Q. AirMed Hawai'i began operations in 2006 as the state's second air ambulance service. Are there enough flights to support more than one company?

A. Since we've taken over, the number of air ambulance transports from the Neighbor Islands has actually doubled. So in a lot of ways it's a good thing that there's another company here because I don't believe that any one company could do all of the transports, which is one of the reasons the state gave us an emergency certificate of need: because there was such an outcry to have another means of transportation, because a lot of patients were waiting two or three days to be transported.

Q. What’s the wait now?

A. We have staff in the office and it usually takes us about 15 minutes to get to the aircraft and then the flight time to whatever island we’re going to. So it's in hours as opposed to days.

Q. Is the air ambulance business a money-making business?

A. It's not a break even, but the money that you make is measured more in pennies than in dollars. That is always a challenge. It's a challenge with any medical facility. The reimbursements are low and your expenses are high. Our Mainland company does international flying, and we do have an air ambulance base and we're expanding into China, so Hawai'i is just a spoke in the wheel. So, at the end of the day, things work out financially for us. I really feel committed to the community. I have relatives who live on the Neighbor Islands and I feel very obligated. I've had a wonderful career and if there was an opportunity to give back to that community I wanted to do that. So when the CEO of AirMed came to ask me if I would help him with that, absolutely.

Q. In the past there was opposition to other air ambulance companies coming in, including from incumbent Hawai'i Air Ambulance. Do you feel competition is good?

A. One of the reasons there's always been opposition is because any one company is quite fearful that they're not going to do enough transports or raise enough revenue for one company. Because we're an island state, if you're an air ambulance company in California and you have to fly a patient from Nevada, you can do that. But in Hawai'i you only have transports in Hawai'i.

Q. The state initially granted AirMed Hawai'i a certificate of need that allows the company to do business for two years. Have there been any developments there?

A. It was for two years, but since that time the attorney general's office has come down with a ruling that air medical services do not have to apply for a certificate of need to enter the market.

Q. Mercy Air Hawai'i tried to provide an alternative to Hawai'i Air Ambulance in the late 1990s using helicopters, but failed. What are you doing to prevent a similar fate?

A. First of all, for a helicopter company the amount of revenue that you would have to ascertain every month is considerably higher because it costs about three times more to run a helicopter than it does for a fixed-wing aircraft. They did have problems getting the numbers that they needed. That education part of it wasn't really done before they entered into the market and they just couldn't sustain themselves. The reimbursement part wasn't really as much as they wanted too.

Q. How many employees does AirMed have here?

A. About 100. We have three aircraft on O'ahu.

Q. What is AirMed doing to prevent accidents?

A. AirMed has an impeccable safety record. We work very hard to keep it that way. We fly with two pilots. It reduces the pilot-error aspect. We have all of our pilots go to flight training on the Mainland. We spend a lot of time on safety classes for them and for the entire company. We do fire safety training. We're working on water egress training. We just spend a lot of money in terms of keeping our pilots and our medical people safe and happy.

Q. What drew you to the emergency medical services field?

A. I happened to work for a physician and he acquired a ground ambulance company because he opened an office at the airport to assist travelers and assist airline employees. He decided that one of our real downfalls is being able to transport people or patients or people that needed help from the airport to any of the major hospitals. So he bought a ground ambulance company and he asked me to help him. So I just happened to be at the right place at the right time. I helped him with the scheduling and that type of thing.

Q. Was it a natural move into the air ambulance business?

A. He passed away suddenly and the family sold the ground ambulance company and at that time another air ambulance company was starting up and they had asked me to help them. I told them I was only going to give them six months. EMS is hard, I had a young son and it was a 24/7 job and six months turned into many, many years. I always used to say, "I'm only a temporary employee." I retired from that company and I had known the owner of AirMed for quite some time and he had asked me to help him with this venture. I didn't tell them six months this time because I knew it was going to be longer than that.

Q. That previous company was Hawai'i Air Ambulance?

A. Yes. I was there for 23 years. I was at home, retired and watching my grandson and was enjoying it and then there were the fatal accidents that happened with Hawai'i Air Ambulance and (AirMed International CEO) Jeff Tolbert had asked me if I would help at that particular time. He had to go through a certificate of need with the state and there was quite a bit of paperwork. So he asked me to help with that and I agreed to do it. I came out of retirement because I really felt that there should be two air ambulance companies and there should be some competition, free enterprise and that type of thing.

Q. You mentioned accreditation is a big challenge for you. What are some of the others?

A. The reimbursement. It always is going to be an issue and the hospitals face the same thing. Every other week there's something that comes out about how the reimbursements are low, the uncertainty of being in air transport ... The FAA has got a lot of rules and regulations and you need to toe the line with all of the changes that are being made. As far as providing a service, if you've got a medical (company) and you've got anything to do with air transportation, you're pretty much giving yourself a double whammy. There's fuel costs and there are a lot of different issues that come up.

Reach Curtis Lum at 525-8025 or culum@honoluluadvertiser.com.

Reach Curtis Lum at culum@honoluluadvertiser.com.