HB 2314: Department of Health; State Emergency Medical Systems of Care; State Emergency Medical Services; Community Paramedicine Program; Integrated Mobile Health Care; Advisory Council
- Session Year: 2025-2026
- House: House
- Latest Version Date: 2026-04-29
Current Status:
Passed
(2026-06-04: Act 085, on 06/04/2026 (Gov. Msg. No. 1185).)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Final Decking
Enacted
What does this bill do?
This bill updates Hawaii law to create a statewide, time‑sensitive emergency medical systems of care that changes how patients, emergency responders, hospitals, and the Department of Health coordinate emergency care. It expands community paramedicine to include mobile integrated health, allows partnerships with educational and professional groups, and permits telehealth (remote consults), including some out‑of‑state providers under department protocols. It also expands basic life support duties (tourniquets, IVs, defibrillation under clinician supervision), renames and reshapes the advisory council, and gives the Health Department authority over service levels, air‑medical rules, data, and dispatch.
The summary is provided by generative AI which can make mistakes. For original language, please view the details in the table below.
Modernizes Hawaii's emergency medical services laws to align with current best practices and adopt a time-sensitive emergency medical systems of care model. Expands the Community Paramedicine Program to include integrated mobile health care; permit additional partnerships with professional organizations and educational institutions; and authorize certain telehealth services by providers located in or out of the State, under certain circumstances. Renames the State Emergency Medical Services Advisory Council the Hawaii Emergency Medical Systems of Care Advisory Council and amends its membership. (CD1)
Modernizes Hawaii's emergency medical services laws to align with current best practices. Effective 7/1/3000. (SD1)
Modernizes Hawaii's emergency medical services laws to align with current best practices. Effective 7/1/3000. (HD2)
Modernizes Hawaii's emergency medical services laws to align with current best practices. Effective 7/1/3000. (HD1)
Modernizes Hawaii's emergency medical services statutes to align with current best practices.
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
2314 |
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THIRTY-THIRD LEGISLATURE, 2026 |
H.D. 2 |
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STATE OF HAWAII |
S.D. 1 |
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C.D. 1 |
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A BILL FOR AN ACT
RELATING TO EMERGENCY MEDICAL SYSTEMS OF CARE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature further finds that contemporary models of emergency and acute care prioritize integrated systems that address time-sensitive emergencies, such as burns, heart attacks, strokes, sepsis, and trauma, with the same urgency and structure as traditional emergency response. By adopting a time-sensitive emergency medical systems of care model, Hawaii can improve patient survival, reduce long-term disability, and strengthen statewide resilience in times of disaster or public health crisis.
Aligning Hawaii's emergency medical services laws with national best practices in systems integration will:
(1) Ensure coordinated, evidence-based care for time-sensitive emergencies across all islands;
(2) Modernize emergency medical services and trauma systems to meet current and future challenges;
(3) Improve patient outcomes through standardized, statewide protocols; and
(4) Enhance preparedness for future natural disasters, mass casualty incidents, and public health threats.
Accordingly, the purpose of this Act is to update Hawaii's emergency medical services laws to establish a comprehensive, time-sensitive emergency medical systems of care model that strengthens the State's capacity to respond effectively to emergencies and safeguard the health of the State's residents, living on all islands.
SECTION 2. Section 46-191, Hawaii Revised Statutes, is amended by amending the definition of "basic life support" to read as follows:
""Basic
life support" means initiating noninvasive emergency patient care designed
to optimize the patient's chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures that constitute the
practice of medicine; provided that state-approved basic life support personnel
may use fully automatic external defibrillators, initiate intravenous lines, place
tourniquets, and perform manual external defibrillation under the direction
and personal supervision of a [mobile intensive care technician.] state-licensed
clinician and in accordance with rules adopted by the department of health."
SECTION 3. Section 46-196, Hawaii Revised Statutes, is amended to read as follows:
"[[]§46-196[]] Emergency
medical services; levels of service; contracts. The county shall determine the levels of
emergency medical services that shall be implemented throughout the county[;],
unless otherwise determined by the department of health in consultation with
the Hawaii emergency medical systems of care advisory council; provided
that the county shall provide no fewer than twenty-one ground ambulance
units. The county may contract to
provide emergency medical services, including emergency [aeromedical] air-medical
services, or any necessary component of the county system."
SECTION 4. Section 321-221, Hawaii Revised Statutes, is amended to read as follows:
"§321-221 Findings and purpose. The legislature finds that the establishment
of [a] state emergency medical [services system,] systems of
care, including emergency medical services, emergency
medical services for children, and trauma and critical care services, is
a matter of compelling state interest and necessary to protect and preserve
public health. [A system] The
legislature further finds that a state emergency medical systems of care
designed to reduce medical emergency deaths, injuries, and permanent long-term
disability through the implementation of a fully integrated, cohesive network
of components[, the legislature further finds,] will best serve public
health needs. Accordingly, the purpose
of this part is to establish and maintain [a] state emergency medical [services
system] systems of care in communities that can be most effectively
served by the State[,] and [to] fix the responsibility for the
administration of [this] the state [system,] emergency
medical systems of care, which shall provide for the arrangement of
personnel, facilities, and equipment for the effective and coordinated delivery
of health care services under emergency conditions, whether occurring as the
result of a patient's condition, from natural disasters, or from other
causes. The [system] emergency
medical systems of care shall provide for personnel, personnel training,
communications, emergency transportation, facilities, coordination with
emergency medical and critical care services, coordination and use of available
public safety agencies, promotion of consumer participation, accessibility to
care, mandatory standard medical recordkeeping, consumer information and
education, independent review and evaluation, disaster linkage, mutual aid
agreements, and other components necessary to meet the purposes of this
part."
SECTION 5. Section 321-222, Hawaii Revised Statutes, is amended to read as follows:
"§321-222 Definitions. As used in this part, unless the context clearly requires otherwise:
"Advanced emergency medical technician" means a health care professional who holds a current certificate from the National Registry of Emergency Medical Technicians and is licensed pursuant to section 453-34 as an advanced emergency medical technician to provide basic and limited advanced emergency medical care and transportation for critical and emergency patients to access the emergency medical systems of care.
"Advanced life support" means initiating all basic life support care as well as invasive patient care designed to stabilize and support a patient's condition due to sudden illness or injury. The care rendered, excluding basic life support, constitutes the practice of medicine.
"Advisory [committee"] council"
means the Hawaii emergency medical [services] systems of care
advisory [committee.] council.
"Air-medical services" means medical care and transport of patients by aircraft provided by a licensed air ambulance operator with qualified medical personnel and regulated as part of the state emergency medical systems of care.
"Basic life support" means
initiating noninvasive emergency patient care designed to optimize the
patient's chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures [which] that
constitute the practice of medicine; provided that state-approved basic life
support personnel may use fully automatic external defibrillators, initiate
intravenous lines, place tourniquets, and perform manual external
defibrillation under the direction and personal supervision of a [mobile
intensive care technician] state-licensed clinician and in
accordance with rules adopted by the department.
"Department" means the department of health.
"Emergency [aeromedical] air-medical
services" means a [secondary] response system that provides
immediate critical care and transport [by rotary-wing aircraft] of a
patient by aircraft to a facility that provides specialized medical
care.
"Emergency medical responder" means a person certified by the National Registry of Emergency Medical Technicians.
"Emergency medical services for children" means emergency medical services, including preventive, pre-hospital, hospital, rehabilitative, and other post-hospital care for children.
"Emergency medical services
personnel" means any [mobile intensive care technician or emergency
medical technician] health care professional who is certified or
licensed by the State[.] to provide emergency medical services.
"Emergency medical systems of care" means a fully integrated and cohesive statewide network of components that provide timely and effective care to individuals experiencing crisis situations. Components of an emergency medical systems of care include but are not limited to community-based services, pre-hospital care, emergency response, facility-based care, disaster response, and other post-hospital services that support stabilization, treatment, and transport.
"Emergency medical technician" means a person who holds a certificate from the National Registry of Emergency Medical Technicians, who is licensed pursuant to section 453-34, and whose primary focus is to provide immediate lifesaving care to patients while ensuring access to the emergency medical systems of care.
"First responder personnel" means
a person who [has successfully completed a United States Department of
Transportation approved First Responder Course of training in emergency basic
life support.] provides initial assistance until emergency medical
services personnel arrive.
"Medicom" means the emergency medical systems of care medical communications that monitor statewide resource availability, emergency dispatch, hospital notifications, interfacility transfers, and disaster communications.
"Medicom center" means the centralized coordination place for medicom functions.
"Paramedic" means a mobile intensive care technician who is an allied health professional certified by the National Registry of Emergency Medical Technicians, who is licensed pursuant to section 453-34, and whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical systems of care.
"Service area" means the State, excluding any county having a population of five hundred thousand or more.
"State system" means the state [pre-hospital]
emergency medical [services system.] systems of care.
"Statewide" means all counties in the State."
SECTION 6. Section 321-224, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) In addition to other functions and duties assigned under this part, the department shall:
(1) Regulate ambulances and ambulance services statewide;
(2) Establish
emergency medical services throughout the service area, including emergency [aeromedical]
air-medical services, which shall meet the requirements of this part,
subject to section 321-228;
(3) Review
and approve the curricula and syllabi of training courses offered to emergency
medical services personnel statewide who provide basic, intermediate, and
advanced life support, consult and coordinate with the [University] university
of Hawaii, or any other accredited community college, college, or university,
or any professional organization that provides emergency medical services
training, regarding the training for basic, intermediate, and advanced life
support personnel, as provided in section 321-229;
(4) Collect
and evaluate data for the continued evaluation of the [statewide] state
emergency medical [services system,] systems of care, subject to
section 321-230;
(5) Coordinate, on a statewide basis, emergency medical resources and the allocation of emergency services and facilities in the event of mass casualties, natural disasters, national emergencies, and other emergencies, ensuring linkage to local, state, and national disaster plans, and participation in exercises to test these plans;
(6) Establish,
administer, and maintain a communication system [for the service area;] statewide,
including interoperability with organizations essential to core operations of
the state system;
(7) [Assist
each county in the service area in the] Oversee the development and
implementation of a statewide "911" emergency [telephone]
dispatch system;
(8) Secure technical assistance and other assistance and consultation necessary for the implementation of this part, subject to section 321-230;
(9) Implement public information and education programs to inform the public of the statewide system and its use, and disseminate other emergency medical information, including appropriate methods of medical self-help and first-aid, and the availability of first-aid training programs statewide;
(10) Establish standards and provide training for dispatchers in the state system, and maintain a program of quality assurance for dispatch equipment and operations; provided that individuals acting as dispatchers in the State as of July 1, 2022, shall obtain emergency medical dispatch certification by July 1, 2026, and shall maintain certification thereafter;
(11) Establish
a program that will enable emergency [service] medical services
personnel statewide to provide early defibrillation;
(12) Establish
[within the department the] and maintain emergency medical [service
system] services for children statewide;
(13) Consult
with the advisory [committee] council on matters relating to the
implementation of this part; and
(14) Establish and maintain statewide standards for emergency medical services course instructor qualifications and statewide requirements for emergency medical services training facilities."
