CAMDEN — Voting 5 to 0, the Camden Select Board agreed April 7 to help LifeFlight of Maine, an emergency air medical services company, to borrow money from Bangor Savings Bank at municipal interest rates. LifeFlight wants to purchase a $2.25 million fixed-wing plane, a King Air B200 turboprop, to increase capacity for transporting patients throughout Maine, and to hospitals around the northeast.

“It is a fabulous thing that you folks are doing,” said Camden Select Board member Don White, after listening to LifeFlight’s director, Tom Judge, explain why his company wanted to acquire the plane. “I didn't realize the breadth or scope of it.”

The Camden-based LifeFlight currently has two helicopters – flying ambulances — on duty, and is actively raising $6.5 million to purchase another helicopter. At the same time, LifeFlight is also raising another $3.5 million for the fixed-wing investment.

The company, which was started and is still owned by two Maine health care businesses, also wants to position the airplane at its hangar in Bangor to accommodate even more kinds of medical emergencies and conditions faced by Maine’s population.

“There is an increasing demand for services that we have not been able to meet,” said Judge, describing a recent effort to transport a Maine patient to a critical care hospital.

“One night three weeks ago, there wasn't a single critical care bed in Maine,” he said. “The closest one was in Albany.”

Maine frequently struggles with a shortage of critical care beds. When there isn't a bed available in Maine, patients need to be transported to facilities further away,m according to LifeFlight. 

LifeFlight of Maine got that patient to Albany, N.Y., but having a plane would have accomplished the transport more rapidly and efficiently.

Then there are cases that require inflight intensive care while people are transported to hospitals outside of Maine.

“We have patients waiting for transplants in New York, Pennsylvania and Virginia,” he said. “There is no consistent way of moving patients today.”

Those patients range from premature infants to adults.

“Because the fixed wing is more efficient than the helicopter over long distances, it's important to have it available for these situations,” said Judge, after the meeting. “But that's just one reason the fixed wing is important for critical care transport in Maine. More often, it will be used for emergency transports within Maine, either because the trip is very long (from one corner or side of Maine to the other), because the two helicopters are already busy transporting other patients, or because it can fly in some weather conditions that the helicopter cannot.”

LifeFlight’s helicopters currently move patients from the islands and the northern reaches of the state to Maine’s biggest hospitals in flights that average 60 miles in distance and 37 minutes in flight.

A plane, however, will fly in more weather conditions and will add distance capabilities. Plus, the plane will go 100 knots faster than the helicopters.

The plane, which LifeFlight now has under contract, already has miles on it, but it will be retrofitted and outfitted with lifesaving equipment that turns it into a flying hospital, like the helicopters already in service.

Devices include ventilators — “36 percent of our patients are intubated and require advanced airway management,” said Melissa Arndt, spokesman for LifeFlight; video laryngoscopes, which allow LifeFlight crews to place a breathing tube in patients struggling to breathe; cardiac pacemakers; ultrasound; critical care monitors (vital signs); and iStats, which analyze blood immediately and allow the crews to adjust treatments while inflight.

“This tool is certainly useful in flight, but it's also an important resource in some small community hospitals which don't have lab staff on hand in the middle of the night,” said Arndt. “Instead of waiting for the hospital to call someone in, LifeFlight can use this tool right in the ED to get results and help make treatment decisions.”

The plane will also have intravenous pumps onboard, which allow the crew to simultaneously administer up to nine different medications.

LifeFlight of Maine LLC is a company owned equally by Central Maine Healthcare Corporation (CMHC), and Eastern Maine Heathcare System (EMHS). While LifeFlight is an LLC, it applied for, and received, tax-exempt status from the Internal Revenue Service — one of the first LLCs in Maine to do so, said LifeFlight’s attorney, Dan Pittman, of Eaton Peabody.

It is in the process of centralizing its administrative offices with its sister organization, the LifeFlight Foundation, in Camden. While the LifeFlight LLC is the operational business, the nonprofit Foundation exists to raise funds to support LifeFlight.

LifeFlight was started 16 years ago, in 1998, by the Lewiston-based CMCH and the Bangor-based EMHS. At that time, there were only two hospitals in the entire state that had dedicated helipads, said Arndt. One was in Sanford, the other at Pen Bay Medical Center in Rockport. The latter had been funded by the Watson family, according to Judge.

