Forrest General Hospital and Wesley Medical Center have talked with private companies about supplying air ambulance service to the Pine Belt hospitals, and a decision could be made before the end of the year.

Currently, both are served by the Rescue 7 helicopter of the Southeast Mississippi Air Ambulance District.

“Our whole goal is to improve health care services for the entire region,” said Ron Seal, chief executive officer of Wesley Medical Center. “Lamar County had been talking about the helicopter service and they’ve been paying in some big bucks per year for Rescue 7.

“We’ve had some meetings at the hospital, discussing some alternatives and opportunities.”

SEMAAD was created by the Legislature in 1971 and is not only the lone air ambulance district in the state, but the sole such entity in the country.

It serves a 10-county area in the region, including Lamar and Forrest counties. Those counties support the district through one of two ways: by paying out of its general fund, or a tax levy of not less than one-half mill

Concerns over the consistency and quality of the SEMAAD service had some of those counties looking closely at whether that money might be better spent elsewhere.

“We did not levy half a mill for SEMAAD,” said Lamar County Supervisor Joe Bounds. “We have got it in the general fund, if needed, but we can also use that for gasoline or anything else we need to.

“It’s really a wait-and-see situation right now. There are one or two companies interested in this area, and we’re still waiting to see what they can do.”

It’s that potential shock to the stability of the district’s financing -the possibility of losing a county like Lamar, which is slated to put $217,287 toward the district in 2008-09 — that has had the Pine Belt’s largest trauma center, FGH, exploring contingencies for the past few months.

“As we go forward, we (need) a stable business model and a product and a provider to make sure that we have access to transporting our patients. That’s it,” said FGH chief operating officer Evan Dillard.

“SEMAAD’s been in business 30 years, and back then, nobody wanted to fly a helicopter in southeast Mississippi. It’s a different world now, and I’m not sure that we could sustain a business model where every year a major player threatens to pull out of the process.”

The threatened pullout, though, came after closer examination uncovered issues with the district’s service.

Pilot logs indicated that in each of the past three years, the helicopter had been unavailable for a minimum of at least nearly two months because of routine maintenance or unexpected repairs.

The helicopter is sidelined again, down for repairs after clipping a tree limb last week.

That maintenance didn’t come cheap. Last year, the bill was $450,000 — 11.8 percent of the district’s $3.8 million budget.

Dillard said the loss of even one of the counties means SEMAAD’s support would be spread over fewer entities.

Then, if another county decided to leave, or a private company could provide better service … “You can’t expect to hold that group together,” Dillard said. “It becomes a self-fulfilling prophecy.”

At least two private medical air evacuation companies have announced their interest in providing helicopter transportation in the area: Mobile-based Gulf Coast MedEvac and Pensacola-based Baptist LifeFlight.

Seal said of the discussions have included the two teaming to provide that service locally “and making something happen.”

“They feel like, ’Hey, we can compete in the marketplace and do it in a quality way.’

Dr. John Nelson, FGH emergency services medical director and president of the SEMAAD board of directors, said recently that no decision had been made regarding the district’s future.

Bounds, Seal and Dillard agree that a decision on whether any of three will rely on the district to provide air service will be decided by the holiday season.

Seal said he intends to look into providing competitive service if a cooperative one doesn’t work out.

“If this one were to fall through, I think we would feel an obligation to explore other options,” Seal said. “I am a big proponent of free enterprise and competition

“This is a service that is much-needed, and if what you have is not working, then you have to do what’s going to be best for the residents you serve.”