SECTION 7. Section 321-224.4, Hawaii Revised Statutes, is amended to read as follows:
"§321-224.4 Community paramedicine and mobile integrated health care program; established. (a) The department shall establish and administer the community paramedicine and mobile integrated health care program within the service area.
(b) The department shall:
(1) Develop guidelines for community
paramedicine[;] and mobile integrated health care;
(2) Explore and develop partnerships with public and private health care entities, insurers, community colleges, colleges, universities, professional organizations, and community organizations; and
(3) Employ telehealth to enhance access and
improve [the] patient experience[.] within the community
paramedicine and mobile integrated health care program by enabling licensed
medical services personnel approved by the department to initiate and
facilitate real-time, asynchronous, and remote patient monitoring interactions
with health care providers, including consultative support from providers
located within or outside the State when conducted under approved department
program protocols and medical direction; provided that the department may adopt
rules pursuant to chapter 91 to establish standards for telehealth use.
(c) For purposes of this part,
"community paramedicine and mobile integrated health care
program" means an enhanced and expanded service in the state emergency
medical [services system] systems of care that allows
state-licensed health care professionals[,] and community health
workers, to assist with public health, primary care, and prevention services,
including services through telehealth.
(d) The department of health shall submit a report on the status of the community paramedicine and mobile integrated health care program, including an accounting of expenses and source of funds, to the legislature no later than twenty days prior to the convening of each regular session of the legislature.
(e) The department shall adopt rules pursuant to chapter 91 to effectuate the purposes of this section.
(f) The department may adopt interim rules, which
shall be exempt from chapter 91 and chapter 201M, to effectuate the purposes of
this section; provided that the interim rules shall remain in effect until July
1, [2023,] 2029, or until rules are adopted pursuant to
subsection (e), whichever occurs sooner."
SECTION 8. Section 321-225, Hawaii Revised Statutes, is amended to read as follows:
"§321-225 The [state] Hawaii emergency medical [services] systems
of care advisory [committee.] council. (a)
There is established within the department [of health] for
administrative purposes only the [state] Hawaii emergency medical
[services] systems of care advisory [committee,] council,
which shall sit in an advisory capacity to the department [of health] on
all matters relating to the state system.
The advisory [committee] council may advise the department
[of health] upon request of the department or upon its own initiative
with regard to the state system. The
advisory [committee] council shall:
(1) Monitor,
review, and evaluate on an ongoing basis the operations, administration, and
efficacy of the state system or any components thereof, to determine conformity
with and maximum implementation of this part[.];
(2) Prepare
and submit periodic assessments, reports, and other documents relating to the state system to ensure the
implementation of this part, as deemed necessary or desirable in the discretion
of the advisory [committee.] council;
(3) Seek
the input of the public in relation to the state system to ensure adequate
fulfillment of the emergency medical services, emergency medical services
for children, and trauma and critical care services needs of the State
consistent with this part[.];
(4) Participate
in any planning or other policymaking with regard to the state system, and seek
the participation of the public, including subarea health planning councils in
its consideration of plans and policies relating to the state system[.];
(5) Perform
other functions, and have other duties necessary to ensuring the fullest
implementation and maintenance of the state system[.]; and
(6) Advise
the department [of health] in formulating a master plan for the emergency
medical [services,] systems of care, including medicom, the
"911" system, and other components necessary to meet the emergency
medical needs of the people of the State, which shall be submitted to
the legislature.
(b)
The advisory [committee] council shall be composed of [twenty]
twenty-three members: [three]
four nonvoting ex-officio members, who shall be the director of
transportation, the [adjutant general,] administrator of emergency
management, the executive director of the 911 board, and the administrator
of the state health planning and development agency, or the designated
representatives thereof, and [seventeen] nineteen members
representing all counties of the State who shall be appointed by the governor
subject to section 26-34 as follows:
(1) Five
members who shall be physicians experienced in the conduct and delivery of
emergency medical services; provided that at least two shall be engaged in the
practice of emergency medicine and be board-eligible or board-certified by the
American Board of Emergency Medicine[, and]; provided further
that at least one physician shall be engaged in the practice of pediatrics and
be board-eligible or board-certified by the American Board of Pediatrics;
(2) Four members who shall be consumers of health care and who shall have no connection with or relationship to the health care system of the State and who shall be representative of all counties;
(3) Four
members of allied health professions related to emergency medical services; [and]
(4) Four
members, one from each county, who shall be mobile intensive care technicians
or emergency medical technicians engaged in the practice of pre-hospital
emergency medical [service.] services; and
(5) Two members who shall be surgeons or clinicians experienced in the conduct and delivery of trauma or acute care services.
(c)
The members of the advisory [committee] council shall
serve without compensation, but shall be reimbursed for necessary expenses
incurred in the performance of their duties, including travel expenses. The chairperson of the advisory [committee]
council shall be elected by the members from among their numbers. A majority of the members of the advisory [committee]
council shall constitute a quorum for the conduct of business of the
advisory [committee.] council.
A majority vote of the members present at a meeting at which a quorum is
established shall be necessary to validate any action of the [committee.]
council.
[(c)] (d) The advisory [committee] council
may adopt rules for its governance.
[(d)] (e) The department [of health] shall
provide necessary staff and other support required by the advisory [committee]
council for the performance of its duties."
SECTION 9. Section 321-228, Hawaii Revised Statutes, is amended to read as follows:
"§321-228 Emergency medical services; counties. The department shall determine, in
consultation with the advisory [committee] council under section
321-225, the levels of emergency medical services that shall be implemented in
each county within the service area. The
department may contract to provide emergency medical services, including
emergency [aeromedical] air-medical services, or any necessary
component of the emergency [services system of] medical systems of
care within a county within the service area in conformance with the state
system. If any county within the service
area [shall apply] applies to the department to operate state
emergency medical ambulance services within the respective county, the
department may contract with the county for the provision of those
services. The department shall operate
emergency medical ambulance services or contract with a private agency in those
counties within the service area that do not apply to it under this
section. Any county or private agency
contracting to provide emergency medical ambulance services under this section
shall be required by the department to implement those services in a manner and
at a level consistent with the levels determined under this section."
SECTION 10. Section 321-230, Hawaii Revised Statutes, is amended to read as follows:
"§321-230 Technical assistance[,]; data
collection[,]; evaluation.
(a) The department may contract
for technical assistance and consultation, including categorization, data
collection, and evaluation appropriate to the needs of the statewide emergency
medical [services system.] systems of care. The collection and analysis of statewide
emergency medical [services] systems of care data, including [pediatrics,
trauma,] behavioral medical, burn, cardiac, medical, pediatrics,
stroke, and [behavioral medical] trauma emergencies, shall be
for the purpose of improving the quality of services provided.
The department may implement and maintain a trauma registry for the collection of information concerning the treatment of critical trauma patients at state designated trauma centers, and carry out a system for the management of that information. The system may provide for the recording of information concerning treatment received before and after a trauma patient's admission to a hospital or medical center. All state designated trauma centers shall submit to the department periodic reports of each patient treated for trauma in the state system in the manner as the department shall specify.
For the purposes of this subsection, "categorization" means systematic identification of the readiness and capabilities of hospitals and their staffs to adequately, expeditiously, and efficiently receive and treat emergency patients.
(b)
The department shall establish, administer, and maintain an [aeromedical]
emergency [medical] air-medical services system designed to
collect and analyze data to measure the efficiency and effectiveness of each
phase of the statewide emergency [aeromedical] air-medical
program.
The department shall monitor [aeromedical]
air-medical emergency ambulance service flights statewide to include
date of service, patient demographics, transport diagnosis, and medical
outcomes. The department medicom
center shall work with each air-medical service provider and health
care facility as the intermediary to arrange emergency transport of [bariatric]
patients by licensed air-medical service providers, or by the United
States Coast Guard, and maintain a registry of all emergency transports
provided [by the United States Coast Guard]. All statewide [aeromedical] air-medical
service providers shall submit their data to the department as specified
and requested by the department.
The statewide [aeromedical]
emergency [medical] air-medical services system shall serve the
emergency health needs of the people of the State by identifying:
(1) The system's strengths and weaknesses;
(2) The allocation of resources; and
(3) The
development of [rotary-wing] emergency [aeromedical] air-medical
services standards;
provided
that emergency helicopter use, including triage protocols, shall be based on
national [aeromedical] air-medical triage and transport
guidelines established by the Association of Air Medical Services, the American
College of Surgeons, the National Association of Emergency Medical [Service]
Services Physicians, or other department-approved national [aeromedical]
air-medical accreditation agency.
The department, in the implementation of this subsection, shall plan,
coordinate, and provide assistance to all entities and agencies, public and
private, involved in the statewide system.
(c)
The department shall use an emergency [aeromedical services] air-medical
quality improvement committee comprised of representatives of trauma,
emergency, and tertiary care physicians and providers to analyze information
collected from the [aeromedical] air-medical quality improvement
performance measures as established by the [American College of Surgeons,]
department, and to recommend system standards and resources to maintain
and improve [the] Hawaii emergency [aeromedical] air-medical
services [system]."
SECTION 11. Section 321-231, Hawaii Revised Statutes, is amended to read as follows:
"[[]§321-231[]]
Grants. The state system may
seek and accept any funds or property and other desirable support and
assistance from any source whatsoever, whether gift, grant, services or any
combination thereof, subject to applicable laws. In the event that any grant applications are
made in relation to the state system, or any component thereof, the department
shall consult with the advisory [committee] council and provide
technical assistance in the preparation, management, or administration of the
application or the grant, or both."
SECTION 12. Sections 321-223 and 321-532, Hawaii Revised Statutes, and the title of chapter 321, part XVIII, Hawaii Revised Statutes, are amended by substituting the term "systems of care" wherever the term "services system" appears, as the context requires.
SECTION 13. Sections 46-191, 46-193, 46-198, and 321-235, Hawaii Revised Statutes, are amended by substituting the word "air-medical" wherever the word "aeromedical" appears, as the context requires.
SECTION 14. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 15. This Act shall take effect upon its approval.
