Mercy Flight

Being an emergency medical service provider in a rural, lower-income population certainly has its challenges, says Dane Sprague, president of Le Roy Ambulance Service, Inc. Board of Directors.

A good percentage of folks using the ambulance service are on Medicaid or Medicare and/or request not to be taken to a hospital, which either cannot be billed or reimbursed.

“I find a good portion of what we do goes unreimbursed in terms of Le Roy Ambulance Service. We go out on a call, and we may provide treatment to an individual that doesn't involve transportation. And we get no reimbursement from the government programs for Medicare or Medicaid for that type of treatment. And if it's a Medicaid patient, we can't even bill them for that,” Sprague said Wednesday to The Batavian. “I haven't seen the specifics of the legislation or what type of rate structure they're proposing, but anything at this point would be beneficial because, as I said, we provide so much unreimbursed care.

“In a typical month, this past month of August, I think we had 125 calls that we went out on. Only 87 of those were actually billable,” he said. “We’re providing a lot of unreimbursed care to people. If they don’t pay us we still can’t refuse service. If somebody needs care they’re going to get care regardless of their insurance status or how much they may owe us for past visits or whatever. If they’re a Medicaid patient, there’s no provision for that.”

He is hopeful that Gov. Kathy Hochul will sign a bill endorsed by the state Association of Counties this week that would allow EMS agencies and ambulance networks to be reimbursed for treating patients at the scene of the incident and/or transporting them to non-emergency room care facilities for treatment and triage.

The legislation has been in the works, and the association adopted a resolution during its annual fall meeting this week. Here is the full resolution awating Hochul's signature. The legislation is now on Hochul’s desk for approval. It is considered critical to ensure that EMS providers, including Le Roy Ambulance Service and Mercy EMS, two providers under contract for Genesee County, are financially stable and can properly operate and serve residents of New York State.

The EMS legislation only covers Medicaid Insurance, which has not been reimbursing providers, county Manager Matt Landers said, and does not cover Medicare or private insurance. 

“I support this resolution as it compensates emergency responders for sevices provided and helps shore up the finances of our resource-strapped first responder agencies,” Landers said.  “The current model of only reimbursing for transports to a hospital ignore the many instances where a patient receives costly treatment at the scene or when the ambulance transports the patient to a more ideal location for the specific situation, such as an urgent care facility or a mental health treatment facility.”

Genesee County has seen a gradual increase in the need for Medicaid, a joint federal and state program that provides health coverage for people with limited income and resources. It has grown from 13.3% a decade ago to about 20 percent in 2022, according to datausa.

About 70 percent of  Le Roy Ambulance Service’s patients are covered by government programs such as Medicaid, Sprague said. And as a result, “we’re operating at a deficit because of poor reimbursement,” he said. 

“A good portion of what we do goes unreimbursed. If we provide treatment to an individual but provide no transportation to a hospital, we receive no reimbursement. We cannot even bill them for that,” he said. “Anything at this point would be beneficial.”

“(Insurance/Medicare) only pay because of a transport to the hospital,” he said. “Anything that will enhance our ability … would be great. Hopefully  Kathy Hochul will sign it.”

Under current law, EMS agencies are only reimbursed when transporting a patient to a hospital emergency room. This arrangement is not only financially challenging for EMS agencies, but it also contributes to patients being transported to healthcare settings when a hospital emergency room may not be the most appropriate setting to administer treatment.

Additionally, hospital emergency rooms across the state are already beyond capacity, county officials said, with extraordinary wait times for admission to a hospital bed and is often the most expensive care setting possible for the patient.

It’s not like there haven’t been exceptions in the past. During the COVID pandemic, the Centers for Medicare and Medicaid Services (CMS) allowed waivers for ambulance services to be reimbursed for treatment in place and transportation to an alternative provider, but those ended in May 2023. Data from these waivers indicates that reimbursing EMS for treatment in place and transportation to an alternate provider would save the federal government around $2 billion annually, and commensurate savings at the state level, according to a related press release.

Allowing EMS practitioners to treat patients at their homes or the scene of the incident and receive reimbursement for delivering those services enables EMS agencies to return to action immediately—rather than waiting for a hospital to admit their patient.

Another issue cited by officials is that many patients dial 9-1-1 to seek emergency medical treatment when they are experiencing a mental health crisis. Allowing EMS agencies to transport a patient immediately to a behavioral healthcare facility not only expedites the patient's mental health treatment but also relieves inpatient hospital mental health units from having to respond to every mental health incident.

Reducing those wait times is one important benefit of this legislation, said Scott Wooton, executive vice president of Mercy Flight Inc., while being able to bill for non transports would be another. 

“Transporting to alternate destinations, as opposed to a hospital, as far as how that's going to impact EMS, it's not a huge difference. I mean, the time to transport somebody to an urgent care or a doctor's office as opposed to a hospital, is roughly about the same,” he said. “Where it could really have an impact is less critical patients going to an urgent care, as opposed to a hospital, is going to help reduce wait times at  ERs. I think it's a good move in terms of utilizing the hospital and utilizing the health resources that are out there in a way that makes sense, where you're not sending patients to an ER that maybe have something that could be treated by an urgent care, because wait times in emergency rooms can be an issue.”

Providers will have to work through the logistics of finding urgent cares that will accept patients via ambulance, and that will get EMS providers back in service more quickly, he said, versus having to wait at the emergency room with a patient while he or she is getting admitted. 

