U .S. Department of Transportation Federal Aviation Administration Advisory Circular Subject: Operations Control Center (OCC) for Helicopter Air Ambulance (HAA) Operations Date: 1/7/16 AC No: 120-96A Initiated by: AFS-200 Change:
Helicopters provide a means of transporting people in urgent need of medical assistance. These operations are unique due to the nature of the flights. Though a helicopter air ambulance (HAA) flight is not to be conducted as an emergency operation, it supports, in the most effective manner, the rapid transportation of patients with life-threatening illnesses or injuries. Each year, thousands of patients are transported by helicopter while being attended by medical personnel trained to respond to their critical medical needs. Therefore, HAAs are equipped with medical monitoring and support systems not found in transport helicopters, to ensure patient care requirements are met en route.
The Federal Aviation Administration (FAA) issued a Final Rule in 2014: Helicopter Air Ambulance, Commercial Helicopter, and Part 91 Helicopter Operations. The 2014 HAA rule package codifies most requirements, formerly contained in Operations Specification (OpSpec) A021, in Title 14 of the Code of Federal Regulations (14 CFR) Part 135 Subpart L, Helicopter Air Ambulance Equipment, Operations, and Training.
Part 135 subpart L requires those conducting HAA operations with 10 or more HAAs to establish an Operations Control Center (OCC) staffed with appropriately trained Operations Control Specialists (OCS).
This advisory circular (AC) provides information and guidance material specifically applicable to HAA OCCs and OCS. It contains information that will assist HAA operators, including existing part 135 operators considering becoming an HAA operator and those considering initiating new HAA operations, in the establishment of an OCC.
J ohn S. Duncan Director, Flight Standards Service
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CONTENTS Paragraph Page
Chapter 1. General1-1
1.1 Purpose1-1
1.2 Cancellation1-1
1.3 Objective1-1
1.4 Audience1-1
1.5 Related 14 CFR Parts1-1
1.6 Definitions/Abbreviations1-1
1.7 Related Source Material1-6
Chapter 2. Operations Control Center (OCC) Functions2-1
2.1 Regulatory Requirements2-1
2.2 Core Concepts—OCC and Operations Control Procedures2-1
2.3 OCC Models2-2
2.4 OCC Facilities2-3
2.5 OCC Physical Space Design Considerations2-4
2.6 OCC Technology and Design Considerations2-5
2.7 Emergency and Abnormal Operations2-8
Chapter 3. Operations Control Specialists (OCS) Duties and Responsibilities3-1
3.1 OCS Duties3-1
3.2 OCS Shift Change/Relief Procedures3-4
3.3 CS/OCS Interfaces3-4
3.4 Accident/Incident Procedures3-5
Chapter 4. Operations Control Specialist (OCS) Training4-1
4.1 Helicopter Air Ambulance (HAA) OCS Training4-1
4.2 OCS Prior Experience4-1
4.3 Training Requirements4-1
4.4 Training Topics4-2
4.5 Methods of Instructional Delivery4-4
4.6 Testing4-5
4.7 Training Records4-6
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Chapter 5. Operations Control Specialist (OCS) Duty Time Limitations5-1
5.1 OCS Duty Time Limitations5-1
Chapter 6. Drug and Alcohol Testing Requirements6-1
6.1 Drug and Alcohol Testing Requirements6-1
Chapter 7. Communications Specialists (CS) Duties and Training7-1
7.1 General7-1
7.2 CS Duties7-1
7.3 CS Training7-2
7.4 Duty Periods7-3
7.5 Shift Change Procedures7-3
7.6 Drug Testing Requirements7-4
1-1 CHAPTER 1. GENERAL
1.1 Purpose. This advisory circular (AC) provides information and recommendations to assist helicopter air ambulance (HAA) operators with the development, implementation, and integration of an Operations Control Center (OCC). By requiring larger HAA operators (per Title 14 of the Code of Federal Regulations (14 CFR) part 135, § 135.619) and encouraging smaller HAA operators to implement OCCs and operational control procedures, the Federal Aviation Administration (FAA) intends to further increase HAA safety through the implementation of OCCs.
1.2 Cancellation. AC 120-96, Integration of Operations Control Centers into Helicopter Emergency Medical Services Operations, dated May 5, 2008, is canceled.
1.3 Objective. This AC provides advice and identifies best practices for HAA OCC implementation and operation. It is based on multiple sources, including the HAA final rule published in 2014.
