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STARS air ambulance facing an uncertain financial future

The 10-year funding agreement between STARS air ambulance and Alberta Health Services expired in 2019. However, before a new one can be finalized, a provincial review of helicopter emergency medical services must be completed first. The non-profit also has another $15 million to raise to complete its $135 million campaign to replace its nine BK117 helicopters in western Canada with the H145 model.

BOW VALLEY – If you listen closely, you can hear when a STARS air ambulance flies through the Bow Valley en route to a local hospital or scene call to help those who have been critically injured and need to be transferred to a medical facility in Calgary quickly.

The distinctive red helicopters responded to dozens of calls in the Bow Valley in 2020, but according to officials with the non-profit organization, it is facing an uncertain future with respect to funding and a recently concluded review of helicopter emergency medical services in the province. 

Major gift manager Glenda Farnden was in front of the MD of Bighorn council in December asking that municipality to maintain its support in light of the fact that both fundraising and funding from the provincial government have decreased over the last year. 

"During these challenging times, we recognize our municipalities are facing countless hardships and this is magnified by the fact there are many that rely upon your help, including STARS," Farnden said. "STARS is experiencing a significant decrease in funding in all areas, including government."

A 10-year agreement between STARS and Alberta Health Services (AHS) that provided 20 per cent of its funding – or $9.2 million annually – expired in 2019. Farnden said the agreement was extended until September 2021, with funding from AHS this year totalling $7.3 million. 

In 2020, she said the STARS lottery and calendar fundraising campaigns did not reach their targeted goals, a loss of $1.2 million in expected revenue, while events to raise money to support the air ambulance service were also affected by COVID-19. 

"We are gearing up for the 2021 lottery in January," she said. "We are going ahead because that is our single largest funding source, so we are very hopeful that we will be able to count on Albertans for that." 

The total operating and capital costs in 2021 is $36.7 million for STARS in Alberta. Fundraising is expected to bring in $7.3 million in funding; $10.4 million from the lottery; $381,000 from the calendar; $3 million for site registration and the emergency contact centre; and $664,000 from other sources.

"On the expenditure side, we see a rise in aviation expenditures and this reflects the demand for increased missions," Farnden said, adding administrative costs have been cut by three per cent. 

"We are truly grateful to municipal community partners like you, who represent the one area of support for STARS that has remained steadfast and unwavering." 

In November 2019, AHS began a helicopter emergency medical service (HEMS) review. Originally expected to be complete in six to nine months, according to the HEMS website, the review has been completed a final report is under review by Alberta Health and AHS. 

The review set out to look at the standards for this specific type of medical service; governance; as well as affordability and sustainability. The review expects to evaluate the existing services, as well as identify any service gaps. 

"As different helicopter services have developed at different times across the province, oversight and structure of each HEMS provider has also evolved differently. A consistent structure, operating guidelines, and funding for all HEMS providers across the province will benefit all Albertans," according to the HEMS website. 

"The HEMS review will provide recommendations that enhance patient care, overall safety, efficiency, reliability and equity for EMS response in remote and rural areas, and to better identify patient need and response areas that would benefit from helicopter medical transport."

Even though there is a comprehensive review underway, STARS air ambulance has invested heavily over the past few years into replacing its entire fleet for western Canada. Farnden said that meant moving from the BK117 helicopter, which have served STARS well for 35 years, to the H145.

The H145, she added, has breakthrough technologically advanced avionics – reducing pilot workload and crew fatigue for complex or back-to-back missions – better manoeuvrability and increased fuel efficiency, speed and range. 

"Currently, we have three of the H145s," Farnden said. "Two are operational out of Calgary and Saskatoon and the third one provides backup and training flights."

The goal is to have nine H145s in the fleet. Two were expected to arrive by the end of 2020, while two more that were scheduled for arrival in 2021 have been delayed due to COVID-19. 

The two expected in 2021 include a new five-blade system, said Farnden, which will increase lift and load capacities especially in mountainous terrain. 

"Currently, the plan is that one will be operational out of Calgary in order to better serve your area in the mountainous terrain," she said, adding the final two helicopters to replace STARS fleet are expected in 2022. "An investment in the future comes with a price. Provincial and federal governments embraced the vision of a fleet of H145s to serve western Canada and they provided funding for seven of the nine helicopters. 

"But during the middle of the capital campaign, COVID-19 hit. However, we must not lose sight of the vision – the future of Albertans depends on it." 

The pricetag for the nine new helicopters is $117 million with $18 million in associated costs like pilot training, mechanic training, specialized tools and ground control equipment. 

Saskatchewan will provide $13 million, or the price for one of the choppers; Alberta will also provide $13 million; the federal government is committed to $65 million; corporate and individual contributions equal $13 million; while municipal contributions have totalled $1 million. 

Farnden said the BK117s can be sold as well for an estimated $15 million. That leaves STARS with $15 million left to raise to cover the total $135 million capital cost for the new aircraft. 

"This new technologically advanced intensive care unit will pave the way for STARS to continue serving Albertans for generations to come," Farnden said. 

The MD of Bighorn has provided $3,000 a year from 2018-21 to STARS. It is the only municipality in the Bow Valley to do so. The towns of Banff and Canmore have opted in the past to not include a contribution in their budgets, as the delivery of ambulance services is a provincial responsibility. 

Reeve Dene Cooper expressed his gratitude for the service STARS provides to residents in the MD of Bighorn and thanked the non-profit for its continued work during difficult times. 

"I want to assure you our residents are as appreciative of you as is council," Cooper said. "It is one of the democratic modifiers for emergency medicine across Alberta. In other words, many facilities are in metropolitan areas and you are our fastest connection to those facilities.

"Not only that, you are already working on the case as you are arriving at the larger hospitals. We have every reason to support you." 

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