The other issue has been when providers complete an on-the-spot evaluation but the patient refuses transport to a hospital. Those cases have not been billable, and although this particular legislation isn’t going to change those scenarios involving private insurance and Medicare, it would ramp up payments from the Medicaid system that has not been reimbursing for such services.

“The fact that the state is now backing that, insurance will now be compelled to cover that we want to be reimbursed, that is smart legislation,” Wooton said.

“You know, we're really not in the business of just transporting patients from one place to another; we're in the business of being ready for emergencies. So anything that we can do to shorten the amount of time that it takes for us to get somebody where they need to go and get back and get ready again for the next one is exciting,” he said. “But then, in terms of the ability to bill for a treat and release, or for a patient refusal, it depends on how that actually works out.”

Given the bill’s freshness, he wasn’t familiar with how billing will work, though he pointed to Medicare as the largest payer for most emergency medical services, he said. Medicare is for people age 65 and older. 

“I don’t know how the law will interact with this plan; it’s a little too early to tell the financial impact, but it’s a good thing for patients, and a good thing for people,” he said.

Wooton is happy about the other piece of legislation, the Direct Pay to Ambulance Service law, already passed and ready to take effect on Jan. 1, that will allow for direct payments from the insurance company to the provider rather than to the patient. When payments went to the patient, there would be a lag in the money being turned over to the EMS provider, Wooton said, and this measure will streamline that process and get payments where they belong more quickly.

“This will pay pay to the provider and bring insurance company to the table and are paying fairly and timely at a rate that allows us to be sustainable,” he said. “We need sustainable ambulance services, and the only way to do that is to make sure that they’re being reimbursed fairly.”

Lei-Ti Campground came through big this year with a donation of $9,050 for Mercy Flight during its annual fundraiser for a nonprofit group. This year's event included 200 basket raffles, a tour of a Mercy Flight helicopter and sales of hotdogs and sausages. 

Fiscal year 2023 was one of “rebuilding” due to the loss of helicopters and the tragic death of a pilot in April 2022. However, the number of ground ambulance calls hit a high, Mercy Flight Executive Vice President Scott Wooton says.

“We actually spent most of the year that fiscal year with only two helicopters as opposed to four, which we're now back up to. But it wasn't until June of 2023 that we took delivery of a third. And then in August, when we got our fourth. So certainly from the flight standpoint of things, it was a very low, very kind of down year for us in terms of being able to respond to the demand for services,” Wooton said during his annual report to county legislators this week. “Ground ambulance activity, as opposed to air ambulance, was the highest year we've had on record. And we've continued to see that's been a trend since 2009.”

A year-to-year comparison would show that air response was down, he said, and out of the 187 requests for air ambulance service, Mercy Flight completed 65 helicopter transports, and another nine were ground transports, he said. Another 78 of those 187 requests were canceled by the caller as not needed, “which is, generally a good thing,” he said, “and then 34 were canceled due to inclement weather conditions that prevented us from being able to fly.”

The nonprofit had to deal with a major financial and emotional blow when pilot James Sauer and a flight instructor died in a crash while aboard a Mercy Flight helicopter on April 26, 2022, in Elba. The company and staff have gradually recovered and built the fleet back up while not only maintaining but growing ground ambulance services, which Wooton opted to include in his report.

“In the past, we've always sort of reported on air ambulance activity in this meeting, but I did add in ground ambulance activity as well. Obviously, the grant that we request is really intended to support the air ambulance service; we have a separate contract with the county related to our ground ambulance service. But again, I figured we'll report on that as well,” Wooton said. “When we came to Genesee County and started performing ground ambulance service, we've just seen a continual sort of organic growth in requests and in transports for ground ambulance services. Certainly, we're receiving very generous support from Genesee County to ensure adequate staffing and stability in our staffing for our ground ambulance service. And that has been very much appreciated. 

“I want to make sure that's made very clear, that's been an enormous benefit for us and our employees. What we've committed to do and what we're doing is taking that support from the county and passing it right on to our providers in the form of pay increases,” he said. “And obviously, what that's done for us is helped to stabilize the staffing so that we're meeting the minimum requirements set by our contract.”

He said that Genesee County’s commitment to Mercy Flight EMS “is really a win-win” for everyone. It means having the infrastructure and systems already in place for that ground ambulance response. The county and nonprofit struck a deal that runs from Jan. 1, 2024, to Dec. 31, 2026, for $452,460 per year. 

“So just some more information on ground ambulance, we received over 10,000, almost 11,000 requests for service that resulted in about 8,300 instances of patient contact, most of those being transports to a facility, but that could be things like lift assists or a treatment release,” he said. “Again, these represent all-time highs for our system here in Genesee County. In November 2022, Mercy Flight EMS absorbed the New York State Department of Health certificate of need that had previously belonged to COVA in Orleans County. We made our best effort to continue to serve Orleans County with the 35 employees that we hired from COVA, and we continued to do that … until April 2023 when Monroe Ambulance obtained the contract for the six or seven towns in Central and Eastern Orleans.”

Mercy Flight EMS has taken those 35 employees and folded them into its Genesee and Niagara County operations, he said, which has helped stabilize staffing.

In looking ahead, Wooton said the nonprofit has hired several pilots, flight medics and flight nurses to replace some staffing lost through attrition over the past two years.

