Air Traffic Control Fully Certified
Communication Breakdown; Confusion
ATC Issue All Types; Deviation / Discrepancy - Procedural Published Material / Policy
General None Reported / Taken
Human Factors; Procedure
Helicopter departed general hospital and advised approach that they were inbound to CRW.  General is located just South of final to Runway 5 at CRW.  The helicopter violated our LOA by departing on his own and came very close to the CRJ-200. We have had this problem before with multiple reports and other complaints being filed. It is rare that we are on Runway 5; so it doesn't come up very often; but when it does it is quite ugly. There are two hospitals just under final. Our airport is located on top of a mountain; so it is hard for pilots to communicate to the Tower using the current LOA. There is talk of a new LOA being in the works; but this has been a rumor for over a year and nothing has been signed. Maintenance has relocated a receiver for 128.5; but that isn't Tower's frequency nor is it mentioned in the current LOA with these helicopters. Until procedures are updated we will continue to have unsafe situations here when we are using Runway 5. Some controllers tell these helicopters to advise on 128.5 when lifting off and some say before lifting off. Yet some controllers tell them nothing at all and expect them to follow the LOA. This varied idea of a procedure is causing more confusion to controllers and pilots. The new LOA with the helicopters landing at the local hospitals needs to be put into effect. All helicopters landing at the hospitals need to be cosigners of this LOA or not be allowed to land there.
CRW Controller voiced concern regarding the handling of medical helicopter operations to local hospitals during the seldom used Runway 5 configuration.  The reporter noted the LOA provision does not cover these operations adequately.