Skip to site content

Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
Share This Page >

Circular 10-01


DEPARTMENT OF HEALTH AND HUMAN SERVICES
INDIAN HEALTH SERVICE
ROCKVILLE, MARYLAND 20852

Refer to: OCPS

INDIAN HEALTH SERVICE CIRCULAR NO. 2010-01

Effective Date:  August 30, 2010

AVIATION MANAGEMENT AND SAFETY

  1. Purpose.  This circular establishes the policy, procedures, standards, and requirements for aviation management and safety in the Indian Health Service (IHS).

  2. Background.  The IHS utilizes fixed wing (FW) and rotary wing (RW) aircraft to transport Agency personnel and patients from point-to-point, and on occasion for reconnaissance and special use missions such as airlift operations.  Aircraft mishaps and incidents sometimes occur that may result in loss of life and injury during these flights.  This circular is designed to increase employee and patient safety during transport in IHS authorized private, commercial, and government-owned aircraft.  This circular does not address flights on scheduled commercial airlines such as common carriers.

  3. Policy.  It is IHS policy that all aircraft used to transport Agency personnel or patients must meet the designated IHS standard operating procedures and the general requirements for any contract or charter aircraft as outlined in this circular.  All pilots, crew members and ground support operations personnel engaged in transporting Agency personnel or patients must be certified, as appropriate.

  4. Authorities.

    1. Federal Aviation Regulations; Code of Federal Regulations (CFR), Title 14, Parts 61,91,119, 120,121, 125,133,135, and 137 http://www.gpo.gov/fdsys/browse/collectionCfr.action?collectionCode=CFR&searchPath=Title+14%2FChapter+I&oldPath=Title+14&isCollapsed=true&selectedYearFrom=2010&ycord=491

    2. Federal Management Regulation (FMR), Management of Government Aircraft, 41 CFR 102, Part 102-33 http://www.access.gpo.gov/nara/cfr/waisidx_10/41cfr102-33_10.html

    3. Part 3,Chapter 17, “Emergency Medical Services,” Indian Health Manual, July 31, 2000 http://www.ihs.gov/ihm/index.cfm?module=dsp_ihm_pc_p3c17

  5. Definitions.

    1. Aeromedical.  Aircraft operations relating to or involving air transportation to a hospital or other health care facility.

    2. Flight Following.  An aviation term that means maintaining contact with a specified aircraft for the purpose of determining en route progress and/or flight termination.  It is primarily used to keep track of an aircraft’s location, should something happen, to expedite search and rescue.

    3. Government Aircraft.  Any aircraft operated or owned, leased, chartered, or rented by a Federal executive Agency.

    4. Pilot-in-Command.  The Pilot-in-Command (PIC) is:

      1. the person who has final authority and responsibility for the operation and safety of the flight;

      2. has been designated as PIC before or during the flight; and

      3. holds the appropriate category, class, and type rating and valid Federal Aviation Administration (FAA) medical certificate, if appropriate, for the conduct of the flight.

    5. Short Takeoff and Landing Aircraft.  A short takeoff and landing (STOL) aircraft is an aircraft that is specially configured for short take off and landing operations.

  6. Contracting Officers.  Contracting Officers are responsible for the acquisition of aircraft charter services, using the procedures, terms, and conditions required under the Federal Acquisition Regulations System, 48 CFR Chapter 1.

  7. Contracting Aircraft Services.  Area Offices and Service Units must confer with the appropriate contracting staff with respect to contracting for chartered aircraft.  Liability insurance must be a part of any aircraft contract for services.  The Division of Acquisition Policy and the Office of the General Counsel will assist in determining an appropriate amount of insurance to be included in the solicitation.  When using aircraft services through National Business Center Aviation Management Directorate (NBCAMD), the requirement for insurance is included in their standard contracts.

  8. Certification and Operations.

    1. Pilot Certification.  Pilot’s certification, including portions applicable to civil air craft, must meet regulations outlined at 14 CFR, Parts 61, as appropriate.

    2. Vendors Certification and Operations.  Vendors providing commercial aircraft services shall be certified and operate under 14 CFR, Parts 119, 120, 121,125, 133, 135, OR 137, as appropriate.

    3. Aircraft Certification and Operations.  Certification and operation of aircraft must meet 14 CFR, Parts 91, 121, 125, 133, 135, or 137 as appropriate, including those portions applicable to civil aircraft.

  9. Agency Employee Operated Aircraft.  An Agency employee may operate a privately-owned aircraft or rental aircraft for the purposes of point-to-point transportation to and from a designated landing strip or helipad if the flight complies with the FAA Regulations and the travel complies with Federal Travel Regulations or with the Joint Federal Travel Regulations.  The holder of a private pilot’s license is not permitted to transport patients.

