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Safety Recommendation Details

Safety Recommendation A-09-132
Details
Synopsis: On September 27, 2008, about 2358 eastern daylight time, an Aerospatiale (Eurocopter) SA365N1, N92MD, call sign Trooper 2, registered to and operated by the MSP as a public medical evacuation (medevac) flight, impacted terrain about 3.2 miles north of the runway 19R threshold at Andrews Air Force Base (ADW), Camp Springs, Maryland, during an instrument landing system (ILS) approach. The commercial pilot, one flight paramedic, one field provider, and one of two automobile accident patients being transported were killed. The other patient being transported survived with serious injuries from the helicopter accident and was taken to a local hospital. The helicopter was substantially damaged when it collided with trees and terrain in Walker Mill Regional Park, District Heights, Maryland. The flight originated from a landing zone at Wade Elementary School, Waldorf, Maryland, about 2337, destined for Prince George's Hospital Center (PGH), Cheverly, Maryland. Night visual meteorological conditions prevailed for the departure; however, Trooper 2 encountered instrument meteorological conditions en route to the hospital and diverted to ADW. No flight plan was filed with the FAA, and none was required. The MSP System Communications Center (SYSCOM) was tracking the flight using global positioning system data transmitted with an experimental automatic dependent surveillance-broadcast (ADS-B) communications link.
Recommendation: TO 40 PUBLIC OPERATORS OF EMS HELICOPTERS: Use formalized dispatch and flight-following procedures that include up-to-date weather information and assistance in flight risk assessment decisions.
Original recommendation transmittal letter: PDF
Overall Status: Open - Acceptable Response
Mode: Aviation
Location: District Heights, MD, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: MIA08MA203
Accident Reports: Crash During Approach to Landing of Maryland State Police Aerospatiale SA365N1, N92MD
Report #: AAR-09-07
Accident Date: 9/27/2008
Issue Date: 11/13/2009
Date Closed:
Addressee(s) and Addressee Status: Commonwealth of Pennsylvania, State Police, Aviation Section (Closed - Reconsidered)
Commonwealth of Virginia, County of Fairfax, Police Department, Helicopter Division (Closed - Acceptable Action)
Commonwealth of Virginia, State Police (Closed - Acceptable Action)
State of Alaska, North Slope Borough, Search and Rescue Department (Closed - Acceptable Action)
State of Arizona, County of Maricopa, Sheriff's Office, Aviation Services Division (Closed - Reconsidered)
State of Arizona, Department of Public Safety, Highway Patrol, Aviation Division (Closed - Reconsidered)
State of California, City of Los Angeles, Fire Department, Air Operations (Closed - Acceptable Action)
State of California, City of San Diego, Fire Department, San Diego Medical Services Enterprise (Open - Acceptable Response)
State of California, County of Los Angeles, Fire Department, Emergency Medical Services (Closed - Acceptable Action)
State of California, County of Los Angeles, Sheriff’s Department, Aero Bureau (Closed - Acceptable Action)
State of California, County of Orange, Sheriff's Department, Air Support Division (Open - Acceptable Response)
State of California, County of San Bernardino, Sheriff's Department (Open - Acceptable Response)
State of California, County of Santa Barbara, Fire Department, Air Unit (Closed--No Longer Applicable)
State of California, County of Santa Barbara, Sheriff's Department, Air Unit (Closed - Acceptable Action)
State of California, County of Sonoma, Sheriff's Office (Closed - Acceptable Action)
State of California, County of Ventura, Fire Department (Closed--No Longer Applicable)
State of California, County of Ventura, Sheriff's Department, Aviation Division (Open - Acceptable Response)
State of California, East Bay Regional Park District Police, Air Support Unit (Closed - Acceptable Action)
State of California, State Police, Highway Patrol, Office of Air Operations (Closed - Reconsidered)
State of Delaware, State Police, Aviation Unit (Closed - Acceptable Action)
State of Florida, City of Palm Beach, Health Care District (Open - Acceptable Response)
State of Florida, County of Broward, Sheriff's Office (Closed - Acceptable Action)
State of Florida, County of Collier, MedFlight (Closed - Reconsidered)
State of Florida, County of Lee, Emergency Medial Services, MEDSTAR (Closed--No Longer Applicable)
State of Florida, County of Martin, Fire-Rescue Life Star (Closed - Reconsidered)
State of Florida, County of Miami-Dade, Fire Rescue, Special Operations Division (Open - Acceptable Response)
State of Florida, County of Volusia, Sheriff's Office (Closed - Acceptable Action)
State of Georgia, County of DeKalb, Police Department, Special Operations (Closed - Unacceptable Action - No Response Received)
State of Maryland, State Police, Aviation Command (Closed - Reconsidered)
State of Nevada, City of Las Vegas, Metro Police Department, Air Support, Search and Rescue (Closed - Reconsidered)
State of New Jersey, State Police, Special Operations Section (Closed - Acceptable Action)
State of New York, City of New York, Police Department, Aviation Unit (Closed - Unacceptable Action - No Response Received)
State of New York, County of Chautauqua, Sheriff's Office (Open - Await Response)
State of New York, County of Nassau, Police, Aviation Unit (Closed - Unacceptable Action - No Response Received)
State of New York, County of Onodaga, Sheriff's Department, Aviation Unit (Open - Acceptable Response)
State of New York, County of Suffolk, Police Department, Aviation Section (Open - Acceptable Response)
State of New York, State Police, Aviation Unit (Closed - Acceptable Action)
State of North Carolina, County of Dare, Emergency Medical Services (Closed - Acceptable Action)
State of Texas, County of Austin-Travis, Emergency Medical Services, STAR Flight (Closed - Acceptable Action)
United States Department of the Interior, National Park Service, Park Police, Aviation Unit (Open - Acceptable Response)
Keyword(s): Dispatch

Safety Recommendation History
From: NTSB
To: State of Nevada, City of Las Vegas, Metro Police Department, Air Support, Search and Rescue
Date: 1/14/2015
Response: On October 14, 2014, we informed you that, because we had received no reply from you, these recommendations were classified “Closed?Unacceptable Action/No Response Received.” We appreciate your notifying us that you do not conduct HEMS operations. Accordingly, Safety Recommendations A 09-97 through -101 and A-09-131 through -133 are classified CLOSED—RECONSIDERED.

From: State of Nevada, City of Las Vegas, Metro Police Department, Air Support, Search and Rescue
To: NTSB
Date: 11/10/2014
Response: -From Jack Clements, Lieutenant, Air Support/ Search and Rescue and Charles Hank, Captain, Support Operations Bureau: 1. LVMPD Air Support pilots utilize the PRISM Safety Management System as referenced above. Pilots check the local weather through web based programs and also are in contact with local Air Traffic Control towers during patrol shifts. 2. Due to the law enforcement mission, patrol flights, which account for approximately 95 percent of flights, are conducted at 500 feet AGL within the urban area designated as class '8' airspace. Pilots stay within the Las Vegas Valley and have access to four separate airports during the course of a patrol flight. 3. For any out of valley flights away from class "B" airspace the pilots complete a FRAT in the PRISM Safety Management System and by policy must contact a section supervisor for approval. 4. In the event that the out of valley flight is a rescue mission, the section lieutenant is contacted and will receive a briefing on the mission, weather. conditions and flight plan. The section lieutenant is the approving authority on helicopter rescue missions.

From: NTSB
To: State of Nevada, City of Las Vegas, Metro Police Department, Air Support, Search and Rescue
Date: 10/14/2014
Response: We have received no reply from you regarding actions you have taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED. If you have completed, or plan to complete soon, any actions to address these recommendations, please submit details of your actions or plans to correspondence@ntsb.gov. If we receive a timely reply from you, we may reclassify one or more recommendations.

From: NTSB
To: State of Nevada, City of Las Vegas, Metro Police Department, Air Support, Search and Rescue
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Las Vegas Metro Police Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: Commonwealth of Pennsylvania, State Police, Aviation Section
Date: 1/14/2015
Response: On October 14, 2014, we informed you that, because we had received no reply from you, these recommendations were classified “Closed?Unacceptable Action/No Response Received.” We learned from your letter, however, that, although you conduct both ground and flight operations, you do not conduct HEMS. Accordingly, Safety Recommendations A-09-97 through 101 and A-09-131 through -133 are classified CLOSED—RECONSIDERED.

From: NTSB
To: Commonwealth of Pennsylvania, State Police, Aviation Section
Date: 10/14/2014
Response: We have received no reply from you regarding actions you have taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED. If you have completed, or plan to complete soon, any actions to address these recommendations, please submit details of your actions or plans to correspondence@ntsb.gov. If we receive a timely reply from you, we may reclassify one or more recommendations.

From: Commonwealth of Pennsylvania, State Police, Aviation Section
To: NTSB
Date: 1/17/2014
Response: -From Trooper Reeve A. Mott, Aviation Safety and Training Officer, Bureau of Emergency and Special Operations: 1. This correspondence is in response to a request for information from the National Transportation Safety Board (NTSB). The NTSB correspondence addresses eight safety recommendations that were issued on October 1, 2009, as a result of a February 3-6, 2009, NTSB investigative hearing held in response to an increase in helicopter emergency medical services (HEMS) accidents in calendar year 2008. 2. The NTSB correspondence is primarily directed towards HEMS operations. The Pennsylvania State Police (PSP) is a law enforcement entity operating under Federal Aviation Regulations (FAR) Part 91 and does not conduct emergency medical services as a common practice. The PSP helicopters are not equipped with the necessary equipment and the pilots/crews are not trained in HEMS operations. PSP has only participated in emergency medical transports on rare or extreme cases. In fact, PSP has not conducted an emergency medical transport dating back to 2008. 3. The following is PSP’s response to the NTSB’s eight safety recommendations: All PSP flights maintain inflight communications with our Department Watch Center. In the event communications are lost, location and rescue efforts are initiated by the Department Watch Center. PSP pilots are required to assess the weather before every flight and complete the risk assessment matrix.

From: NTSB
To: Commonwealth of Pennsylvania, State Police, Aviation Section
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Pennsylvania State Police Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of New Jersey, State Police, Special Operations Section
Date: 7/11/2014
Response: We note that flight following is provided for HEMS flights using a satellite flight tracking system, computer-aided display, and two-way communications, which are maintained for the entire duration of flights. We also note that you have formal procedures in place for responding to incidents and that up-to-date weather information is available in the cockpit. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: State of New Jersey, State Police, Special Operations Section
To: NTSB
Date: 4/7/2014
Response: -From Toby Hill, New Jersey State Police Aviation Bureau, Assistant Bureau Chief: The New Jersey State Police Aviation Bureau is more than happy to share with you the progress we have made in implementing several of your recommendations. Over the past years, much has changed within the Aviation Bureau. The most significant change to the bureau has been the procurement of new AW139 aircraft to replace our aging Sikorsky S76B aircraft. The Aviation Bureau's current fleet is comprised of five (5) Augusta AW139s, one (1) Bell206L4, one (1) Bell206L3 and one (1) OH58A military surplus aircraft. Only the AW139s are utilized for HEMS operations. Below are the responses to your inquiry regarding updates we have made to our aviation program: The New Jersey State Police Aviation Bureau uses formalized dispatch and flight following procedures. The Regional Emergency Medical Communications System (REMCS) dispatches all HEMS in the state of New Jersey and follows formalized dispatch criteria. Flight following is performed by REMCS using Outerlink. All HEMS aircraft are equipped with Outerlink. REMCS does not employ trained weather observers and does not employ FAA certified aircraft dispatchers. REMCS does provide preflight information dissemination such as landing zones, navigation assistance and communication information. REMCS does not provide assistance in flight risk assessment decisions but does provide data and information to assist the pilots in their flight risk assessment.

