The Hawaii Department of Health weighs in on the Fire-EMS merger.

1. NEIL ABERCROMBIE LOREITA J. FUDDY, A.C.S.W., MPH.
GOVERNOR OF HAWAII DIRECTOR OF HEAITH
STATE OF HAVVAII In reply please refer to:
DEPARTMENT OF HEALTH
P. 0. BOX 3378
HONOLULU, HI 96801-3378
July 19, 2012
The Honorable Peter B. Carlisle, Mayor
City and County of Honolulu
530 S. King Street
Honolulu, HI 96813
Dear Mayor Carlisle:
As you know, the State Department of Health has a statutory obligation to
oversee, regulate and contract for Emergency Medical Service (EMS) operations in
each of our counties. Within this context I would like to convey the State’s position in the
proposed merger of the Honolulu Fire Department (HFD) and the Honolulu Emergency
Services Department (HESD).
The report prepared by the HFD consultants promises improved service and
lower costs but does not specify a model of service delivery, i.e. organizational structure
with detailed descriptions of what the employees would be doing. Without the model lUs
impossible to substantiate the claims of financial savings and better service for the
people of Hawaii.
We do not believe the consultants met with Qahu hospital personnel or even the
Fire Department’s own contracted medical director in the preparation of their report.
Our Emergency Medical Services and Injury Prevention System Branch Chief,
Dr. Linda Rosen, has previously expressed her concerns regarding the consultant’s
report to Mr. Doug Chin of your office and to Chief Silva of HFD.
While the counties can periodically examine how they provide ambulance
services in their contracts with the State, any major changes should not be undertaken
unilaterally. It is our conclusion that HFD has not yet demonstrated the suitability of
taking on the EMS medical mission for the City and County of Honolulu. Therefore, it
seems premature to support the proposed merger.
I would also note that both the HESD and HFD are highly respected
organizations that work together daily to respond to emergencies and save lives. Both
organizations also have excellent working relationships with the State. I am confident
that the parties can find ways to work together more productively, and efficiently, by
combining functions in areas that make sense, such as dispatch and medical direction,
perhaps without resorting to a merger.

2. The Honorable Peter B. Carlisle, Mayor
Page 2
July 19 2012
We would be happy to meet with you and your staff to discuss our concerns in
greater detail. We look forward to working with you to provide the best possible service
for our community.
S ince rely,
Loretta J. Fuddy, A.C.S.W, M.P.H.
Director of Health
Prtnt LCfeon’ Er WeU+e
c: Deputy Director for Health Resources Administration
Linda Rosen, M.D.