Report Title:

Emergency Medical Services; Enhancement for Neighbor Islands and Rural Areas

Description:

Establishes an emergency medical services special fund to be funded by an additional fee imposed on certificates of registration for motor vehicles. Appropriates funds for advance life support ambulance services for parts of Oahu, Maui, and Hawaii, and for professional development and training for paramedics on Kauai, Maui, and Hawaii.

THE SENATE

S.B. NO.

2690

TWENTY-SECOND LEGISLATURE, 2004

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO EMERGENCY MEDICAL SERVICES.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

PART I

SECTION 1. The legislature finds that rapid response of emergency medical services is critical for positive outcomes for emergency patients. The need to provide adequate emergency medical care to residents of rural areas, particularly on the neighbor islands, is vital.

The legislature further finds that funding for emergency medical services has always been a critical issue. User fees for emergency medical services are deposited into the general fund, but are not an adequate source of funding for emergency medical services.

The legislature further finds that the retention and recruitment of paramedics plays an essential role in maintaining a top-notch emergency medical service.

The purpose of this Act is to establish an emergency medical services special fund through additional state vehicle registration fees for the department of health to use in operating the State's comprehensive emergency medical services system. The Act further provides for development and training for paramedics to address the recruitment and retention issue that would impede on the State's emergency medical services system.

SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to part XVIII to be appropriately designated and to read as follows:

"321-   Emergency medical services special fund. (a) There is established within the state treasury a special fund to be known as the emergency medical services special fund to be administered and expended by the department.

(b) The moneys in the special fund shall be used by the department for operating the State comprehensive emergency medical services system.

(c) Fees remitted pursuant to section 286-51(c), interest and investment earnings attributable to the moneys in the special fund, legislative appropriations, and grants, donations, and contributions from private or public sources for the purposes of the fund, shall be deposited into the special fund.

(d) The department shall submit an annual report to the legislature no later than twenty days prior to the convening of each regular session that outlines the receipts of, and expenditures from, the special fund."

SECTION 3. Section 286-51, Hawaii Revised Statutes, is amended to read as follows:

"286-51 Registration, expense. (a) Every certificate of registration issued under this part shall expire at midnight on December 31 of each year and shall be renewed annually before April 1 of each year upon application by the registered owner by presentation of the last issued certificate of registration or the last issued application for renewal, such renewal to take effect as of January 1 of each year; provided that the certificate of registration for each motor vehicle in the counties of the State may be renewed on a staggered basis, if a county elects to do so. The director of finance of each county may adopt rules to carry out the purposes stated in this section and shall expend the necessary funds from the director's operating funds as may be necessary for these purposes; provided that the director of finance, if the director has ascertained as of the date of the application that the registered owner has not deposited or paid bail with respect to any summons or citation issued to the registered owner for stopping, standing, or parking in violation of traffic ordinances within the county, may require, as a condition precedent to the renewal, that the registered owner deposit or pay bail with respect to all such summons or citations. The certificates of registration issued hereunder shall show, in addition to all information required under section 286-47, the serial number of the tag or emblem and shall be valid during the registration year only for which they are issued. The certificates of ownership need not be renewed annually but shall remain valid as to any interest shown therein until canceled by the director of finance as provided by law or replaced by new certificates of ownership as hereinafter provided.

(b) This part shall be administered by the director of finance in conjunction with the requirements of sections 249-1 to 249-13 and shall entail no additional expense or charge to the person registering the ownership of a motor vehicle other than as provided by this section or by other laws; provided that for each new certificate of ownership issued by the director of finance under section 286-52, the director of finance may charge a fee which shall be deposited in the general fund. The fees charged to issue a new certificate of ownership shall be established by the county's legislative body.

Notwithstanding any other law to the contrary, an additional fee of not more than $1 for each certificate of registration for a U-drive motor vehicle and $2 for each certificate of registration for all other motor vehicles may be established by ordinance and collected annually by the director of finance of each county, to be used and administered by each county:

(1) For the purpose of beautification and other related activities of highways under the ownership, control, and jurisdiction of each county; and

(2) To defray the additional cost in the disposition and other related activities of abandoned or derelict vehicles as prescribed in chapter 290.

The $2 fee established pursuant to this subsection for certificates of registration for motor vehicles other than U-drive motor vehicles may be increased by ordinance up to a maximum of $5; provided that all amounts received from any fee increase over $2 shall be expended only for the purposes of paragraph (2). The moneys so assessed and collected shall be placed in a revolving fund entitled, "the highway beautification and disposal of abandoned or derelict vehicles revolving fund".

