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Remarks to the Association of Air Medical Services Spring Legislative Conference, Washington, DC
Deborah A. P. Hersman
Association of Air Medical Services Spring Legislative Conference, Washington, DC

Thank you, Dan, for that gracious introduction. And thank for you for inviting me to be here with you today. I remember well from my days working on Capitol Hill that spring time in Washington means two things: cherry blossoms and legislative conferences. And you have picked a great time of year to be here. Unfortunately, the cherry blossoms are predicted to peak in two weeks and as luck would have it, that's just about when the most recent appropriations extension expires.

For those of us in the public sector, these are indeed interesting times. And I think the same could be said for your industry as well. Many of you are familiar with the National Transportation Safety Board's work and mission. We are charged by Congress with investigating all aviation accidents and after a thorough investigation we make findings and determine the probable cause of those accidents. But our most significant action is in making recommendations to prevent future accidents.

However, our recommendations are just that: recommendations. Implementation is up to other agencies, like the Federal Aviation Administration, and you, the industry. However, it can take years before we see action on our safety recommendations because the process of converting recommendations into requirements doesn't happen overnight. The legislative process is slow and the rulemaking process is even slower. But that's just a fact of life here in Washington.

But outside of the beltway, some of you have been in this industry, operating for decades. You may recall that the NTSB's interest in HEMS safety isn't new. Back in 1988, the NTSB conducted a special investigative report as a result of a series of accidents. Eighteen years later, in 2006, the Safety Board issued additional recommendations arising out of a special investigative report that looked at fifty-five helicopter and fixed-wing medical transport accidents. Next, we issued a series of recommendations arising from a public hearing we conducted in 2009. Then, as a result of a 2009 accident involving a Maryland State Police helicopter, the Safety Board issued more recommendations.

Over the years, the Safety Board's recommendations and concerns have focused largely on ten specific areas:

  • Establishing weather minimums,
  • FAA and company oversight,
  • Pilot decision making,
  • Use of formal dispatch and flight control processes,
  • Pilot workload and fatigue,
  • Establishing safety management systems and risk management programs,
  • Pilot training,
  • Flight data recorders for FOQA-type programs,
  • Installation of safety equipment, such as Terrain Awareness and Warning Systems, and
  • Airspace and facility infrastructure improvements

In many respects, these issues are no different from other issues of concern to all of the aviation industry. Pilot fatigue and safety management systems are issues that span aviation — whether it is an air ambulance or a large commercial airline operation. Any fatal aviation accident is a tragedy. I don't have to tell you that tragedy is further compounded when it involves an EMS operation. I remember meeting Dawn during my first year on the Safety Board. At the NTSB, we are particularly pleased to see your continued engagement in the process of improving safety. Your interest and support is critical. And we're working with you – by hearing information and listening to you – to support continued HEMS safety improvements. But there is still a lot of work to do. In 2010, there were 12 crashes; seven of those involved 18 fatalities.

As you know, the FAA issued a notice of proposed rulemaking on air ambulance and commercial helicopter operations. The proposed rule addresses a number of our recommendations. More than 300 comments were submitted to the FAA from the HEMS community. A majority of these comments supported improving safety and were very constructive.

We applaud the FAA's comprehensive proposal and believe it is a significant step in the right direction. It would address all four issue areas on our Most Wanted List by: (1) requiring the application of part 135 for all legs of medical flights; (2) requiring a pre-flight risk assessment; (3) equipping helicopters with TAWS; and (4) requiring operations control centers to incorporate formalized dispatch and flight-following procedures. However that proposal would only apply to operators with ten or more helicopters. We believe, and commented, that if the goal is an equivalent level of safety across the industry, it should apply not just to the largest operators but to all operators. The fact is that in 2009, of the seventy-four certificate holders for EMS operations, the vast majority had fewer than ten helicopters.

Many NTSB recommendations are addressed in the FAA's NPRM. And it codifies a number of the safety actions that have been addressed through advisory materials. We believe this is good progress. But let me acknowledge what organizations in this room have accomplished. The FAA's proposal is comprised of actions many of you have already taken. Also worthy of mention, several of your members are working with the Flight Safety Foundation to establish a research program to test the installation and use of flight recorders to create a FOQA program for HEMS operations. We see this as a fantastic step, and you have the Board's strong support.

However, even with all of the very positive things advanced in the NPRM, we are concerned that the proposed rule does not adopt a number of other outstanding recommendations. Since rulemaking is such a challenging process, by not taking this opportunity to address the following issues, we are losing an opportunity for further safety enhancements, like:

  • Improved weather reporting and access,
  • Lightweight flight recorder installation requirements,
  • Autopilot for single-pilot operations – which may be a defacto standard as new equipment replaces older models in the fleet,
  • Simulator training requirements,
  • Reporting of exposure data for HEMS operations, and
  • Night vision imaging system requirements (NVIS).

Perhaps NVIS is the most significant omission from the proposed rule based on the comments that were filed. In fact, it has been reported that almost 70 percent of the HEMS fleet has night vision goggle capability now. We believe that the final rule, if it incorporates these additional recommendations, would make HEMS operations even safer.

I would also note that we are very pleased with the interest and responsiveness of other stakeholders with respect to our safety recommendations. For one, the Federal Interagency Committee on Emergency Medical Services, or FICEMS, responded quickly and enthusiastically to our recommendations to develop national and local planning guidelines for the selection of appropriate emergency transportation modes for urgent care.

At the Safety Board we are well aware that implementing our recommendations is often very challenging. But in creating the Safety Board, this is precisely what the Congress wanted: to have an independent agency that could investigate an accident and hold up a mirror and accurately reflect what we saw. That's what we do. The facts from an accident investigation lead us to our recommendations. We know that sometimes our recommendations may be expensive and technically challenging, and at times they may not be popular. But we also know that when implemented, they result in significant improvements in transportation safety.

Adlai Stevenson once said, "All progress has resulted from people who took unpopular positions." If you are advocating for some of these safety measures, you know that it may be unpopular to advocate for these necessary changes. But you will be in good company. At the Safety Board we are committed to working with you to raise the bar on safety.

Thank you for your interest in our work, and I know we have plenty of time for questions.