Examining the rural need for helicopter membership in Mendocino County

Orsi's helicopter ride alone would have cost her $117,000, but thanks to the membership her husband secured for their entire family as the fire chief of Fort Bragg Volunteer Fire Department, she never paid a penny. photo credit: Global Medical Response via Bay City News
REACH crew in Willits, Calif., in an undated photo. REACH, which acquired CalStar in 2016, operates under the Global Medical Response umbrella, meaning
members picked up by either aircraft are covered.

Mendocino County might be known throughout the state for its towering redwood trees, stunning coastlines, wine, cannabis and small-town communities.

But one thing the locals know about this rustic, rural region when it comes to health care: you need a helicopter membership.

For many, the less than $100 they spend for the year to cover themselves and loved ones in the event of an emergency could wipe away the entire bill for an airlift during a medical emergency.

This was exactly the case for Fort Bragg resident Kathy Orsi, who two years ago experienced the most fatal type of heart attack known as a "widowmaker" and received a transport by air to Adventist Health St. Helena, a hospital located in northern Napa County. The 30-minute helicopter trip from her small coastal town to the hospital with the cardiologist who ultimately saved her life would have otherwise taken three hours by car.

"For help for heart attacks, especially, it's either Santa Rosa or St. Helena," Orsi said, explaining that smaller nearby hospitals offer more basic care than what she needed during the heart attack that has a notoriously low survival rate.

The American Heart Association cites the survival rate following a widowmaker heart attack to be 12% if it occurs outside of an advanced care center.

Orsi's helicopter ride alone would have cost her $117,000, but thanks to the membership her husband secured for their entire family as the fire chief of Fort Bragg Volunteer Fire Department, she never paid a penny.

Tanya Taylor shared a similar story. And because of her experience, she urges everyone she knows living in rural Mendocino County to make sure they too become members.

Taylor is still recovering from the injuries she suffered from an accident on a Kawasaki Mule, a utility task vehicle, in August 2021 when she was 64 years old. She and her brother were at the ranch their family has owned for more than 60 years near Leggett.

As dinner was ready, Taylor took the Mule to pick up her brother who was out on the property. But on the way back to the house, she lost control of her steering going down a steep hill.

"What I learned later is that the front axle had broken and snapped and went into the front wheels and took out my brakes and steering capability," Taylor explained.

When the Mule flipped, her brother stayed in the vehicle and suffered a minor concussion. But Taylor was ejected, her ear ripped off and the skin torn from her left hand. She broke all her ribs on one side, along with her back in several places.

"My brother thought I was dead," she shared.

The helicopter took her to Enloe Medical Center in Chico.

"By the time I got there, they could no longer get a blood pressure on me, and it had been probably just about three hours total, not quite. But had it been any longer, I certainly would not be here," she said.

She commended everyone involved -- from the first responders who managed to get an IV in her while driving down a bumpy dirt road to the helicopter crew and the hospital staff.

When she got home, however, the medical bills arrived promptly, and she contacted her regular health insurance to learn they would only cover about $20,000 of the nearly $90,000 bill that arrived for the helicopter flight.

"And I just thought to myself, this is going to put me in the poorhouse," Taylor said. "How can I afford $60,000 worth of a bill for one trip, not to mention all the other ones?"

But then she remembered her membership. When she called and provided her number, she was told, "You will never hear from us again."

"They completely swallowed the entire bill," she said.

When a resident in Mendocino County needs an emergency flight like Orsi or Taylor did, REACH or CalStar helicopters are set to arrive. REACH acquired CalStar in 2016 and merged under the Global Medical Response umbrella, covered by the AirMedCare Network membership. In other words, Mendocino County members might get picked up by either REACH or CalStar, but their membership would cover a flight with either.

Sarah Gordon, AirMedCare Network director of membership, shared that the network has 320 aircraft across 38 states. She explained that while the service might sound like insurance, it's technically a membership, as AirMedCare Network owns and operates its aircraft, as opposed to paying another vendor for those services.

"We do not pay money to anyone else. So if you're a member with us, we do bill your major medical or whatever insurance plan is applicable, and any remaining is written off as a member. So we're not exchanging funds, not paying out to anyone else," she said. "And also, we do not offer reciprocity with other (aircraft) providers, because we don't own their assets."

Much like a ground ambulance, the helicopters will transport a patient regardless of their membership, but it's the bill that arrives later that's the difference.

While rural residents are inclined to become members, Gordon explained that interfacility transfers also make up a significant number of their flights even in urban areas.

"Sometimes it's not that they can't get to a hospital, but it's that they're not at the right hospital," she said. "You may go to a facility that cannot meet the needs of the patient at the moment -- whether it be a burn, stroke, trauma -- and they will actually use our helicopters or fixed wing airplanes to send that person to a higher level of care."

According to Mendocino County Supervisor Maureen Mulheren -- whose young daughter required an emergency flight in October 2018 -- every parent should be prepared for the chance that their child might need an interfacility transfer flight.

"So you may think, as a parent, oh, we're not hunting, we're not out four-wheeling, we're not out of the remote country," she explained. "But almost any kid that goes to our local hospital is airlifted to Oakland Children's Hospital."

"I remember hearing the doctors call for the helicopter, and my very first thought was, 'I can't afford that. I know that cost.' And it makes me emotional now, because no parent should have to think that," Mulheren said. "You're in this super hard situation with your child, you shouldn't have to be thinking about money and how much it's going to cost."

Remembering that she had purchased a plan brought her tremendous relief.

Daniel Schoenfeld, firefighter and emergency medical technician with the Gold Ridge Fire Protection District, said if a rescue is needed in addition to medical response, sometimes the crew will call for a Sheriff's Office helicopter, but this is rare.

"Quite honestly, unless your medical insurance company is going to 100% cover it, you should have a helicopter membership," he said.

Given the rural landscape in Northern California, he also urged residents to call for help before it becomes a life-or-death emergency. He noted that the pain from an injury like a broken ankle could trigger a heart attack in some patients.

He also stressed the importance of staying up to date on visits and vaccinations.

"For rural people, it's kind of hard to make appointments, because it might take you 45 minutes to get there, it might take an hour and a half -- you never know," he said. "But it's preventative medicine, and it's really important."

For more information about helicopter memberships, visit www.airmedcarenetwork.com.