  10. Commercially Operated Aircraft

    1. Pilot-in-Command.  The PIC for the aircraft must hold a valid FAA Commercial or Airline Transport Pilot license with currency and endorsements applicable to the category, class and type of aircraft being piloted and have a current FAA medical examination commensurate with the level of endorsement.  The PIC must have a minimum of 1500 total hours with 1200 hours PIC in category and 100 hours of flight time in the last 12 months.

    2. Aircraft.  Aircraft used for transporting employees or patients from point-to-point must be a turbo charged multi-engine aircraft, when available, and when flight conditions make it the safest mode of air transport.  The use of turbine powered aircraft is preferable whenever possible.

    3. Single Engine or Specifically Configured Aircraft.  When landing or take-off conditions dictate the use of a single engine aircraft or a specially configured aircraft for water, tundra, snow operations, or a rotary wing aircraft, a STOL aircraft, etc., the individual responsible for leasing, procuring, or contracting for aircraft other than multi-engine aircraft must document the circumstances mandating its use.  The documentation becomes part of the air charter record.

  11. Aeromedical Transport.

    1. Non-essential Personnel.  Non-essential personnel from the IHS may not fly on an IHS-ordered aircraft; only with concurrence from the PIC are authorized personnel and authorized patient escorts permitted on the flight.

    2. Aeromedical Service Vendors.  Aeromedical service must be licensed by appropriate patient care licensing boards or agencies that are available or required in every State where the vendors or contractors have a base of operation.  In addition, these services must be accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS) and comply with all general and type aircraft standards.

      1. The IHS may choose not to utilize a particular CAMTS accredited Aeromedical service vendor if the IHS has patient or aviation safety or liability concerns regarding a vendor.

      2. The IHS may choose to suspend or not use an accredited service until a pending National Transportation Safety Board investigation is completed.

    3. Emergency Medical Air Transportation Services.  Aeromedical service companies that provide emergency medical air transportation services must provide the appropriate number of medical personnel and level of care as ordered by the IHS that are consistent with State or CAMTS defined levels of care.

    4. Emergency Medical Air Transportation Services’ Personnel.  All emergency medical air transportation services’ personnel must be under the direction of an on-line medical director who ensures that flights are staffed in accordance with Federal, State, and local standards for air medical personnel.

    5. Attending Physician.  The IHS attending physician will order aeromedical transport for a patient based on the patient’s condition and the transfer requirements of the Emergency Medical Treatment and Active Labor Act and the Centers for Medicare and Medicaid Services’ conditions of participation.  The physician may order aeromedical transport that supersedes an Area contract or basic ordering agreement for use of a particular aeromedical transport company when he or she determines that it is in the patient’s best interest because of life support capabilities, speed of transport, or safety issues.  Justification for this change must be documented for the record and is subject to review.

  12. Point-to-Point Transportation of Agency Personnel and Non-Hazardous Materiel.

    1. Charter or Contract Aircraft.  Charter or contract aircraft is authorized for Agency business under the following conditions:

      1. when commercial airline or aircraft service is not reasonably available,

      2. when highly unusual circumstances present a clear and present danger,

      3. when an emergency exists,

      4. when the use of government aircraft is more cost-effective, or

      5. when other compelling operational considerations make commercial transportation unacceptable.

    2. Compliance.  All aircraft and pilots used for point-to-point flights must comply with all standards and requirements as specified by the NBCAMD, formerly the Office of Aircraft Services.

    3. Safety.  Occupants shall wear seat belts and installed shoulder harnesses during all phases of flight unless there is a valid operational or safety requirement that would cause a PIC to direct otherwise.

  13. Special Use Missions.

    1. Special Use Missions Types.  The IHS may authorize aircraft for special use missions such as low-level aerial reconnaissance, “sling loading” and aerial spraying during an emergency or disaster, or for approved routine missions for environmental or engineering purposes.

    2. Standards and Requirements.  All aircraft and pilots used for low-level flights will comply with all standards and requirements as specified by the NBCAMD unless the aircraft and pilots are affiliated with the military or other government service, in which case they must meet the standards appropriate for that affiliation as follows:

      1. Single engine night flying in mountainous areas is discouraged.

      2. Single engine night visual flight rules (VFR) flights are strongly discouraged and for each instance require written documentation that describes the compelling features of mission or circumstance requiring night VFR operations.

      3. Flight following will occur during the flight at pre-determined intervals not to exceed 30 minutes.

      4. Check-ins will be documented and provide enough information so that aircraft can be located if overdue or missing.

  14. Approved Vendor Lists.  All aircraft and pilots used for low-level flights will be on the approved vendor list of the NBCAMD unless the aircraft and pilots are affiliated with the military or other government service, in which case they must meet the standards appropriate for that affiliation as follows:

    1. Special Use Missions.  All aircraft used for special use flights will comply with all standards and requirements for type aircraft as specified by the NBCAMD unless the aircraft and pilots are affiliated with the military or other government service, in which case they must meet the standards appropriate for that affiliation.