Report Title:
Department of Health; State Emergency Medical Systems of Care; State Emergency Medical Services; Community Paramedicine Program; Integrated Mobile Health Care; Advisory Council
Description:
Modernizes Hawaii's emergency medical services laws to align with current best practices and adopt a time-sensitive emergency medical systems of care model. Expands the Community Paramedicine Program to include integrated mobile health care; permit additional partnerships with professional organizations and educational institutions; and authorize certain telehealth services by providers located in or out of the State, under certain circumstances. Renames the State Emergency Medical Services Advisory Council the Hawaii Emergency Medical Systems of Care Advisory Council and amends its membership. (CD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
2314 |
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THIRTY-THIRD LEGISLATURE, 2026 |
H.D. 2 |
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STATE OF HAWAII |
S.D. 1 |
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A BILL FOR AN ACT
RELATING TO EMERGENCY MEDICAL SYSTEMS OF CARE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature further finds that contemporary models of emergency and acute care prioritize integrated systems that address time-sensitive emergencies, such as burns, heart attacks, strokes, sepsis, and trauma, with the same urgency and structure as traditional emergency response. By adopting a time-sensitive emergency medical systems of care model, Hawaii can improve patient survival, reduce long-term disability, and strengthen statewide resilience in times of disaster or public health crisis.
Aligning Hawaii's emergency medical services laws with national best practices in systems integration will:
(1) Ensure coordinated, evidence-based care for time-sensitive emergencies across all islands;
(2) Modernize emergency medical services and trauma systems to meet current and future challenges;
(3) Improve patient outcomes through standardized, statewide protocols; and
(4) Enhance preparedness for future natural disasters, mass casualty incidents, and public health threats.
Accordingly, the purpose of this Act is to update Hawaii's emergency medical services laws to establish a comprehensive, time-sensitive emergency medical systems of care model that strengthens the State's capacity to respond effectively to emergencies and safeguard the health of the State's residents, living on all islands.
SECTION 2. Section 46-191, Hawaii Revised Statutes, is amended by amending the definition of "basic life support" to read as follows:
""Basic
life support" means initiating noninvasive emergency patient care designed
to optimize the patient's chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures that constitute the
practice of medicine; provided that state-approved basic life support personnel
may use fully automatic external defibrillators, initiate intravenous lines, place
tourniquets, and perform manual external defibrillation under the direction
and personal supervision of a [mobile intensive care technician.] state-licensed
clinician and in accordance with rules adopted by the department of health."
SECTION 3. Section 46-196, Hawaii Revised Statutes, is amended to read as follows:
"[[]§46-196[]] Emergency
medical services; levels of service; contracts. The county shall determine the levels of
emergency medical services that shall be implemented throughout the county[;],
unless otherwise determined by the department of health in consultation with
the Hawaii emergency medical systems of care advisory council; provided
that the county shall provide no fewer than twenty-one ground ambulance
units. The county may contract to
provide emergency medical services, including emergency aeromedical services,
or any necessary component of the county system."
SECTION 4. Section 321-221, Hawaii Revised Statutes, is amended to read as follows:
"§321-221 Findings and purpose. The legislature finds that the establishment
of [a] state emergency medical [services system,] systems of
care, including emergency medical services, emergency
medical services for children, and trauma and critical care services, is
a matter of compelling state interest and necessary to protect and preserve
public health. [A system] The
legislature further finds that state emergency medical systems of care
designed to reduce medical emergency deaths, injuries, and permanent long-term
disability through the implementation of a fully integrated, cohesive network
of components[, the legislature further finds,] will best serve public
health needs. Accordingly, the purpose
of this part is to establish and maintain [a] state emergency medical [services
system] systems of care in communities that can be most effectively
served by the State[,] and [to] fix the responsibility for the
administration of [this] state [system,] emergency medical
systems of care, which shall provide for the arrangement of personnel,
facilities, and equipment for the effective and coordinated delivery of health
care services under emergency conditions, whether occurring as the result of a
patient's condition, from natural disasters, or from other causes. The [system] emergency medical
systems of care shall provide for personnel, personnel training,
communications, emergency transportation, facilities, coordination with
emergency medical and critical care services, coordination and use of available
public safety agencies, promotion of consumer participation, accessibility to
care, mandatory standard medical recordkeeping, consumer information and
education, independent review and evaluation, disaster linkage, mutual aid
agreements, and other components necessary to meet the purposes of this part."
SECTION 5. Section 321-222, Hawaii Revised Statutes, is amended to read as follows:
"§321-222 Definitions. As used in this part, unless the context clearly requires otherwise:
"Advanced emergency medical technician" means a health care professional who holds a current certificate from the National Registry of Emergency Medical Technicians and is licensed pursuant to section 453-34 as an advanced emergency medical technician to provide basic and limited advanced emergency medical care and transportation for critical and emergency patients to access the emergency medical systems of care.
"Advanced life support" means initiating all basic life support care as well as invasive patient care designed to stabilize and support a patient's condition due to sudden illness or injury. The care rendered, excluding basic life support, constitutes the practice of medicine.
"Advisory [committee"] council"
means the Hawaii emergency medical [services] systems of care
advisory [committee.] council.
"Air-medical services" means medical care and transport of patients by aircraft provided by a licensed air ambulance operator with qualified medical personnel and regulated as part of the state emergency medical systems of care.
"Basic life support" means
initiating noninvasive emergency patient care designed to optimize the
patient's chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures [which] that
constitute the practice of medicine; provided that state-approved basic life
support personnel may use fully automatic external defibrillators, initiate
intravenous lines, place tourniquets, and perform manual external
defibrillation under the direction and personal supervision of a [mobile
intensive care technician] state-licensed clinician and in
accordance with rules adopted by the department.
"Department" means the department of health.
"Emergency [aeromedical] air-medical
services" means a [secondary] response system that provides
immediate critical care and transport [by rotary-wing aircraft] of a
patient by aircraft to a facility that provides specialized medical
care.
"Emergency medical responder" means a person certified by the National Registry of Emergency Medical Technicians.
"Emergency medical services for children" means emergency medical services, including preventive, pre-hospital, hospital, rehabilitative, and other post-hospital care for children.
"Emergency medical services
personnel" means any [mobile intensive care technician or emergency
medical technician] health care professional who is certified or
licensed by the State[.] to provide emergency medical services.
"Emergency medical systems of care" means a fully integrated and cohesive statewide network of components that provide timely and effective care to individuals experiencing crisis situations. Components of an emergency medical systems of care include but are not limited to community-based services, pre-hospital care, emergency response, facility-based care, disaster response, and other post-hospital services that support stabilization, treatment, and transport.
"Emergency medical technician" means a person who holds a certificate from the National Registry of Emergency Medical Technicians, who is licensed pursuant to section 453-34, and whose primary focus is to provide immediate lifesaving care to patients while ensuring access to the emergency medical systems of care.
"First responder personnel" means
a person who [has successfully completed a United States Department of
Transportation approved First Responder Course of training in emergency basic
life support.] provides initial assistance until emergency medical
services personnel arrive.
"Medicom" means the emergency medical systems of care medical communications that monitor statewide resource availability, emergency dispatch, hospital notifications, interfacility transfers, and disaster communications.
"Medicom center" means the centralized coordination place for medicom functions.
"Paramedic" means a mobile intensive care technician who is an allied health professional certified by the National Registry of Emergency Medical Technicians, who is licensed pursuant to section 453-34, and whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical systems of care.
"Service area" means the State, excluding any county having a population of five hundred thousand or more.
"State system" means the state [pre-hospital]
emergency medical [services system.] systems of care.
"Statewide" means all counties in the State."
SECTION 6. Section 321-224, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) In addition to other functions and duties assigned under this part, the department shall:
(1) Regulate ambulances and ambulance services statewide;
(2) Establish
emergency medical services throughout the service area, including emergency [aeromedical]
air-medical services, which shall meet the requirements of this part,
subject to section 321-228;
(3) Review
and approve the curricula and syllabi of training courses offered to emergency
medical services personnel statewide who provide basic, intermediate, and
advanced life support, consult and coordinate with the [University] university
of Hawaii, or any other accredited community college, college, or university,
or any professional organization that provides emergency medical services
training, regarding the training for basic, intermediate, and advanced life
support personnel, as provided in section 321-229;
(4) Collect
and evaluate data for the continued evaluation of the statewide emergency
medical [services system,] systems of care, subject to section
321-230;
(5) Coordinate, on a statewide basis, emergency medical resources and the allocation of emergency services and facilities in the event of mass casualties, natural disasters, national emergencies, and other emergencies, ensuring linkage to local, state, and national disaster plans, and participation in exercises to test these plans;
(6) Establish,
administer, and maintain a communication system [for the service area;] statewide,
including interoperability with organizations essential to core operations of
the state system;
(7) [Assist
each county in the service area in the] Oversee the development and
implementation of a statewide "911" emergency [telephone]
dispatch system;
(8) Secure technical assistance and other assistance and consultation necessary for the implementation of this part, subject to section 321-230;
(9) Implement public information and education programs to inform the public of the statewide system and its use, and disseminate other emergency medical information, including appropriate methods of medical self-help and first-aid, and the availability of first-aid training programs statewide;
(10) Establish standards and provide training for dispatchers in the state system, and maintain a program of quality assurance for dispatch equipment and operations; provided that individuals acting as dispatchers in the State as of July 1, 2022, shall obtain emergency medical dispatch certification by July 1, 2026, and shall maintain certification thereafter;
(11) Establish
a program that will enable emergency [service] medical services
personnel statewide to provide early defibrillation;
(12) Establish
[within the department the] and maintain emergency medical [service
system] services for children statewide;
(13) Consult
with the advisory [committee] council on matters relating to the
implementation of this part; and
(14) Establish and maintain statewide standards for emergency medical services course instructor qualifications and statewide requirements for emergency medical services training facilities."
SECTION 7. Section 321-224.4, Hawaii Revised Statutes, is amended to read as follows:
"§321-224.4 Community paramedicine and mobile integrated health care program; established. (a) The department shall establish and administer the community paramedicine and mobile integrated health care program within the service area.
(b) The department shall:
(1) Develop guidelines for community
paramedicine[;] and mobile integrated health care;
(2) Explore and develop partnerships with public and private health care entities, insurers, community colleges, colleges, universities, professional organizations, and community organizations; and
(3) Employ telehealth to enhance access and
improve [the] patient experience[.] within the community paramedicine
and mobile integrated health care program by enabling licensed medical services
personnel approved by the department to initiate and facilitate real-time,
asynchronous, and remote patient monitoring interactions with health care
providers, including consultative support from providers located within or
outside the State when conducted under approved department program protocols
and medical direction; provided that the department may adopt rules pursuant to
chapter 91 to establish standards for telehealth use.
(c) For purposes of this part,
"community paramedicine and mobile integrated health care
program" means an enhanced and expanded service in the state emergency
medical [services system] systems of care that allows
state-licensed health care professionals, and community health workers, to
assist with public health, primary care, and prevention services, including
services through telehealth.
