It was Super Bowl weekend 2001.

Tampa was playing host to the big game between the Baltimore Ravens and the New York Giants.

As 41- year-old Robin Powell left work that Friday night, she warned her coworkers to be cautious on the roads. Little did she know they were words of caution that would apply to her the following Saturday morning.

Robin Powell stands with air medical service workers. She credits an air ambulance with saving her life after a car crash 16 years ago.

“I did not know when I left the house about 10 in the morning, I did not know my life was going to change in less than two hours later,” says Powell.

At 11:45 a.m. the car that Powell was riding in was hit head-on by a 21-year-old woman who had worked overnight and decided to spend the morning drinking.

“I could hear all the screams in the background with tears and all of that,”  Powell clearly recalls that morning. “My son would not leave my side. I couldn’t talk with him. I couldn’t say baby it is going to be okay. I couldn’t tell him I love him.”

Her neck was broken. Time was of the essence. Traffic was heavy because of the big weekend.

Paramedics decided to call in an air medical service to airlift Powell to a nearby hospital. It was a decision that she’s convinced saved her life.

“To this day I owe them my life.”

Medical experts say access to a Level I or Level II trauma facility within an hour after a person suffers a major medical problem is critical to ensuring a positive outcome.

With the current network of ground and air ambulances, most Floridians are within an hour of a Level I or Level II facility.

But, emergency air medical services are facing a financial strain that threatens their survival both here in Florida and across the nation.

There are about 30 air medical service bases in Florida. Two bases, covering the Key West and Tallahassee areas, were recently forced to close.

“I think it’s in a fragile state right now,” said Paul Webster, an air medical service based in Colorado. “The services exist and the access exists for 98 percent of Floridians. But, that is at risk because of reimbursement challenges in terms of covering costs.”

Webster is working with emergency air ambulance services across the country to secure their financial existence.

He says it takes about $3 million a year to operate an air medical services base.

The median cost of an emergency air transport is $10,200.

The problem is that seven of every 10 emergency airlifts involve patients who are covered by Medicaid, Medicare, or don’t have insurance at all.  In those cases, emergency air medical transportation services get little or no compensation.

Medicaid reimburses air medical services in Florida about $1200. Medicare covers about $5000 of the costs. In the case of those with no insurance, the air ambulance service is left holding the entire bill.

Webster says there is a basic question facing air medical services, “At the end of the day, when the dust settles, is the provider able to collect enough reimbursement to cover the cost of having that access in that community?”

That’s a question also being asked by the Emergency Medical Transportation Working Group that was created by Florida’s Office of the Insurance Consumer Advocate. The group, which includes representatives from air ambulance providers, insurers, patient advocates, doctors, and local governments, is studying the issue of reimbursement rates for air ambulance transportation service.

Members of Florida’s Emergency Medical Transportation Working Group meets this week in Tallahassee.

The group is spending a year gathering information and analyzing data on how best to address the needs of air medical services, the insurance industry and consumers.

The issue comes down to money. How much should emergency medical air services be compensated for the work they perform?

But, for Robin Powell the debate goes beyond money. She sees the issue in a different context and asks what the cost might be if there is no air medical service available in an emergency situation.

“The odds are you may never need it in your lifetime. But what if you need it one time. I’m 57 years old now and I didn’t know back when I was 41 years old that I would need it one day. Thank God it was there for me.”