New RFPs issued for for 911 ground ambulance services on Kaua‘i and Maui

The Hawaiʻi Department of Health announced a Request for Proposals for Comprehensive Emergency Medical Services or EMS for 911 Ground Ambulance Transport in Maui and Kauaʻi Counties. The RFPs, from the Emergency Medical Services and Injury Prevention System Branch, replace those that were canceled on Oct. 23, 2023 after concerns were raised.

“While it was never the intent of DOH to reduce the qualifications of emergency responders, the previous RFPs did not make this entirely clear,” said Hawai‘i State Health Director Kenneth S. Fink. “The new RFPsclearly require that every district will have an ambulance staffed with a paramedic and a second responder who is at least an EMT, which is the current qualification for and level of staffing.”

Changes with the new RFPs include the following:

• Another ambulance for Moloka‘i: Currently, 10 ambulance units serve Maui County. Under the new contract there will be 11, increasing from one to two, the number on Moloka‘i.
• Quality and performance: These RFPs emphasize quality and performance. There are new requirements for a quality assurance coordinator and for a pediatric emergency care coordinator. There are new expectations for clinical performance standards, quality measures and outcomes. Specific areas of focus include maintenance of skills in addressing low-volume conditions such as large vessel occlusion stroke.

Also, there is additional emphasis on disaster preparedness, and the RFPs include initiatives for community paramedicine.

These RFPs do not include aeromedical transport. However, there will be no interruption to current 911 aeromedical response. This legislative session, DOH is seeking to expand an air ambulance system that would gain efficiencies through multi-county operating and maintenance agreements. If unsuccessful at the legislature, DOH will separately procure aeromedical services (currently referred to as the Maui MedEvac) for Maui County. Ground ambulance services are expected to coordinate hand-offs with other providers to optimize patient outcomes.  

Current contracts were extended during the new procurement process to ensure that Maui and Kauaʻi County residents have uninterrupted access to ground ambulance services.

The City and County of Honolulu operates its own EMS system, and the County of Hawaiʻi’s Fire Department operates its EMS system through an agreement with the DOH. DOH contracts with private emergency medical ground ambulance services for counties that do not operate or contract for this service.