 “So I think, as of probably about a month or so from now, we're going to have a full complement of flight paramedics, flight nurses that are out of orientation, and many of them coming from other services where they have plenty of helicopter EMS experience or are very longtime ground ambulance paramedics that are looking to get their wings if you will,” he said. “So all signs are really pointing to Mercy Flight being back on firm footing and being ready to respond and help the residents and many visitors of Genesee County.”

Legislators who are part of the Human Services Committee tentatively approved Mercy Flight’s request for $12,825 in funding. The request will go to the full Legislature for a vote next Wednesday.

Investigators with the National Transportation Safety Board Safety Board found no mechanical issues with a Bell helicopter operated by Mercy Flight that crashed during training in Elba on April 26, 2022.

The available evidence suggests, according to a final NTSB report, that an instructor did not provide adequate information to the pilot of the craft to recover from a maneuver, causing the Bell 429 to break apart mid-air.

The actions the pilot did take likely caused the main rotor blades to contact the tail boom, which caused the tail boom to separate from the body of the helicopter.

The pilot and trainer were working on dealing with a "vortex ring state," or VRS, which is a dangerous airflow condition that a pilot might encounter during flight.

Pilot James E. Sauer, 60, of Churchville, was being trained that day by Stewart M. Dietrick, 60, of Prosper, Texas. Sauer was the second pilot of the day to embark on a training mission with Dietrick.

The first pilot of the day told investigators he didn't think the VRS training went well.

Discussion of a new Mercy Flight contract for basic and advanced life support services was no big surprise, perhaps, on Wednesday, but was a big step forward nonetheless as the process continued past the Ways & Means Committee, Matt Landers said.

The county manager presented the $452,000 contract to the committee on its last leg of a journey to the full Legislature for approval. 

While neighboring communities take on ambulance services themselves — and the high costs of labor, salaries, benefits, retirement, vehicles and maintenance that goes with it — Landers was pleased that Genesee County will have contracts with two providers (one has already been approved for Le Roy Ambulance Service), and looks forward to working with Mercy Flight, he said. 

“I think that this is a very good step for this Legislature to enter this contract with the county. It's a good step to avoid us having to buy ambulances and hire EMTs and things that our other neighboring counties have had to do because they didn't have a centralized strong entity like we have here in Genesee County,” he said. “And so let's support the private sector solution that's already here. And let them do the job that they're best at doing versus us entering into another business. 

“So I think it's a good contract; it’s something that we'll monitor closely. And I'm sure, once we start, this is something that we’ll be relying on for years, it will be going on for years and years and years, and we'll be discussing increases in future contracts,” he said. “But it's nice to know we've got a fixed amount for three years for strengthening our ambulance service.”

A study was conducted prior to this contract, and it was determined that in order to improve response times, an ambulance would stationed at each the east and west end of the county. 

So one will be placed in Stafford and in East Pembroke, plus Batavia will also have a base, and the new configuration will be monitored over time to see if that helps or if further adjustments need to be made, Landers said.

He pointed to Emergency Management Services Coordinator Tim Yaeger as the one integrally involved in the study and strategy for this plan. Yaeger was not at Wednesday’s meeting, and The Batavian plans to catch up with him in the future to further discuss the county’s contract.

“We were exploring different ways to potentially require certain response times from Mercy Flight. The more we examined it, it was looking to be a challenge because there's always explanations for why a response time might not have been met for a certain case. So overall, we thought that if we just had a deployment coming from Stafford and a deployment coming from East Pembroke, have enough pushing it out further from just being around the time of Batavia, that naturally, the response time should improve,” Landers said. “And it's something that we can monitor every year, per the contract. And if the response times truly are improving, then we made the right decision. If this is not having a material impact on response times in the outer parts of the county, then we will just have to reexamine a different way to have those response times improved.”

So nothing would change for three years?
“Well, I wouldn’t say nothing. But there is a three-year contract. So it's something that we know we can monitor because we have a relationship with Mercy Flight directly now. So it's something that we're going to have a close eye on because we want to make sure that we're investing taxpayer money into this venture, we want to make sure we're getting some improved response times from it,” he said. “I suppose that if there was a mutually agreeable alternative aid contract, we could engage in that certainly, but right now, we're hoping that over the next three years, we'll see a better response time from having these deployments from outside the town of Batavia. 

"Well, I want to emphasize they're still ambulances in Batavia. So, we are not looking to improve response times to the town at the expense of people here in Batavia,” he said.

Of the total $452,000, $375,000 will go for personnel salaries and benefits, and the remaining $77,000 is for training and education, Landers said. 

“That amount is for education. So one of the things that was expressed to us was that sometimes when people are going through a lengthy training process for EMT, they're going through training, and they're not getting paid,” he said. “And that's difficult for people and with families, and to make ends meet. So this would allow them to get paid while getting trained.”

The contract begins Jan. 1, 2024, and it is competitive within this region, he said.

“So I ran into a Mercy Flight person who said, ‘Yeah, I hear that when I’m working in Genesee County, I get a bigger rate.’ So the word’s out there because if that’s the stipulation, we don’t want Mercy Flight to be paying people in another county with these monies. So what they’re paying their people here is gonna be higher based on this contract,” he said. “It holds their feet to the fire a little bit more than we’ve ever had that ability to pass because they operated here without the contract between us and them. So this puts into place some expectations.”

The new setup is to “improve response time without hurting response time,” he said. 

