LIHU‘E — A longtime emergency service provider for Maui and Kaua‘i is protesting the state’s decision to award a contract to a new provider, as the newly selected organization maintains it is committed to getting a signed agreement in place and begin servicing Hawai‘i.
In June, the state Department of Health’s (DOH) Emergency Medical Services and Injury System Preventions branch put out a request for proposals for both Kaua‘i and Maui’s emergency services, stating the selected provider would be awarded 3.5-year contracts totaling approximately $91 million — roughly $32 million for Kaua‘i and $59 million for Maui.
The state department selected Falck Northwest Corp., a Danish-based emergency assistance organization, for both contracts expected to begin on Jan. 1, 2024, and run through June 30, 2027, with the possibility of a 24-month extension.
According to Speedy Bailey, the regional director for American Medical Response (AMR) in Hawai‘i, the organization was “surprised and shocked” by the state’s decision to award the contract to another provider.
He noted AMR has provided “proven good service” on both Maui and Kaua‘i for over 40 years.
“I think the process was faulty. I think it was a paper chase. I don’t think it factored proven abilities and track record in the field,” he said.
Maui paramedic David Kingdon, who is also the spokesperson for both the Kaua‘i and Maui Paramedics Associations, said his associations are most concerned with the terms of the DOH’s request for proposals — not the selected company.
“We’re not taking a position on one company or the other,” said Kingdon in an interview with The Garden Island. “We are most concerned with the reduction in the standard of care.”
Kingdon pointed to a “number of errors” within the terms of the DOH’s request for proposals, most notably the removal of a previous requirement that every ambulance be an Advanced Life Support (ALS) unit.
He stated Basic Life Support (BLS) units are staffed with EMTs and no paramedics — who are able to provide more advanced care including intubation, use EKGS to respond to cardiac conditions and insert IVs.
Kingdon referred to an addendum in the terms, which states “DOH does not have a preferred ratio between ALS and BLS ambulance deployment.”
The statement continues, saying the “proposer may provide their recommendation based on the data provided in the RFP and attached to this addendum.”
According to Kingdon, those terms mean the DOH may accept a company providing one ALS ambulance in each county and allow the rest to be Basic Life Support (BLS).
“For decades … every contracted 911 EMS unit has needed to have at least one paramedic on board and been equipped for the advanced life support level. They changed that (requirement) to basically tell whoever wins the bet that they could provide whatever ratio of ALS or BLS they wanted,” he said.
“It was grossly irresponsible, grossly irresponsible of (the DOH) to do so. And furthermore, to make that kind of radical change without reaching out to stakeholders, like the paramedics and EMTs, who work in the field in Kaua‘i and Maui is ludicrous,” he said.
‘A false rumor’
But Jeff Lucia, Falck’s communications director, said a new system replacing paramedics with basic EMTs was “a false rumor.”
“This idea that we’re going to be reducing the number of paramedics, it’s just not true,” Lucia said. “We’re going to provide the same number of paramedics responding to emergencies as there currently are or more.”
Lucia also commented on recent reports, including an article last week by the Honolulu Star-Advertiser, which noted several previous compliance issues by Falck.
The article referred to a March 2023 report by the San Diego Union-Tribune, which stated Falck received $1.2 million in fines for failing to meet response-time goals during October, November and December of 2022.
It also referred to issues in California’s Alameda County, noting the European-based company failed to meet the standard 10-minute response time and instead took up to 25 minutes to respond to emergencies, according to a February 2022 story by ABC7 News.
Lucia admitted previous reports were correct, and he attributed those issues to staffing shortages due to the pandemic.
“During the pandemic … many providers, many different communities experienced fines or shortages of staff and delayed response times,” said Lucia.
The company has worked hard to resolve those issues, and their system is now running at a “very high-performance level,” he said.
“In the San Diego system, we did aggressive recruiting. We offered very generous signing bonuses. We increased pay and entered a new collective bargaining agreement with organized labor in San Diego and we’re fully staffed and meeting the city’s requirements,” he said.
Falck also plans on hiring the existing paramedic and EMT workforce on Maui and Kaua‘i. He praised the staff for their work during the recent Maui wildfires.
“They have done an incredible job, especially during the fires. And we’re very excited about the opportunity to work with them,” Lucia said.
He added that Falck is looking forward to continuing discussions with the state once the protests are resolved and “getting a signed agreement in place.”
Bailey, on the other hand, criticized Falck’s plans to hire current Maui and Kaua‘i paramedics, saying it puts their “workforce in a very unfortunate situation of being in the middle. They’re not a commodity,” he said.
He added AMR is not “afraid of competing in a fair bid,” and believes his organization has “made a strong case” during the protest process.
He noted AMR has never had a shortage of paramedics and EMTS on Maui or Kaua‘i, despite national shortages.
“Our competition, in this case, has a history of overpromising. The facts in San Diego and Alameda are clear,” he said, referring to Falck’s previous compliance fines.
“That’s one of the strengths that we’ve delivered, despite national shortages. And Hawai‘i shortages that are well-documented for paramedics. That’s part of delivering quality service on time, on point, and on budget. We’re very proud of that.”
In an email response, DOH information specialist Rosemarie Bernardo said the department had received AMR’s “timely submitted protests” regarding their decision to award the contracts to Falck.
“The filing of these protests triggers suspension of any further action on contract award and execution until a disposition is made of the protests,” she said.
“Until that time, DOH is unable to provide comment or other information regarding the RFPs and protests,” she added.
The DOH did not say when a decision on AMR’s appeal would be made public.
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Emma Grunwald, reporter, can be reached 808-652-0638 or egrunwald@thegardenisland.com.
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