(d) The department of health shall submit a report on the status of the community paramedicine and mobile integrated health care program, including an accounting of expenses and source of funds, to the legislature no later than twenty days prior to the convening of each regular session of the legislature.
(e) The department shall adopt rules pursuant to chapter 91 to effectuate the purposes of this section.
(f) The department may adopt interim rules, which
shall be exempt from chapter 91 and chapter 201M, to effectuate the purposes of
this section; provided that the interim rules shall remain in effect until July
1, [2023,] 2029, or until rules are adopted pursuant to
subsection (e), whichever occurs sooner."
SECTION 8. Section 321-225, Hawaii Revised Statutes, is amended to read as follows:
"§321-225 The [state] Hawaii emergency medical [services] systems
of care advisory [committee.] council. (a)
There is established within the department [of health] for
administrative purposes only the [state] Hawaii emergency medical
[services] systems of care advisory [committee,] council,
which shall sit in an advisory capacity to the department [of health] on
all matters relating to the state system.
The advisory [committee] council may advise the department
[of health] upon request of the department or upon its own initiative
with regard to the state system. The
advisory [committee] council shall:
(1) Monitor,
review, and evaluate on an ongoing basis the operations, administration, and
efficacy of the state system or any components thereof, to determine conformity
with and maximum implementation of this part[.];
(2) Prepare
and submit periodic assessments, reports, and other documents relating to the state system to ensure the
implementation of this part, as deemed necessary or desirable in the discretion
of the advisory [committee.] council;
(3) Seek
the input of the public in relation to the state system to ensure adequate
fulfillment of the emergency medical services, emergency medical services
for children, and trauma and critical care services needs of the State
consistent with this part[.];
(4) Participate
in any planning or other policymaking with regard to the state system, and seek
the participation of the public, including subarea health planning councils in
its consideration of plans and policies relating to the state system[.];
(5) Perform
other functions, and have other duties necessary to ensuring the fullest
implementation and maintenance of the state system[.]; and
(6) Advise
the department [of health] in formulating a master plan for emergency
medical [services,] systems of care, including medicom, the
"911" system, and other components necessary to meet the emergency
medical needs of the people of the State, which shall be submitted to
the legislature.
(b)
The advisory [committee] council shall be composed of [twenty]
twenty-three members: [three] four nonvoting ex-officio
members, who shall be the director of transportation, the [adjutant general,]
administrator of emergency management, the executive director of the 911
board, and the administrator of the state health planning and development
agency, or the designated representatives thereof, and [seventeen] nineteen
members representing all counties of the State who shall be appointed by the
governor subject to section 26-34 as follows:
(1) Five
members who shall be physicians experienced in the conduct and delivery of
emergency medical services; provided that at least two shall be engaged in the
practice of emergency medicine and be board-eligible or board-certified by the
American Board of Emergency Medicine[, and]; provided further
that at least one physician shall be engaged in the practice of pediatrics and
be board-eligible or board-certified by the American Board of Pediatrics;
(2) Four members who shall be consumers of health care and who shall have no connection with or relationship to the health care system of the State and who shall be representative of all counties;
(3) Four
members of allied health professions related to emergency medical services; [and]
(4) Four
members, one from each county, who shall be mobile intensive care technicians
or emergency medical technicians engaged in the practice of pre-hospital
emergency medical [service.] services; and
(5) Two members who shall be surgeons or clinicians experienced in the conduct and delivery of trauma or acute care services.
(c)
The members of the advisory [committee] council shall
serve without compensation, but shall be reimbursed for necessary expenses
incurred in the performance of their duties, including travel expenses. The chairperson of the advisory [committee]
council shall be elected by the members from among their numbers. A majority of the members of the advisory [committee]
council shall constitute a quorum for the conduct of business of the
advisory [committee.] council.
A majority vote of the members present at a meeting at which a quorum is
established shall be necessary to validate any action of the [committee.]
council.
[(c)] (d) The advisory [committee] council
may adopt rules for its governance.
[(d)] (e) The department [of health] shall
provide necessary staff and other support required by the advisory [committee]
council for the performance of its duties."
SECTION 9. Section 321-228, Hawaii Revised Statutes, is amended to read as follows:
"§321-228 Emergency medical services; counties. The department shall determine, in
consultation with the advisory [committee] council under section
321-225, the levels of emergency medical services that shall be implemented in
each county within the service area. The
department may contract to provide emergency medical services, including
emergency [aeromedical] air-medical services, or any necessary
component of the emergency [services system of] medical systems of
care within a county within the service area in conformance with the state
system. If any county within the service
area [shall apply] applies to the department to operate state
emergency medical ambulance services within the respective county, the
department may contract with the county for the provision of those
services. The department shall operate
emergency medical ambulance services or contract with a private agency in those
counties within the service area that do not apply to it under this
section. Any county or private agency
contracting to provide emergency medical ambulance services under this section
shall be required by the department to implement those services in a manner and
at a level consistent with the levels determined under this section."
SECTION 10. Section 321-230, Hawaii Revised Statutes, is amended to read as follows:
"§321-230 Technical assistance[,]; data
collection[,]; evaluation.
(a) The department may contract
for technical assistance and consultation, including categorization, data
collection, and evaluation appropriate to the needs of the statewide emergency
medical [services system.] systems of care. The collection and analysis of statewide
emergency medical [services] systems of care data, including [pediatrics,
trauma,] behavioral medical, burn, cardiac, medical, pediatrics,
stroke, and [behavioral medical] trauma emergencies, shall be
for the purpose of improving the quality of services provided.
The department may implement and maintain a trauma registry for the collection of information concerning the treatment of critical trauma patients at state designated trauma centers, and carry out a system for the management of that information. The system may provide for the recording of information concerning treatment received before and after a trauma patient's admission to a hospital or medical center. All state designated trauma centers shall submit to the department periodic reports of each patient treated for trauma in the state system in the manner as the department shall specify.
For the purposes of this subsection, "categorization" means systematic identification of the readiness and capabilities of hospitals and their staffs to adequately, expeditiously, and efficiently receive and treat emergency patients.
(b)
The department shall establish, administer, and maintain an [aeromedical]
emergency [medical] air-medical services system designed to
collect and analyze data to measure the efficiency and effectiveness of each
phase of the statewide emergency [aeromedical] air-medical
program.
The department shall monitor [aeromedical]
air-medical emergency ambulance service flights statewide to include
date of service, patient demographics, transport diagnosis, and medical
outcomes. The department medicom
center shall work with each air-medical service provider and health
care facility as the intermediary to arrange emergency transport of [bariatric]
patients by licensed air-medical service providers, or by the United
States Coast Guard, and maintain a registry of all emergency transports
provided [by the United States Coast Guard]. All statewide [aeromedical] air-medical
service providers shall submit their data to the department as specified
and requested by the department.
The statewide [aeromedical]
emergency [medical] air-medical
services system shall serve the emergency health needs of the people of
the State by identifying:
(1) The system's strengths and weaknesses;
(2) The allocation of resources; and
(3) The
development of [rotary-wing] emergency [aeromedical] air-medical
services standards;
provided
that emergency helicopter use, including triage protocols, shall be based on
national [aeromedical] air-medical triage and transport
guidelines established by the Association of Air Medical Services, the American
College of Surgeons, the National Association of Emergency Medical [Service]
Services Physicians, or other department-approved national [aeromedical]
air-medical accreditation agency.
The department, in the implementation of this subsection, shall plan,
coordinate, and provide assistance to all entities and agencies, public and
private, involved in the statewide system.
(c)
The department shall use an emergency [aeromedical services]
air-medical quality improvement committee comprised of representatives
of trauma, emergency, and tertiary care physicians and providers to analyze
information collected from the [aeromedical] air-medical quality
improvement performance measures as established by the [American College of
Surgeons,] department, and to recommend system standards and
resources to maintain and improve [the] Hawaii emergency [aeromedical]
air-medical services [system]."
SECTION 11. Section 321-231, Hawaii Revised Statutes, is amended to read as follows:
"[[]§321-231[]]
Grants. The state system may
seek and accept any funds or property and other desirable support and
assistance from any source whatsoever, whether gift, grant, services or any
combination thereof, subject to applicable laws. In the event that any grant applications are
made in relation to the state system, or any component thereof, the department
shall consult with the advisory [committee] council and provide
technical assistance in the preparation, management, or administration of the
application or the grant, or both."
SECTION 12. Sections 321-223 and 321-532, Hawaii Revised Statutes, and the title of chapter 321, part XVIII, Hawaii Revised Statutes, are amended by substituting the term "systems of care" wherever the term "services system" appears, as the context requires.
SECTION 13. Sections 46-191, 46-193, 46-196, 46-198, and 321-235, Hawaii Revised Statutes, are amended by substituting the word "air-medical" wherever the word "aeromedical" appears, as the context requires.
SECTION 14. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 15. This Act shall take effect on July 1, 3000.
Report Title:
Department of Health; State Emergency Medical Services System; Systems of Care
Description:
Modernizes Hawaii's emergency medical services laws to align with current best practices. Effective 7/1/3000. (SD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
2314 |
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THIRTY-THIRD LEGISLATURE, 2026 |
H.D. 2 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO EMERGENCY MEDICAL SYSTEMS OF CARE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature further finds that contemporary models of emergency and acute care prioritize integrated systems that address time-sensitive emergencies, such as burns, heart attacks, strokes, sepsis, and trauma, with the same urgency and structure as traditional emergency response. By adopting a time-sensitive emergency medical systems of care model, Hawaii can improve patient survival, reduce long-term disability, and strengthen statewide resilience in times of disaster or public health crisis.
Aligning Hawaii's emergency medical services laws with national best practices in systems integration will:
(1) Ensure coordinated, evidence-based care for time-sensitive emergencies across all islands;
(2) Modernize emergency medical services and trauma systems to meet current and future challenges;
(3) Improve patient outcomes through standardized, statewide protocols; and
(4) Enhance preparedness for future natural disasters, mass casualty incidents, and public health threats.
Accordingly, the purpose of this Act is to update Hawaii's emergency medical services laws to establish a comprehensive, time-sensitive emergency medical systems of care model that strengthens the State's capacity to respond effectively to emergencies and safeguard the health of the State's residents, living on all islands.
SECTION 2. Section 46-191, Hawaii Revised Statutes, is amended by amending the definition of "basic life support" to read as follows:
""Basic
life support" means initiating noninvasive emergency patient care designed
to optimize the patient's chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures that constitute the
practice of medicine; provided that state-approved basic life support personnel
may use fully automatic external defibrillators, initiate intravenous lines, place
tourniquets, and perform manual external defibrillation under the direction
and personal supervision of a [mobile intensive care technician.] state-licensed
clinician and in accordance with rules adopted by the department of health."