A legislator wanted to know what would happen if there was a request for an ambulance and there wasn’t enough staff on duty to ensure the minimum staffing level. 

Mercy EMS won’t be able to take a voluntary transport if it jeopardizes that minimum staffing expectation of the county, per this new contract, Landers said. “It may be a longer delay."

The contract will go from Jan. 1, 2024, to Dec. 31, 2026, for $452,460 per year.

After taking several months to evaluate Genesee County’s issues and needs in regard to ambulance services for residents, county Manager Matt Landers delivered a solution this week that he believes will do the job.

Landers worked with Emergency Management Services Coordinator Tim Yaeger and county Attorney James Wujcik to establish a formal contract with Le Roy Ambulance Services and Mercy Flight, Landers told legislators during the Ways and Means meeting Wednesday.

“We’ve spent about a year reviewing this issue of shoring up and strengthening our local ambulance providers between Mercy Flight and Le Roy Ambulance. We think we have all the bases covered. And this allows us to provide additional funding to those two professional ambulance providers, paid professional ambulance providers  … The one here with Le Roy takes effect Oct. 1. The one for Mercy Flight that we're negotiating with would take effect Jan. 1,” Landers said after the meeting. 

“So it provides additional funds to stabilize, it holds them, it makes them more accountable. They have to meet minimum standards for response times, or they have to meet minimum standards for number of ambulances to keep on staff. So there's minimum requirements that they must comply with in order to keep the funding throughout the county.”

Back in February, Landers confirmed that he and others had been asked by legislators to work on this issue and also clarified that, contrary to popular belief, the county did not have any formal contract for ambulance services. 

The issue of ambulance services and response times had come up during budget talks by City Council members, and The Batavian asked Landers for his input at the time. His concern was primarily on response times in the rural areas of the county, which provides “a minimum contract of $12,500 on an annual basis to go towards their Mercy Flight air,” and nothing official or directly for ambulance service.

The county Legislature is set to give the final vote next week on the resolution to pay Le Roy Ambulance Service $77,220 for ambulance and emergency advanced life support/paramedic service needs, $5,000 for related financial documents, and $187,705 for equipment and related maintenance for a three-year term beginning Oct. 1. 

The contract stipulates that Le Roy will provide pre-hospital emergency medical services within its Certificate of Need operating authority or when mutual aid has been requested by a municipality located within the county.

The total cost of $212,005 is to be offset by county sales tax proceeds.

“So Le Roy would be within the boundaries of Le Roy, and Mercy Flight will be throughout the whole county,” Landers said. “And that one we’re still finalizing, but they should come before this Legislature in October. 

“So I have many counterparts in the state that have actually had to invest in buying ambulances and having a county-run ambulance system with county EMTs,” he said. “We already have paid professional providers in our community that are doing an excellent job. This ensures their longer-term viability, their longer-term success and ensures the county doesn't have to enter into the business itself.”

While at least one City Councilman has expressed concern about ambulance response times in the city of Batavia, Genesee County officials are mulling similar issues elsewhere, Manager Matt Landers says.

“My understanding is that Mercy Flight has a good response time. But there's going to be isolated incidents that inevitably happen because there could be a call for service somewhere else that happens to pull ambulances out. So my concern, honestly, is more of a response time in our rural areas in the county, where response times are greater than the nine minutes that are currently being experienced in the city of Batavia,” Landers said to The Batavian Wednesday. “So that is something that this Legislature and myself are aware of, and that there's a lot of issues out there that we're trying to tackle and work on.”

Landers clarified the current arrangement with Mercy Flight and Mercy EMS. The county provides “a minimum contract of $12,500 on an annual basis to go towards their Mercy Flight air, that's, the contract that we have in place with Mercy Flight currently,” he said, and there is no official contract for ambulance service. An article published Tuesday stated that there was a countywide contract for ambulance service.

“There was a county RFP issued but it wasn't for a county contract. It was something that was for individual towns, so they could contract specifically the Mercy Flights. Some did, some didn’t,” he said. “But Mercy Flight has built a base of operations here at Genesee County, they are here to stay, they are an asset to our community. But there is no current contract with Genesee County for any kind of ambulance service.”

The topic of ambulance response times came up during city budget talks Tuesday evening at City Hall. Councilman Paul Viele raised concern after hearing about a child getting stung by a bee last summer. After reportedly lengthy response time from Mercy EMS, city police ended up taking the child to the hospital for medical treatment, Viele said.

During the conversation, Council President Eugene Jankowski Jr. added that there’s been a countywide struggle to accommodate the need.

County officials are working with Mercy Flight to try and remedy the situation, especially in Genesee’s outskirts, Landers said Wednesday.

“We are in talks with Mercy Flight, and how potentially we can help,” Landers said. “I understand why people would think there might be a contract … we understand as a county that response times is a countywide issue. So Legislature and myself are exploring the issue currently and seeing what we could do to help improve those response times, primarily in our rural corners of the county. Less so in the city of Batavia.”

Mercy Flight is receiving a $3,043,000 federal loan to purchase a new helicopter that will be modified for medical service operations and stationed at the Genesee County Airport in Batavia, the USDA announced this week.

Mercy Flight has not been able to station a helicopter in Batavia since a fatal crash in Elba in April.  The crash of the Bell 429 helicopter claimed the lives of pilot James E. Sauer, 60, of Churchville, and Stewart M. Dietrick, 60, of Prosper, Texas.