From: NTSB
To: State of New Jersey, State Police, Special Operations Section
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the New Jersey State Police have formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: Commonwealth of Virginia, County of Fairfax, Police Department, Helicopter Division
Date: 6/25/2014
Response: We note that flight following is provided for HEMS flights using a satellite flight tracking system and two-way communications, which are maintained for the entire duration of flights. We also note that you have formal procedures in place for responding to incidents and that up-to-date weather information is available in the cockpit. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—ACCEPTABLE ACTION.

From: Commonwealth of Virginia, County of Fairfax, Police Department, Helicopter Division
To: NTSB
Date: 2/20/2014
Response: -From Edwin C. Roessler, Jr., Chief of Police: The Fairfax County Police Department has been conducting Public Helicopter EMS (HEMS) operations since 1983 and has seen significant upgrades since our 2009 response with safety as the driving factor. We now operate two Model Bell 429 helicopters purchased in 2011 and 2012. The Fairfax County Police Department no longer operates the two Bell 407 helicopters as described by Mr. Paul Schaaf in the 2009 response. Both 429 helicopters are configured with dual engines, NVG compatible glass cockpit, auto pilot, Traffic Collision Avoidance System (TCAS), HTAWS, Garmin 530 and 430 GPS, Westcam MX-10 FLIR camera system, Trakka 800 search light and operated with a minimum crew of three and the use of NVG’s at night is mandatory. The size of Fairfax County is approximately 400 square miles located in northern Virginia with a level one trauma center centrally located in the county. Nearly all of HEMS flights are less than 20 minutes in length total time (outbound to landing zone and to the level one trauma center). The population of Fairfax County is approximately 1.2 million and has some of the worst traffic in the nation. Approximately 97 percent of the flying is within 20 nautical miles of the level one trauma center, with the remaining 3 percent to surrounding counties who request assistance on for law enforcement events, maintenance ferry flights, and on the rare occasion a private HEMS operator is unavailable, HEMS flights. The vast majority (99%) of flights consist of no more than a 7 minute flight to the Law Enforcement (LE) mission location or HEMS landing zone. The Fairfax County Police Department considers itself to be in reasonable compliance with the recommendations issued in the NTSB letter dated December 31, 2013 in follow-up to NTSB inquiries in 2009 and 2011. All pilots of Fairfax County’s hold an FAA Commercial license with Instrument endorsements and receive annual simulator events unique to HEMS, bi-annual inadvertent flight into IMC training, bi-annual autopilot and HTAWS training. We have also implemented a comprehensive SMS with an online incident and hazard reporting tool, a thorough risk management tool that is archived daily and have incorporated the use of NVG’s since 2005. Our current SOP’s mandate weather minimums that are higher than current part 135 HEMS operations by the FAA and we are testing cost effective real time flight tracking of our helicopters. Also, we have sought out the guidance of our local Flight Standards District Office (FSDO) to ensure compliance with the final rule recently issued by the FAA regarding Helicopter Air Ambulance, Commercial Helicopter, and Part 91 Operations (RIN 2120-AJ53.) The Fairfax County Police Department helicopter operates almost exclusively inside the Washington DC Special Flight Rules Area (SFRA) and Flight Restricted Zone (FRZ) due to the fact that the entirety of Fairfax County is inside this special and restrictive airspace. The FAA has required all aircraft that operate inside of this airspace to be assigned a secret discreet squawk code, SHALL have two way communications with the appropriate Air traffic Control (ATC), SHALL be in positive radar contact at all times along with prior permission from the National Capital Regional Coordination Center (NCRCC) to operate inside this airspace (See FDC NOTAMs 4/2985, 1/6386, 1/1155, 0/8326). In addition to ATC and NCRCC real time tracking of our helicopters when airborne, the Fairfax County Public Safety Transportation and Operations Center (PSTOC), who notifies the helicopter for a HEMS and Law Enforcement (LE) mission request, assigns a dispatcher for status and position from the time the helicopter is launched until its return. On the approximate 5% of HEMS flights conducted annually, at the time of launch, the HEMS event is given its own operating channel and dispatcher for the approximate 7 minute flight (or less) to the Landing Zone. An entire Fire Department Engine company is assigned to assess the Landing Zone in accordance with the Fairfax County Fire Departments Standard Operating Procedures and General Orders. On landing and takeoff to or from the Landing Zone, the radio channel used for communication on the event is “held” for emergency traffic only so that ground personnel can alert the helicopter to previously unseen hazards to the Landing Zone and notify the helicopter crew. Before the helicopter leaves the Landing Zone, it has already been determined which hospital is to be our destination. Once the helicopter departs the Landing Zone with the patient, the helicopter flies directly to the Level one Trauma Center (5-7minutes) or in the event of burn patients or pediatric patients, to the Burn Trauma Center or Pediatric Trauma Center (6-9 minutes), which are co-located. After landing, the dispatcher is notified of the safe arrival at the appropriate hospital. Also, there is annual down aircraft drills with PSTOC, patrol and helicopter personnel. In addition, the Fairfax County Police Department is looking into additional real time cost effective flight tracking solutions and is in the process of testing out AirNav Radar Box. The members of the PSTOC who request the helicopter for a mission (HEMS or LE) do not have and are not trained weather observers and have NO operational command or control of the helicopter. It is the crew, through use of the risk management assessment tool, SMS, Standard Operating Procedures (SOPs), current weather and forecast who ultimately make the decision as to launch and carry out or deny ANY mission. In addition, current and forecasted weather access for pilots is available at Fairfax Base, hospitals, and the appropriate ATC facility that we are required to be in constant communication with due to the SFRA and FRZ around Washington DC.

From: NTSB
To: Commonwealth of Virginia, County of Fairfax, Police Department, Helicopter Division
Date: 12/31/2013
Response: The Fairfax County Police Department’s only letter concerning Safety Recommendation A-09-132, dated January 6, 2010, stated that the Police Department’s requests for HEMS are submitted by fire and rescue personnel, directly from the accident scene, to the Fairfax County 911 Dispatch System. In addition, because both of the county’s helicopters are equipped with Garmin’s GDL-90 datalink system, which provides flight crews with in-flight weather information and at-a-glance airport conditions, the Public Safety Transportation Operations Center and the Transportation Security Administration’s National Capitol Regional Command Center can access flight-following information. Our January 25, 2011, reply reiterated that HEMS flight requests should be reviewed by a designated individual who is familiar with HEMS operations, who can evaluate the local and regional weather conditions, and who has the opportunity to make a no-go decision based on this evaluation before the flight crew is notified of the mission. This individual could also be involved in the risk assessment process recommended in Safety Recommendation A-09-131. Pending our receipt and review of the specific details regarding the facility’s staff and the formal dispatch procedures that are performed, Safety Recommendation A-09-132 was classified “Open—Acceptable Response” on January 25, 2011. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Fairfax County Police Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: Commonwealth of Virginia, County of Fairfax, Police Department, Helicopter Division
Date: 1/25/2011
Response: The NTSB emphasizes that the main focus of this recommendation is on the establishment of formalized dispatch procedures and flight-following functions. Your letter indicates that requests for HEMS are submitted by fire and rescue personnel, directly from the accident scene, to the Fairfax County 911 Dispatch System. In addition, because both of the Fairfax County helicopters are equipped with Garmin’s GDL-90 datalink system, which provides flight crews with in-flight weather information and at-a-glance airport conditions, the Public Safety Transportation Operations Center and the Transportation Security Administration’s National Capitol Regional Command Center can access flight-following information. We reiterate that HEMS flight requests should be reviewed by a designated individual who is familiar with HEMS operations, who can evaluate the local and regional weather conditions, and who has the opportunity to make a no-go decision based on this evaluation before the flight crew is notified of the mission. This individual could also be involved in the risk assessment process recommended in Safety Recommendation A-09-131. Please provide us with specific details regarding the facility’s staff and the formal dispatch procedures that are performed. For additional guidance on establishing formalized dispatch and flight-following procedures, the NTSB suggests FAA Advisory Circular 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services . Pending our receipt and review of the requested information, Safety Recommendation A-09-132 is classified OPEN – ACCEPTABLE RESPONSE.

From: Commonwealth of Virginia, County of Fairfax, Police Department, Helicopter Division
To: NTSB
Date: 1/6/2010
Response: MC# 2100061 - From Paul M. Schaaf, Chief Pilot, Fairfax County Police Helicopter Division: Unlike many Part 135 EMS providers, the Helicopter EMS mission in Fairfax County is part of the County 91 1 Dispatch System. As such, a vast majority of our EMS missions come directly from Fire and Rescue personnel on the scene of an accident. From the moment of take-off until landing at the scene of the accident we are in direct communication with personnel on the scene. Consequently, there is truly no third party dispatch invoked in the helicopter component of the EMS operation in Fairfax County. There are rare exceptions to this when we are called upon to backfill the Part 135 operators due to aircraft shortages or overlapping missions. In these cases, we assimilate with the Part 135 operators dispatch system using their designated radio frequencies and flight following procedures. Both of the Division's helicopters are equipped with Garmin's GDL-90 datalink system (ADS-B). ADS-B information is accessed by several CRABS (Comprehensive, Real-time Analysis of Broadcasting Systems) terminals. We have terminals installed and trained personnel in our Public Safety Transportation Operations Center, Heliport facility and at TSA's National Capitol Region Command Center. The CRABS system provides current and historical aircraft position, heading, speed and altitude data updated once per second that is useful for monitoring an aircraft's progress, and for locating the last reported position of a missing aircraft. The Division's CRABS mapping is overlaid on a VFR terminal area chart for more precise locating and all Division personnel are trained in the various latitude and longitude formats in order to best coordinate a missing aircraft search. An additional benefit of the ADS-B system worthy of note is the in-flight weather information that is displayed in the pilot's EFIS. This weather information provides pilot's with at-a-glance airport conditions, NEXRAD updated every few minutes as well as detailed and ,freshly updated METAR and TAF reports. This information assists flight crews in their compliance with the intent of this particular safety recommendation as well as modifying tactical risk assessment (safety recommendation A-09-1 31) NVGs - In 2005, the Helicopter Division completed Night Vision Goggle (NVG) cockpit modifications and crew training and conducts all night operations aided by NVGS Pilot Training - Fairfax County Police Helicopter Pilots all possess FAA Commercial Rotorcraft Licenses with Instrument Ratings. All pilots maintain instrument proficiency by completing regular instrument procedures and an annual instrument proficiency check. Annually, each pilot completes Bell Helicopter Factory Refresher training, scenario-based internal NVG check ride, scenario-based emergency procedures check ride and written test. Voice-alerting system - Each Bell 407 aircraft is equipped with a voice alerting system that audibly warns pilots of transient power, engine overspeed, fuel low and master caution conditions. This system enables more "eyes-out" time during critical phases of flight. Wescam MX-15 Large Format Triple Sensor - In 2007, the Helicopter Division equipped each aircraft with the Wescam MX-15 system which due to it's high degree of stability and surveillance quality optics enable flight crews to effectively perform all manner of search and surveillance missions from significantly higher altitudes, thus providing an addition measure of safety. Standard Operating Procedures - Over the past several years, the Helicopter Division has completely re-written it's internal SOP governing Division administration, flight operations, maintenance and training with the primary goal of enhancing safety though additional directives and clarification of existing procedures. Safety Management System principals were assimilated into this SOP. In summary, the Fairfax County Police Department considers itself in full compliance with the safety recommendations issued in the NTSB's letter dated 13 November, 2009. If there is any further information that you would like us to provide, please let us know. Additionally, if there is anything that the Fairfax County Police Helicopter Division can do to assist the NTSB in it's mission of improving Helicopter EMS Safety, we hope that you will feel free to visit with us or call upon us at any point.

