8900.1 CHG 22



Section 6 Public Helicopter Emergency Medical Services (HEMS) Operations


A.     Introduction. Helicopter Emergency Management Services (HEMS) operations are conducted using both civil and public helicopters. Civil helicopters conduct these operations for hire under Title 14 of the Code of Federal Regulations (14 CFR) part 135. Public aircraft also conducts HEMS operations, such as those operated by a governmental entity, and are not required to hold an FAA air carrier or operating certificate unless such operations result in compensation.

B.     Preliminary Review of Civil HEMS Accidents. A preliminary review of the commercial HEMS accidents from January 1998 through December 2004 reveals that controlled flight into terrain (CFIT), night operations, and inadvertent flight into instrument meteorological conditions (IMC) are predominant factors. Of the 27 fatal HEMS accidents, 21 occurred during night operations. Of the 21 night accidents, 16 of the operations originated under visual flight rules (VFR) and inadvertently flew into IMC conditions resulting in CFIT. In addition, approximately 13 accidents during this timeframe were attributed to maintenance. See the table below.

Table 4-19, Number of HEMS Accidents

Total Number of HEMS Accidents (98-04)


Fatal HEMS Accidents (all)


Day Operations


Night Operations


In 16 of the 27 fatal accidents, the National Transportation Safety Board (NTSB) lists VFR into IMC and CFIT as contributing factors.

C.     The Types and Circumstances of the Studied Accidents Indicate the Need for the Following:

1)      Strengthening operational control.
2)      Increasing pilot skill in adverse weather operations, especially in the avoidance of and recovery from inadvertent IMC.
3)      Applying risk assessment in flight decisions.
4)      Fostering collaborative decisionmaking between ground and flight personnel.
5)      Developing a safety culture in HEMS operations.

D.    Federal Aviation Administration (FAA) Efforts. To meet these needs, the FAA has accomplished several actions that directly address the safety concerns revealed in the preliminary review. Specifically, the following documents were issued:

1)      Notice 8000.293, Helicopter Emergency Medical Services (HEMS) Operations, issued 1/28/05 (now more widely distributed by SAFO 06001).
2)      Notice 8000.301, Operational Risk Assessment Programs for Helicopter Emergency Medical Services (HEMS), issued 8/01/05).
3)      Notice 8000.307, Special Emphasis Inspection Program for Helicopter Emergency Medical Services, issued 9/27/05).
4)      Advisory Circular (AC) 00-64, Air Medical Resource Management, issued 9/22/05.
5)      HBAT 06-01, Helicopter Emergency Medical Services; OpSpec A021/A002 Revisions, issued 1/23/06.
6)      HBAT 06-02, Helicopter Emergency Medical Services (HEMS) Loss of Control (LOC) and Controlled Flight into Terrain (CFIT) Accident Avoidance Programs, issued 1/23/06.

E.     The HEMS Task Force. This force consisting of representatives from the Flight Standards Service, the Aircraft Certification Service, and the Office of Aircraft Accident Investigation, continues to review accident data to determine the desired course(s) of action to address accident safety causal factors in the HEMS operating environment. Additional guidance will be developed because of this ongoing effort. Such guidance may be in the form of advisory circulars, notices, handbook bulletins or revisions, and the Aeronautical Information Manual.


A.     The safety guidance that has been developed for the civil HEMS industry has wider application, to include the public HEMS community. While certain aspects of public HEMS operations are different from the civil sector, the operational safety considerations are the same.

B.     Accordingly, the FAA will provide the current HEMS guidance documents to each identified public HEMS operation. Public HEMS operators should be encouraged to review FAA civil HEMS operations standards, and adopt those components that have application to their specific operation.

C.     In addition, FAA personnel should be alert to indications of noncertificated public HEMS providers operating for compensation or hire contrary to the provisions of 14 CFR parts 119 and/or 135.


A.     Flight Standards District Offices (FSDOs) will provide copies of this notice, and the documents cited in paragraph 3(d) to all public aircraft HEMS operators in their district. Where possible, electronic means should be used to minimize copying and postage costs.

B.     Each aviation safety inspector (ASI) should be alert for indications that public HEMS operations are being conducted contrary to the definition of public aircraft (14 CFR part 1, section 1). Should such indications exist, such as a noted direct or indirect fee for HEMS service, further investigation should be initiated. Supporting guidance is contained in:

1)      FAA Order 8900.1, Flight Standards Information Management System, Volume 3, Chapter 14, Section 1, General Information on Public Aircraft Operations.
2)      AC 00-1.1, Government Aircraft Operations.
3)      Public Law 103-411, Independent Safety Board Act Amendments of 1994.

RESERVED. 4‑994 through 4‑1000.