From the press from the U.S. Department of Agriculture announcing several funding initiatives in Upstate New York:

USDA Rural Development New York State Director Brian Murray announced investments totaling more than $46 million across 10 projects throughout the state to expand market opportunities for rural businesses and enterprises. This is part of a national announcement where U.S. Department of Agriculture (USDA) Secretary Tom Vilsack announced that the Department is investing $981 million to help create new and better market opportunities and expand essential services for rural people, businesses and entrepreneurs in 47 states, Guam and the Virgin Islands.

“Rural people provide the everyday essentials our country depends on,” Murray said. “Under the leadership of President Biden and Vice President Harris, USDA is dedicated to helping people through job creation and expansion of entrepreneurial opportunities in the rural places they live. The partnerships we’re announcing today demonstrate USDA’s commitment to advocating for rural business owners and building brighter futures for residents and stakeholders in rural New York and throughout America.”

The funding will help keep resources and wealth made by rural people right at home through affordable financing and technical assistance. It will help rural Americans start businesses and allow small business owners to grow. It will also open the door to new economic opportunities for communities and people who historically have lacked access to critical resources and financing.  

Photo: File photo by Howard Owens of the Bell helicopter that crashed taken a few days prior to the accident during an emergency medical response in Batavia.

Mercy Flight/Mercy EMS hosted an open house at its facility on Call Parkway on Saturday, with Cub Scouts selling hot dogs, a craft room where kids could paint coupons, a basket raffle, a mum sale, games, and displays and apparatus from State Police, and fire departments from Town of Batavia, Stafford, Elba, Alabama, and Pavilion.

Press release:

The 9th annual GLOW Corporate Cup was run this August with over 700 participants registering for the annual 5K run and walk.  The race brought in $21,000 in support of the GLOW YMCA.  This money will support the YMCA Scholarship program, ensuring that no one is turned away from the Y due to their inability to pay.

In addition to the race, teams design their own T-Shirts and compete for the most creative design.  Each year the local Merrill Lynch office makes a $500 donation to the winning team’s charity of choice.  This year, US Gypsum won the contest for the second year in a row and elected to direct the donation to Mercy Flight of Batavia.  Mercy Flight is an independent, not-for-profit provider of emergency and non-emergency air and ground medical transport and supporting services; ensuring rapid, safe and cost-effective delivery of expert response teams. 

Pictured above from left to right are Duane Van Duuren of US Gypsum, Calvin Klemmer of Merrill Lynch, Jennifer Crotty, Flight Nurse for Mercy Flight, Blake Leddick of US Gypsum and Jeff Abbott, Flight Paramedic for Mercy Flight.

Press release:

In the wake of enduring a tragic loss in April, Mercy Flight is announcing today that it will host its signature fundraiser again this fall. The BASH for Mercy Flight at Buffalo RiverWorks will be held on Saturday, September 24, 2022.

“We continue to provide access to high-quality emergency medical transportation, and holding our BASH fundraiser is another way that we can help sustain our lifesaving mission,” said Scott Wooton, Executive Vice President. “This fundraiser is crucial for us as it helps offset the ever-increasing costs of providing Emergency Medical Service for all those in need.”

Wooton adds, “While we all continue to grieve the terrible loss that occurred in April, we know our community still need us, and we still need our community. Our friend Jim Sauer will forever hold a special place in our hearts, and we look forward to honoring his life again as part of our event on September 24th.”

Tickets for The BASH, featuring Nerds Gone Wild, DJ Milk, a spectacular Skylighters fireworks show, food, beverages, silent auction, and much more, are available starting at $50 each for a four-pack, $65 each for a two-pack, and $75 for an individual ticket. Designated driver tickets are also available for $35. To purchase tickets now, please visit MercyFlightBASH.givesmart.com.

For information on VIP Tickets/Sponsorships, please contact Elaine Duquette at (716) 626-5808, extension 1358 or eduquette@mercyflight.org. 

Photo: File photo from 2022 by Howard Owens.

Press release:

After a period of voluntary pause in its air ambulance operations, Mercy Flight’s team of dedicated helicopter emergency medical professionals will resume their lifesaving service at 7:00AM tomorrow May 7.

Mercy Flight President, Margaret Ferrentino, states, “We continue to grieve and to mourn the terrible loss we experienced April 26th. A piece of Mercy Flight’s collective heart has been forever changed, but we know that our patients still need us. It is our duty and our honor to work beside our partners to be there for those in need of air ambulance service, and we know without a doubt that getting back in the air to help them is what Jim would want us to do. Our employees have banded together during this tragedy like never before, and our helicopter maintenance staff has truly gone above and beyond to assure the mechanical airworthiness of our remaining fleet.”

Scott Wooton, Executive Vice President, adds, “We have spent every minute since last Tuesday’s tragic accident ensuring that all of our team members are properly cared for and confirming that our two remaining helicopters are completely safe and operationally sound. Exhaustive internal and third-party maintenance inspections have indicated that N506TJ and N508TJ are fully functional and ready to resume their lifesaving work.”

All of Mercy Flight’s employees, Medical Directors, and members of its Board of Directors would like to thank everyone who has expressed their support throughout this difficult time. The flowers, cards, messages, donations, and beautiful displays of orange and blue have been so thoughtful and encouraging. While there are simply too many to name, and many have remained anonymous, the specific efforts of Mercy Flight Central of Canandaigua, NY to provide backup air ambulance coverage to our service area have been nothing short of extraordinary. Mercy Flight and all of its constituents owe a great debt of gratitude to Mercy Flight Central. 