From: NTSB
To: State of Florida, County of Martin, Fire-Rescue Life Star
Date: 3/27/2014
Response: We note that Martin County does not operate public-use helicopters and that you have always contracted with a corporate vendor for HEMS. Accordingly, Safety Recommendations A 09 97 through -101 and A-09-131 through -133 are classified CLOSED—RECONSIDERED.

From: State of Florida, County of Martin, Fire-Rescue Life Star
To: NTSB
Date: 1/6/2014
Response: -From Joseph V. Ferrara, CFO, MPA, Fire Rescue Chief: This is a follow up to our conversation regarding the letter received by our County Administrator on December 31st, 2013 which was a follow up letter requesting information and action on the Fire Rescue Department’s part dating back to 10/1/09 and 11/13/09. In 2009 our department received the letters and forwarded them to our aviation vendor Air Methods Inc. Since Martin County government is not a Public Helicopter Emergency Medical Services (HEMS) Operator as defined in your documents. We have always contracted with a corporate vendor for the purposes of providing HEMS. Martin County provides the medical care only and the aviation vendor provides the helicopter, the pilots and the maintenance and is the Part 135 operator. We have had such a program in place since October 1st, 2000 and we have never been an operator of Public Helicopter Emergency Medical Services. We have acted only as the medical service provider and not the Part 135 or Part 91 provider. I hope this helps to clear up any confusion and please feel free to contact me if you have any further questions. Otherwise, I trust you will remove reference to Martin County Fire Rescue Department as a Public HEMS Operator and consider this issue closed.

From: NTSB
To: State of Florida, County of Martin, Fire-Rescue Life Star
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Martin County Fire-Rescue Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of North Carolina, County of Dare, Emergency Medical Services
Date: 1/14/2015
Response: We note that you have provided formalized flight following for your single helicopter operation since June 2013 and that your procedures are consistent with the basic operations control center model described in FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—ACCEPTABLE ACTION.

From: State of North Carolina, County of Dare, Emergency Medical Services
To: NTSB
Date: 10/14/2014
Response: -From John J. Watts, MPH, NRP, Chief Officer, Dare County Emergency Medical Services, Dare MedFlight: Prior to 2013, Dare Medflight utilized a formalized radio dispatch communication platform with Dare Central Communications. Currently, an internet based flight tracking software program is used by Dare Medflight. Dare County Communications maintains a large screen monitor in central communications to visually track the movement of the helicopter from inception of call to termination and a return to home base. Also, the Dare County EMS Shift Supervisor tracks the helicopter from a separate location as a redundant flight following safety procedure. The pilot checks in with land-based communications on a regular basis with a position report. If the pilot does not check in at the specified time, Dare Central Communications attempts to make contact with the helicopter pilot until contact is made.

From: NTSB
To: State of North Carolina, County of Dare, Emergency Medical Services
Date: 10/3/2014
Response: We have received no reply from you regarding actions you have either taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED.

From: NTSB
To: State of North Carolina, County of Dare, Emergency Medical Services
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether Dare County EMS has formal dispatch and flight following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: Commonwealth of Virginia, State Police
Date: 7/11/2014
Response: We are aware that both of your dispatch centers provide flight-following for the entire duration of HEMS flights through two-way communication and that dispatchers are assisted by a computer-aided display. We also note that you have procedures in place for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that flight medics and nurses are trained in accessing this information to assist pilots during times of high workload. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: Commonwealth of Virginia, State Police
To: NTSB
Date: 3/27/2014
Response: -From Colonel W.S. (Steve) Flaherty, Superintendent: This recommendation is an area that has been recognized to be in need of improvement. The Unit utilizes two different dispatch centers for our two HEMS operations and law enforcement missions are dispatched through the State Police communications center. Due to the decentralized nature of our operations, each dispatching center handles things differently. In all cases, flight requests are passed on to flight crews to be evaluated for a go, no-go decision. Dispatchers at all locations can provide minimal flight information regarding landing zone information and can provide coordination with hospitals and ground crews. Dispatchers are not trained weather observers and do not have operational control during responses. The HEMS missions are monitored with flight following by the dispatchers and position reporting is manually conducted every 1 0 minutes. A centralized dispatch center has been explored using the State Police communications to address this recommendation but, as of this time, no decision has been reached.

From: NTSB
To: Commonwealth of Virginia, State Police
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Virginia State Police have formal dispatch and flight following procedures in place, how these procedures are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of New York, County of Onodaga, Sheriff's Department, Aviation Unit
Date: 7/30/2014
Response: We note that you have flight-following procedures in place that include two-way communication for the entire duration of flights and a formal incident response protocol if communication is lost and cannot be reestablished. We also note that dispatchers are able to provide up-to-date weather information if requested by the flight crew. We appreciate your taking these positive measures, yet we believe that the flight risk evaluation that we discussed above in our response to Safety Recommendation A-09-131 should also be implemented before we close Safety Recommendation A-09-132. Accordingly, pending completion of this final action, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: NTSB
To: State of New York, County of Onodaga, Sheriff's Department, Aviation Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Onondaga County Sheriff's Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Delaware, State Police, Aviation Unit
Date: 6/20/2014
Response: We are aware that your dispatch center provides flight-following for the entire duration of flights through two-way communication and that they are assisted by a computer-aided display. We also note that you have procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that flight medics are trained in accessing this information to assist pilots during times of high workload. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—ACCEPTABLE ACTION.

From: State of Delaware, State Police, Aviation Unit
To: NTSB
Date: 1/28/2014
Response: -From Colonel Nathaniel McQueen, Jr., Superintendent: Delaware State Police dispatch aircraft from 2 locations covering 3 counties. DSP aircraft can be dispatched by police or fire public safety answering point personnel, based on a request from the field or through automatic dispatch protocols. After dispatch, flight crews conduct flight following by radio with our aviation communications center (AVCOM), which is located in the central county dispatch center. Crews provide departure, arrival, estimated times of arrival and numbers of passengers on board the aircraft to the dispatch center. With the addition of Sky Node equipment to the aircraft in 2014, real time flight tracking will be accomplished in our dispatch centers. Currently staff members who dispatch aircraft have not received formal training as weather observers, HEMS operations, and have limited operational control during responses. Future plans include, working towards a more formal dispatch program implementing the recommendations of FAA AC 120-96.

From: NTSB
To: State of Delaware, State Police, Aviation Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Delaware State Police have formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of New York, County of Nassau, Police, Aviation Unit
Date: 10/14/2014
Response: We have received no reply from you regarding actions you have taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED--UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED. If you have completed, or plan to complete soon, any actions to address these recommendations, please submit details of your actions or plans to correspondence@ntsb.gov. If we receive a timely reply from you, we may reclassify one or more recommendations.

From: NTSB
To: State of New York, County of Nassau, Police, Aviation Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Nassau County Police has formal dispatch and flight following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Texas, County of Austin-Travis, Emergency Medical Services, STAR Flight
Date: 6/19/2014
Response: We note that aviation communication specialists dispatch and provide flight-following for the entire duration of flights through two-way communication and that they are assisted by a satellite flight tracking system. We also note that you have established procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that flight medics and nurses are trained in accessing this information to assist pilots during times of high workload. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—ACCEPTABLE ACTION.

From: State of Texas, County of Austin-Travis, Emergency Medical Services, STAR Flight
To: NTSB
Date: 3/4/2014
Response: -From Casey Ping, Program Director, Travis County STAR Flight: Travis County STAR Flight utilizes trained personal designated as Aviation Communication Specialist to perform formalized dispatch flight following procedures. Aviation Communication Specialists are specifically trained by the Director of Operations on aviation-related subjects, i.e. weather, airspace and crew resource management. An Aviation Communication Specialist is assigned to shift and has the responsibility to dispatch the aircraft on emergency flight as authorized by the Dispatch Matrix signed by the Director of Operation and approved by the Travis County Commissioners Court. The Director of Operations maintains Operational Control of the aircrafts at all times, and the Aviation Communication Specialist is the agent who is dispatching the flight and performing the flight-following and location procedures in accordance with the Travis County Operation Manual. All STAR Flight Helicopters are equipped with Outerlink Satellite Tracking System providing the Aviation Communication Specialist and aviation managers the ability to monitor the exact location, flight path, speed and altitude of each aircraft. Flight crews maintain direct radio contact with the Aviation Communication Specialist at all times via radio or Satellite Messaging System.

From: NTSB
To: State of Texas, County of Austin-Travis, Emergency Medical Services, STAR Flight
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. This individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether STAR Flight has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of Ventura, Fire Department
Date: 9/10/2014
Response: Notation 8597, adopted 9/10/2014: We issued these recommendations to both the Ventura County Sheriff’s Office and the Ventura County Fire Department; however, the Ventura County Sheriff’s Office and Fire Department have since combined their air support units to form the Aviation Search and Rescue Unit, under the direction and management of the Ventura County Sheriff’s Office. Because the Ventura County Fire Department no longer operates an air operations unit, Safety Recommendations A-09-97 through -101 and -131 through -133 are classified CLOSED—NO LONGER APPLICABLE.

From: NTSB
To: State of California, County of Ventura, Fire Department
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Sheriff’s Department or Fire Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of New York, City of New York, Police Department, Aviation Unit
Date: 10/14/2014
Response: We have received no reply from you regarding actions you have taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED. If you have completed, or plan to complete soon, any actions to address these recommendations, please submit details of your actions or plans to correspondence@ntsb.gov. If we receive a timely reply from you, we may reclassify one or more recommendations.

From: NTSB
To: State of New York, City of New York, Police Department, Aviation Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the New York City Police has formal dispatch and flight following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Florida, County of Lee, Emergency Medial Services, MEDSTAR
Date: 2/10/2014
Response: We are aware that, on August 1, 2013, LeeFlight became Lee County’s provider of medevac services. We are also aware that it is operated by Air Methods, a private civil air medical transport company that is required to comply with Federal Aviation Administration (FAA) rules and requirements and is subject to extensive FAA oversight and surveillance. We continue to support the safety improvements discussed in these safety recommendations, but because Lee County no longer conducts public flight operations, these recommendations no longer apply to your organization. Accordingly, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—NO LONGER APPLICABLE.

From: NTSB
To: State of Florida, County of Lee, Emergency Medial Services, MEDSTAR
Date: 9/26/2011
Response: The NTSB appreciates receiving Lee County EMS’s initial responses to these recommendations. We note that the county has included, in at least one of its aircraft, additional safety features, including a flight data recorder, night vision goggle equipment, and an autopilot. In addition, we note that Lee County is working with an outside consultant to develop a full SMS program that is appropriate for the size and type of operations performed. We commend you for these efforts to improve the overall safety of your organization in response to our safety recommendations. However, in an August 18, 2011, phone discussion with you, NTSB staff discussed additional information that we need, regarding actions that you either have taken or plan to take, before we can classify your actions in response to these safety recommendations. Accordingly, pending our receipt and review of this information, Safety Recommendations A-09-97 through -101 and -131 through -133 remain classified OPEN—AWAIT RESPONSE.

From: NTSB
To: State of California, County of Santa Barbara, Fire Department, Air Unit
Date: 6/19/2014
Response: We note that, in July 2012, the Santa Barbara County Sheriff’s Department and Fire Department combined their air support units to form the Santa Barbara County Air Support Unit, which is under the direction and management of the Santa Barbara County Sheriff’s Department. Because the Santa Barbara County Fire Department no longer operates an air operations unit, Safety Recommendations A-09-97 through -101 and -131 through -133 are classified CLOSED—NO LONGER APPLICABLE for this department.

