camts blog

Commission on Accreditation of Medical Transport Systems

Category: aviation

Lift-off Time Clarification


There has been a lot of misinterpretation about CAMTS’ position on lift-off times. Recently, we were told that CAMTS requires a 5-7 minute lift-off from the time of the request. This is not true!

Medical transport services are measured against the Accreditation Standards. There is no such standard, and there never will be such a specific number. The only reference to lift-off is listed as part of the performance metrics in Accreditation Standard 02.01.07  5. under “Communications.” This is a metric that programs are collecting, tracking and trending as part of the Quality Management process. It is the program’s responsibility to determine a range of acceptable lift-off times based on their specific scope of practice.

There are many variables that could affect setting a realistic lift-off time:

  • complexity of the aircraft, start and checklists
  • immediate request versus request from a stand-by
  • two stage dispatch under operational control
  • weather checks, route checks
  • IFR flight plan
  • etc., etc.


Therefore, an acceptable range is set based on the program’s profile. If a specific request falls outside of that range and tracking reveals a trend, there may be a need to change policy, process or training practices. This is the intent of quality management.

The use of specified lift-off times to put pressure on crews and to use as a competitive tool should not be the intent and is highly discouraged.


CAMTS lost a valuable friend & leader

CAMTS lost a valuable friend and leader yesterday. Ralph N. Rogers, MD, died after a courageous battle with an illness. Ralph was only 64 years old, leaving behind the people and the work he loved.

Ralph - Seattle July '15

Dr. Ralph Rogers and daughter, Madison

Ralph spent more than 25 years as a board-certified emergency physician at Spectrum Health in Grand Rapids, Michigan. His legacy includes initiatives in critical care, trauma and pain management. Ralph’s ability to clearly and succinctly provide situational analysis positively impacted physician and advanced practice provider engagement, clinical service lines, regional hospital clinical integration and the development and success of CAMTS.

Ralph spent the last 20 years on the CAMTS Board of Directors representing ACEP. He was the Chair of the Board since year 2000, re-elected unanimously by the Board every 2 years. Ralph was a major contributor to the success of CAMTS, setting the tone for our commitment to excellence in patient care and safety during transport. His ability to build consensus among 22 Board members, each with their own perspective, was a gift we cannot easily replace. Our thoughts and prayers are with Karen and his 4 children who were at his bedside when he passed. Madison, the 13 year-old youngest daughter, was a frequent visitor and spectator at Board meetings, sitting quietly with her books and crayons and interfacing with us during breaks. Karen was a member of the CAMTS Board as the NFNA representative from its inception and she was our Quality and Site Survey Coordinator for many years. CAMTS was actually the conduit for Karen and Ralph to meet and marry and they are like family to all of us.

The entire CAMTS Board sends their thoughts and prayers to the Rogers family and we will gather to celebrate his life along with many hospital peers, family and friends on June 23rd in Grand Rapids.

 Celebration of Life

Following Ralph’s wishes, the family will host a “Celebration of Life”

Thursday, June 23, 2016 from 12pm to 4pm at

Frederick Meijer Gardens & Sculpture Park in the Grand Ballroom

1000 E. Beltline Ave. NE, Grand Rapids, MI

Please wear colorful spring/summer colors. NO black allowed.

In lieu of flowers, the family requests donations be made

“In Memory of Ralph N. Rogers, MD” to:

David’s House Ministries, 2390 Banner Dr. SW, Wyoming, MI 49509

or Spectrum Health Foundation: Aero Med Fund, 100 N Michigan St NE, MC004

Grand Rapids, MI 49503

Here is a link to Ralph’s obituary if you would like to learn more about our CAMTS Emeritus Chairman of the Board  Dr. Ralph Rogers



10 Edition Accreditation Standards Draft #5 – Invitation to review and comment

The 10th Edition Accreditation Standards – DRAFT #5 – have been posted on the website as of December 1, 2014.

This includes:

  • General Standards
  • Types of Care
  • Medical Escort revisions

There is a comment document for your suggestions, additions or  changes. Please reference the standard by section and number if you would like to provide feedback no later than March 1, 2015.

We will review all comments and responses at the April Board meeting and prepare the last draft that will then be posted for an opportunity to comment before they are finalized and approved by the Board of Directors in July 2015.



Drone near miss reported:

A near miss with a drone – Geisinger Life Flight – one of the CAMTS accredited services in Pennsylvania as described by the pilot.