1.4 Audience. This AC is for existing and prospective part 135 certificate holders intending to conduct HAA operations, their employees, employees of associated medical and communications services, and FAA principal inspectors (PI) with oversight responsibility for HAA certificate holders.
1.5 Related 14 CFR Parts. Title 14 CFR parts 1, 27, 29, 43, 61, 65, 91, 119, 120, 135, and 157.
1.6 Definitions/Abbreviations.
1. Accident/Incident Plan (AIP)/Post-Accident/Incident Plan (PAIP). Emergency response procedures that should be used as a basis for training or for reference in the event of a mishap or other emergency.
2. Advisory Circular (AC). Provides guidance materials to the aviation community. This guidance can be methods, procedures, and practices acceptable to the Administrator for complying with regulations and grant requirements.
3. Aeromedical Director. A licensed medical professional associated with an HAA operation, ultimately responsible for patient care during transport. The Aeromedical Director has no operational control authority or influence over decisionmaking related to conduct of flights.
4. Air Ambulance. An aircraft used in air ambulance operations. The aircraft need not be used exclusively as an air ambulance aircraft, and the medical equipment need not be permanently installed.
5. Air Ambulance Operations. Air transportation of a person with a health condition that requires attending medical personnel, as determined by a health care provider; transportation of human organs or tissue; or holding out to the public as willing to provide air transportation to a person with a health condition that requires attending medical personnel or transplant organs
1-2 including, but not limited to, advertising, solicitation, or association with a hospital or medical care provider.
6. Air Medical Resource Management (AMRM). A dynamic process including pilots, medical personnel (including hospital personnel involved in HAA operations), maintenance technicians, operational support personnel, and management staff that optimizes human–machine interfaces and related interpersonal issues with maximum focus on communication skills and team-building curricula (refer to the current edition of AC 00-64, Air Medical Resource Management).
7. Certificate-Holding District Office (CHDO). The FAA Flight Standards Service (AFS) CHDO with responsibility for compliance oversight of an air carrier’s certificate, charged with the overall inspection and surveillance of that certificate holder’s operations (refer to part 1, § 1.2).
8. Code of Federal Regulations (CFR).
9. Communications Specialist (CS). An individual trained and qualified by the certificate holder, or their designee, to receive and coordinate one or more of a range of activities, including but not limited to receiving flight requests for HAA operations; communications with medical, emergency response, and other HAA organizations; and communications with HAA pilots. The definition of job responsibilities and task performance and delivery of appropriate training for CS has been identified as an HAA industry best practice (see Chapter 7).
10. Crew Resource Management (CRM). The use of all the available resources, information, equipment, and people to achieve safe and efficient flight operations; approved CRM training is required for flightcrews in accordance with § 135.330 (refer to § 135.330 and the current edition of AC 120-51, Crew Resource Management Training).
11. Datalink. A general term referring to a variety of technologies used to transmit and receive data between on-aircraft systems and off-aircraft systems and between ground-based systems.
12. Extended Overwater Operation. Per § 1.1, with respect to helicopters, an operation over water at a horizontal distance of more than 50 nautical miles (NM) from the nearest shoreline or from the nearest offshore heliport structure.
13. Flight Monitoring. Active contact with an aircraft throughout all of the phases of a flight (including time on the ground) either through voice radio contact with the pilot or through automated flight monitoring systems. This is considered a best practice in the HAA industry.
14. Flight Locating. The HAA part 135 certificate holder is required by regulation to use flight locating procedures meeting, at minimum, the standards established by § 135.79 unless an FAA flight plan is filed and activated. Flight locating may be overshadowed by HAA flight monitoring operations, even where it is not required by regulation. Additional means for monitoring each
1-3 HAA flight operation, such as satellite tracking, Automatic Dependent Surveillance-Broadcast (ADS-B), etc., is recommended as an HAA industry best practice.
15. Flight Standards District Office (FSDO).
16. General Operations Manual (GOM). Required to be compiled (§ 135.21) to include, at minimum, sections mandated by regulation, (§ 135.23) including visual flight rules (VFR) flight planning procedures (§ 135.615) and an FAA-approved preflight risk analysis (§ 135.617). The operator’s GOM must be accepted by the FAA, and though it may contain procedures and programs approved by the FAA, these required approvals of individual sections do not supersede the overall acceptance requirements of the manual.
17. Geographic Information System (GIS). A collection of computer hardware, software, and geographic data designed to efficiently capture, store, manage, map, analyze, and display geographically referenced information.
18. Helicopter Air Ambulance (HAA). A helicopter, defined for the purposes of § 135.619, that is identified in the operator’s OpSpecs. It need not be used exclusively as an HAA. HAA-specific equipment need not be permanently installed.
