so VFR is the way to go to get to those kinds of places,” she added. “But let’s say there’s a hospital up in Centralia that has a patient that is very sick and needs to come down to Portland for a higher level of care. They typically get fogged in very good up there, so if we can’t go VFR to get that patient, we can go IFR.”

    Helicopters make up the bulk of Life Flight’s fleet. Of Life Flight’s 25 bases, eight also have a fixed-wing aircraft alongside the rotor-wing. (Two bases are ground bases, with an ambulance instead of any aircraft.) Helicopters can pick up and transport patients within 175 miles of their base, while fixed-wing aircraft can fly across the country.

    Helicopters usually fly between 40 and 50 hours a month, said Coy Boen, the Aurora-based regional maintenance manager. Given the hourly requirements for maintenance, that means that helicopters are repaired on a monthly basis. Additionally, every 800 hours helicopters are sent to Aurora for more exhaustive repairs that require the engine and transmission to be removed and inspected.

    Similarly, Boen said “big items” such as “major cracks or cracks in the firewall” were handled at Aurora, due to the headquarters’ more advanced tooling.

    Boen joined the Life Fight team in 2014, the same year that the organization became an FAA Part 135 air carrier, enabling them do all of their maintenance on their own rather than outsource it.

    “Having it all under one roof is nice,” he said.

    ‘They saved my life’

    Life Flight’s greatest leap yet was in 2007, when the organization formed its own limited liability company. Dalstra said that this came as a result of OHSU planning to start its own air ambulance service — which Legacy Emanuel and Providence already had, leading them all to team up.

    “The three hospitals came together and said, ‘This is crazy. Why are we all competing against each other? Let’s just all come together and form one program,’ ” Dalstra said.

    After establishing itself as its own entity, Life Flight began operating without hospital oversight. (Legacy, Providence and OHSU still co-own Life Flight.) Since then, Life Flight has expanded dramatically, adding 17 new bases over the next decade. Subsequent milestones in Life Flight’s history include acquiring Boise, Idaho-based Saint Alphonsus Life Flight in 2009 and Spokane-based Northwest MedStar in 2016. (Saint Alphonsus Regional Medical Center subsequently became a co-owner of Life Flight.)

    Dalstra said that while Life Flight had no plans for further expansions, they were always on the lookout for new opportunities.

    “If there was a way that we could better serve our community, I think we would heavily consider that,” he said.

    As it is, Life Flight celebrated its 40th anniversary with a sale on new memberships — offered for $40. Dalstra said the sale, which ended Labor Day, added “in the neighborhood of hundreds” of new memberships. Currently, Life Flight has roughly 150,000 members. Memberships also cover the owner’s spouse or domestic partner and dependents, as well as elderly or disabled family members living in the same household.

    While the costs of Life Flight’s services can run well up into the thousands of dollars, insurance can cover most, if not all, of the expenses. Whatever out-of-pocket costs remain will be written off by Life Flight if the patient is a member.

    “If you’re not a member, then there could be some potential for out-of-pocket costs or expenses,” he added, “but we don’t transport patients based off of their ability to pay.”

    That’s how it was for Jerry Ramey, 49, of Woodland. On July 23, Ramey was riding his motorcycle along state Highway 4 when he collided with a motorhome. Though Ramey wasn’t a Life Flight member, the first responders on the scene called Life Flight due to the severity of the accident; it only took 45 minutes for Life Flight to transfer Ramey to PeaceHealth Southwest Medical Center, where he was rushed into surgery for severe internal bleeding and several fractures. The cost of Ramey’s flight was more than $25,000, but it was covered by his insurance.

    He’s still got a few weeks before he can walk again, but if the first responders had not called Life Flight, Ramey said he would have been “dead, no questions asked.”

    “They saved my life,” he said.

    Ramey praised the Life Flight crew as “top-notch” and “absolutely five-star,” but even after his experience, he said he would not be buying a membership.

    “I plan on never needing them again,” he joked.