AMR protests emergency services contract award | News, Sports, Jobs

An ambulance makes its way through traffic on Honoapiilani Highway on Aug. 16, the first day the road was reopened to the general public last month. American Medical Response is protesting the state Department of Health’s decision to award an ambulance service contract for Maui County to Falck Northwest Corp. Paramedic unions are raising concerns that units will not provide consistent advanced life support services under the DOH’s contract. The Maui News / MATTHEW THAYER photo

American Medical Response, which provides 911 ground ambulance transport for Maui County, has filed a protest with the state Department of Health after it selected a different company in a recent awarding of contracts for the service, the DOH said Tuesday evening.

AMR also filed a bid protest after it was not selected for a similar contract in Kauai County, a DOH spokesperson said via email.

The protest is over the decision by the DOH’s Emergency Medical Services & Injury Prevention System Branch to award a nearly $59 million contract to Falck Northwest Corp. on Aug. 29 for a contract that begins on Dec. 28 and ends on June 30, 2027, according to the Hawaii Awards & Notices Data System.

Falck, which is also an international ambulance operator, was awarded a $32 million contract for services on Kauai for the same time frame.

The Maui County Paramedics Association and the Kauai Paramedics Association said in a letter to more than a dozen elected officials and the media on Saturday that the state has set no minimum level of advanced life support unit coverage in its recent request for contract proposals for emergency medical services in Maui County and Kauai.

An ambulance passes the food and supply distribution site at Lahaina Gateway Center last month while making its way through traffic on Honoapiilani Highway on the first day the road was reopened to the general public. The Maui News / MATTHEW THAYER photo

Basic life support refers to life-saving medical procedures performed in the early stages of an emergency to keep a person alive until more advanced care can be provided, according to the Red Cross. Advanced life support involves more sophisticated techniques, with the goal of stabilizing critical patients while preparing them for transport to a hospital.

During the Aug. 8 firestorms on Maui, paramedics set up a medical incident command and triage, and in the first hours of the incident, treated approximately 60 patients and transported 32 for further medical attention, the unions said in their letter. Paramedics provided advanced life support “to more burn patients in one night” than most emergency medical services systems see in a year.

When flames blocked regular routes to Maui Memorial Medical Center, advanced life support providers “continued lengthy care of their patients, and even had to transport some via a treacherous 40-mile northern route along sea cliffs” via Kahakuloa to get to Central Maui.

“Integral to EMS management of the medical aspect of this disaster was Maui’s system design as a 100 percent ALS system,” the letter said.

Now, however, the unions worry that under the new contracts, there will no longer be the assurance that an advanced life support unit will respond to every emergency in Maui County, including rural Hana, Molokai or Lanai, as well as on Kauai.

AMR officials could not immediately be reached for comment Tuesday night. Discussing the contract selection with KITV 4, AMR Regional Director Speedy Bailey said, “we firmly believe that this is not a decision in the best interest of the state.” He added that AMR provides “this service without issue, without problem.”

DOH said it could not comment on Tuesday.

“The filing of these protests triggers suspension of any further action on contract award and execution until a disposition is made of the protests,” the department said in an email. “Until that time, DOH is unable to provide comment or other information regarding the RFP’s and protests.”

Falck, the newly selected provider, did not respond to a request for comment Tuesday.

California-based media have reported that the company has run into response-time issues with its ambulances. Reports in San Diego earlier this year said that Falck did not meet staffing and response-time promises it made to the city, which later required the company to contract with AMR to get more ambulances on the road for more hours. Bay Area media reported issues with response times from Falck in Alameda County in December 2021.

The Maui County and Kauai paramedic unions said the debate between basic and advanced life support is “one of many flaws” in the DOH’s request for proposals for emergency services.

“DOH unilaterally advised bidders for EMS service delivery in these counties that there will now be no minimum level of ALS coverage,” the unions said in their letter. “In fact, when bidding companies themselves sought clarification, DOH doubled down on diluting the level of care, publishing, ‘DOH does not have a preferred ratio between ALS and BLS ambulance deployment.'”

The unions raised the concern that DOH could accept a company providing one advanced life support ambulance for an entire county and allow the rest to be basic life support ambulances, which would be staffed with basic emergency medical technicians and no paramedics.

David Kingdon of the Maui County Paramedics Association said on Tuesday afternoon that EMTs are also crucial members of the team along with paramedics.

However, the unions said there are things that paramedics can do that EMTs alone cannot, including: applying extensive knowledge and experience to conduct an advanced assessment, inserting breathing tubes in patients with respiratory failure and treating life-threatening lung collapse, using EKGs to identify and respond to potentially life-threatening cardiac conditions, and inserting IVs and administering dozens of different life-saving medications.

The unions represent both paramedics and EMTs. In Maui County, the union has 91 members — 49 are paramedics and 42 are EMTs.

Kingdon said the unions have not taken a position on the awarding of the contracts.

However, they did express support for maintaining advanced life support providers on every unit.

They also said that there should be a “thorough” reexamination of the request for proposal process and that substantive changes should be made in consultation “with the true experts in community health and safety: Maui and Kauai’s front-line paramedics.”

Kingdon said that since the letter was sent out, some elected officials have reached out and “unanimously they are extremely concerned about this” and have said they will look into the matter.

* Staff Writer Melissa Tanji can be reached at mtanji@mauinews.com.

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