Honorable Robert Bunda

President of the Senate

Twenty-Second State Legislature

Regular Session of 2004

State of Hawaii

Sir:

Your Committee on Health, to which was referred S.B. No. 2690 entitled:

begs leave to report as follows:

The purpose of this measure is to supplement the general funds appropriated to the emergency medical system by establishing an emergency medical services special fund.

This measure also appropriates funds for advance life support ambulance services for parts of Oahu, Maui, and Hawaii, and provides for necessary training opportunities on the neighbor islands.

Testimony in support of this omnibus measure was received from members of the Maui County Council, the United Public Workers (UPW), American Medical Response, several Maui County paramedics, and private individuals. Testimony from the Department of Health supported the intent of this measure, but opposed the imposition of new fees.

Your Committee is cognizant that the rapid response of emergency medical services is critical to positive outcomes for emergency patients. The need to provide sufficient emergency medical care to residents of rural areas, particularly on the neighbor islands, is long overdue. Your Committee further finds that funding has been a critical issue in financing the emergency services. User fees for emergency medical services are deposited into the general fund, but are not an adequate source of funding for the services.

Additionally, your Committee finds that the retention and recruitment of paramedics is vital in maintaining a top-notch emergency medical service. Paramedics are an essential component of the continuum of care and serve as linkages among health resources. Your Committee further finds that professional development and training for paramedics and new recruits is a sound way to address the challenge of retention and recruitment, which was identified as a top priority in keeping Hawaii's emergency response system in top shape at the 2003 Hawaii EMS Agenda for the Future Summit.

Accordingly, your Committee has amended this measure by:

Your Committee has further amended this bill by changing the effective date for the additional fee for the motor vehicle registration to October 1, 2004, and making other changes to allow for the transaction and imposition of the additional fee.

Your Committee considered various funding sources to provide emergency medical services, and finds that the best method is to increase the motor vehicle registration fees because your Committee finds a direct nexus between use of motor vehicles and the need for emergency medical services. Your Committee feels very strongly that there is a need for greater resources, and if new funding mechanisms are not created, improved services will never be realized. Your Committee notes that the increased fees are to be used for enhanced emergency services, and may not be used to supplant existing services.

As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 2690, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 2690, S.D. 1, and be referred to the Committee on Ways and Means.