HONOLULU — The Department of Health announced on Friday it has awarded two four-year contracts for emergency ground ambulance service for Kaua‘i and Maui to International Life Support, doing business as American Medical Response (AMR).
AMR had been a contractor for both counties for 44 years before controversy arose in 2023 when Falck Northwest Corp., a multinational company based in Denmark, was selected.
DOH issued the Notices of Awards on Thursday after required competitive procurements.
The new contracts will begin Jan. 1, 2025, and end Dec. 31, 2028, and will ensure every district has an ambulance staffed with a paramedic and a second responder, who is at least an emergency medical technician, commonly called an EMT, which are the current qualifications and level of staffing.
The Maui contract provides for a second ambulance on Molokai.
The value of the Kaua‘i contract is $38 million and $74 million for Maui County, which includes Lanai, Molokai and Maui.
And they will “add requirements for a quality assurance coordinator and a pediatric emergency care coordinator, among other improvements in quality and performance.”
In 2023, DOH awarded Falck a three-and-a-half year, $59 million contract for Maui and a $32 million contract for Kaua‘i. They were to run Dec. 28 through June 30, 2027.
After hearing concerns raised about the Falck contracts, DOH on Oct. 23 canceled the request for proposals for Comprehensive Emergency Medical Services for 911 Ground Ambulance Transport for the two counties.
DOH on April 15 announced new RFPs for Emergency Medical Services Injury Prevention Systems for Maui and Kaua‘i counties.
“While it was never the intent of DOH to reduce the qualifications of emergency responders, the previous RFPs did not make this entirely clear,” state Health Director Kenneth S. Fink said in an April 15 news release. “The new RFPs clearly require that every district will have an ambulance staffed with a paramedic and a second responder who is at least an EMT.
Troy Hagen, chief commercial officer for Falck USA, said in a written statement Friday: “We are disappointed that Falck was not selected by the Department of Health, who found us more qualified than the incumbent to provide emergency medical services to Maui and Kaua‘i counties just last year before canceling the request for proposals in response to a challenge.
“We are carefully reviewing our options and continue to stand ready to serve. As a foundation-owned healthcare provider, Falck would bring a fresh perspective, unmatched financial stability, reliable services developed around global best practices, and a deep commitment to delivering the highest quality care to the communities we serve.”
Falck USA provides ambulance services in California, Colorado and Oregon. It is owned by philanthropic foundations.
The Maui and Kaua‘i paramedics associations had concerns about lower levels of care from the contracts issued in the previous bidding. They opposed lowering a standard of care that currently offers at least one highly trained paramedic, who could provide necessary advanced life support with all the needed equipment. Paramedics are more highly trained than EMTs and can insert breathing tubes into patients with respiratory failure, use electrocardiograms and insert IVs to administer medications.
The unions said they were most concerned about dropping a required Advanced Life Support unit for every unit.
The Maui County Council had also expressed concern over the loss of AMR. Council Chair Alice Lee wrote in a resolution in September that AMR had “performed very well for the past 44 years, as they demonstrated in their response to the wildfires. They know our community and our needs. We do not want services to be cut, nor do we want a contractor who has under-performed in other communities.”
AMR Regional Director Speedy Bailey said in September he was stunned with the selection of Falck over AMR because AMR had a proven track record while Falck had a history of response-time penalties and compliance issues.
In San Diego, Falck’s response-time failures due to persistent staffing shortages had been reported in the local media. The San Diego Union-Tribune reported the company was fined $1.2 million for failing to meet response-time goals in 2022.