(c) Notwithstanding any other law to the contrary, an additional fee of not more than $         for each certificate of registration for a U-drive motor vehicle and $         for each certificate of registration for all other motor vehicles shall be collected annually by the director of finance of each county. The fees shall be deposited into the emergency medical services special fund, pursuant to section 321-   ."

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $          , or so much thereof as may be necessary for fiscal year 2004-2005, to the emergency medical services special fund.

SECTION 5. The sum appropriated shall be expended by the department of health for the purposes of this part.

PART II

SECTION 6. The legislature finds that the Waianae Coast in Leeward Oahu has only one ambulance, which is insufficient to serve the emergency medical needs of the over forty thousand residents living in Waianae, Nanakuli, and Maili. Waianae is also one of several areas on Oahu where back-up response time standards may be exceeded. The growing population and relative isolation of the area make improving emergency health services there critical.

The legislature further finds that on the Waianae Coast, ninety per cent of emergency calls are answered within an average of fifteen minutes, but thirty per cent of those calls must be handled by adjacent emergency response units, usually by the ambulance stationed at St. Francis Medical Center West in Ewa Beach, twenty miles from Makaha.

SECTION 7. There is appropriated out of the emergency medical services special fund the sum of $1,500,000, or so much thereof as may be necessary for fiscal year 2004-2005, for an additional ambulance to serve the residents of and visitors to the Waianae Coast.

The sum appropriated shall be expended by the department of health for the purpose of section 6.

SECTION 8. The legislature finds that the Kihei/Wailea region of Maui is the State's fastest growing community, as well as a tourist center, that includes only one twenty-four hour, locally based advanced life support ambulance service for its residents and visitors. Thus, in emergency situations occurring when the single overburdened ambulance is already on call, the response time of ambulances from nearby communities increases by an additional twenty to thirty minutes, depending on the location of the ambulance. The legislature further finds that in many emergency medical situations, this prolonged response time can mean the difference between life and death for individuals visiting or living in this community.

The legislature intends to provide parity in emergency health care for residents and visitors of the Kihei/Wailea region of Maui by providing an additional twenty-four hour advanced life support ambulance service.

SECTION 9. There is appropriated out of the emergency medical services special fund the sum of $850,000, or so much thereof as may be necessary for fiscal year 2004-2005, to provide sufficient twenty-four hour advanced life support ambulance services for the Kihei/Wailea region of Maui.

The sum appropriated shall be expended by the department of health for the purpose of section 8.

SECTION 10. The legislature finds that unacceptably long and potentially life-threatening delays in emergency ambulance service have occurred in the Hawaiian Ocean View Estates area of the island of Hawaii. These delays, which can last up to two hours, occur when the Ka'u ambulance--located in Naalehu--is already on call. Although emergency medical technicians with the fire department can provide basic life support until a back-up advanced life support ambulance with mobile intensive care technicians arrives on scene, there is a vast difference between the level of care that each kind of technician is qualified to provide. Delays in the provision of appropriate emergency medical care because of geography are inhumane and unfair.

Consequently, the legislature finds a need to appropriate funds to the department of health to provide emergency advanced life support ambulance service to the residents of Hawaiian Ocean View Estates on the island of Hawaii.

SECTION 11. There is appropriated out of the emergency medical services special fund the sum of $850,000, or so much thereof as may be necessary for fiscal year 2004-2005, to provide emergency advanced life support ambulance service to the residents of Hawaiian Ocean View Estates on the island of Hawaii; provided that any emergency advanced life support ambulance and its crews shall be based at the fire station constructed by the volunteer fire department in Hawaiian Ocean View Estates.

The sum appropriated shall be expended by the department of health for the purpose of section 10.

PART III

SECTION 12. The legislature finds that retention and recruitment of highly qualified paramedics is a challenge and a top priority for Hawaii. Studies have shown that scores of paramedics have quit or been dismissed for numerous reasons. One of the main reason is the absence of a challenging work environment. Many paramedics find that running the same calls over time becomes routine, and thus look for other avenues of work.

The legislature further finds that professional development and training for paramedics is a good way to address the challenge of retention and recruitment of paramedics, which was identified as a top priority in keeping Hawaii's emergency response system in top shape at the 2003 Hawaii EMS Agenda for the Future Summit.

SECTION 13. There is appropriated out of the emergency medical services special fund the sum of $350,000, or so much thereof as may be necessary for fiscal year 2004-2005, for:

(1) Development and training instructor

for Kauai $75,000

(2) Video conference system to connect

Kauai, Maui, and Hawaii with EMS

Instruction on Oahu $75,000

(3) Paramedic training equipment for

Kauai, Maui, and Hawaii $200,000

The sum appropriated shall be expended by the department of health for the purpose of this part.

SECTION 14. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 15. This Act shall take effect on July 1, 2004.

INTRODUCED BY:

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