SECTION 3. Section 46-196, Hawaii Revised Statutes, is amended to read as follows:
"[[]§46-196[]] Emergency
medical services; levels of service; contracts. The county shall determine the levels of
emergency medical services that shall be implemented throughout the county[;],
unless otherwise determined by the department of health in consultation with
the Hawaii emergency medical systems of care advisory council; provided
that the county shall provide no fewer than twenty-one ground ambulance
units. The county may contract to
provide emergency medical services, including emergency aeromedical services,
or any necessary component of the county system."
SECTION 4. Section 321-221, Hawaii Revised Statutes, is amended to read as follows:
"§321-221 Findings and purpose. The legislature finds that the establishment
of [a] state emergency medical [services system,] systems of
care, including emergency medical services, emergency
medical services for children, and trauma and critical care services, is
a matter of compelling state interest and necessary to protect and preserve
public health. [A system] The
legislature further finds that state emergency medical systems of care
designed to reduce medical emergency deaths, injuries, and permanent long-term
disability through the implementation of a fully integrated, cohesive network
of components[, the legislature further finds,] will best serve public
health needs. Accordingly, the purpose
of this part is to establish and maintain [a] state emergency medical [services
system] systems of care in communities that can be most effectively
served by the State[,] and [to] fix the responsibility for the
administration of [this] state [system,] emergency medical
systems of care, which shall provide for the arrangement of personnel,
facilities, and equipment for the effective and coordinated delivery of health
care services under emergency conditions, whether occurring as the result of a
patient's condition, from natural disasters, or from other causes. The [system] emergency medical
systems of care shall provide for personnel, personnel training,
communications, emergency transportation, facilities, coordination with
emergency medical and critical care services, coordination and use of available
public safety agencies, promotion of consumer participation, accessibility to
care, mandatory standard medical recordkeeping, consumer information and
education, independent review and evaluation, disaster linkage, mutual aid
agreements, and other components necessary to meet the purposes of this
part."
SECTION 5. Section 321-222, Hawaii Revised Statutes, is amended to read as follows:
"§321-222 Definitions. As used in this part, unless the context clearly requires otherwise:
"Advanced emergency medical technician" means a health care professional who holds a current certificate from the National Registry of Emergency Medical Technicians and is licensed pursuant to section 453-34 as an advanced emergency medical technician to provide basic and limited advanced emergency medical care and transportation for critical and emergency patients to access the emergency medical systems of care.
"Advanced life support" means initiating all basic life support care as well as invasive patient care designed to stabilize and support a patient's condition due to sudden illness or injury. The care rendered, excluding basic life support, constitutes the practice of medicine.
"Advisory [committee"] council"
means the Hawaii emergency medical [services] systems of care
advisory [committee.] council.
"Air-medical services" means medical care and transport of patients by aircraft provided by a licensed air ambulance operator with qualified medical personnel and regulated as part of the state emergency medical systems of care.
"Basic life support" means
initiating noninvasive emergency patient care designed to optimize the
patient's chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures [which] that
constitute the practice of medicine; provided that state-approved basic life
support personnel may use fully automatic external defibrillators, initiate
intravenous lines, place tourniquets, and perform manual external
defibrillation under the direction and personal supervision of a [mobile
intensive care technician] state-licensed clinician and in
accordance with rules adopted by the department.
"Department" means the department of health.
"Emergency [aeromedical] air-medical
services" means a [secondary] response system that provides
immediate critical care and transport [by rotary-wing aircraft] of a
patient by aircraft to a facility that provides specialized medical
care.
"Emergency medical responder" means a person certified by the National Registry of Emergency Medical Technicians.
"Emergency medical services for children" means emergency medical services, including preventive, pre-hospital, hospital, rehabilitative, and other post-hospital care for children.
"Emergency medical services
personnel" means any [mobile intensive care technician or emergency
medical technician] health care professional who is certified or
licensed by the State[.] to provide emergency medical services.
"Emergency medical systems of care" means a fully integrated and cohesive statewide network of components that provide timely and effective care to individuals experiencing crisis situations. Components of an emergency medical systems of care include but are not limited to community-based services, pre-hospital care, emergency response, facility-based care, disaster response, and other post-hospital services that support stabilization, treatment, and transport.
"Emergency medical technician" means a person who holds a certificate from the National Registry of Emergency Medical Technicians, who is licensed pursuant to section 453-34, and whose primary focus is to provide immediate lifesaving care to patients while ensuring access to the emergency medical systems of care.
"First responder personnel" means
a person who [has successfully completed a United States Department of
Transportation approved First Responder Course of training in emergency basic
life support.] provides initial assistance until emergency medical
services personnel arrive.
"Medicom" means the emergency medical systems of care medical communications that monitor statewide resource availability, emergency dispatch, hospital notifications, interfacility transfers, and disaster communications.
"Medicom center" means the centralized coordination place for medicom functions.
"Paramedic" means a mobile intensive care technician who is an allied health professional certified by the National Registry of Emergency Medical Technicians, who is licensed pursuant to section 453-34, and whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical systems of care.
"Service area" means the State, excluding any county having a population of five hundred thousand or more.
"State system" means the state [pre-hospital]
emergency medical [services system.] systems of care.
"Statewide" means all counties in the State."
SECTION 6. Section 321-224, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) In addition to other functions and duties assigned under this part, the department shall:
(1) Regulate ambulances and ambulance services statewide;
(2) Establish
emergency medical services throughout the
service area, including emergency [aeromedical] air-medical
services, which shall meet the requirements of this part, subject to section
321-228;
(3) Review
and approve the curricula and syllabi of training courses offered to emergency
medical services personnel statewide who provide basic, intermediate, and
advanced life support, consult and coordinate with the [University] university
of Hawaii, or any other accredited community college, college, or university,
or any professional organization that provides emergency medical services
training, regarding the training for basic, intermediate, and advanced life
support personnel, as provided in section 321-229;
(4) Collect
and evaluate data for the continued evaluation of the statewide emergency
medical [services system,] systems of care, subject to section
321-230;
(5) Coordinate, on a statewide basis, emergency medical resources and the allocation of emergency services and facilities in the event of mass casualties, natural disasters, national emergencies, and other emergencies, ensuring linkage to local, state, and national disaster plans, and participation in exercises to test these plans;
(6) Establish,
administer, and maintain a communication system [for the service area;] statewide,
including interoperability with organizations essential to core operations of
the state system;
(7) [Assist
each county in the service area in the] Oversee the development and
implementation of a statewide "911" emergency [telephone]
dispatch system;
(8) Secure technical assistance and other assistance and consultation necessary for the implementation of this part, subject to section 321-230;
(9) Implement public information and education programs to inform the public of the statewide system and its use, and disseminate other emergency medical information, including appropriate methods of medical self-help and first-aid, and the availability of first-aid training programs statewide;
(10) Establish standards and provide training for dispatchers in the state system, and maintain a program of quality assurance for dispatch equipment and operations; provided that individuals acting as dispatchers in the State as of July 1, 2022, shall obtain emergency medical dispatch certification by July 1, 2026, and shall maintain certification thereafter;
(11) Establish
a program that will enable emergency [service] medical services
personnel statewide to provide early defibrillation;
(12) Establish
[within the department the] and maintain emergency medical [service
system] services for children statewide;
(13) Consult
with the advisory [committee] council on matters relating to the
implementation of this part; and
(14) Establish and maintain statewide standards for emergency medical services course instructor qualifications and statewide requirements for emergency medical services training facilities."
SECTION 7. Section 321-225, Hawaii Revised Statutes, is amended to read as follows:
"§321-225 The [state] Hawaii emergency medical [services] systems
of care advisory [committee.] council. (a)
There is established within the department [of health] for
administrative purposes only the [state] Hawaii emergency medical
[services] systems of care advisory [committee,] council,
which shall sit in an advisory capacity to the department [of health] on
all matters relating to the state system.
The advisory [committee] council may advise the department
[of health] upon request of the department or upon its own initiative
with regard to the state system. The
advisory [committee] council shall:
(1) Monitor,
review, and evaluate on an ongoing basis the operations, administration, and
efficacy of the state system or any components thereof, to determine conformity
with and maximum implementation of this part[.];
(2) Prepare
and submit periodic assessments, reports, and other documents relating to the state system to ensure the
implementation of this part, as deemed necessary or desirable in the discretion
of the advisory [committee.] council;
(3) Seek
the input of the public in relation to the state system to ensure adequate
fulfillment of the emergency medical services, emergency medical services
for children, and trauma and critical care services needs of the State
consistent with this part[.];
(4) Participate
in any planning or other policymaking with regard to the state system, and seek
the participation of the public, including subarea health planning councils in
its consideration of plans and policies relating to the state system[.];
(5) Perform
other functions, and have other duties necessary to ensuring the fullest
implementation and maintenance of the state system[.]; and
(6) Advise
the department [of health] in formulating a master plan for emergency
medical [services,] systems of care, including medicom, the
"911" system, and other components necessary to meet the emergency
medical needs of the people of the State, which shall be submitted to
the legislature.
(b)
The advisory [committee] council shall be composed of [twenty]
twenty-three members: [three] four nonvoting ex-officio
members, who shall be the director of transportation, the [adjutant general,]
administrator of emergency management, the executive director of the Hawaii 911
board, and the administrator of the state health planning and development
agency, or the designated representatives thereof, and [seventeen] nineteen
members representing all counties of the State who shall be appointed by the
governor subject to section 26-34 as follows:
(1) Five
members who shall be physicians experienced in the conduct and delivery of
emergency medical services; provided that at least two shall be engaged in the
practice of emergency medicine and be board-eligible or board-certified by the
American Board of Emergency Medicine[, and]; provided further
that at least one physician shall be engaged in the practice of pediatrics and
be board-eligible or board-certified by the American Board of Pediatrics;
(2) Four members who shall be consumers of health care and who shall have no connection with or relationship to the health care system of the State and who shall be representative of all counties;
(3) Four
members of allied health professions related to emergency medical services; [and]
(4) Four
members, one from each county, who shall be mobile intensive care technicians
or emergency medical technicians engaged in the practice of pre-hospital
emergency medical [service.] services; and
(5) Two members who shall be surgeons or clinicians experienced in the conduct and delivery of trauma or acute care services.
(c)
The members of the advisory [committee] council shall
serve without compensation, but shall be reimbursed for necessary expenses
incurred in the performance of their duties, including travel expenses. The chairperson of the advisory [committee]
council shall be elected by the members from among their numbers. A majority of the members of the advisory [committee]
council shall constitute a quorum for the conduct of business of the
advisory [committee.] council.
A majority vote of the members present at a meeting at which a quorum is
established shall be necessary to validate any action of the [committee.]
council.
[(c)] (d) The advisory [committee] council
may adopt rules for its governance.
[(d)] (e) The department [of health] shall
provide necessary staff and other support required by the advisory [committee]
council for the performance of its duties."