Photo: File photo by Howard Owens.

Recruitment and retention continue to be the biggest challenge for Mercy Flight Inc., especially in its ground operations in Genesee County, Mercy EMS, said Scott P. Wooton, executive VP and treasurer of the Buffalo-based non-profit.

On Monday, Wooton delivered the agency's annual report to the Human Services Committee of the County Legislature.

It's a competitive job environment with record-low unemployment in the region and rising wages throughout the nation, and not as many young people are choosing an EMT career path, he said.

"As wages continue to rise in part-time and even entry-level positions in other industries, it's imperative that the EMS system is able to continue to offer competitive wages and benefits for long-term sustainability," Wooton said.

It's difficult to remain competitive, Wooton said, when the Federal government is not increasing Medicare and Medicaid reimbursements to keep up with rising expenses.

"The stress on the EMS system as a whole could approach a breaking point," he said. "This is almost verbatim what we had in our report last year. It continues to be the number one challenge in EMS."

The pandemic has also made recruitment and retention more of a challenge.

"We feel that there may be folks who are choosing other occupations as opposed to one which will put them in the way of this virus and other such situations," Wooton said. 

Mercy Flight recently gave its employees an across-the-board 5.9 percent raise, he told the committee.

"We intend to continue to champion the courageous men and women who do choose EMS as their way of life, and will lead the charge ensuring that they're adequately compensated for their service," Wooton said.

As for numbers for the fiscal year, Mercy Flight was called upon 209 times in Genesee County. Of those, 123 resulted in patient transports. There were 72 of those 209 calls for service canceled by the requesting agency and 14 canceled due to weather.  

For Mercy EMS, there were more than 10,000 calls for service resulting in more than 7,000 patient contacts. Those contacts included both transports and lift assists.

"These figures are down about five percent as compared to pre-COVID numbers," Wooton said. "We feel that essentially, some patients would rather choose to delay care at times, especially during the pandemic, rather than having our service coming and assist them. Certainly, we tried to make it a point of public information that's not the right thing to do. When you need an ambulance, when you feel you need an ambulance, certainly you need to call and at the very least let our first responders give you sort of a checkout and see what your condition is."

The pandemic has also hampered community outreach, Wooton said. There have been fewer safety training classes and events, fewer ground training sessions for firefighters, fewer career days, and fewer DWI drills at high schools.

"Those are very impactful, and we were able to fit in a few in the previous fiscal year," he said. "All were canceled the year before. We're looking forward to getting back and doing those again, as well as our participation in various third-party open houses in recruitment demonstrations."

Wooton also addressed the recent fatal accident in Elba that claimed the life of Mercy Flight Pilot James Sauer.

"This is the first time that this has ever happened, and God willing, the last time that it will ever happen that we've lost one of our own in the line of duty," Wooton said. 

He had just come to the meeting from Sauer's funeral in Churchville.

See also: Mercy Flight pilot killed in Elba crash on Tuesday lauded as 'top-class human'

He said Mercy Flight voluntarily grounded its aircraft out of an "overabundance of caution and safety" following the accident, and Mercy Flight Central has been filling in for emergency ambulance service.

"We suspended all of our flights not only just to ensure that we're able to ensure the mechanical functioning of our helicopters, but also to give our providers time to process and integrate."

Mercy Flight tentatively plans to return to normal operations on Thursday, he said.

Photo above: Scott P. Wooton presents Mercy Flight's annual report to Genesee County Legislature's Human Services Committee Monday. Photo by Howard Owens.

James Sauer, the Mercy Flight pilot who died Tuesday when the Bell 429 he was flying crashed just off Norton Road in Elba, was laid to rest today following a funeral service at Open Door Baptist in Chili.

Hundreds of first responders from throughout Western New York attended the service.

The 60-year-old husband, father, and grandfather lived in Churchville. He retired from the New York Army National Guard after 40 years in 2020. During his career Sauer also worked as a Rochester police officer, from 1993 to 2001, and for 17 years as a pilot for the State Police, retiring in 2021.  He also worked for a time with the Holley Police Department.

He joined Mercy Flight in October 2020.

"Mercy Flight was his retirement job," said Scott P. Wooton, executive VP and treasurer of Mercy Flight Inc., during an emotional statement this afternoon at the Genesee County Legislatiure's Human Services Committee meeting. "He joined Mercy Flight out of a wish to continue to serve his community with his special skills.

"Not only was he an outstanding aviator, a top-class aviator, absolutely, but he was a top-class individual as well, a top-class human. He was a man who loved his family, loved his friends. And he's gonna be greatly missed."

Photos by Howard Owens, except inset photo (social media photo) and second photo.

 Press pool photo courtesy Democrat and Chronicle.

There have been nine accidents involving the Bell 429, the model helicopter being flown by James E. Sauer, 60 of Churchville, and Stewart M. Dietrick, 60, of Prosper, Texas, when it went down in a field near Norton Road in Elba at 1 p.m. Wednesday.

The National Transportation Safety Board has determined the cause of four of those accidents.  Three of them were the result of human error and one was an apparent mechanical failure.

The preliminary evidence in Wednesday's crash of the Mercy Flight aircraft, said Aaron McCarter, air safety investigator with the NTSB, is that the rear tail section of the aircraft became detached during the flight.

