Last month, after years of prodding from the NTSB and extensive consultation with the industry, the FAA issued its much anticipated notice of proposed rulemaking (NPRM) that tightens the equipment, training and operational requirements for helicopter EMS providers in the name of safety. However, the 133-page NPRM doesn’t stop with the helicopter EMS community. Much like a piece of congressional omnibus budget legislation, it “Christmas trees” items not related to helicopter EMS, hanging on the NPRM new regulatory ornaments that also cover all Part 91 and Part 135 helicopter operators, as well as revamping load manifest requirements for everyone flying Part 135–rotary and fixed wing.

Conversely, the NPRM does contain alternate means of compliance on certain training and operational issues, differentiating some requirements for small and larger operators and making allowances for local pilot knowledge when it comes to weather minimums. 

At first blush, helicopter industry leaders viewed the NPRM as a positive development.

“For the most part, everything we’ve read so far looks good,” said Dawn Mancuso, executive director of the Association of Air Medical Services.

Helicopter Association International (HAI) president Matt Zuccaro echoed those sentiments, commenting, “I think, on the face of it, it is a good foundation and something we could move forward with. Once we get into it we may raise certain questions and get a little more focus on certain issues, but it wasn’t a big surprise.”

The proposed rule would require EMS helicopters to be equipped with helicopter terrain awareness and warning systems (HTaws) and radio altimeters; to conduct all operations under Part 135–including crew rest and duty time restrictions–when medical personnel are on board; and to conduct flights under IFR at airports and heliports without weather reporting, procedures for VFR approaches and VFR flight planning. It would mandate instrument ratings, although not currency, for all helicopter EMS pilots-in-command and the establishment of operations control centers for any EMS operator that has 10 or more helicopter air ambulances. All commercial helicopter operators would be required to equip their helicopters with radio altimeters, train and test pilots for ability to recover from flight into inadvertent IMC and revise IFR alternate weather minimums. Part 91 helicopter operators would be required to revise VFR weather minimums. The NPRM also redefines “extended overwater operations” for helicopters and the survival equipment they must carry to engage in such operations.

The new definition sets the boundary at 50 miles from shore, as opposed to 50 miles from the nearest offshore platform or structure capable of launching rescue, which is the current standard. The proposed rule mandates that all helicopters operating offshore more than 50 miles be equipped with electronically deployable, or externally mounted and accessible, life rafts and that each be equipped with an ELT-type approved device (such as a 406-MHz emergency position-indicating radio beacon or Epirb). 

Kade Monlezun, manager of business development for the Bristow Group, said that OGP operators in the Gulf of Mexico are already largely compliant with the proposed standard. He said even Bristow’s smallest helicopters in the Gulf–the Bell 206L4 LongRanger IVs–are equipped with automatic rafts incorporated into the external emergency floats of the aircraft, and that, as a matter of course, pilots flying there wear Epirbs, which cost $250 to $300 each.

No Allowance for NVGs
Aside from the new overwater requirements, the NPRM had a few other surprises. It does not require night-vision systems or autopilots for helicopter EMS operations, two mandates long advocated by the NTSB.

“I thought we would have seen more attention paid to night-vision goggles,” said Zuccaro, noting that HAI, other associations and helicopter EMS providers support their use. “That was an initiative we would like to have seen.”

In the NPRM, the FAA rejected night-vision goggles as a substitute for HTaws, stating, “The FAA notes that it considered allowing certificate holders to use NVGs in lieu of HTaws. However, the FAA has decided against such a proposal because NVGs may not be appropriate for all operations–for example, inadvertent flight into IMC–and additional time is needed to research the best use of the equipment before allowing it to be used as an alternate method of compliance.”

However, EMS helicopters with approved night-vision-imaging systems such as NVGs would be able to take advantage of lower VFR weather minimums set by the proposed rule.

The FAA used the NPRM to put operators on notice that it is considering mandating the installation of lightweight aircraft recording systems (Lars) in EMS helicopters and having data from them qualify for flight operations quality assurance (Foqa) programs. The agency estimates the average cost of a Lars unit at  $6,450, excluding installation and software.

The FAA estimates the total cost of compliance for all items in the NPRM at $225 million, with the helicopter EMS community to bear $136 million of that.

Deadly Crashes
The impetus for the proposed rule came from the increased number of helicopter EMS crashes as the nationwide fleet began its massive growth spurt in the late 1990s. Between 2002 and 2008, the number of EMS helicopters doubled. It currently stands at approximately 850. Not surprisingly during this same period, the number of helicopter EMS accidents increased, reaching a crescendo in 2008, when six crashes killed 24. (In the first nine months of this year 16 helicopter EMS crewmembers died in accidents.)

The chief causes of these crashes, as documented by the NTSB, were inadvertent flight into IMC while operating VFR and controlled flight into terrain. However, there were a variety of contributory factors, often unique to helicopter EMS operations, including pilot fatigue; lack of operational control; the practice of flying under Part 91 rules when medical personnel, but not patients, are aboard; and the practice of hospitals engaging in “helicopter shopping,” calling one EMS provider after another had turned down a flight for weather or other safety reasons.

Since 2004 the industry has been working with the FAA to voluntarily adopt safety initiatives proposed by it and the NTSB. The FAA has issued numerous advisory circulars on best practices for the industry.  In the NPRM, the FAA notes that much of the industry is already in compliance with key elements of the proposed rule. A 2009 FAA survey of helicopter EMS operators found that 94 percent had established risk-assessment programs, 89 percent had pilot training designed to avoid loss of control and ­controlled flight into terrain, 89 percent were using operational control centers, 41 percent were using Taws, 11 percent had flight data recorders and 94 percent were using radio altimeters.

The HTaws mandate had long been assumed. The NPRM would require operators using Taws to upgrade to HTaws because of the “operational difficulties,” including “nuisance warnings,” inherent in Taws installations in helicopters.
HAI’s Zuccaro said the new ­technology mandates, while a step in the right direction, are not a “magic bullet.”

“The majority of accidents are happening because of human factors–a lack of risk assessment and an absence of a safety culture. It is up to the industry to change the way we do business and adjust the culture,” he said.