Cooperation between Airlift Northwest and Island Air Ambulance Service has become more difficult as of late.

Airlift Northwest, the UW-affiliated emergency medical transport system, announced it has terminated its participation in the reciprocal payment program of the Association of Air Medical Membership Programs, which has the effect of terminating its reciprocal payment program with the San Juan Island EMS Medivac Air Ambulance Service.

“Reciprocal payment,” a common arrangement among providers of emergency transportation services, means that a dues-paying member of, for instance,  Airlift Northwest who is transported by Island Air Ambulance will have costs in excess of insurance payments (“out-of-pocket” costs) paid by Airlift Northwest. A resident of San Juan Island Public Hospital District is covered for out-of-pocket expenses by the EMS Medivac program in any event.

Although Airlift Northwest will continue to provide emergency transportation to county residents, it will no longer cover out-of-pocket costs if Airlift Northwest members are flown off San Juan Island by Island Air Ambulance, a service of San Juan Island EMS.

Airlift Northwest said this change became necessary partly as a result of increased utilization by the fixed-wing Island Air Ambulance service and reduced utilization of helicopter Airlift Northwest services by San Juan Island EMS. There are a number of differences in equipment and services available from each program, the primary one being that Airlift Northwest helicopters fly directly to hospitals with landing pads, while fixed-wing planes must land at airports.

“We cannot have reciprocity with Island Air Ambulance because we’re not communicating with Island Air Ambulance” as in the past, said Chris Martin, executive director of Airlift Northwest.

Airlift Northwest has about 3,700 San Juan County residents who pay to participate in its AIRCare membership program, which pays for out-of-pocket costs not covered by health care insurance. San Juan Island EMS Medivac has recently begun signing up residents of islands other than San Juan Island  for its similar program, which it says is not being offered to residents of San Juan Island Hospital District 1 because their out-of-pocket costs are already covered by the hospital district.

Martin points to a reduction in completed Airlift Northwest flights from San Juan County in recent years as evidence that San Juan Island EMS has relied less on Airlift Northwest helicopters and more on Island Air Ambulance Medivac fixed-wing aircraft, and on the EMS emergency boat Guardian for transportation.

In 2011, Martin says, Airlift Northwest completed 552 missions to the county; in 2012, the number decreased to 370; so far in 2013, the number is 287.

Martin believes the utilization reduction cannot be explained simply by the new emergency services provided by PeaceIsland Medical Center, but rather is the result of decisions made by San Juan Island EMS.

Jim Cole, EMS Chief, disputes Martin’s interpretation.

“All medical emergency transportation decisions are made on the basis of what’s best for the patient,” Cole said.