S.R. NO.













Requesting the auditor to assess the social and financial effects of mandating coverage of ambulance and community paramedicine services.



     WHEREAS, community paramedicine is a model of community-based health care in which paramedics and emergency medical technicians (EMTs) function outside their customary emergency response and transport roles in ways that facilitate more appropriate use of emergency care resources and enhance access to primary care and support services for medically underserved populations; and


     WHEREAS, community paramedicine allows traditional paramedics and EMTs to care for persons with a variety of chronic diseases such as diabetes, hypertension, and asthma at home without transport to a hospital or clinic, which has been shown to benefit patients in underserved areas; and


     WHEREAS, community paramedicine programs can help address certain issues such as improving access to primary and preventive care, ensuring that services are triaged appropriately, and alleviating overburdened hospital emergency departments; and


     WHEREAS, it is recognized that a substantial number of transfers to a hospital provided by an emergency ambulance service are for health conditions that are not considered to be an emergency, which result not only in wasted healthcare resources but also potentially preventing these life-saving services from individuals who may truly be experiencing a life-threatening emergency; and


     WHEREAS, utilizing specially trained EMT and paramedic personnel would increase access to primary and preventive care and decrease unnecessary use of emergency departments, thereby decreasing health care costs; and


     WHEREAS, S.B. No. 283, Regular Session of 2021, requires health insurers and similar entities that provide coverage for health care to provide coverage for ambulance and community paramedicine services; and


     WHEREAS, pursuant to section 23-51, Hawaii Revised Statutes, before any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, a concurrent resolution shall be passed that designates a specific legislative bill for the Auditor to review and on which to prepare a report for submission to the Legislature that assesses both the social and financial effects of the proposed mandated coverage under that legislative bill; now, therefore,


     BE IT RESOLVED by the Senate of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2021, that the Auditor is requested to conduct an assessment, pursuant to sections 23-51 and 23-52, Hawaii Revised Statutes, of the social and financial effects of mandating health care coverage of ambulance and community paramedicine services, as provided in S.B. No. 283, Regular Session of 2021; and


     BE IT FURTHER RESOLVED that in conducting the assessment, the Auditor is requested to consider the following definition of community paramedicine services: an organized system of services, based on local need, that are provided by EMTs and paramedics integrated into the local or regional health care system and overseen by emergency and primary care physicians, which not only addresses gaps in primary care services, but enables the availability of emergency medical service (EMS) personnel for emergency response in low call volume areas by providing routine use of their clinical skills and additional financial support from these non-EMS activities; and


     BE IT FURTHER RESOLVED that the Auditor is requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2022; and


     BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Auditor and Insurance Commissioner.









Report Title:  

Auditor; Assessment; Insurance Coverage; Ambulance; Community Paramedicine