Report Title:

Emergency Medical Services

Description:

Establishes the Emergency Medical Services Special Fund to receive a portion of the motor vehicles registration fee. Appropriates funds for additional emergency medical services for the Waianae Coast and Nanakuli, and for professional development and training for paramedics. (SB2690 HD1)

THE SENATE

S.B. NO.

2690

TWENTY-SECOND LEGISLATURE, 2004

S.D. 2

STATE OF HAWAII

H.D. 1


 

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. There is also a need to expand emergency medical services on Oahu to meet nationally recognized guidelines for advanced life support response time to medical emergencies.

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 quality emergency medical services.

The purpose of this Act is to:

(1) Establish an emergency medical services special fund through additional state vehicle registration fees for the department of health to provide additional services by the State's comprehensive emergency medical services system;

(2) Provide funds for an additional emergency medical services to serve residents of the Waianae coast and Nanakuli; and

(3) Provide for development and training for paramedics to address 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 to provide additional services by the state comprehensive emergency medical services system.

(c) Fees remitted pursuant to section 249-31, 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 249-31, Hawaii Revised Statutes, is amended to read as follows:

"249-31 State registration fee. (a) All vehicles and motor vehicles in the State as defined in section 249-1, including antique motor vehicles, except as otherwise provided in sections 249-3 to 249-6 shall be subject to a [$20] $    annual vehicle registration fee. The fee shall become due and payable on January 1, and shall be paid before April 1 in each year together with all other taxes and fees levied by this chapter; provided that should any county elect to renew motor vehicle registrations on a staggered basis as authorized by section 286-51, the state registration for that county shall likewise be staggered so that the state registration fee is due and payable at the same time and shall be collected together with the county fee. The state registration fee shall be deemed delinquent if not paid with the county registration fee. The respective counties shall collect this fee together with the vehicle registration tax collected for the county and shall transfer the moneys collected under this section to the State to be paid into the state highway fund.

(b) From each annual motor vehicle registration fee, the director shall deposit $ into the state highway fund and $      into the emergency medical services special fund."

PART II

SECTION 4. 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.

In addition, the legislature finds that Waianae and Nanakuli areas lack sufficient emergency medical services that are commensurate with its population growth and high rates of motor vehicle crashes, medical emergencies, and other trauma. This situation combined with the fact that Hawaii finds itself in an ongoing state of heightened readiness, especially by first-responders, in response to the potential for terrorist attacks, creates a need for an increased level of medical self-sustainability due to the extremely limited availability of mutual aid resources posed by our island geography.

Accordingly, the legislature determines that it is necessary to provide funding for an emergency ambulance, including staffing, equipment, supplies, and quarters for an emergency ambulance unit in the Waianae and Nanakuli areas of Oahu.

SECTION 5. There is appropriated out of the general revenues for the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2004-2005 for additional emergency medical services for the residents of and visitors to the Waianae coast.

The sum appropriated shall be expended by the department of health.

SECTION 6. 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 provide additional emergency medical services for Nanakuli, Oahu.

The sum appropriated shall be expended by the department of health.

PART III

SECTION 7. 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 at the 2003 Hawaii EMS Agenda for the Future Summit as a top priority in keeping Hawaii's emergency response system in top shape.

SECTION 8. There is appropriated out of the general revenues for the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2004-2005 for:

(1) Development and training instructor

for Kauai; $       

(2) Video conference system to connect

Kauai, Maui, and Hawaii with EMS

Instruction on Oahu; and $       

(3) Paramedic training equipment for

Kauai, Maui, and Hawaii. $       

The sum appropriated shall be expended by the department of health.

PART IV

SECTION 9. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 10. This Act shall take effect on July 1, 2004; provided that section 3 shall take effect on October 1, 2004.