19. Helicopter Air Ambulance (HAA) Operation. A flight or sequence of flights with a patient, donor organ, human tissue, or medical personnel on board for the purpose of medical transportation conducted by a part 135 certificate holder authorized by the Administrator to conduct HAA operations. An HAA operation also includes, but is not limited to:
• Flights conducted with medical personnel aboard to position the helicopter at a site where a patient, donor organ, or human tissue will be picked up;
• Flights conducted with medical personnel aboard to reposition the helicopter after completing transportation of the patient, donor organ, or human tissue transport;
and
• Flights initiated with medical personnel aboard with the intent to transport a patient, donor organ, or human tissue that are terminated due to weather or other reasons (refer to § 135.601).
20. Helicopter Emergency Medical Service (HEMS). This is an obsolete term.
The FAA and industry are transitioning to the term HAA for enhanced accuracy. HAA flights do not constitute an emergency flight and must be conducted with due regard for all regulatory requirements. Replacement of the term HEMS with HAA will take place over the next several years as each relevant document is updated. The term HAA will be used exclusively throughout this document.
21. Helicopter Landing Area (also Heliport or Landing Zone (LZ)). An area of land or water or a structure used or intended to be used for the landing and takeoff of helicopters. Operations Specification (OpSpec) A021 grants latitude
1-4 to a helicopter operator for landing site selection as well as the authority to land on appropriate sites during both day and night in HAA operations (refer to § 1.1; the current edition of AC 150/5390-2, Heliport Design; and OpSpec A021).
22. Helicopter Night Vision Goggle Operations (HNVGO). That portion of a flight that occurs during the time period from one hour after sunset to one hour before sunrise where the pilot maintains visual surface reference using night vision goggles (NVG) in an aircraft that is approved for such operations (refer to part 61, § 61.1). HNVGOs conducted under part 135 must be authorized by the issuance of OpSpec A050. Any HAA operation with HNVGO must also comply with OpSpec A050.
23. Helicopter Terrain Awareness and Warning System (HTAWS). A terrain and obstacle database-driven awareness and warning system configured specifically for a helicopter’s operating environment. This system correlates the aircraft’s position, altitude, direction of flight, and speed with digital obstacle and terrain maps.
24. Inadvertent Instrument Meteorological Condition (IIMC). An emergency condition when an aircraft inadvertently transitions from visual meteorological conditions (VMC) into instrument meteorological conditions (IMC).
25. Instrument Flight Rules (IFR). Operations when weather conditions are below the minimum for flight under VFR.
26. Instrument Meteorological Conditions (IMC). Meteorological conditions expressed in terms of visibility, distance from clouds, and ceiling that are less than that specified for VFR, requiring a flight to be conducted under IFR.
27. Landing Zone (LZ). See subparagraph 1-6u, Helicopter Landing Area.
28. Local Flying Area (LFA). A geographic area of not more than 50 NM in any direction from a location designated by an HAA operator and approved by the FAA in OpSpec A021 (refer to § 135.609(b)(1)).
29. Medical Personnel. Medical personnel, as opposed to flightcrew members, are considered passengers for part 135 purposes (refer to § 135.601). Medical personnel are individuals with medical training and medical responsibilities carried aboard an HAA during flights or flight segments and typically include flight nurses, paramedics, respiratory specialists, neonatal specialists, physicians, and other medically-trained specialists (refer to § 135.601(b)(2)).
30. Mountainous. Designated mountainous areas, as listed in 14 CFR part 95.
31. Night Vision Goggles (NVG). An NVG is a Night Vision Imaging System (NVIS) appliance worn by crewmembers that enhances the ability to maintain visual surface reference under low-light flight conditions.
32. Night Vision Imaging System (NVIS). An approved light amplification appliance enhancing visual sensitivity in low-light conditions combined with specialized lighting systems that are type certificate (TC) approved for the
1-5 type of helicopter in which it is installed and are compatible with NVGs being used in that helicopter.
33. Non-Mountainous. Areas other than mountainous areas, as listed in part 95 (refer to § 135.601).
34. Operations Control Center (OCC). An OCC is a dedicated facility staffed by trained HAA Operations Control Specialist (OCS) (see subparagraph 1-6ii, Operations Control Specialist (OCS)). The OCC is further described in § 135.619. OCC functional responsibilities include a wide range of safety-related items detailed in § 135.619(a).
