NTSB · Safety Recommendation
Safety Recommendation A-09-093
Recommendation
TO THE FEDERAL AVIATION ADMINISTRATION: Conduct a systematic evaluation and issue a report on the requirements necessary for a viable low-altitude airspace infrastructure that can accommodate safe helicopter emergency medical services (HEMS) operations. The evaluation should consider improved collection and dissemination of weather data, the role of automatic dependent surveillance-broadcast (ADS-B), approaches to helipad and designated landing zones, and integration into the National Airspace System. Include in the evaluation process HEMS operators, related industry associations, and hospitals, among others.
Safety Issue and Context
Calendar year 2008 was the deadliest year on record for the helicopter emergency medical services (HEMS) industry, with 12 accidents (8 fatal accidents) and 29 fatalities. As a result of this increase in fatal accidents involving HEMS operations, the National Transportation Safety Board (NTSB) placed the issue of HEMS safety on its Most Wanted List of Transportation Safety Improvements on October 28, 2008, and also conducted a 4-day public hearing to critically examine safety issues concerning this industry.
Based on testimony given at this hearing, in addition to findings from recent HEMS accidents, the NTSB believes the Federal Aviation Administration (FAA) needs to take action to prevent additional accidents. These actions include improved pilot training; collection and analysis of flight, weather, and safety data; development of a low-altitude airspace infrastructure; and the use of dual pilots, autopilots, and night vision imaging systems (NVIS).
Additional recommendations have been addressed to the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS), the Department of Homeland Security’s Federal Interagency Committee on Emergency Medical Services (FICEMS), and 40 public HEMS operators.
Response History
August 22, 2018 · NTSB Correspondence · FAA
We previously told you that the February 21, 2014, final rule, titled “Helicopter Air Ambulance, Commercial Helicopter, and Part 91 Helicopter Operations,” partially satisfies Safety Recommendations A-09-93 and -94. The final rule amended section 135.221 to allow helicopter operators to designate an airport as an alternate if the ceiling at the alternate airport is 200 feet above the minimum required for the approach and the visibility is at least 1 statute mile.
Further, the section was amended to encourage greater instrument flight rules capability among commercial helicopter and helicopter air ambulance operators and to enhance a portion of the airspace infrastructure for helicopter air ambulance operations. We further stated that, to fully satisfy the intent of these recommendations, you would also need to systematically evaluate and report on the requirements necessary for viable low-altitude airspace infrastructure that can accommodate safe helicopter air ambulance operations. Additionally, you would need to initiate action to develop this infrastructure.
We note that you formed a corrective action plan (CAP) development team, which used frequency data from traffic collision avoidance system resolution advisory (TCAS RA) events and near-midair collision reports to assess the operating procedures of helicopters when they are in close proximity to airport safety events. You indicated that, because of this review, the CAP directed 16 air traffic facilities with the highest number of TCAS RAs to review, and revise as necessary, their operating procedures for helicopters when they are close to the airport.
We also note that you have required that staff at all facilities in the NAS take a recurrent helicopter operations training course that addresses proximity to airport safety events.
Our recommendation asks you to consider, as part of your evaluation, improved collection and dissemination of weather data, the role of ADS-B, approaches to helipad and designated landing zones, and integration into the NAS. We also asked you to issue a report that outlines the requirements necessary for a low-altitude airspace infrastructure to safely accommodate helicopter air ambulance operations. Although we believe the CAP development team’s evaluation and the actions that resulted are consistent with the intent of these recommendations, we are disappointed that you did not evaluate all of the items that we recommended.