SECTION 8. Section 321-228, Hawaii Revised Statutes, is amended to read as follows:
"§321-228 Emergency medical services; counties. The department shall determine, in
consultation with the advisory [committee] council under section
321-225, the levels of emergency medical services that shall be implemented in
each county within the service area. The
department may contract to provide emergency medical services, including
emergency [aeromedical] air-medical services, or any necessary
component of the emergency [services system of] medical systems of
care within a county within the service area in conformance with the state
system. If any county within the service
area [shall apply] applies to the department to operate state
emergency medical ambulance services within the respective county, the
department may contract with the county for the provision of those
services. The department shall operate
emergency medical ambulance services or contract with a private agency in those
counties within the service area that do not apply to it under this
section. Any county or private agency
contracting to provide emergency medical ambulance services under this section
shall be required by the department to implement those services in a manner and
at a level consistent with the levels determined under this section."
SECTION 9. Section 321-230, Hawaii Revised Statutes, is amended to read as follows:
"§321-230 Technical assistance[,]; data
collection[,]; evaluation.
(a) The department may contract
for technical assistance and consultation, including categorization, data
collection, and evaluation appropriate to the needs of the statewide emergency
medical [services system.] systems of care. The collection and analysis of statewide
emergency medical [services] systems of care data, including [pediatrics,
trauma,] behavioral medical, burn, cardiac, medical, pediatrics,
stroke, and [behavioral medical] trauma emergencies, shall be
for the purpose of improving the quality of services provided.
The department may implement and maintain a trauma registry for the collection of information concerning the treatment of critical trauma patients at state designated trauma centers, and carry out a system for the management of that information. The system may provide for the recording of information concerning treatment received before and after a trauma patient's admission to a hospital or medical center. All state designated trauma centers shall submit to the department periodic reports of each patient treated for trauma in the state system in the manner as the department shall specify.
For the purposes of this subsection, "categorization" means systematic identification of the readiness and capabilities of hospitals and their staffs to adequately, expeditiously, and efficiently receive and treat emergency patients.
(b)
The department shall establish, administer, and maintain an [aeromedical]
emergency [medical] air-medical services system designed to
collect and analyze data to measure the efficiency and effectiveness of each
phase of the statewide emergency [aeromedical] air-medical
program.
The department shall monitor [aeromedical]
air-medical emergency ambulance service flights statewide to include
date of service, patient demographics, transport diagnosis, and medical
outcomes. The department medicom
center shall work with each air-medical service provider and health
care facility as the intermediary to arrange emergency transport of [bariatric]
patients by licensed air-medical service providers, or by the United
States Coast Guard, and maintain a registry of all emergency transports
provided [by the United States Coast Guard]. All statewide [aeromedical] air-medical
service providers shall submit their data to the department as specified
and requested by the department.
The statewide [aeromedical]
emergency [medical] air-medical
services system shall serve the emergency health needs of the people of
the State by identifying:
(1) The system's strengths and weaknesses;
(2) The allocation of resources; and
(3) The
development of [rotary-wing] emergency [aeromedical] air-medical
services standards;
provided
that emergency helicopter use, including triage protocols, shall be based on
national [aeromedical] air-medical triage and transport
guidelines established by the Association of Air Medical Services, the American
College of Surgeons, the National Association of Emergency Medical [Service]
Services Physicians, or other department-approved national [aeromedical]
air-medical accreditation agency.
The department, in the implementation of this subsection, shall plan,
coordinate, and provide assistance to all entities and agencies, public and
private, involved in the statewide system.
(c)
The department shall use an emergency [aeromedical services]
air-medical quality improvement committee comprised of representatives
of trauma, emergency, and tertiary care physicians and providers to analyze
information collected from the [aeromedical] air-medical quality
improvement performance measures as established by the [American College of
Surgeons,] department, and to recommend system standards and
resources to maintain and improve [the] Hawaii emergency [aeromedical]
air-medical services [system]."
SECTION 10. Section 321-231, Hawaii Revised Statutes, is amended to read as follows:
"[[]§321-231[]]
Grants. The state system may
seek and accept any funds or property and other desirable support and
assistance from any source whatsoever, whether gift, grant, services or any
combination thereof, subject to applicable laws. In the event that any grant applications are
made in relation to the state system, or any component thereof, the department
shall consult with the advisory [committee] council and provide
technical assistance in the preparation, management, or administration of the
application or the grant, or both."
SECTION 11. Sections 321-223, 321-224.4, and 321-532, Hawaii Revised Statutes, and the title of chapter 321, part XVIII, Hawaii Revised Statutes, are amended by substituting the term "systems of care" wherever the term "services system" appears, as the context requires.
SECTION 12. Sections 46-191, 46-193, 46-196, 46-198, and 321-235, Hawaii Revised Statutes, are amended by substituting the word "air-medicine" wherever the word "aeromedical" appears, as the context requires.
SECTION 13. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 14. This Act shall take effect on July 1, 3000.
Report Title:
Department of Health; State Emergency Medical Services System; Systems of Care
Description:
Modernizes Hawaii's emergency medical services laws to align with current best practices. Effective 7/1/3000. (HD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
2314 |
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THIRTY-THIRD LEGISLATURE, 2026 |
H.D. 1 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO EMERGENCY MEDICAL SYSTEMS OF CARE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature further finds that contemporary models of emergency and acute care prioritize integrated systems that address time-sensitive emergencies such as trauma, heart attacks, strokes, sepsis, and burns with the same urgency and structure as traditional emergency response. By adopting a time-sensitive emergency medical systems of care model, Hawaii can improve patient survival, reduce long-term disability, and strengthen statewide resilience in times of disaster or public health crisis.
Aligning Hawaii's emergency medical services laws with national best practices in systems integration will:
(1) Ensure coordinated, evidence-based care for time-sensitive emergencies across all islands;
(2) Modernize emergency medical services and trauma systems to meet current and future challenges;
(3) Improve patient outcomes through standardized, statewide protocols; and
(4) Enhance preparedness for future natural disasters, mass casualty incidents, and public health threats.
Accordingly, the purpose of this Act is to update Hawaii's emergency medical services laws to establish a comprehensive, time-sensitive emergency medical systems of care model that strengthens the State's capacity to respond effectively to emergencies and safeguard the health of our residents, living on all islands.
SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by amending the title of part XVIII to read as follows;
"PART XVIII.
STATE EMERGENCY MEDICAL [SERVICES SYSTEM] SYSTEMS OF CARE"
SECTION 3. Section 321-221, Hawaii Revised Statutes, is amended to read as follows:
"§321-221 Findings and purpose. The legislature finds that the establishment
of [a] state emergency medical [services system,] systems of
care, including emergency medical services, emergency
medical services for children, and trauma and critical care services is
a matter of compelling state interest and necessary to protect and preserve
public health. [A system] The
legislature further finds that state emergency medical systems of care
designed to reduce medical emergency deaths, injuries, and permanent long-term
disability through the implementation of a fully integrated, cohesive network
of components[, the legislature further finds,] will best serve public
health needs. Accordingly, the purpose
of this part is to establish and maintain [a] state emergency medical [services
system] systems of care in communities that can be most effectively
served by the State[,] and [to] fix the responsibility for the
administration of [this] state [system,] emergency medical
systems of care, which shall provide for the arrangement of personnel,
facilities, and equipment for the effective and coordinated delivery of health
care services under emergency conditions, whether occurring as the result of a
patient's condition, from natural disasters, or from other causes. The [system] emergency medical
systems of care shall provide for personnel, personnel training,
communications, emergency transportation, facilities, coordination with
emergency medical and critical care services, coordination and use of available
public safety agencies, promotion of consumer participation, accessibility to
care, mandatory standard medical recordkeeping, consumer information and
education, independent review and evaluation, disaster linkage, mutual aid
agreements, and other components necessary to meet the purposes of this
part."
SECTION 4. Section 321-222, Hawaii Revised Statutes, is amended to read as follows:
"§321-222 Definitions. As used in this part, unless the context clearly requires otherwise:
"Advanced emergency medical technician" means a health care professional who holds a current certificate from the National Registry of Emergency Medical Technicians and is licensed pursuant to section 453-34 as an advanced emergency medical technician to provide basic and limited advanced emergency medical care and transportation for critical and emergency patients to access the emergency medical systems of care.
"Advanced life support" means initiating all basic life support care as well as invasive patient care designed to stabilize and support a patient's condition due to sudden illness or injury. The care rendered, excluding basic life support, constitutes the practice of medicine.
"Advisory [committee"] council"
means the Hawaii emergency medical [services] systems of care
advisory [committee.] council.
"Air-medical services" means medical care and transport of patients by aircraft provided by a licensed air ambulance operator with qualified medical personnel and regulated as part of the state emergency medical systems of care.
"Basic life support" means
initiating noninvasive emergency patient care designed to optimize the
patient's chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures [which] that
constitute the practice of medicine; provided that state-approved basic life
support personnel may use fully automatic external defibrillators, initiate
intravenous lines, place tourniquets, and perform manual external
defibrillation under the direction and personal supervision of a [mobile
intensive care technician] state-licensed clinician and in
accordance with rules adopted by the department.
"Department" means the department of health.
"Emergency [aeromedical] air-medical
services" means a [secondary] response system that provides
immediate critical care and transport [by rotary-wing aircraft] of a
patient by aircraft to a facility that provides specialized medical
care.
"Emergency medical responder" means a person certified by the National Registry of Emergency Medical Technicians.
"Emergency medical services for children" means emergency medical services, including preventive, pre-hospital, hospital, rehabilitative, and other post-hospital care for children.
"Emergency medical services
personnel" means any [mobile intensive care technician or emergency
medical technician] health care professional who is certified or licensed by the State[.]
to provide emergency medical services.
"Emergency medical systems of care" means a fully integrated and cohesive statewide network of components that provide timely and effective care to individuals experiencing crisis situations. Components of an emergency medical systems of care include but are not limited to community-based services, pre-hospital care, emergency response, facility-based care, disaster response, and other post-hospital services that support stabilization, treatment, and transport.
"Emergency medical technician" means a person who holds a certificate from the National Registry of Emergency Medical Technicians and is licensed pursuant to section 453-34 whose primary focus is to provide immediate lifesaving care to patients while ensuring access to the emergency medical systems of care.
"First responder personnel" means
a person who [has successfully completed a United States Department of
Transportation approved First Responder Course of training in emergency basic
life support.] provides initial assistance until emergency medical
services personnel arrive.
"Medicom" means the emergency medical systems of care medical communications that monitor statewide resource availability, emergency dispatch, hospital notifications, interfacility transfers, and disaster communications.
"Medicom center" means the centralized coordination place for medicom functions.
"Paramedic" means a mobile intensive care technician who is an allied health professional certified by the National Registry of Emergency Medical Technicians whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical systems of care.