From: NTSB
To: State of California, County of Santa Barbara, Fire Department, Air Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Santa Barbara County Sheriff’s Department or Fire Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Florida, County of Miami-Dade, Fire Rescue, Special Operations Division
Date: 6/20/2014
Response: We note that you use flight-following procedures for HEMS flights that include the use of a satellite flight tracking system, computer aided display, and two-way communications, which are maintained for the entire duration of flights. We also note that you have formal procedures in place for responding to incidents and that up-to-date weather information is available in the cockpit. These measures are positive actions; however, we believe that the flight risk evaluation form you are developing in response to Safety Recommendation A-09-131 should be implemented before we close Safety Recommendation A-09-132. Accordingly, pending confirmation from you that the flight risk evaluation form is being used before every flight, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: State of Florida, County of Miami-Dade, Fire Rescue, Special Operations Division
To: NTSB
Date: 1/24/2014
Response: -From Dave Downey, Fire Chief: Air Rescue helicopters utilize the same fire alarm dispatchers working in conjunction with 911 dispatchers responsible for call assignments throughout the County. While a specific dispatch assignment protocol exists, it does not formally include a no-go decision based on flight risk assessment. Being a trained weather observer is not presently required of fire alarm dispatchers. Air Rescue crews utilize established weather minima criteria and crew comfort level. Weather decisions from fire alarm dispatchers are primarily deferred to the Air Rescue crews. Flight following is primarily a function of two-way communication maintained with the fire alarm dispatchers. Also, all Air Rescue aircraft are equipped with the satellite-based SkyTrac® system. SkyTrac® monitors are located at the fire alarm office and each of the helicopter bases.

From: NTSB
To: State of Florida, County of Miami-Dade, Fire Rescue, Special Operations Division
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Fire Rescue has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Arizona, County of Maricopa, Sheriff's Office, Aviation Services Division
Date: 4/4/2014
Response: We are pleased to learn that you are committed to providing safe ground and flight operations, but we note that you do not provide HEMS services. Accordingly, Safety Recommendations A 09-97 through -101 and A-09-131 through -133 are classified CLOSED--RECONSIDERED.

From: State of Arizona, County of Maricopa, Sheriff's Office, Aviation Services Division
To: NTSB
Date: 1/24/2014
Response: -Paul Chagolla, Deputy Chief, Maricopa County Sheriff’s Office: My letter is in response to written correspondence sent to Maricopa County Sheriff Joseph M. Arpaio, dated December 31, 2013; a letter regarding 2009 safety recommendations for the Sheriffs Aviation Services Division from the National Transportation Safety Board. This correspondence was also sent to the Maricopa County Board of Supervisors. I write to resolve the matter brought forward. We too believe the four-year "Open- Awaiting Response" classification for the recommendations is certainly unusual. Unfortunately, the Maricopa County Sheriff's Office (MCSO) has no record of receiving the NTSB recommendations, and I am unable to determine where the original communique was delivered. However, our response to both the original letter and the follow-up inquiry is that the MCSO Aviation Services Division (ASD) does not operate as a Helicopter Emergency Medical Service (HEMS) provider. The MCSO ASD oversees and manages a helicopter unit which provides support for basic law enforcement services, such as crime suppression and traffic enforcement. Also, our rotor-craft unit conducts technical Search and Rescue operations only in a law enforcement capacity, as mandated by Arizona State statutes; meaning rescued citizens are turned over to awaiting medical personnel for treatment and transportation by ground or by air­ ambulance. Nonetheless, MCSO has reviewed your correspondence with the idea in mind of improving upon safety. MCSO is committed to both safe and efficient ground and flight operations. I am pleased to inform you that our current training regimen provides our rotor-pilots biennial flight training at Bell Helicopter School; Bell Helicopter is the manufacturer of the primary helicopters operated by the MCSO. Over the last year, while budgetarily possible, our pilots attend additional flight simulator training at Flight Safety International. These training courses provide instruction in the following areas: • Aircraft Emergency procedures, both in a classroom and flying the actual aircraft. • Aircraft systems management, both in the classroom and in flight. Moreover, MCSO ASD has integrated and implemented a safety management program (SMS) within its aviation operations through standardized operating procedures. MCSO flight crews conduct risk assessments specific to the mission at hand, with final determinations being made by the pilot in command and/or Chief Pilot. Flight risk assessments include the continuous review of available weather information, and/or contact with Flight Service Stations prior to flight operations. MCSO pilots seek real-time weather conditions, and while en route to their destination, investigate updated information available through tablet and smart phone technologies. With respect to aviation maintenance operations, ASD commanders utilize a subscription based aviation software program (Digital Air-Ware) to evaluate pilot and aircraft performance. This software provides ASD supervisors time-sensitive information, including information such as 90-day training update notices for operational systems; example, night vision equipment (NVG). Though MCSO helicopters do not possess autopilot or terrain avoidance equipment, ASD continuously deploys two-member flight crews. With an eye to the future, MCSO may seek these options in future aircraft purchases. We appreciate your follow-up correspondence and hope this response will allow for closure of the recommendations. Lastly, in consideration of this response, the Maricopa County Sheriffs Office respectfully requests that the NTSB remove our agency from the list of HEMS operators, as we are a government law enforcement agency with statutorily mandated Search and Rescue duties. I have enclosed my business card and make myself available to answer any further inquiries that serve to gain closure.

From: NTSB
To: State of Arizona, County of Maricopa, Sheriff's Office, Aviation Services Division
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Maricopa County Sheriff’s Office has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Maryland, State Police, Aviation Command
Date: 6/20/2012
Response: The NTSB is aware that, prior to the issuance of this recommendation, the MSP developed and implemented the recommended formalized dispatch and flight-following procedures, which are functions of the MSP System Communications Center (SYSCOM); we are also aware that the SYSCOM duty officer (DO) has access to the HEMS weather tool, which provides up-to-date weather information. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—RECONSIDERED.

From: State of Maryland, State Police, Aviation Command
To: NTSB
Date: 1/4/2012
Response: -From Major Mark E. Gibbons, Commander, Aviation Command, Maryland State Police: In 2007, the Maryland Department of Transportation (MDOT) was tasked by the Maryland State Legislators to begin development of a “Request for Proposal” (RFP) to replace the MSPAC’s current fleet of AS-365 helicopters. In response to this recommendation, as well as NTSB recommendation A-06-15, the MSPAC requested that any helicopter procured by MDOT to replace the MSPAC’s current fleet of helicopters be equipped with the following: Autopilot (AP), Flight Director (FD), Helicopter Terrain Awareness Warning System (HTAWs), Traffic Collision Avoidance System (TCAS), Cockpit Voice Recorder (CVR), Health and Usage Management System (HUMS), Satellite Flight Tracking and cockpit image recorder(s), in both the cockpit and cabin, as well as be certified to conduct night flight operations with Night Vision Google (NVG). Prior to 2007, due to State budget constraints, only three of the MSPAC’s twelve AS-365 helicopters were equipped with a Honeywell “Enhanced Ground Proximity Warning System” (EGPWS) which is comparable to the “Terrain Awareness Warning System” (TAWS) recommended by the NTSB in A-06-15. Regrettably, the helicopter involved in the “Trooper 2” accident (N92MD) was not one of the helicopters equipped with HTAWS. To bridge the gap after the accident, on January 9, 2009, the Commander of the MSPAC testified before Maryland’s EMS Board (SEMSAC) and requested that funding be allocated to purchase 11 portable Garmin 696 GPS units to provide TAWS information, as well as satellite weather information, to all MSPAC flightcrews until replacement helicopters have been identified and purchased by MDOT for the MSPAC. The SEMSAC Board approved funding and eleven “Garmin 696” portable GPS units were purchased for the MSPAC and delivered in May of 2009. An aircraft mount for the Garmin 696 was engineered for the AS-365 helicopters and approved by the FAA. The Garmin 696 units were placed in service at each operational section in October 2009 after all MSPAC pilots were trained on its operation. The policy, process, and procedures concerning the utilization of the Garmin 696 GPS/TAWS unit by MSPAC flight crews were officially codified when the Commander of the MSPAC signed Active Flight Policy #80 on January 28, 2010. MSPAC Comment: On October 20, 2010, MDOT signed a contract with the Agusta Aircraft Corporation (AAC) to purchase six with the option to purchase a maximum of twelve, AW-139 helicopters to replace the MSPAC’s current fleet of AS-365 helicopters. Each AW-139 helicopter purchased will be delivered to the MSPAC with the following equipment installed: Four Axis Autopilot, Helicopter Terrain Awareness Warning System (HTAWs), Traffic Collision and Avoidance System (TCAS), Cockpit Voice Recorder (CVR), Health and Usage Management System (HUMS), cockpit image recorder and be certified to conduct night flight operations with Night Vision Google (NVG). When delivered, each MSPAC AW-139 helicopter will meet and/or exceed all NTSB equipment recommendations issued to Public, Commercial HEMS Operators and the FAA to improve the operational flight safety of the HEMS industry. Contractually, the aircraft manufacturer (AAC) will be responsible for providing all initial helicopter ground and flight training in the AW-139. The manufacturer will utilize an AW-139 Level D, Full Flight Simulator to conduct this training, to include training on the operation and management of the installed helicopter terrain awareness and warning systems (HTAWS). Attached to this document is Active Flight Policy #80 GARMIN 696 (Incorporation into MSPAC aircraft – Helicopter/Cessna/King Air) for your review.

From: NTSB
To: State of Florida, County of Volusia, Sheriff's Office
Date: 5/27/2014
Response: We are aware that your operations manual contains formal dispatch and flight-following procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that flight medics are trained in accessing this information to assist pilots during times of high workload. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: State of Florida, County of Volusia, Sheriff's Office
To: NTSB
Date: 1/21/2014
Response: -From Ben F. Johnson, Sheriff: VCSO utilizes Flight Following in accordance with 14 CFR 135.23(1) and 135.79. VCSO has formalized procedures contained in the Departments General Operations Manual (GOM) for the initiation, commencing, conducting and terminating of all flights conducted under 14 CFR Part 135 to include HEMS operations. The Department's GOM is explicit in what duties and responsibilities that each Operational Control Employee, Pilot, Crew Member and Flight Locator is required to perform.

From: NTSB
To: State of Florida, County of Volusia, Sheriff's Office
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Volusia County Sheriff’s Office has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Arizona, Department of Public Safety, Highway Patrol, Aviation Division
Date: 5/22/2014
Response: We note that you follow formalized dispatch and flight-following procedures consistent with the guidance contained in FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations. Specifically, we note that your dispatchers receive specialized training in dispatching HEMS, are assisted by a computer-aided dispatch system and flight tracking software, and can access and relay up-to-date weather information to flight crews. Because these procedures were in place before we issued Safety Recommendation A-09-132, the recommendation is classified CLOSED—RECONSIDERED.

From: State of Arizona, Department of Public Safety, Highway Patrol, Aviation Division
To: NTSB
Date: 1/14/2014
Response: -From Terry Miyauchi, Aviation Administrator, Aviation Bureau: AZ DPS has a formal dispatch and flight-following procedure in place. This is performed by full time dispatchers that are individually trained in the uniqueness of dispatching aviation operations to include HEMS. They are assisted with a Computer Aided Dispatch (CAD) system and GPS based flight following (Spider Tracks). The current Spider Tracks system updates location every 2-5 minutes or shorter if directed by the flight crew or dispatcher. The AZ DPS dispatch system is extensive, has multiple repeaters throughout the state and covers nearly 100% of Arizona’s state roadways. The AZ DPS dispatch group does not have trained weather observers, but does have access to a unique network of Officers “in the field” covering the entire area of operation.

From: NTSB
To: State of Arizona, Department of Public Safety, Highway Patrol, Aviation Division
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Highway Patrol Division has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, City of San Diego, Fire Department, San Diego Medical Services Enterprise
Date: 6/19/2014
Response: We note that you have flight-following procedures, which include two-way communication for the entire duration of flights and a formal incident response protocol if communication is lost and cannot be reestablished. We also note that dispatchers are assisted by automated flight-following that sends aircraft position reports at 2-minute intervals, that up to date weather information is available in the cockpit, and that crew chiefs are trained in accessing and interpreting this information to assist pilots. Although we appreciate these positive measures, we believe that the flight risk evaluation discussed above regarding Safety Recommendation A-09-131 should also be implemented before we close this recommendation. Accordingly, pending completion of this final action, Safety Recommendation A 09 132 is classified OPEN-ACCEPTABLE RESPONSE.