59BE7EDC9786471746CC6550CD578057_787_442 Last evening while on route to Zerby for Hershey to refuel a drone was encountered – the details are as follows:

 At 1635 SkyTrac had us at 40 40.58  076 22.22 which is located in Schuylkill County, Foster Township 2.06 Miles Southeast of J.Zerbe Airport.  Our altitude at this time was 2398 MSL (on a descent from 4000msl) heading 030 degrees at 121knots. I had just made my second CTAF call to Zerby when the crew member in the copilot seat yelled watch out.  At the same moment I witnessed an object approaching the aircraft at a very high rate of speed.  The drone was at our altitude and 1230 -0100 clock position approximately 2-4 rotor discs away, I banked to the right to avoid collision.  The collision avoidance system did not pick the object up.

 In the event this happens to you, an Air Traffic Mandatory Occurrence Report must be submitted, just call pilot brief and they will take the details.

Safety Directors are getting regular reports on close calls.

It appears drones are here to stay so be careful!

Many other events are being reported:   

An NYPD helicopter 800 feet in the air had a near-miss with a drone as the cops searched for a missing teenage boy in Brooklyn.  According to the NY POST “The hovering gizmos have become increasingly popular in New York skies.”

The Fiscal Times reports: “Pilots around the United States have reported a surge in near-collisions and other dangerous encounters with small drones in the past six months at a time when the Federal Aviation Administration is gradually opening the nation’s skies to remotely controlled aircraft, according to FAA records.

Since June 1, commercial airlines, private pilots and air-traffic controllers have alerted the FAA 25 episodes in which small drones came within a few seconds or a few feet of crashing into much larger aircraft, records show. Many close calls occurred during takeoffs and landings at the nation’s busiest airports, presenting a new threat to aviation safety after decades of steady improvement in air travel.”

The Washington Post says “Close encounters on the rise as small drones gain in popularity”

Rotor News – posted:

Pilots across the United States have reported a surge in near-collisions and other dangerous encounters with small drones in the past six months – some of which came within mere feet of hitting drones in flight, according to newly released data from the FAA.

The data reveals nearly 200 incident reports between February and November of this year, including several near misses with commercial airliners. The FAA says it receives approx. 25 reports per month from pilots who have seen drones or model aircraft flying near their aircraft. While most of the reports suggest the incidents were not threatening enough to force pilots to take evasive action, one alarming report out of Cleveland, Ohio, describes a helicopter having to bank to avoid a quadcopter 50 feet away. Another medical helicopter was “almost struck” by a drone while taking off from a Las Vegas hospital.

The FAA is expected to issue regulations related to the operation of small drones by the end of the year, and FAA Administrator Michael Huerta says his agency is working to regulate drones throughout the country to ensure the safety of all aircraft – a staged integration to possibly allow commercial use of unmanned aircraft, starting with lower-risk uses and then moving on to other applications.

The FAA can fine drone operators for flying unmanned vehicles in a reckless or careless manner, according to a recent ruling by the National Transportation Safety Board (NTSB), representing a turnaround from an administrative law judge’s earlier decision that had represented an embarrassing setback for the aviation agency’s drone regulation efforts.

Quality and Safety at Risk!

Several recent events have been a concern regarding fixed wing air medical services. The issue of aviation transport brokers representing themselves as air ambulances is one. The other issue is that some air ambulance providers are charging outrageous and unadvertised costs for transport. These are unacceptable in this age of transparency.

Ethical business practices by some companies jeopardize their own volumes because they are competing with unscrupulous providers who are mainly concerned with increasing their profit margin. Quality and safety are at risk under these conditions.

CAMTS recently visited the Department of Transportation (DOT) to once again to bring these issues to their attention. We have been told in the past, the DOT can fine companies without a FAA 135 Certificate who are misrepresenting themselves as an aircraft operator.  Unfortunately, they could not do anything about the patient component of an air ambulance flight.

During this most recent visit with the DOT, we discussed flights that have been brought to our attention by the public. One flight for example, from Mexico, to San Diego, was contracted at a charge of $30,000 but when the patient received the bill – it was $300,000.  Another flight from Paris to Boston was billed to insurance for $798,000.

Why does CAMTS care about these issues if they do not involve accredited services? Because our mission is to improve safety and quality overall.  That means we have a responsibility to the public. Such practices reflect poorly on the entire air ambulance community. Perhaps brokers advertising as air ambulances and companies that charge way above current market values have been acceptable in the past; but these trends cannot continue – we need a change in culture.

We learned from visiting with a top official at the DOT that there is now an active Aviation Consumer Protection Division (under the DOT) and complaints such as unfair charges and flights conducted by a different entity than identified in the contract fall under the realm of this Agency.  If you have encountered these situations – please contact the Aviation Consumer Protection Division of the DOT at 866 835-5322 or file a complaint by email to