"Service area" means the State, excluding any county having a population of five hundred thousand or more.
"State system" means the state [pre-hospital]
emergency medical [services system.] systems of care.
"Statewide" means all counties in the State."
SECTION 5. Section 321-223, Hawaii Revised Statutes, is amended to read as follows:
"§321-223 State emergency medical [services
system,] systems of care, establishment. The department shall establish, administer,
and maintain the state emergency medical [services system] systems of
care to serve the emergency health needs of the people in the service
area. All emergency medical services or
ambulance services contracted by or under the authority of the department or
any county within the service area shall be consistent with this part."
SECTION 6. Section 321-224, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) In addition to other functions and duties assigned under this part, the department shall:
(1) Regulate ambulances and ambulance services statewide;
(2) Establish
emergency medical services throughout the
service area, including emergency [aeromedical] air-medical
services, which shall meet the requirements of this part, subject to section
321-228;
(3) Review and approve the curricula and syllabi of training courses offered to emergency medical services personnel statewide who provide basic, intermediate, and advanced life support, consult and coordinate with the University of Hawaii, or any other accredited community college, college, or university, or any professional organization that provides emergency medical services training, regarding the training for basic, intermediate, and advanced life support personnel, as provided in section 321-229;
(4) Collect
and evaluate data for the continued evaluation of the statewide emergency
medical [services system,] systems of care, subject to section
321-230;
(5) Coordinate, on a statewide basis, emergency medical resources and the allocation of emergency services and facilities in the event of mass casualties, natural disasters, national emergencies, and other emergencies, ensuring linkage to local, state, and national disaster plans, and participation in exercises to test these plans;
(6) Establish,
administer, and maintain a communication system [for the service area;] statewide
including interoperability with organizations essential to core operations of the
state system;
(7) [Assist
each county in the service area in the] Oversee the development and
implementation of a statewide "911" emergency [telephone]
dispatch system;
(8) Secure technical assistance and other assistance and consultation necessary for the implementation of this part, subject to section 321-230;
(9) Implement public information and education programs to inform the public of the statewide system and its use, and disseminate other emergency medical information, including appropriate methods of medical self-help and first-aid, and the availability of first-aid training programs statewide;
(10) Establish standards and provide training for dispatchers in the state system, and maintain a program of quality assurance for dispatch equipment and operations; provided that individuals acting as dispatchers in the State as of July 1, 2022, shall obtain emergency medical dispatch certification by July 1, 2026, and shall maintain certification thereafter;
(11) Establish a program that will enable emergency service personnel statewide to provide early defibrillation;
(12) Establish
[within the department the] and maintain emergency medical [service
system] services for children statewide;
(13) Consult
with the advisory [committee] council on matters relating to the
implementation of this part; and
(14) Establish and maintain statewide standards for emergency medical services course instructor qualifications and statewide requirements for emergency medical services training facilities."
SECTION 7. Section 321-224.4, Hawaii Revised Statutes, is amended by amending subsection (c) to read as follows:
"(c)
For purposes of this part, "community paramedicine
program" means an enhanced and expanded service in the state emergency
medical [services system] systems of care that allows
state-licensed health care professionals, and community health workers, to
assist with public health, primary care, and prevention services, including
services through telehealth."
SECTION 8. Section 321-225, Hawaii Revised Statutes, is amended to read as follows:
"§321-225 The [state] Hawaii emergency medical [services] systems
advisory [committee.] council. (a)
There is established within the department of health for administrative
purposes only the [state] Hawaii emergency medical [services]
systems advisory [committee,] council, which shall sit in
an advisory capacity to the department of health on all matters relating to the
state system. The advisory [committee]
council may advise the department of health upon request of the
department or upon its own initiative with regard to the state system. The advisory [committee] council
shall:
(1) Monitor,
review, and evaluate on an ongoing basis the operations, administration, and
efficacy of the state system or any components thereof, to determine conformity
with and maximum implementation of this part[.];
(2) Prepare
and submit periodic assessments, reports, and other documents relating to the state system to ensure the
implementation of this part, as deemed necessary or desirable in the discretion
of the advisory [committee.] council;
(3) Seek
the input of the public in relation to the state system to ensure adequate
fulfillment of the emergency medical services, emergency medical services
for children, and trauma and critical care services needs of the State
consistent with this part[.];
(4) Participate
in any planning or other policymaking with regard to the state system, and seek
the participation of the public, including subarea health planning councils in
its consideration of plans and policies relating to the state system[.];
(5) Perform
other functions, and have other duties necessary to ensuring the fullest
implementation and maintenance of the state system[.]; and
(6) Advise
the department of health in formulating a master plan for emergency medical [services,]
systems of care, including medicom, the "911" system, and
other components necessary to meet the emergency medical needs of the people of
the State, which shall be submitted to the legislature.
(b)
The advisory [committee] council shall be composed of [twenty]
twenty-three members: [three] four nonvoting ex-officio
members, who shall be the director of transportation, the adjutant general, the
executive director of the Hawaii 9-1-1 board, and the administrator of the
state health planning and development agency, or the designated representatives
thereof, and [seventeen] nineteen members representing all
counties of the State who shall be appointed by the governor subject to section
26-34 as follows:
(1) Five members who shall be physicians experienced in the conduct and delivery of emergency medical services; provided that at least two shall be engaged in the practice of emergency medicine and be board-eligible or board-certified by the American Board of Emergency Medicine, and provided further that at least one physician shall be engaged in the practice of pediatrics and be board-eligible or board-certified by the American Board of Pediatrics;
(2) Four members who shall be consumers of health care and who shall have no connection with or relationship to the health care system of the State and who shall be representative of all counties;
(3) Four
members of allied health professions related to emergency medical services; [and]
(4) Four
members, one from each county, who shall be mobile intensive care technicians
or emergency medical technicians engaged in the practice of pre-hospital
emergency medical [service.] services; and
(5) Two members who shall be surgeons or clinicians experienced in the conduct and delivery of trauma or acute care services.
(c)
The members of the advisory [committee] council shall
serve without compensation, but shall be reimbursed for necessary expenses
incurred in the performance of their duties, including travel expenses. The chairperson of the advisory [committee]
council shall be elected by the members from among their numbers. A majority of the members of the advisory [committee]
council shall constitute a quorum for the conduct of business of the
advisory [committee.] council.
A majority vote of the members present at a meeting at which a quorum is
established shall be necessary to validate any action of the [committee.]
council.
[(c)] (d) The advisory [committee] council
may adopt rules for its governance.
[(d)] (e) The department of health shall provide
necessary staff and other support required by the advisory [committee] council
for the performance of its duties."
SECTION 9. Section 321-228, Hawaii Revised Statutes, is amended to read as follows:
"§321-228 Emergency medical services; counties. The department shall determine, in
consultation with the advisory committee under section 321-225, the levels of
emergency medical services that shall be implemented in each county within the state
service area. The department may
contract to provide emergency medical services, including emergency [aeromedical]
air-medical services, or any necessary component of the emergency [services
system of] medical systems of care within a county within the
service area in conformance with the state system. If any county within the service area shall
apply to the department to operate state emergency medical ambulance
services within the respective county, the department may contract with the
county for the provision of those services.
The department shall operate emergency medical ambulance services or
contract with a private agency in those counties within the service area that
do not apply to it under this section.
Any county or private agency contracting to provide emergency medical
ambulance services under this section shall be required by the department to
implement those services in a manner and at a level consistent with the levels
determined under this section."
SECTION 10. Section 321-230, Hawaii Revised Statutes, is amended to read as follows:
"§321-230 Technical assistance, data collection,
evaluation. (a) The department may contract for technical
assistance and consultation, including categorization, data collection, and
evaluation appropriate to the needs of the statewide emergency medical [services
system.] systems of care. The
collection and analysis of statewide emergency medical [services] systems
of care data, including pediatrics, trauma, cardiac, stroke, burn,
medical, and behavioral medical emergencies, shall be for the purpose of improving
the quality of services provided.
The department may implement and maintain a trauma registry for the collection of information concerning the treatment of critical trauma patients at state designated trauma centers, and carry out a system for the management of that information. The system may provide for the recording of information concerning treatment received before and after a trauma patient's admission to a hospital or medical center. All state designated trauma centers shall submit to the department periodic reports of each patient treated for trauma in the state system in the manner as the department shall specify.
For the purposes of this subsection, "categorization" means systematic identification of the readiness and capabilities of hospitals and their staffs to adequately, expeditiously, and efficiently receive and treat emergency patients.
(b)
The department shall establish, administer, and maintain an [aeromedical]
emergency [medical] air-medical services system designed to
collect and analyze data to measure the efficiency and effectiveness of each
phase of the statewide emergency [aeromedical] air-medical
program.
The department shall monitor [aeromedical]
air-medical emergency ambulance service flights statewide to include
date of service, patient demographics, transport diagnosis, and medical
outcomes. The department medicom
center shall work with each air-medical service provider and health
care facility as the intermediary to arrange emergency transport of [bariatric]
patients by licensed air-medical service providers, or by the United
States Coast Guard, and maintain a registry of all emergency transports
provided [by the United States Coast Guard]. All statewide [aeromedical] air-medical
providers shall submit their data to the department as specified and requested
by the department.
The statewide [aeromedical]
emergency [medical] air-medical
services system shall serve the emergency health needs of the people of
the State by identifying:
(1) The system's strengths and weaknesses;
(2) The allocation of resources; and
(3) The
development of [rotary-wing] emergency [aeromedical] air-medical
services standards;
provided
that emergency helicopter use, including triage protocols, shall be based on
national [aeromedical] air-medical triage and transport
guidelines established by the Association of Air Medical Services, the American
College of Surgeons, the National Association of Emergency Medical Service
Physicians, or other department-approved national [aeromedical] air-medical
accreditation agency. The department, in
the implementation of this subsection, shall plan, coordinate, and provide
assistance to all entities and agencies, public and private, involved in the
statewide system.
(c)
The department shall use an emergency [aeromedical services]
air-medical quality improvement committee comprised of representatives
of trauma, emergency, and tertiary care physicians and providers to analyze
information collected from the [aeromedical] air-medical quality
improvement performance measures as established by the [American College of
Surgeons,] department, and to recommend system standards and
resources to maintain and improve [the] Hawaii emergency [aeromedical]
air-medical services [system]."
SECTION 11. Section 321-532, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) The department shall participate in a systematic process to evaluate, improve, and sustain stroke care throughout the State to reduce death and disability from stroke. The stroke system of care shall include:
(1) The requirement that hospitals meet specific stroke patient treatment capabilities that will ensure that stroke patients receive safe and effective care;
(2) The
coordination with the State's emergency medical [services system] systems
of care to ensure that stroke patients are quickly identified, transported
to, and treated in facilities that have specialized programs for providing
timely and effective treatment for stroke patients to improve outcomes; and
(3) The continuation of a statewide stroke coalition to provide a mechanism to evaluate and improve stroke care in the State."
