LIHU‘E — The Kaua‘i County Council passed a resolution urging the state Department of Health (DOH) to continue with a longtime emergency service provider on Wednesday, Oct. 4, amid protests surrounding the decision to switch to a new provider.
The controversy surrounding emergency medical services began in August after the DOH announced that emergency medical provider Falck had been awarded 3.5-year contracts, totaling roughly $32 million for Kaua‘i and $59 million for Maui, to provide paramedic services on both islands.
The announcement launched protests from the current provider American Medical Response (AMR), an organization that has been providing the service for over 44 years.
The Kaua‘i County Council, members of the public, several AMR staff, and two Falck representatives spent hours debating the state’s decision during the Wednesday meeting, as they discussed Resolution 2023-60, introduced by council members Felicia Cowden and Ross Kagawa.
The resolution urges the state Department of Health to continue its contract with AMR, noting AMR has provided a “high quality of care and has become accustomed to the county’s people, culture, and communities.”
A major concern, first voiced by AMR, and now the county, stems from the removal of a DOH requirement that every ambulance be equipped to operate at Advanced Life Support (ALS), not just Basic Life Support (BLS).
“The citizens of the county of Kaua‘i deserve advanced-life support services in all ambulances,” the resolution states.
ALS units have at least one paramedic staffed alongside EMTs, making them able to provide more advanced care including intubation, the use of EKGS to respond to cardiac conditions, and the insertion of IVs.
But Doug Chin, an attorney for Falck, told council members that Falck was awarded the contract based on quality and emphasized the organization would not be cutting services.
“There will be no reduction in services, particularly ALS services … there has been some false information about that,” Chin said. He added that current staff working with AMR would be able to join their organization.
“If they want to come over, they’re more than welcome to come over,” he said.
Chin was joined by Falck representative Julian Dewberry, who made similar remarks.
“We will continue the Advanced Life Support staff to be part of this contract,” Dewberry said.
“In the past when we’ve taken over an agreement, we’ve welcomed over 90 percent of the incumbent workforce,” he added.
Council member KipuKai Kuali’i asked Cowden and Kagawa how the statements in the resolution were true when Falck was present at the meeting, testifying there would be no reduction in services.
“Did you get this information from the Department of Health?” Kuali’i asked.
Cowden replied that the resolution was written in alignment with the County of Maui’s resolution, but she admitted the information had not been confirmed with the DOH.
“(The DOH) said they couldn’t give us any information,” she said, criticizing the DOH for not being open with any information.
“This isn’t against Falck. It’s against the process. The process was not open (and) was not transparent. It wasn’t inclusive to the public. It wasn’t inclusive to the elected representatives of the public,” she said.
Cowden admitted she had not read the bid from the DOH, which is available publicly on the state’s website.
According to addendum 3 in the Kaua‘i RFP, the DOH said it “does not have a preferred ratio of ALS and BLS deployment” in a section on common questions raised by applicants.
“The proposer may provide their recommendation based on the data provided in the RFP and attached to this addendum,” it states.
The pending contract, which would presumably state the exact number of ALS units that Falck intends to provide, has not been released publicly.
Kuali’i said he was recently informed that the council members for the County of Maui did not pass their similar resolution due to concerns of potential inaccuracies.
“Their resolution has been passed on to the committee to work on it further,” he said.
County attorney Matthew Bracken was then brought up to be asked whether the document’s potential factual inaccuracies could be challenged in a court of law.
“This (resolution) affects nothing. The state can’t take this into consideration,” said Bracken noting the DOH will need to ignore it due to state procurement laws. “It’s really just a political statement. But even saying that the resolution should still be factually accurate.”
Kaua‘i resident Lonnie Sykos said the county should not be preferring one provider over another if the same quality of care will be provided to the public.
“This needs to be addressed with the state. And at this point, I’m unclear as to what the actual facts are,” Sykos said.
He questioned whether the state is actually planning on reducing the level of service, or if the controversy stems from a lack of information. He pointed out that if the state is not actually planning on reducing the level of care, “this whole conversation is irrelevant.”
Council members proposed an amended resolution after breaking for lunch, which removed statements including that the DOH advised bidders that a minimum level of advanced-life support was not required.
It also removed references to Falck’s substantial fines for failing to meet response times in California. A Falck spokesperson previously told The Garden Island the failure was caused by staffing shortages during the COVID-19 pandemic, and that the issue has been resolved.
Speedy Bailey, the regional director of AMR in Hawai‘i, referred to Falck’s struggles in his testimony earlier, stating AMR has provided a very high level of care for decades and has always been fully staffed.
“We’re fully staffed on Kaua‘i and have always been throughoutour tenure. I’m very proud of that,” he said.
“No COVID excuses here,” he added.
All council members voted to approve the amended resolution. Council chair Mel Rapozo was not present.
In September, the DOH told The Garden Island that the contracts with Falck had been suspended after receiving “timely submitted protests” from AMR, and they are not able to provide any further comment until a decision is made.
The DOH repeated those statements earlier this week and declined to provide a timeline for when a decision or update would be announced.
“Due to the ongoing RFP process, the Hawai’i State Department of Health (DOH) cannot comment on the matter. The DOH continues to stand by its (earlier) response,” said DOH Information Specialist Rosemarie Bernardo in an email response on Wednesday.
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Emma Grunwald, reporter, can be reached 808-652-0638 or egrunwald@thegardenisland.com.