    2. Pilot-in-Command.  When appropriate the PIC must be approved for external loads in accordance with 14 CFR 133.

    3. Non-essential Crew Members.  Non-essential crew members are not allowed on the aircraft during special use missions.

    4. Single Engine Night Flying.  Single engine night flying in mountainous areas shall only be authorized within 20 miles of a lighted airport and be conducted at least 2000 feet above the highest obstacle within a five mile area from course of flight and with a minimum of three miles visibility.

    5. Flight Following.  Flight following will occur during the flight at pre-determined intervals not to exceed 30 minutes.

    6. Check-ins.  Check-ins will be documented and provide enough information so that aircraft can be located if overdue or missing.

  15. Low-Level Reconnaissance Flight.

    1. Authorization.  The IHS may authorize a low-level reconnaissance flight during an emergency or disaster or for approved public health, environmental, or engineering purposes.

    2. Standards and Requirements.  All aircraft and pilots used for low-level reconnaissance flights must comply with all standards and requirements as specified by the NBCAMD unless the aircraft and pilots are affiliated with the military or other government service, in which case they must meet the standards appropriate for that affiliation as follows:

      1. Single engine night flying in mountainous areas is discouraged.

      2. Single engine night VFR flights are strongly discouraged and for each instance require written documentation that describes the compelling features of mission or circumstances requiring night VFR operations.

      3. Flight following will occur during the flight at pre-determined intervals not to exceed 30 minutes.

      4. Flight check-ins will be documented and provide enough information so that aircraft can be located if overdue or missing.

    3. Approved Vendor Lists.  All aircraft and pilots used for low-level reconnaissance flights will be on the approved vendor list of the NBCAMD unless the aircraft and pilots are affiliated with the military or other government service, in which case they must meet the standards appropriate for that affiliation.

    4. Purpose.  The purpose for low-level flight is reconnaissance.

    5. Safety.  Occupants shall:

      1. wear seat belts and installed shoulder harnesses during all phases of flight unless there is a valid operational or safety requirement that would cause a PIC to direct otherwise.

      2. wear an approved flame retardant garment, an approved flight helmet, leather or fire retardant gloves, and 8" or higher leather footwear.

  16. Employees’ Rights To Refuse To Fly.

    1. Employees.  Employees may refuse to fly on aircraft ordered by the IHS:

      1. Employees who refuse to fly on aircraft ordered by the IHS must submit their reasons in writing to their immediate supervisor.

      2. Refusing to fly on aircraft ordered by the IHS does not relieve an employee of his or her responsibilities and duties, unless so authorized by his or her supervisor.

      3. If an alternative mode of transportation is approved, regulations allow employees reasonable travel time and ensure they are reimbursed for travel expenses.

    2. Supervisors.  If an employee refuses to fly on an aircraft for reasons other than his or her general fear of flying (aviophobia), the supervisor must document, on Safety Communique' form (AMD-34 / FS-5700-14), the employee's concerns, complaints, or allegations of improper aircraft operation or inappropriate vendor or contractor personnel actions.  The SAFECOM Aviation Safety Committee form AMD-34/FS-5700-14 (Circular Exhibit 2010-01-A) can be found at: http://www.safecom.gov/safecom_form_instr.pdf

    3. Area Chief Contracting Officer.  The Area Chief Contracting Officer (CCO) reviews all Safety Communique' form AMD-34 / FS-5700-14 reports and forwards them to the NBCAMD.  For non-NBCAMD flights (those affiliated with the military or other government service), Area and Service Unit management staff should act appropriately to alleviate any safety issues.  The Area CCO must forward a copy of all reports to the Director of Emergency Services, at IHS Headquarters.

  17. Patients’ Rights to Refuse to Fly.  Ambulatory patients are not required to board an IHS-ordered aircraft.  The IHS ordering official must advise patients who refuse to fly on IHS-ordered aircraft that another air transportation service may not be ordered based solely on his or her refusal.  Ordering officials should solicit and report immediately to the Area CCO all reasons that patients cite for refusing to fly on IHS-ordered aircraft.

  18. Supersedure.  This circular supersedes IHS Circular No. 97-08, “Aircraft Services Used to Transport Employees and Ambulatory and Emergency Patients,” dated October 8, 1997.

  19. Effective Date.  This circular becomes effective on the date of signature.

/Yvette Roubideaux, M.D./
Yvette Roubideaux, M.D., M.P.H.
Director
Indian Health Service


Back To Top  |  Previous Page
CPU: 28ms Clock: 0s