Note: OCCs are required for certificate holders authorized to conduct HAA operations with 10 or more HAA-capable helicopters assigned to their OpSpecs, and are strongly encouraged for all operators (refer to § 135.619).
35. Operations Control Specialist (OCS). An individual within the OCC who provides operational support for the certificate holder’s air ambulance operations and is both initially and recurrently trained, as specified in § 135.619(d) and (f). An OCS interfaces with the HAA pilot(s) prior to each flight request acceptance, and as necessary, during flight.
36. Operations Specification (OpSpec). Issued by the FAA to specify the commercial air transportation operations it has authorized the certificate holder to carry out. OpSpec A021 authorizes HAA service. Before OpSpec A021 can be issued, the operator must meet the regulatory requirements of Part 135, Subpart L, Helicopter Air Ambulance Equipment, Operations, and Training Requirements.
37. Overwater Flight. Operation of a rotorcraft beyond autorotational distance from the shoreline (see subparagraph 1-6ww, Shoreline).
38. Patient. A person under medical treatment. For the purposes of this definition, donor organs or human tissue are not patients, but are explicitly included under HAA operations, regulations, and practices. They are treated in the same manner as people under medical treatment.
39. Pilot in Command (PIC). The PIC of an aircraft is directly responsible for and is the final authority for the operation of that aircraft.
40. Principal Avionics Inspector (PAI). The inspector at the CHDO specifically responsible for aviation safety inspection and oversight of an HAA operator, with respect to avionics.
41. Principal Maintenance Inspector (PMI). The inspector at the CHDO specifically responsible for aviation safety inspection and oversight of an HAA operator, with respect to maintenance.
42. Principal Operations Inspector (POI). The inspector at the CHDO specifically responsible for aviation safety inspection and oversight of an HAA operator, with respect to operations.
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43. Residual Risk. Residual risk is the safety risk that exists after all controls have been implemented or exhausted and verified (to ensure that the risk acceptance is in accordance with a pre-existing documented risk analysis procedure).
44. Response Scene. Unimproved ad hoc LZ sites and other off-airport and off-heliport site locations where HAA flight landings are authorized under the authority of OpSpec A021.
45. Risk Analysis. Risk Analysis is a formal documented risk identification, assessment or rating, and mitigation methodology used to guide HAA decisionmaking. The terms “risk assessment” and “risk analysis” should not be used interchangeably (see subparagraph 1-6tt, Risk Assessment).
46. Risk Assessment. Risk assessment is the rating of the probability of a hazard occurring and the severity of the outcome.
47. Safety Management System (SMS). An SMS is a formal, top-down approach to managing risk. It is a system to manage safety, including the necessary organizational structures, accountabilities, policies, and procedures.
Implementing an SMS can provide useful tools to the HAA operator for complying with the requirements of § 135.617. Additional information and resources on SMS can be found in the current edition of AC 120-92, Safety Management Systems for Aviation Service Providers.
48. Second in Command (SIC).
49. Shoreline. Land adjacent to the water of an ocean, sea, lake, pond, river, or tidal basin that is above the high-water mark at which a rotorcraft could be landed safely. This does not include land areas unsuitable for landing, such as vertical cliffs or land intermittently under water (refer to § 135.168).
Additional information is available in 14 CFR part 136, § 136.1.
50. Standard Operating Procedures (SOP). An established or prescribed method to be followed routinely for the performance of a designated operation or in a designated situation and is used to guide training to meet such contingencies.
51. Suitable Offshore Heliport Structure. A heliport structure that can support the size and weight of the rotorcraft being operated where a safe landing can be made.
52. Supplemental Type Certificate (STC). A TC issued when an applicant has received approval to modify an aircraft from its original design.
1.7 Related Source Material. This identifies published documents that are applicable to HAA operations.
Note: Current editions of ACs can be found on the FAA Web site at http://www.faa.gov/regulations_policies/advisory_circulars. Current editions of FAA handbooks can be found on the FAA Web site at http://www.faa.gov/regulations_policies/handbooks_manuals.