From: State of California, City of San Diego, Fire Department, San Diego Medical Services Enterprise
To: NTSB
Date: 2/18/2014
Response: -From Javier Mainar, Fire Chief: All aircraft requests come through our Fire Communications Center (FCC). The dispatch of an aircraft is based on the needs of an Incident Commander; and, depending on the mission, may require a higher level of approval prior to being dispatched. In addition, the pilot and crew then accept or reject the mission based on conditions such as aircraft status, crew status and weather conditions. Flight following is performed by FCC via voice communications and is augmented by automated flight following (AFF) that sends aircraft position reports at two minute intervals via the Iridium Communications Satellite Network. This information can be viewed real-time by FCC, our Air Operations Chief and Chief Pilot.

From: NTSB
To: State of California, City of San Diego, Fire Department, San Diego Medical Services Enterprise
Date: 1/14/2014
Response: SENT TO THE MAYOR OF SAN DIEGO: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the San Diego Fire-Rescue Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, City of San Diego, Fire Department, San Diego Medical Services Enterprise
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the San Diego Fire-Rescue Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Georgia, County of DeKalb, Police Department, Special Operations
Date: 10/3/2014
Response: We have received no reply from you regarding actions you have either taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED.

From: NTSB
To: State of Georgia, County of DeKalb, Police Department, Special Operations
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Dekalb County Police Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of Los Angeles, Fire Department, Emergency Medical Services
Date: 6/19/2014
Response: We are aware that formal flight-following is provided for the entire duration of your HEMS flights through two-way communication and that dispatchers are assisted by a computer aided display. We also note that you have established procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that flight medics are trained in accessing this information to assist pilots during times of high workload. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—ACCEPTABLE ACTION.

From: State of California, County of Los Angeles, Fire Department, Emergency Medical Services
To: NTSB
Date: 2/24/2014
Response: -From Daryl L. Osby, Fire Chief: The Unit works closely with the Department's Dispatch Center in discussing and obtaining real-time weather information from approved weather sites as well as "unofficial" area weather from the requesting ground units as well as local police aviation units. Since the majority of the Unit's HEMS missions are "scene" responses that are sometimes in remote locations, approved ground-based weather reporting is not always available or accurate. Additional weather tools such as the "HEMS weather" tool and mobile applications such as Aero Weather and similar mobile programs are available to the pilot for obtaining current weather from remote weather stations that have reporting capability in the local flying area. The limitation on current weather still exists in some regions of the local flying area in that not all of the automated weather sites are capable of 24-hour reporting. The PIC has the ultimate authority to accept or cancel a flight request based upon the known weather conditions at the departure point, enroute phase and destination if available. Once the decision has been made to launch on a response, the PIC has the ultimate authority to abort the mission and return to their base. Continuous communications are maintained via radio with the Dispatch Center and requesting ground units so that additional resources can be requested to provide for the rapid transport of injured parties that may involve the use of ground transportation should the aircrew decide to abort the response. There is no "second-guessing" of the PIC's decision to abort a response due to a cancellation made during the response sequence. If the decision to abort is made due to a performance consideration (i.e. , density altitude, etc.) then the best available resource is then reassigned to respond to the mission request. An example would be substituting the Sikorsky S-70 for the Bell 412 when the mission profile requires the additional performance and endurance capabilities of the Firehawk. Long distance or high altitude hoist mission profiles are a specific example of such a mission request that the Unit has been asked to participate in through the years with great success. The additional usage of the FRAT tool's scoring system allows the pilot to make go/nogo decisions quickly in order to minimize delays to requesting first responder ground units so that patient care is not seriously compromised.

From: NTSB
To: State of California, County of Los Angeles, Fire Department, Emergency Medical Services
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Los Angeles County Sheriff’s Department or Fire Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, East Bay Regional Park District Police, Air Support Unit
Date: 5/27/2014
Response: We are aware that your operations manual contains formal dispatch and flight-following procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that TFOs are trained in accessing this information to assist pilots during times of high workload. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: State of California, East Bay Regional Park District Police, Air Support Unit
To: NTSB
Date: 2/3/2014
Response: -From William Probets, Sergeant, Chief Pilot, Air Support Unit: I am responding to your December 13, 20 13 letter on behalf of General Manager Robert Doyle. It appears that your initial 2009 inquiry was sent during a period when the former Chief Pilot was on an extended job injury leave, from which he eventually retired. The East Bay Regional Park District operates two Eurocopter AS350 helicopters in support of its public safety responsibilities within Alameda and Contra Costa Counties, California, which is the District's jurisdictional area. Additionally, the helicopters respond to mutual aid requests for law enforcement assistance, fire suppression and occasional EMS calls within the immediate San Francisco Bay area. The helicopters are classified by formal agreement with Alameda County as Advanced Life Support "rescue aircraft" and provide these services, subject to strict scene response protocols, free of charge to the patient and incidental to our primary law enforcement role. Our operations are conducted entirely in visual flight (VFR) conditions and the great majority of missions are flown during daylight hours. Crews are comprised of experienced commercial, instrument rated pilots, who are also sworn police officers, and volunteer flight medics who are sourced from local fire departments and ambulance operators. I will address each specific safety recommendation and outline the steps that have been taken in response to the recommendations and in the normal course of operations: As a support "rescue aircraft," District helicopters are not generally dispatched under County Helicopter Emergency Medical Service (HEMS) response protocols. Local commercial operators routinely provide such services. Consistent with the majority of law enforcement aviation units, we are dispatched by our in-house 24 hour/7 days per week dispatch center, which utilizes a dedicated computer aided dispatch (CAD) system. Personnel within the dispatch center are not trained in specifics of aviation weather nor aviation risk management and are not qualified to participate in go/no go decisions by the crew. Dispatchers are provided basic training in relation to unit capabilities, latitude and longitude format issues and operational requirements to assist them in determining relevant and accurate information from callers. Details of a call are logged and the information provided to the crew for a weather and risk assessment to be made by them, with any subsequent "no go" decision being final and without negative comment. When airborne, the aircraft crew is in constant communication with the dispatch center and updates its current and projected location approximately every I 0 minutes. If the aircraft has been out of contact for more than 20 minutes, the CAD system flags the dispatcher to re-establish radio communication with the aircraft. If communications are not re-established, a formal incident response protocol is initiated. This protocol, which is constantly being updated as part of the unit's SMS development, includes a "red book" binder containing all necessary information, checklists and guidance regarding response, personnel notifications and individual responsibilities. Detailed response information is provided in the event of an overdue or missing incident or confirmed aircraft accident. This will be available in both hard copy and electronic format to all stakeholders.

From: NTSB
To: State of California, East Bay Regional Park District Police, Air Support Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the East Bay Regional Park District Police have formal dispatch and flight-following procedures in place, how these are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of New York, County of Suffolk, Police Department, Aviation Section
Date: 7/15/2015
Response: We note that the Suffolk County Police Department uses an independent police radio band dedicated to its aviation section for flight following, and that either a tactical flight officer who holds a private pilot certificate with the addition of a helicopter rating, or a second pilot, is part of the flight crew and is trained to assist the pilot flying with routine tasks in the cockpit and risk assessment decisions. However, we would like to know whether formal procedures are in place to ensure that two-way communication is maintained for the entire duration of all HEMS flights, whether flight-tracking technology is used, and whether real-time weather information is available in the cockpit. In addition, we believe that a flight risk evaluation program that satisfies Safety Recommendation A-09-131 should be implemented before we close Safety Recommendation A 09-132. Pending confirmation from you that these procedures are in place for all HEMS flights, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: State of New York, County of Suffolk, Police Department, Aviation Section
To: NTSB
Date: 2/23/2015
Response: -From Edward Webber, Police Commissioner:, County of Suffolk, Police Department: County Executive Steve Bellone referred your letter of October 30, 2014 to me for response. The eight safety recommendations that you outlined in your correspondence were reviewed by the Suffolk County Police Department. Our Aviation Section has an exceptional safety record and I am cognizant that a continual and ongoing focus on safety is necessary to maintain this going forward. We have monitored the recent spate of tragic HEMS crashes and the tragic loss of life, and we are aware why this inquiry is necessary. We have a robust pilot training program, which includes both initial and recurrent original equipment manufacturer (OEM) training on the two airframes that we operate. We have intentionally configured our helicopter fleet with uniformity in mind. When we take delivery of our new Airbus EC-145 later this year, our fleet will be comprised of two EC-145s and two Airbus A Stars. We generally fly with two pilots or one pilot and a tactical flight officer (TFO) (all TFOs hold at least a private helicopter rating). I believe that we utilize a conservative approach in our aviation section and safety is always a paramount concern. With respect to the specific safety recommendations contained in your letter, I would like to address each one individually. Our Aviation does not operate a formalized dispatch system, however, flight following is performed by on duty Section personnel who are not flying. Flight following is conducted via an independent police radio band dedicated to the Aviation Section. Up to date weather information is relayed to the flight crew via the above mentioned radio band by non-flying Section personnel.

From: NTSB
To: State of New York, County of Suffolk, Police Department, Aviation Section
Date: 10/30/2014
Response: We have received no reply regarding actions you have taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, request for such information. Because we still have received no reply from you, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED.

From: NTSB
To: State of New York, County of Suffolk, Police Department, Aviation Section
Date: 10/14/2014
Response: We have received no reply from you regarding actions you have taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED. If you have completed, or plan to complete soon, any actions to address these recommendations, please submit details of your actions or plans to correspondence@ntsb.gov. If we receive a timely reply from you, we may reclassify one or more recommendations.

From: NTSB
To: State of New York, County of Suffolk, Police Department, Aviation Section
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Suffolk County Police Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Florida, City of Palm Beach, Health Care District
Date: 12/31/2013
Response: The District’s only letter concerning Safety Recommendation A-09-132, dated December 21, 2009, stated that flight-following services are provided under an interlocal agreement by the County Communication Center, but that the communication specialists who relay flight requests to pilots are not trained weather observers and do not have operational control. Our January 11, 2011, reply reiterated that HEMS flight requests should be reviewed by a designated individual who is familiar with HEMS operations and can evaluate the local and regional weather conditions, and who has the opportunity to make a no-go decision based on this evaluation before the flight crew is notified of the mission. We also encouraged the District to establish formalized dispatch procedures that include up-to-date weather information and assistance in flight risk assessment decisions. Pending the establishment of such procedures, Safety Recommendation A-09-132 was classified “Open—Acceptable Response” on January 11, 2011. We continue to believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the District has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Florida, City of Palm Beach, Health Care District
Date: 1/11/2011
Response: The NTSB emphasizes that the main focus of this recommendation is on the establishment of formalized dispatch procedures and flight-following functions. We note that, although flight-following services are provided under an interlocal agreement by the County Communication Center, the communication specialists that relay flight requests to pilots are not trained weather observers and do not have operational control. We reiterate that HEMS flight requests should be reviewed by a designated individual who is familiar with HEMS operations and can evaluate the local and regional weather conditions and have the opportunity to make a no-go decision based on this evaluation before the flight crew is notified of the mission. This individual could also be involved in the risk assessment process recommended in Safety Recommendation A-09-131. Although the District’s procedures for providing continual flight-following are acceptable, the NTSB encourages the District to also establish formalized dispatch procedures that include up-to-date weather information and assistance in flight risk assessment decisions. For additional guidance on establishing formalized dispatch and flight-following procedures, the NTSB suggests FAA Advisory Circular 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services. Pending its establishment of such procedures, Safety Recommendation A-09-132 is classified OPEN -- ACCEPTABLE RESPONSE.