Aaron McCarter

"Onboard (the helicopter) were two pilots and seasoned professionals about 1300 or 1 p.m. local time, several credible witnesses of the helicopter transitioning the area behind me over Elba, New York, at about 2,000 feet observed and heard a loud boom. We don't know which occurred first (the tail separating or the boom). The tail separated from the helicopter and was found 300 feet from the main wreckage."

The main wreckage was in a gully just a few yards from the edge of Norton Road, about a mile north of Edgerton Road.

McCarter said he will be at the accident scene gathering evidence for three to five days.

"The on-scene portion of the investigation is only a small part of a much larger list, or process," he said. "Most of the work being done by the investigative team happens behind the scenes when the on-scene portion is over. In 10 days, I will be completing the preliminary report. In approximately 12 months, the factual report, followed very shortly by the probable cause, signed off by the Transportation Safety Board members (will be released)."

The cause won't be determined until the investigation is complete, and that investigation, regardless of what the evidence shows now, looks at all factors of the case, McCaster said.  That includes mechanical, environmental, and human elements, and how all three elements interacted.

While both Sauer and Dietrick are experienced pilots, they were on a training mission.

"Even though they are seasoned pilots, you know how much time they had in this particular helicopter?" McCarter said. "I'm not trying to equate aircraft with cars, but have you ever gotten to a car rental that was completely different than yours? It takes you a while to kind of figure out where all the buttons are and how how to maneuver. So that's what we're looking at, we're looking at their familiarity with the machine, how much experience did they have in this particular machine, in addition to all the other aircraft that they have flown."

Wreckage to be examined in Delaware
The wreckage, which was spread over a 2,000-foot area from beginning to end, will be transported to Clayton, Delaware.

"It will be transported back to this facility to a two-dimensional assembly of it on a hangar floor and we'll be able to see how the helicopter -- it can assist us in determining how the helicopter came apart and what happened first."

He added, "We will be doing a thorough engine check. We're gonna be checking on the rotor blades. We're gonna be checking the tail rotor. And we're gonna be downloading data."

While the Bell 429 doesn't have a "black box" as most people are familiar with -- its data isn't in a hardened protective case -- McCarter is confident the flight recorder data can be recovered.

Investigators will also look at flight and maintenance logs and any reports on the helicopter's performance on previous flights.

The aircraft was manufactured in Canada so by international treaty, Canadian aviation experts will be participating in the investigation.

McCarter indicated he doesn't believe there was anything of the ordinary for a training mission prior to the crash.  The mission started at the Genesee County Airport at 11:15 a.m. and the crew did a typical training flight pattern around the airport for about an hour before heading toward Elba.

Once the tail separated, McCarter said, the pilot would have found it impossible to maintain directional control over the aircraft.

"That tail rotor is what keeps the nose of the helicopter pointed in the correct direction," he said. "Because the torque when the rotor blades are spinning around the helicopter, the fuselage wants to spin in the opposite direction, if you remember your high school physics, so the tail rotor actually keeps the nose of the helicopter pointed in a specific direction."

Of the nine prior crashes involving the Bell 429, four claimed six lives.

Prior aviation crashes locally
Of the nine Bell 429 crashes, one was in Batavia on Oct. 6, 2021. That 429 was also owned and operated by Mercy Flight but was not the same aircraft involved in Wednesday's accident. There were no injuries when that helicopter had a hard landing at the Genesee County Airport.  The cause has not yet been determined.

There has been one other helicopter crash in Genesee County over the past 30 years. On Dec. 27, 2003, in Byron, when a pilot practicing autorotations over an airport open field made a hard landing. The pilot was seriously injured. 

The NTSB reported, "The pilot reported that he felt a shudder during the autorotation and tried to regain airspeed by using forward cyclic, but he was unable to regain airspeed. Examination of the helicopter found evidence of low main rotor rpm. No discrepancies were found with the flight controls and engine."

Previous airplane accidents, as reported by the NTSB, in Genesee County:

• March 31, 1983, Batavia, Cessna 182, mechanical failure, four aboard, no injuries;
• Sept. 24, 1983, Batavia, Cessna 152, an unexpected gust of wind on landing, two aboard, no injuries;
• Oct. 7, 1984, Cessna 150H, pilot error at dusk, no injuries; 
• May 17, 1985, Batavia. Piper PA-22-150, commercial-rated flight instructor encountered unexpected wind at takeoff, no injuries;
• May 29, 1985, Batavia, Piper PA-28-235, loss of power during takeoff, two aboard, no injuries;
• Oct. 15, 1986, Le Roy, Piper PA-38, instructor error, two aboard, no injuries;
• June 20, 1987, Batavia, Cessna 177RG, mechanical failure resulting in an emergency landing, no injuries;
• March 17, 1991, Le Roy, Cessna 172M, inexperienced pilot error in poor lighting conditions, four aboard, no injuries;
• Feb. 15, 2004, Batavia, Cessna 172E, the inability of the pilot to maintain control in winds on an icy runway, no injuries;
• June 15, 2007, Cessna 172s, student pilot error, no injuries;
• Feb. 7, 2009, Le Roy, Cessna 172A,  pilot error in heavy winds, no injuries;
• July 15, 2011, Batavia, Murphy Aircraft Elite, pilot error, one serious injury;
• Aug. 2, 2012, Alexander, Piper PA-25-260, pilot error, no injuries;
• Sept. 20, 2014, Bethany Center, Cessna 182A, pilot error, no injuries;
• June 11, 2915, Le Roy, Brandt Leroy E Challenger II, pilot error, no injuries;
• Oct. 27, 2019, Batavia, Beech A36, pilot error in heavy winds, four aboard, no injuries;
• June 1, 2020, Le Roy, Beech 36, pilot error, no injuries.