“From the very beginning, LifeFlight knew it would have to play an active role in building out the infrastructure necessary for a helicopter EMS program,” said Arndt. “Today, nearly every hospital in the state has built a dedicated helipad. The exceptions are Mercy Hospital in Portland, St. Mary's in Lewiston and St. Joseph in Bangor, which are all within a mile or two of the helipads at MMC, CMMC and EMMC, and two more community hospitals where plans are underway.”

LifeFlight has also expanded its low-level instrument flight rules network by helping towns, hospitals and airports build helipads and install weather stations, navigation aids and instrument approaches.

Much of the money for that has derived from transportation bonds approved at the polls by Maine voters.

“Building out this aviation infrastructure across Maine, especially in the more rural areas of the state; i.e. anywhere outside of Bangor, Augusta, Lewiston and Portland, is important to LifeFlight's continual efforts to achieve the highest levels of safety and more accurate weather reports, and for having secure, established landing zones, said Arndt. “We can answer more calls for help because with more accurate weather information and electronic instrument approaches and we can safely fly in a wider range of weather conditions.”

In 2008, the International Association of Air Medical Services gave LifeFlight of Maine its Program of the Year award, recognizing “an emergency medical transport program that has demonstrated a superior level of patient care, management prowess, quality leadership through visionary and innovative approaches, customer service, safety consciousness, marketing ingenuity, community service and commitment to the medical transport community as a whole."

The Federal Aviation Administration regards LifeFlight as a model for other states to follow in order to create similar networks, she said.

Currently, LifeFlight’s two helicopters and ground ambulances see, on average, 1,600 patients a year, and fly approximately 230,000 miles within a given 12 months.

“We put more hours on our helicopters in Maine than helicopters in Afghanistan,” said Judge.

With the acquisition of the airplane, LifeFlight anticipates hiring eight pilots, one mechanic, a communications specialist and two more medical crew members. Currently, LifeFlight employs 90.

While the plane itself costs $2.5 million, the total price tag will be $3.5 million, which includes purchasing specialized medical equipment, upgrading communications and renovating new and larger hangar space at the Bangor airport.

“We have more technology in the helicopters than what some small hospitals have,” he said.

LifeFlight is raising $6.5 million for its third helicopter. So far, $4.5 million of that has been secured for the helicopter and $120,000 for its equipment.

Camden was asked by LifeFlight to help finance the borrowing of $2.25 million from Bangor Savings Bank through a program that would allow the nonprofit to secure lower interest rates.

Under the Municipal Securities Approval Program, Maine towns and cities may issue revenue bonds on behalf of qualifying nonprofits (or LLCs), like LifeFlight. When a town borrows money, they receive a tax exempt interest rate. The Municipal Securities Approval Program allows towns to pass along that financing benefit to qualified organizations.

There is no financial liability to the town of Camden.

“The debt is secured by the assets of the exempt organization, and the law makes clear that under no circumstances will the debt be an obligation of the municipality, or payable by the municipality or the taxpayers,” wrote Pittman, in a memo to the Camden Select Board. “The exempt organization bears all responsibility for repayment of the loan.”

The town, however, must approve the nonprofit’s request. 

“The basic premise of the law is to recognize that some nonprofit organizations may want to do a project that is a public benefit,” said Camden Town Manager Patricia Finnigan.  

Interest rates for municipalities are currently around 3 percent, while commercial loans in Maine can be 4.5 percent and higher.

The Camden Select Board voted 5 to 0 to endorse LifeFlight’s request followed a brief discussion concerning the organization’s fiscal integrity.

Select Board member Leonard Lookner referenced the dissolution of Camden First Aid, the nonprofit ambulance service that fell apart dramatically two years ago.

“Camden First Aid seemed to have an appetite that was greater than their income,” he said. “I would not want to have your organization go the same way.”

 Judge responded: “Our boards are extremely conservative and the Foundation board has financial acumen. We did not go into this lightly. This is a long-term project. The board required a complete outside analysis. We are not looking at the business of international ambulatory transport. We are looking at emergency transport for people in Maine.”

Reach Editorial Director Lynda Clancy at lyndaclancy@penbaypilot.com; 207-706-6657