From: State of Florida, City of Palm Beach, Health Care District
To: NTSB
Date: 12/21/2009
Response: MC# 2100068 - From Gerald M. Pagano, DO: The District owns and operates two Sikorsky S76C+ helicopters which are Single Pilot IFR certificated and equipped with weather radar, satellite XM weather, lightning detection, terrain and obstacle avoidance, radar altimeter, Satellite phone, and a moving map all available at the pilot station. Each pilot's competency is maintained through a combination of a Federal Aviation Administration approved training program at Flight Safety International, utilizing full motion simulators and courseware, which, includes a recurrent course at least every six months with FAR 135.293 and 135.297 competency checks, and regular company line orientated training in the aircraft with an annual 135.299 line check by the company Check Airman. Call requests, flight locating and flight following services are provided under an interlocal agreement by the County Communication Center. All transfer requests are routed through the Communications Center; Communication Specialists pass flight requests from EMS ground providers and hospital personnel to the pilot in command and medical flight crew through aural and separate digital paging systems. Once the pilot has verified launch criteria is met, the Communications Center is notified and provides continual flight following, utilizing flight tracking software and two-way radio communication. The Communicators are not trained weather observers and do not have Operational Control but monitor each flight on the SkyConnect flight tracking system which provides weather display. They relay pertinent information to the flight crew shown on the SkyConnect system and coordinate with ground personnel when applicable. During cross county flights out of the local area normal Federal Air Traffic System VFR flight following or IFR procedures are used by the flight crew. WSI, SkyConnect and the HEMS Weather tool are used by flight crews in pre-flight planning to determine and maintain knowledge of current and forecast weather conditions throughout shift assignment and before each flight acceptance. Program minimum weather requirements for flight acceptance are 1,000' ceiling and 3 miles visibility except visibility minimums for night cross-country out of the local flying area are increased to 5 miles. Assistance in flight risk assessment is enhanced since normal staffing at the facility is two or three pilots on duty from noon to midnight and dual pilot crews fly the aircraft during the overnight shift.

From: NTSB
To: State of Florida, County of Collier, MedFlight
Date: 4/30/2014
Response: We note that the Collier County Sheriff Dispatch Center has provided formalized flight following for your single helicopter operation since June 2009. We also note that you have developed procedures that involve the Chief Pilot or Pilot Manager in flight risk assessment decisions if the risk associated with a particular mission reaches the “yellow range” of your risk matrix. Because these procedures are consistent with the basic operations control center model described in FAA Advisory Circular (AC) 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, and were implemented before Safety Recommendation A-09-132 was issued, the recommendation is classified CLOSED—RECONSIDERED.

From: State of Florida, County of Collier, MedFlight
To: NTSB
Date: 1/10/2014
Response: -From Steve Adams, County Chief Pilot: A-09-132 Collier County MedFlight continues to utilize the Collier County Sheriff dispatch center for our formalized flight-following program. Each flight-follower is trained on the procedures for the job at hand and on in-flight emergencies. An in-depth Aircraft Accident/Incident Response Plan was developed for the operation and each flight-follower is trained on the their duties and the use of the manual should an incident occur.

From: NTSB
To: State of Florida, County of Collier, MedFlight
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether Collier County EMS has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, City of Los Angeles, Fire Department, Air Operations
Date: 7/24/2014
Response: We note that you have formalized dispatch and flight-following procedures in place for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that crew chiefs are trained in accessing this information to assist pilots during times of high workload. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—ACCEPTABLE ACTION.

From: State of California, City of Los Angeles, Fire Department, Air Operations
To: NTSB
Date: 3/10/2014
Response: -From Peter Benesch, Battalion Chief, Air Operations: The Los Angeles Fire Department uses the “SkyTrack” satcom technology to facilitate flight following during emergency and non-emergency missions. Aircraft position, flight path and detailed flight information is overlaid onto Google Maps and able to be monitored at Air Operations by administrative staffing The Los Angeles Fire Department’s aviation program maintains an all risk mission profile that includes HEMS operations along with search and rescue, hoist operations, firefighting, and swift water rescue. As a public use agency, flight requests are relayed via emergency calls which are received via the 911 system. Based on the information received, Fire Department dispatchers assign an incident type and dispatch appropriate resources, including aircraft, based on the incident algorithm. The dispatchers are not familiar with HEMS specific operations nor are they trained weather observers. The incident is transmitted to Air Operations, the FRAP is reviewed, a PIC is assigned, and the mission is accepted or not accepted based on the FRAP. Once a HEMS mission is relayed to Air Operations (dispatched) the dispatcher may report additional information if available. However, operational control of the mission, once in flight, remains the responsibility of the PIC. The pilot will use Crew Resource Management (CRM) as an asset to assist him in the decision making process.

From: NTSB
To: State of California, City of Los Angeles, Fire Department, Air Operations
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Los Angeles Fire Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Alaska, North Slope Borough, Search and Rescue Department
Date: 7/11/2014
Response: We note that flight following is provided for the entire duration of HEMS flights using a satellite flight tracking system and computer-aided display. We also note that you have formal procedures in place for responding to incidents and a web-based risk assessment program, and that up-to-date weather information is available to both pilots in the cockpit. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: State of Alaska, North Slope Borough, Search and Rescue Department
To: NTSB
Date: 3/24/2014
Response: -From Price E. Bower, Director, North Slope Borough Department of Search and Rescue: The North Slope Borough Police Department is currently tasked with providing 24/7, 365 day flight following for all SAR flights. This process includes real time web based flight tracking. The tracking is available for both IFR and VFR flights everywhere we operate. FAA flight plans are also filed for both VFR and IFR flights. All aircraft have "anytime anywhere" iridium satellite telephone capability to remain in contact with the Police Dispatch Center. The pilot computed dispatch release is emailed to the CP, Police Dispatch Center, Fire Department Director, and SAR Division Manager. The release has complete flight information to include weight and balance, ETA, fuel on board, souls on board, performance and runway requirements.

From: State of Alaska, North Slope Borough, Search and Rescue Department
To: NTSB
Date: 1/29/2014
Response: -From Katherine Ahgeak, Chief of Staff, North Slope Borough, Office of the Mayor: The Mayor of the North Slope Borough, Charlotte E. Brower is in receipt of your letter dated December 31, 2013 regarding eight safety recommendations issued to the North Slope Borough in 2009. Electronic copies of this correspondence are being provided to the following staff who will prepare a formal response to NTSB for the Mayor’s signature no later than April 1, 2014: Dawn Winalski, Interim Borough Attorney Price Brower, Director of NSB Search & Rescue Dennis Tiepelman, Deputy Director of NSB Search & Rescue John Boyle, Chief Advisor to the Mayor Hugh Patkotak, 2009 Director of NSB Search & Rescue If you have any questions concerning this email, please do not hesitate to call my office at 852-0200 and request to speak to John Boyle, Chief Advisor to the Mayor.

From: NTSB
To: State of Alaska, North Slope Borough, Search and Rescue Department
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the North Slope Borough has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of Florida, County of Broward, Sheriff's Office
Date: 5/27/2014
Response: We note that you provide dispatch and flight-following for your four-helicopter operation through the Sheriff’s Office Dispatch Center, which uses flight tracking software. We are aware that your dispatch and flight following includes formal procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that flight medics are trained in accessing this information to assist the pilot during periods of high workload. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: State of Florida, County of Broward, Sheriff's Office
To: NTSB
Date: 1/9/2014
Response: -From Alphonso Jefferson, Jr., Assistant to County Administrator: I am in receipt of your letter dated December 31, 2013 to Ms. Bertha Henry, County Administrator, referencing responses to recommendations that were issued by the National Transportation Safety Board (NTSB) to the Broward County Sheriff’s Office in 2009. This letter is intended to inform you that responses to the recommendations will be forthcoming. If you have any questions please contact me. -From Sergeant Christine Ponticelli, Supervisor, Aviation Unit: I just received a letter dated December 31, 2013 regarding your Safety Recommendations for A-09-97 through A-09-133. A09-132: Flight following procedures: The Broward Sheriff’s Office Aviation Unit operates VFR on demand transports. Our flight following which was approved by the FAA are conducted by our BSO Dispatch Center. They have all the required information logged (ie. Souls on board, fuel, location, eta, destination etc). The aircraft can be tracked by dispatch, pilots, crew, etc for locations, weather etc. Some of the aircraft have on board weather systems. Pilots have access to weather on smartphones carried on their person. As 99% of the medevacs are in the county, any weather phenomena encountered are resolved by the pilot landing at the nearest safe field if necessary. There are four airports in the county that can be utilized also.

From: NTSB
To: State of Florida, County of Broward, Sheriff's Office
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Broward County Sheriff’s Office has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of New York, County of Chautauqua, Sheriff's Office
Date: 5/22/2014
Response: We note that, on February 24, 2014, Chautauqua County Sheriff’s Office was awarded a commercial air carrier Part 135 certificate. Although we are encouraged to learn that you now operate under these more stringent regulations, we would like to know, specifically, what actions you have taken to address the recommendations listed above. Pending our prompt receipt of this information and our subsequent review of it, Safety Recommendations A-09-97 through -100 and A-09-131 through -133 remain classified OPEN—AWAIT RESPONSE.

From: State of New York, County of Chautauqua, Sheriff's Office
To: NTSB
Date: 1/21/2014
Response: -Joseph A. Gerace, Sheriff: Thank you for your inquiry regarding the safety recommendations issued to the Chautauqua County Sheriff's Office (CCSO) regarding our HEMS operation. I apologize for the delay in responding to your initial letter. I did not interpret it as a document that required a follow-up, but rather an informational notice and it was forwarded to my aviation division. At the time of your correspondence, we were operating as a public aircraft entity and working extensively to qualify for a commercial air carrier certificate. Our primary focus was to achieve a higher degree of safety by coming into compliance with 14 CFR Part 119 and Part 135. After several years of planning, training and developing our program, we were ultimately awarded a commercial air carrier certificate on February 24t\ 2011 (CCOA-015Z). I am proud of the fact that our HEMS program only operates in a dual pilot configuration. In my opinion, this is a significant measure for the safety of our crew and the patients we fly. We have strict weather minimums and only fly visual flight rules (VFR) flights. As you may be aware, the Federal Aviation Administration (FAA) is actively addressing similar recommendations to those you provided in your letter. They (FAA) have issued a Notice of Proposed Rule Making (NPRM) which provides background and proposed regulatory changes to address the NTSB' s recommendations. Please be assured that CCSO is working directly with our Principal Inspectors from the Rochester Flight Standards District Office to prepare for implementation of these proposals should they indeed become regulatory. CCSO has voluntarily achieved advanced compliance with several of the proposed rules. However, as a small operator, we are financially limited in our ability to voluntarily address all of the recommendations at this time. As a part 135 operator, we will be required to comply with all finalized regulations in the time frame established within those regulations if and when the NPRM becomes law. I hope that this information is helpful to you. As a certificated air carrier, we will be held to the same standard as all other carriers regarding the timeline for compliance with and implementation of the adopted portions of NPRM. We will continue to work diligently to implement as many as we can within our financial ability to do so.