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1.7.1 ACs (current editions):
1. AC 00-6, Aviation Weather.
2. AC 00-64, Air Medical Resource Management.
3. AC 27-1, Certification of Normal Category Rotorcraft.
4. AC 29-2, Certification of Transport Category Rotorcraft.
5. AC 91.21-1, Use of Portable Electronic Devices Aboard Aircraft.
6. AC 91-32, Safety In and Around Helicopters.
7. AC 120-27, Aircraft Weight and Balance Control.
8. AC 120-49, Certification of Air Carriers.
9. AC 120-51, Crew Resource Management Training.
10. AC 120-92, Safety Management Systems for Aviation Service Providers.
11. AC 135-5, Maintenance Program Approval for Carry-On Oxygen Equipment for Medical Purposes.
12. AC 135-14, Helicopter Air Ambulance Operations.
13. AC 150/5390-2, Heliport Design.
14. AC 150/5230-4, Aircraft Fuel Storage, Handling, Training, and Dispensing on Airports.
1.7.2 Orders (current editions):
1. Order 8040.4, Safety Risk Management Policy.
2. Order 8900.1 Volume 3, Chapter 65.
1.7.3 Handbooks and Manuals (current editions):
1. FAA-H-8083-16, Instrument Procedures Handbook.
2. FAA-H-8083-21, Rotorcraft Flying Handbook.
3. FAA-H-8083-25, Pilot’s Handbook of Aeronautical Knowledge.
4. Airman’s Information Manual (AIM).
1.7.4 Pamphlets (current editions):
1. DOT/FAA/PM-86/45, Aeronautical Decision Making for Helicopter Pilots.
2. DOT/FAA/DS-88/7, Risk Management for Air Ambulance Helicopter Operators.
3. Federal Aviation Administration Safety Team (FAASTeam) Library, Flying in Flat Light and White Out Conditions.
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4. National EMS Pilots Association (NEMSPA), Preparing a Landing Zone.
NEMSPA is located in Layton, UT, 84041-9128, telephone 877-668-0430.
5. Helicopter Association International (HAI). HAI is located at 1920 Ballenger Avenue, Alexandria, VA, 22314-2898, telephone 703-683-4646. Check their Web site for other documents and links to resources, including their Fly Neighborly Guide.
6. The National Fire Protection Association (NFPA) is located at 1 Batterymarch Park, Quincy, MA, 02169-7471, telephone 617-770-3000. They have many publications about fire protection. The 400 series may be the most helpful. For example, the current edition of NFPA 418, Standard for Heliports, has fire standards for heliports.
7. Air Ambulance Guidelines published by both the Department of Transportation’s (DOT) National Highway Traffic Safety Administration (NHTSA) and the American Medical Association’s (AMA) Commission on Emergency Medical Services.
8. The National Association of Air Medical Communications Specialists (NAACS) is located at PO Box 19240, Topeka, KS, 66619, telephone 877-396-2227. Check their Web site for links to resources, including training courses.
9. Special Airworthiness Information Bulletin (SAIB) SW-10-43, Non-Aviation Transmitters. (Includes, for example, 800 megahertz (MHz) radios used to communicate with hospitals.)
10. Policy Letter (PL) ASW-2001-01, Certification Guidelines for Compliance to the Requirements for Electro-Magnetic Compatibility (EMC) Testing for Equipment Known to Have a High Potential for Interference when Installed on Rotorcraft with Electronic Controls that Provide Critical Functions.
11. DOT/FAA/AR-99/50, High Intensity Radiated Fields (HIRF) Risk Analysis.
12. TSO-C194, Helicopter Terrain Awareness and Warning System (HTAWS).
13. International Civil Aviation Organization (ICAO) Doc 9977-AN/489, Manual on Civil Aviation Jet Fuel Supply.
14. RTCA Inc. DO-160, Environmental Conditions and Test Procedures for Airborne Equipment.
15. RTCA Inc. DO-178, Software Considerations in Airborne Systems and Equipment Certification.
16. RTCA Inc. DO-254, Design Assurance Guidance for Airborne Electronic Hardware.
17. RTCA Inc. DO-309, Minimum Operational Performance Standards (MOPS) for Helicopter Terrain Awareness and Warning System (HTAWS) Airborne Equipment.
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1.7.5 OpSpecs/Management Specifications (MSpecs) (current editions):
1. OpSpec/MSpec A005—Exemptions and Deviations.
2. OpSpec A008—Operational Control.
3. MSpec A008—Flight Management.
4. OpSpec/MSpec A010—Aviation Weather Information.
5. OpSpec A021—Air Ambulance Operations—Helicopter.
6. OpSpec A050—Helicopter Night Vision Goggle Operations (HNVGO).
7. OpSpec/MSpec A061—Use of Electronic Flight Bag.
8. OpSpec/MSpec A096—Actual Passenger and Baggage Weight Problem for All Aircraft.
9. OpSpec/MSpec A097—Small Cabin Aircraft Passenger and Baggage Weight Problem.
10. OpSpec/MSpec D085—Aircraft Listing.