The only other fatal aviation crash in Genesee County since the early 1980s was on Oct. 2, 2020, in Corfu, which claimed the lives of attorneys Steve Barnes and Elizabeth Barnes. The cause of that crash remains undetermined.

CORRECTION: There was another fatal airplane crash in Genesee County on Aug. 11, 2001.  Two people were killed when a Dominiak Kitfox crashed in Byron. Alcohol and drugs were found in the inexperienced pilot's blood.

Statement from Mercy Flight:

Our neighboring non-profit Helicopter EMS provider based in Canandaigua, NY, Mercy Flight Central, is on location at our Buffalo Base to continue to deliver critical air ambulance service to the people of Western New York. Requests for air ambulance within our service area should continue to be directed to our Communications Center as normal. We are so grateful to have the full support of the Mercy Flight Central team during this difficult time, and we thank them and all who have expressed to us their well wishes and encouragement from the bottom of our hearts.

Previously:

• Mercy Flight standing down temporarily while staff grieves for lost co-worker, Bell trainer
• Edgerton Road resident heard a helicopter in trouble before Mercy Flight crash in Elba

Press release:

At approximately 1:00 p.m. the Mercy Flight Communications Center was notified that a Mercy Flight helicopter had sustained an accident in the area of Elba, NY in Genesee County during Mercy Flight’s annual Bell Helicopter factory training.

Mercy Flight Pilot James Sauer and a Bell Helicopter Flight Instructor perished in the accident. Mr. Sauer, a retired NYS Police Pilot, began working with Mercy Flight in October 2020.

“It goes without saying that our attention needs to be focused on the families of those lost and on our own employees as we deal with this unspeakable tragedy. This is a very dark day for the Mercy Flight family, we are so grateful for the expressions of love, concern and support expressed by many,” said Margaret Ferrentino, Mercy Flight’s President.

“Mercy Flight has temporarily suspended operations in order to allow time for our employees to process the event, and to ensure the complete safe mechanical operation of our other helicopters pending a preliminary accident team investigation. The Mercy Flight Communications Center will remain operational and will refer any requests to other area resources who are standing by to assist,” states Scott Wooton, Mercy Flight’s Executive Vice President.

The cause of the accident has not been determined. FAA, NTSB, Bell Helicopter and Underwriter Accident Investigation teams are responding to the scene. We will provide additional information as it becomes available. 

Previously: Edgerton Road resident heard a helicopter in trouble before Mercy Flight crash in Elba

Charlene Schultz is used to hearing helicopters over her house on Edgerton Road in Elba.  She seems to live in a flight path for both the military and Mercy Flight. So she knows what a helicopter passing overhead sounds like when all is all right.

Shortly before 1 p.m. today, she knew she heard a helicopter that was in trouble.

"The motor sounded weird," Schultz said. "You know when you start your car and it goes woo-woo? That's what it sounds like to me twice. Like it won't start. Then it went out completely. Then it came back on and I heard the Big Bang."

She speculated the pilot managed to get the motor started again as the helicopter was heading down but it was too late.

She went outside expecting to see smoke but there was no smoke.  She got in her car and drove to the scene.

"Three men stopped me and I was from here to your car (less than 50 yards) and saw what I didn't want to see. So I turned around and came back home."

Major Eugene Staniszewski, State Police, confirmed this afternoon that two crew members aboard the flight died in the crash. Their names have not yet been released.

The cause of the accident is under investigation. Investigators from both the Federal Aviation Administration and the National Transportation Safety Board have been dispatched to the scene.

"We will be here for quite a while," Staniszewski said. "This could be into tomorrow while we're still on scene and then after that, it usually takes quite a while, it could be months until they come up with a final determination (as to the cause of the crash)."

The helicopter was on a training mission, Staniszewski confirmed, and it was flying out of the Mercy base at the Genesee County Airport. 

The major said there is at least one person who saw the helicopter go down and several who heard the helicopter in the area.

One neighbor said she saw a Mercy Flight helicopter circle the area before she and her husband went to Walmart.  They only learned of the crash while at the store and returned home immediately.  Schultz, however, said she believes the helicopter that circled the scene showed up after the crash.  She said when she first saw it, she hoped it was a sign that the crew survived but then the Mercy Flight helicopter left without landing.

"We are interviewing several witnesses and local neighbors that live on this road," Staniszewski said. "We'll be working with Mercy Flight and NTSB and FAA to come up with a reason for this crash."

UPDATE:  The pilot was James E. Sauer, 60 of Churchville. The second person was a Bell Helicopter employee and pilot, Stewart M. Dietrick, 60 of Prosper, Texas. They were flying a Bell 429 that was based in Batavia. They were pronounced dead at the scene and taken to the Monroe County Medical Examiner’s Office.

An unidentified helicopter circled the scene an hour or so after the accident.

Power lines were cut because lines had fallen dangerously close to the helicopter, impeding the investigation.

File photo of a Mercy Flight helicopter taken April 24 at GCC following a serious injury accident at Clinton Street Road and Seven Springs Road. Photos by Howard Owens.