From: NTSB
To: State of New York, County of Chautauqua, Sheriff's Office
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Sheriff’s Office has formal dispatch and flight following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of Los Angeles, Sheriff’s Department, Aero Bureau
Date: 1/14/2015
Response: We note that your procedures for following HEMS for the entire duration of the flight include using a satellite flight tracking system and computer aided display. These procedures satisfy Safety Recommendation A 09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: State of California, County of Los Angeles, Sheriff’s Department, Aero Bureau
To: NTSB
Date: 10/23/2014
Response: -From Roberta A. Abner, Chief, Homeland Security Division: The LASD utilizes a "Skytrac" satellite flight following system for all its aircraft. HEMS calls originate from the fom1al dispatch center which is staffed 24/7 by personnel from Los Angeles County Fire Department. Flights are continuously monitored on Skytrac by the formal dispatch center and from the LASD Aero Bureau dispatch desk, which is staffed 24/7 by personnel trained to monitor the aircraft. Aero Bureau supervisory personnel and senior maintenance personnel also monitor the satellite flight following system. Dispatch personnel actively monitor weather conditions during all HEMS flights.

From: NTSB
To: State of California, County of Los Angeles, Sheriff’s Department, Aero Bureau
Date: 10/3/2014
Response: We have received no reply from you regarding actions you have either taken or planned to take in response to these recommendations since we issued them, despite our December 31, 2013, followup request for such information. Because we have received no reply from you to our request, we conclude that you have neither acted nor plan to act to address these safety issues. Consequently, Safety Recommendations A-09-97 through -101 and A-09-131 through -133 are classified CLOSED—UNACCEPTABLE ACTION/ NO RESPONSE RECEIVED.

From: NTSB
To: State of California, County of Los Angeles, Sheriff’s Department, Aero Bureau
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Los Angeles County Sheriff’s Department or Fire Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of Orange, Sheriff's Department, Air Support Division
Date: 5/22/2014
Response: We note that flight following is provided for flights that are conducted in mountainous areas at night and that you intend to purchase satellite tracking systems, which will assist your dispatchers in following flights. We also note that weather is available for other flights from several local airports. However, we are concerned that flight-following is only provided for those flights that are conducted in mountainous areas at night, and we encourage you to provide this service to all HEMS flights. Pending confirmation from you that these procedures are in place for all HEMS flights, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: State of California, County of Orange, Sheriff's Department, Air Support Division
To: NTSB
Date: 1/19/2014
Response: -From William D. Fitzgerald, Jr., Aviation Support Unit, Operations Sergeant: We received the letter dated December 31, 2013, reference the eight NTSB safety recommendations for the Orange County Sheriff’s Department Aviation Support Unit. These safety recommendations were sent to Sergeant Han 0 who is no longer the unit. Unfortunately, the information was never passed on. I am currently the Operations Sergeant for the Aviation Support Unit and an Airborne Law Enforcement Association (ALEA) Accreditor for unit standards. Our unit now has a fully implemented Safety Management System (SMS) exceeding the standards set by ALEA and the International Helicopter Safety Team (IHST). We also have conducted full accident rehearsals for the past two years in order to improve our emergency response plan. We have had Elliot Simpson and Patrick Jones from the NTSB monitor both of our exercises. The Orange County Sheriff’s Department Aviation Support Unit notifies dispatch anytime flight is conducted into the mountainous areas at night. This process will be improved by the recently approved purchase of Satellite Tracking Systems. The majority of flying by the ASU is located within the county with immediate access of weather from several local area airports. Risk Management Worksheets must be approved at the appropriate level based on the residual risk level (Enclosure 5).

From: State of California, County of Orange, Sheriff's Department, Air Support Division
To: NTSB
Date: 1/9/2014
Response: -From Sergeant William Fitzgerald, Aviation Support Unit, Orange County Sheriff’s Department: We received the letter dated December 31, 2013, from Paula Sind-Prunier reference the eight NTSB safety recommendations for the Orange County Sheriff’s Department’s Aviation Support Unit. These safety recommendations were sent to Sergeant Han O who is no longer the unit. Unfortunately, he never passed on the information. We look forward to informing the NTSB about our Aviation Safety Program. I am currently the Operations Sergeant for the Aviation Support Unit and an Airborne Law Enforcement Association (ALEA) Accreditor for unit standards. Our unit now has a fully implemented Safety Management System (SMS) exceeding the standards set by ALEA and IHST. We also have conducted full accident rehearsals for the past two years in order to improve our emergency response plan. We had Elliot Simpson and Patrick Jones from the NTSB monitor both of our exercises. I will have a formal letter sent to your office detailing how we addressed the eight NTSB safety recommendations within 2 weeks. If the NTSB has any future correspondence for our unit, please email me or mail to our hangar.

From: NTSB
To: State of California, County of Orange, Sheriff's Department, Air Support Division
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Orange County Sheriff’s Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of San Bernardino, Sheriff's Department
Date: 6/26/2014
Response: We note that you have formal flight-following procedures in place, that pilots and crew chiefs have access to up-to-date weather information in the cockpit, and that you are planning to install automatic flight-following transponders in your helicopters. Although these are positive measures, we would like to know whether you have a formal incident response protocol in place, in case communication with a flight is lost and cannot be reestablished. Pending our receipt of this additional information, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: State of California, County of San Bernardino, Sheriff's Department
To: NTSB
Date: 4/16/2014
Response: -From John McMahon, Sheriff-Coroner: The San Bernardino County Sheriff's Department's Aviation Unit is pleased to provide a response to the National transportation & Safety Board's recommendations resulting from an investigative hearing occurring in February 2009. We apologize for the delay as it was not clear, at the closing of the hearing, that a formal response to the recommendations was required. While we recognize the importance of flight safety, in all aspects, we also share the position of our brother public safety agencies that our mission profiles are quite different than that of private HEMS operators. In fact, many of our missions, in particular hoist rescue (day and night), pose a much greater safety risk than our colleagues in the aero-medical transportation industry. Thus, we tend to train harder and respond in many diverse terrain environments than a civilian air transport provider. Public safety or government flight operations are driven by mission and not so much making a profit. Therein lies the potential cause of many of the fatal incidents. Whether it is training, maintenance, or equipment costs, often financial short cuts are realized in the private industry resulting in tragedy as we, too, are charged with aircraft crash investigations. With the aforesaid, many of us in the public safety sector recognize that the private sector will continue to attempt to legislate us out of our missions, our responsibility to our citizens, and our current mandates. Again, we are not profit driven. We have seen that the majority of the fatal incidents are private operators and not public safety. We have noted that a private aircraft operator can contract with a government agency, have an incident, yet, the incident is charged against government or public safety statistics. It is our desire to continue to advocate the separation of private and public safety flight operations, largely based on the fact that our missions and motivations are different. The public safety flight statistics show we have an exceptional flight safety history and should enjoy reasonable exemptions from the private, profit motivated operator. The San Bernardino County Sheriff's Aviation Unit crews currently use formal flight following, both with dispatch and "in-house" with aviation staff. If crews are not formally dispatched to calls, the flight crew initiates flight following with a dispatch center and aviation staff. Our pilots are trained in flight operations within the county. Weather information is available to crew members at any time prior to flight and in-flight. Additionally, flight crews have available to them iPads and smart phones to acquire flight data information as needed.

From: State of California, County of San Bernardino, Sheriff's Department
To: NTSB
Date: 1/6/2014
Response: -From Janice Rutherford, Board of Supervisors Chair, Second District Supervisor, County of San Bernardino: Thank you for your letter dated Dec. 31, 2013, regarding recommendations the National Transportation Safety Board has made to the San Bernardino County Sheriffs Department. I took steps to ensure San Bernardino County Sheriff John McMahon is aware of the NTSB's recommendations and the agency's desire to receive a response from the Sheriffs Department as soon as possible. Again, thank you for your letter and for your efforts to improve safety among emergency medical service operators. Please let me know if I may be of any further assistance.

From: NTSB
To: State of California, County of San Bernardino, Sheriff's Department
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the San Bernardino County Sheriff’s Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of Santa Barbara, Sheriff's Department, Air Unit
Date: 6/19/2014
Response: We note that you provide dispatch and flight-following through your law/fire communication center, which uses flight tracking software and a computer-aided display. We are aware that your dispatch and flight following includes formal procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that crew chiefs are trained in accessing this information to assist the pilot during periods of high workload. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED—ACCEPTABLE ACTION.

From: State of California, County of Santa Barbara, Sheriff's Department, Air Unit
To: NTSB
Date: 3/5/2014
Response: -From Lieutenant Steven Johnson, Air Support Unit: Currently we do have flight following with our 24 hour law/fire communications center. This flight following is initiated at the crews request through our communications center and time intervals are established at that time. In addition to flight following, we have a satellite web-based system installed in three (3) of our aircraft, which enables any person the ability to login to the website and monitor the track of the aircraft. These systems automatically report our position to our computers, as well as the United States Forest Service. Our staff members who work in our communications center and responsible for flight following are not trained weather observers, they do not have knowledge in HEMS, nor do they have operational control during the response. The pilot has operational control during responses and they work within the CRM protocol.

From: NTSB
To: State of California, County of Santa Barbara, Sheriff's Department, Air Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Santa Barbara County Sheriff’s Department or Fire Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of Sonoma, Sheriff's Office
Date: 3/6/2015
Response: We are aware that you have formal dispatch and flight-following procedures in place for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that you train TFOs in accessing this information to assist pilots during times of high workload. Accordingly, Safety Recommendation A-09-132 is classified CLOSED—ACCEPTABLE ACTION.

From: State of California, County of Sonoma, Sheriff's Office
To: NTSB
Date: 12/9/2014
Response: -From Steve Freitas, Sheriff-Coroner: We are in receipt of your letter dated December 31, 2013 and are pleased to report that all NTSB recommendations have been addressed as requested. We are hopeful that upon reviewing our work and progress on these eight NTSB recommendations you will feel confident in reclassifying our program as "compliant" with all NTSB HEMS recommendations. The Sonoma County Sheriffs Office operates a 1996 Bell407 helicopter with approximately 8,500 flight hours. The Sheriffs Office has launched a formal project to replace the Bell407 with a category "A" twin engine helicopter and anticipates a new or nearly new helicopter will be purchased within the next 18-24 months. We want to emphasize that our helicopter (Henry-1) is multi-mission program incorporating Advanced Life Support (ALS) capability, rescue and law enforcement missions. We do not operate primarily as an HEMS provider; that role is filled by two regional HEMS providers REACH and CALSTAR. Henry 1 provides emergency medical transport when primary providers are unavailable or when urgent transport is required in the interest of patient care. Most importantly, as a public use helicopter program, the Sheriffs Office does not seek compensation for medical transports and is prohibited from doing so by law. It appears that many of the NTSB safety recommendations directed at HEMS operators focus on safety management and risk assessment where profit was the motivating factor driving poor decisions to accept risky missions. Therefore, we believe our compliance with these NTSB recommendations is voluntary and not mandated. We appreciate the eight recommendations as best practices that all helicopter operators should strive for, however our aircraft is not capable of supporting some of the technical recommendations at this time. The Sonoma County Sheriffs Office attained full accreditation by the nationally recognized ALEA (Airborne Law Enforcement Association) in May 2014. Our successful accreditation by an independent, nationally recognized panel of experts validates the revision and rewriting of our Flight Operations Manual (FOM) and creation of a formal Safety Management System (SMS). The process was a multi-year endeavor developed with the assistance of aviation consultants, California Training Institute. We are extremely proud of our program and the service we provided to the public. With over 40 years of experience operating rescue helicopters on the northern coast of California we are recognized as the leaders in rescue safety. The Sonoma County Sheriff's Office has a dispatch policy on how the call is dispatched. To accept a call, the pilot is final authority and responsible for determining weather, dispatchers do not make the weather "go-no" calls. Hard weather minimums are covered in our FOM, all crew members are aware of limitations and have authority to cancel a flight. Flight tracking and following is handled by our GPS Skytrac system which is monitored through our dispatch center at all times. We also have in our FOM a policy covering voice radio contacts and position reports with our dispatch center within mandatory timed check-ins.

From: State of California, County of Sonoma, Sheriff's Office
To: NTSB
Date: 3/26/2014
Response: -From Lieutenant Mark Essick, Manager, Helicopter and Marine Operations, Sonoma County Sheriff’s Office: The Sonoma County Sheriff’s Office is in receipt of your letter dated December 31, 2013. We are preparing a detailed response addressing the eight safety recommendations made by the NTSB to HEMS operators. We anticipate having our final response to you no later than December 31, 2014. In our review of the eight safety recommendations made by the NTSB we believe the recommendations have either been addressed or do not apply to our aircraft. We look forward to providing you detail on the actions we have taken.

From: NTSB
To: State of California, County of Sonoma, Sheriff's Office
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Sonoma County Sheriff’s Office has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, State Police, Highway Patrol, Office of Air Operations
Date: 7/23/2014
Response: We note that formal flight-following is provided for the entire duration of flights through two-way communication and that dispatchers are assisted by a computer-aided display. We also note that you have procedures for assessing risk and responding to incidents, that up-to-date weather information is available in the cockpit, and that flight officers are trained in accessing this information to assist pilots during times of high workload. Because these measures were in place before we issued Safety Recommendation A-09-132, it is classified CLOSED—RECONSIDERED.

From: State of California, State Police, Highway Patrol, Office of Air Operations
To: NTSB
Date: 3/26/2014
Response: J.A. Farrow, Commissioner: California Highway Patrol air crews are normally dispatched by CHP communications centers, but are sometimes dispatched by other sources such as allied emergency medical services agencies, law enforcement agencies, fire departments, or other public safety agencies. Air crews maintain constant contact with CHP communications centers and are required to regularly update CHP public safety dispatchers with their location. California Highway Patrol dispatchers do not have specialized weather observation training and have no operational control over CHP flights. Air crews are responsible for checking weather before each flight and consider this information part of their risk assessment. Aircraft are equipped with devices which receive weather updates including en route weather and weather being reported at airports. The decision to perform a mission is left to the air crew. All AOP personnel receive weather observation training. Any crewmember can refuse a mission or cancel it at any time. Specifications for replacement aircraft include flight tracking devices which will give regular updates via satellite. This data will be accessible by other AOP personnel, supervisors, and managers at all times. New CHP aircraft specifications include Automatic Dependent Surveillance-Broadcast equipment to comply with the FAA's Next Generation Air Transportation system and will therefore receive official weather data in the aircraft.

From: NTSB
To: State of California, State Police, Highway Patrol, Office of Air Operations
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the California Highway Patrol has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of New York, State Police, Aviation Unit
Date: 3/8/2017
Response: We note that, in April 2016, you implemented a flight risk evaluation program, which incorporates an effect/probability?type risk assessment and predetermined levels of risk that require management approval if the risk reaches an established level. We are aware that this program falls under your SMS program, and that you provide your employees with adequate training. Because your program addresses the intent of Safety Recommendation A-09-131, the recommendation is classified “Closed—Acceptable Action.” We also note that Federal Aviation Administration-licensed flight dispatchers relay up to date weather information to flight crews and use flight-tracking software, a computer-aided display, and a satellite phone to follow flights and maintain communication with flight crews for the entire flight duration. In addition, your standard operating procedures include formalized dispatch and flight following procedures that include a formal incident response protocol. These measures satisfy Safety Recommendation A-09-132, which is classified CLOSED--ACCEPTABLE ACTION.

From: State of New York, State Police, Aviation Unit
To: NTSB
Date: 11/3/2016
Response: -From Major Brent B. Gillam, Director of Aviation, New York State Police: The NYSP Aviation Unit uses FAA-licensed dispatchers as part of our dispatch procedures and flight following. Our pilots, dispatchers and command staff routinely utilize a plethora of internet based sources that provide real-time information to aid in decision making. The purchase, integration and embracing of PRISM and FRAT in April 2016 adds to our established improvements in formalized dispatch, flight-following procedures, satellite phones, and incident response protocols. The Unit made another improvement in 2015 by investing in a satellite tracking system that allows live monitoring of each flight and storage of flight data for later review.

From: NTSB
To: State of New York, State Police, Aviation Unit
Date: 6/20/2014
Response: We note that your SOPs include formalized dispatch and flight-following procedures that include a formal incident response protocol. We also note that you have two FAA-licensed flight dispatchers who use flight tracking software, a computer-aided display, and a satellite phone to provide flight-following and maintain communication with flight crews for the entire duration of their flight. We appreciate your taking these positive measures, yet we believe that the flight risk evaluation program we recommended in Safety Recommendation A-09-131 should be implemented before we close Safety Recommendation A-09-132. Accordingly, pending completion of that action, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: State of New York, State Police, Aviation Unit
To: NTSB
Date: 6/13/2014
Response: -From Major Chuck Guess, Detail Commander, New York State Police Aviation: Received. We will review, assess and follow up on all outstanding recommendations. The NYSP Aviation Unit recognizes the importance of assimilating and implementing Best Practices. Safety remains our number one priority. Thank you.

From: State of New York, State Police, Aviation Unit
To: NTSB
Date: 2/10/2014
Response: -From Major Charles E. Guess, NYSP Director of Aviation: The Unit does operate with formalized flight dispatch procedures. Again, the responsibility of flight following is defined in the Unit SOP. During most operations, the Unit HQ, located in Albany, N.Y. is staffed by one of our two FAA licensed Flight Dispatchers. As licensed dispatchers these two personnel are trained in various aspects of weather interpretation amongst other FAA mandated requirements. These two personnel attend annual training at Flight Safety International. All flights are closely followed using Honeywell SkyConnect and flights are displayed on a large flat screen display located at the dispatch desk. In addition, each NYSP aircraft is equipped with a satellite phone that allows dispatchers to pass changes in observed conditions to the pilots while in flight. Our dispatchers are used in an informational role only and are not afforded any measure of operational control. Procedures are in place however for information to be passed to the HQ command staff who do retain operational control. In addition, the HQ command staff offices are all located within steps of the dispatch area. The dispatchers are tasked with also advising service requestors with updates in regards to status changes due to weather or equipment. As a redundant feature, Unit policy dictates that aircrews call "in service" when entering the airspace over a local State Police Troop's region of responsibility and maintain positive communication with their HQ throughout the duration of their mission. Conversely, they call "out of service" upon mission completion. In cases where Unit dispatch personnel are not available, the Unit has an agreement with the NYSP communications section in Latham, NY to provide flight following of all flights. Although they are not afforded the capability to see a flights progress and they are not trained in weather observation, they do provide basic flight following and the on-duty NCO of the facility is responsible for the tracking of aircraft. Any incidents or lapses of communication are immediately communicated to the designated Unit duty officer. Again, this is in addition to the aforementioned requirements.

From: NTSB
To: State of New York, State Police, Aviation Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the New York State Police have formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: United States Department of the Interior, National Park Service, Park Police, Aviation Unit
Date: 6/20/2014
Response: We note that your formalized dispatch and flight following is primarily provided through Maryland’s “Systems Communication Center.” We also note that your dispatchers use flight tracking software and a computer-aided display to provide their own flight following and that they maintain communication with flight crews for the entire duration of the flight. We further note that you have a formal incident response protocol if communication is lost and cannot be reestablished. We appreciate your taking these positive measures, yet we believe that the flight risk evaluation program we recommended in Safety Recommendation A-09-131 should be implemented before we close Safety Recommendation A 09-132. Accordingly, pending completion of that action, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: United States Department of the Interior, National Park Service, Park Police, Aviation Unit
To: NTSB
Date: 2/27/2014
Response: -From Robert MacLean, Acting Chief, United States Park Police: The USPP utilize SYSCOM as our primary means of flight following. The USPP use radio communications, as well as Latitude Technologies, FAA NCRCC, and SYSCOM for flight following and dispatch. All missions are flight followed by SYSCOM via two computer based tracking systems (flight vector, and web sentinel); additionally, the Aviation Crew checks in with SYSCOM and USPP communications at least every fifteen minutes via radio. The USPP also have the ability to flight follow from our hangar using the Latitude Technologies web based program. As we upgrade our USPP Communications Center, the USPP plan to install a dedicated Latitude monitor allowing USPP dispatchers to track our progress as well.

From: NTSB
To: United States Department of the Interior, National Park Service, Park Police, Aviation Unit
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the United States Park Police have formal dispatch and flight-following procedures in place, how these procedures are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.

From: NTSB
To: State of California, County of Ventura, Sheriff's Department, Aviation Division
Date: 6/13/2014
Response: We are aware that you use formalized dispatch and flight-following procedures, which include two-way communication for the entire duration of flights and a formal incident response protocol if communication is lost and cannot be reestablished. We also note that dispatchers are assisted by a computer-aided display, that up-to-date weather information is available in the cockpit, and that crew chiefs are trained in accessing this information to assist pilots. We appreciate your taking these positive measures, yet we believe that the flight risk evaluation program you discussed in response to Safety Recommendation A-09-131 should also be implemented before we close Safety Recommendation A-09-132. Accordingly, pending completion of this final action, Safety Recommendation A-09-132 is classified OPEN—ACCEPTABLE RESPONSE.

From: State of California, County of Ventura, Sheriff's Department, Aviation Division
To: NTSB
Date: 2/11/2014
Response: -From Bill Ayub, Captain, Ventura County Sheriff’s Office: The Ventura County Sheriff’s Office operates the only public safety aviation program, hereinafter referred to as “aviation unit,” in Ventura County, California. The aviation unit performs law enforcement support, medevac, search and rescue operations, and aerial firefighting support. Although the aviation unit is managed by the Ventura County Sheriff’s Office, it is a blended unit staffed by Sheriff’s Office members as well as Ventura County Fire Department members with the shared common goal of providing for public safety. As the manager of the aviation unit, I am responsible for the oversight of the program and am therefore responding to the NTSB safety recommendations on behalf of both the Ventura County Sheriff’s Office and the Ventura County Fire Department. This department utilizes formalized dispatch and flight-following procedures throughout the County of Ventura. In addition, the Ventura County Fire Department and the United States Forest Service are regularly involved in the flight-following process however; they do not provide up-to-date weather information. Up-to-date weather is obtained from a variety of sources that the pilots have available to them. These include approach control facilities, and ATIS&ASOS facilities. The unit also utilizes a “paperless” electronic flight bag system and can retrieve critical flight information though its use of iPad and iPhone systems along with subscriptions to ForeFlight.

From: NTSB
To: State of California, County of Ventura, Sheriff's Department, Aviation Division
Date: 12/31/2013
Response: The intent of Safety Recommendation A-09-132 is to ensure that HEMS operators establish formalized dispatch and flight-following functions to determine flight risk. We believe that having clear, defined procedures in place that support coordinated communication and consider ongoing weather conditions is key to helping HEMS operators make appropriate risk assessment decisions. Some of the other operators who received this recommendation are provided dispatch and flight-following services by their local fire, rescue, or communications centers. Although such general service agreements are common, these operators also have developed procedures that involve a designated individual familiar with HEMS operations in flight risk assessment decisions. The designated individual evaluates the local and regional weather conditions displayed on the HEMS weather tool and can make a no-go decision based on this evaluation before the flight crew is notified. Also, as discussed previously, the designated individual is notified by the flight crew if the crew determines the flight risk is near the high end of the yellow range. The designated individual is then responsible for notifying the requesting agency that the helicopter’s arrival could be delayed or the flight cancelled if operational risk increases. This individual also may be involved in the risk assessment process recommended in Safety Recommendation A-09-131. We would like to know whether the Sheriff’s Department or Fire Department has formal dispatch and flight-following procedures in place, how they are performed, and by which staff members. We would also like to know whether the staff members who relay flight requests to pilots are trained weather observers, familiar with HEMS operations, and whether they have any operational control during responses. Please see FAA AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, issued May 5, 2008, for additional guidance on establishing formalized dispatch and flight-following procedures.