SECTION 12. Sections 46-191, 46-193, 46-196, and 46-198, Hawaii Revised Statutes, are amended by substituting the word "air-medicine" wherever the word "aeromedical" appears, as the context requires.
SECTION 13. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 14. This Act shall take effect on July 1, 3000.
Report Title:
Department of Health; State Emergency Medical Services System; Systems of Care
Description:
Modernizes Hawaii's emergency medical services laws to align with current best practices. Effective 7/1/3000. (HD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
2314 |
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THIRTY-THIRD LEGISLATURE, 2026 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO EMERGENCY MEDICAL SYSTEMS OF CARE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature further finds that contemporary models of emergency and acute care prioritize integrated systems that address time-sensitive emergencies such as trauma, heart attacks, strokes, sepsis, and burns with the same urgency and structure as traditional emergency response. By adopting a time-sensitive emergency medical systems of care model, Hawaii can improve patient survival, reduce long-term disability, and strengthen statewide resilience in times of disaster or public health crisis.
Aligning Hawaii's emergency medical services statutes with national best practices in systems integration will:
(1) Ensure coordinated, evidence-based care for time-sensitive emergencies across all islands;
(2) Modernize emergency medical services and trauma systems to meet current and future challenges;
(3) Improve patient outcomes through standardized, statewide protocols; and
(4) Enhance preparedness for future natural disasters, mass casualty incidents, and public health threats.
Accordingly, the purpose of this Act is to update Hawaii's emergency medical services statutes to establish a comprehensive, time-sensitive, emergency medical systems of care model that strengthens the State's capacity to respond effectively to emergencies and safeguard the health of our residents, living on all islands.
SECTION 2. Section 321-221, Hawaii Revised Statutes, is amended to read as follows:
"§321-221 Findings and purpose. The legislature finds that the
establishment of [a] state emergency medical [services system,] systems
of care, including emergency medical services, emergency medical services for children, and trauma and
critical care services is a matter of compelling state interest and
necessary to protect and preserve public health. A system designed to reduce medical emergency
deaths, injuries, and permanent long-term disability through the implementation
of a fully integrated, cohesive network of components, the legislature further
finds, will best serve public health needs. Accordingly, the [purpose] purposes
of this part [is] are to establish and maintain [a] state
emergency medical [services system] systems of care in
communities that can be most effectively served by the State, and to fix the
responsibility for the administration of [this] state [system,] emergency
medical systems of care, which shall provide for the arrangement of
personnel, facilities, and equipment for the effective and coordinated delivery
of health care services under emergency conditions, whether occurring as the
result of a patient's condition, from natural disasters, or from other causes. The [system] emergency medical
systems of care shall provide for personnel, personnel training,
communications, emergency transportation, facilities, coordination with
emergency medical and critical care services, coordination and use of available
public safety agencies, promotion of consumer participation, accessibility to
care, mandatory standard medical recordkeeping, consumer information and
education, independent review and evaluation, disaster linkage, mutual aid
agreements, and other components necessary to meet the purposes of this part."
SECTION 3. Section 321-222, Hawaii Revised Statutes, is amended to read as follows:
"§321-222 Definitions. As used in this part, unless the context clearly requires otherwise:
"Advanced emergency medical technician" means a health professional certified by the National Registry of Emergency Medical Technicians and licensed by the State of Hawaii as an advanced emergency medical technician to provide basic and limited advanced emergency medical care and transportation for critical and emergency patients to access the emergency medical systems of care.
"Advanced life support" means initiating all basic life support care as well as invasive patient care designed to stabilize and support a patient's condition due to sudden illness or injury. The care rendered, excluding basic life support, constitutes the practice of medicine.
"Advisory [committee"] council"
means the Hawaii emergency medical [services] systems of care
advisory [committee.] council.
"Air-medical services" means medical care and transport of patients by aircraft, provided by a licensed air ambulance operator with qualified medical personnel, and regulated as part of the statewide emergency medical systems of care.
"Basic life support" means
initiating noninvasive emergency patient care designed to optimize the patient's
chances of surviving the emergency situation. The care rendered consists of all first aid
procedures needed, but does not include invasive procedures [which] that
constitute the practice of medicine; provided that state-approved basic life
support personnel may use fully automatic external defibrillators, initiate
intravenous lines, place tourniquets, and perform manual external
defibrillation under the direction and personal supervision of a [mobile
intensive care technician] state-licensed clinician and in
accordance with rules adopted by the department.
"Department" means the department of health.
"Emergency [aeromedical] air-medical
services" means a [secondary] response system that provides
immediate critical care and transport [by rotary-wing aircraft] of a
patient by aircraft to a facility that provides specialized medical
care.
"Emergency medical responder" means a person certified by the National Registry of Emergency Medical Technicians.
"Emergency medical services for children" means emergency medical services, including preventive, pre-hospital, hospital, rehabilitative, and other post-hospital care for children.
"Emergency medical services personnel"
means any [mobile intensive care technician or] paramedic, advanced
emergency medical technician, emergency medical technician, emergency
medical responder, or other healthcare worker who is certified or licensed
by the State.
"Emergency medical systems of care" means a fully integrated and cohesive statewide network of components that provide timely and effective care to individuals experiencing crisis situations. Components of an emergency medical systems of care include, but are not limited to, community-based services, pre-hospital care, emergency response, facility-based care, disaster response, and other post-hospital services that support stabilization, treatment, and transport.
"Emergency medical technician" means a person certified by the National Registry of Emergency Medical Technicians and licensed by the State of Hawaii whose primary focus is to provide immediate lifesaving care to patients while ensuring access to the emergency medical systems of care.
"First responder personnel" means
a person who [has successfully completed a United States Department of
Transportation approved First Responder Course of training in emergency basic
life support.] provides initial assistance until emergency medical
services personnel arrive.
"Medicom" means the emergency medical systems of care medical communications that monitor statewide resource availability, emergency dispatch, hospital notifications, interfacility transfers, and disaster communications.
"Medicom center" means the centralized coordination place for medicom functions.
"Paramedic" means a mobile intensive care technician who is an allied health professional certified by the National Registry of Emergency Medical Technicians whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical systems of care.
"Service area" means the State, excluding any county having a population of five hundred thousand or more.
"State system" means the state [pre-hospital]
emergency medical [services system.] systems of care.
"Statewide" means all counties in the State."
SECTION 3. Section 321-223, Hawaii Revised Statutes, is amended to read as follows:
"§321-223 State emergency medical [services
system,] systems of care, establishment. The department shall establish, administer,
and maintain the state emergency medical [services system] systems of
care to serve the emergency health needs of the people in the service area.
All emergency medical services or
ambulance services contracted by or under the authority of the department or
any county within the service area shall be consistent with this part."
SECTION 4. Section 321-224, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) In addition to other functions and duties assigned under this part, the department shall:
(1) Regulate ambulances and ambulance services statewide;
(2) Establish
emergency medical services throughout the
service area, including emergency [aeromedical] air-medical
services, which shall meet the requirements of this part, subject to section
321-228;
(3) Review and approve the curricula and syllabi of training courses offered to emergency medical services personnel statewide who provide basic, intermediate, and advanced life support, consult and coordinate with the University of Hawaii, or any other accredited community college, college, or university, or any professional organization that provides emergency medical services training, regarding the training for basic, intermediate, and advanced life support personnel, as provided in section 321-229;
(4) Collect
and evaluate data for the continued evaluation of the statewide emergency
medical [services system,] systems of care, subject to section
321-230;
(5) Coordinate, on a statewide basis, emergency medical resources and the allocation of emergency services and facilities in the event of mass casualties, natural disasters, national emergencies, and other emergencies, ensuring linkage to local, state, and national disaster plans, and participation in exercises to test these plans;
(6) Establish,
administer, and maintain a communication system [for the service area;] statewide
including interoperability with organizations essential to core operations of
Hawaii's emergency medical systems of care;
(7) [Assist
each county in the service area in the] Oversee the development and
implementation of a statewide "911" emergency [telephone]
dispatch system;
(8) Secure technical assistance and other assistance and consultation necessary for the implementation of this part, subject to section 321-230;
(9) Implement public information and education programs to inform the public of the statewide system and its use, and disseminate other emergency medical information, including appropriate methods of medical self-help and first-aid, and the availability of first-aid training programs statewide;
(10) Establish standards and provide training for dispatchers in the state system, and maintain a program of quality assurance for dispatch equipment and operations; provided that individuals acting as dispatchers in the State as of July 1, 2022, shall obtain emergency medical dispatch certification by July 1, 2026, and shall maintain certification thereafter;
(11) Establish a program that will enable emergency service personnel statewide to provide early defibrillation;
(12) Establish
[within the department the] and maintain emergency medical [service
system] services for children statewide;
(13) Consult
with the advisory [committee] council on matters relating to the
implementation of this part; and
(14) Establish and maintain statewide standards for emergency medical services course instructor qualifications and statewide requirements for emergency medical services training facilities."
SECTION 5. Section 321-225, Hawaii Revised Statutes, is amended to read as follows:
"§321-225 The [state] Hawaii
emergency medical [services] systems advisory [committee.]
council. (a) There is established within the department of
health for administrative purposes only the [state] Hawaii
emergency medical [services] systems advisory [committee,]
council, which shall sit in an advisory capacity to the department of
health on all matters relating to the state system. The advisory [committee] council
may advise the department of health upon request of the department or upon its
own initiative with regard to the state system.
The advisory [committee] council shall:
(1) Monitor,
review, and evaluate on an ongoing basis the operations, administration, and
efficacy of the state system or any components thereof, to determine conformity
with and maximum implementation of this part[.];
(2) Prepare
and submit periodic assessments, reports, and other documents relating to the state system to ensure the
implementation of this part, as deemed necessary or desirable in the discretion
of the advisory [committee.] council;
(3) Seek
the input of the public in relation to the state system to ensure adequate
fulfillment of the emergency medical services, emergency medical services
for children, and trauma and critical care services needs of the State
consistent with this part[.];
(4) Participate
in any planning or other policymaking with regard to the state system, and seek
the participation of the public, including subarea health planning councils in
its consideration of plans and policies relating to the state system[.];
(5) Perform
other functions, and have other duties necessary to ensuring the fullest
implementation and maintenance of the state system[.]; and
(6) Advise
the department of health in formulating a master plan for emergency medical [services,]
systems of care, including medicom, the "911" system, and
other components necessary to meet the emergency medical needs of the people of
the State, which shall be submitted to the legislature.
(b) The
advisory [committee] council shall be composed of [twenty]
twenty-three members: [three] four nonvoting ex-officio
members, who shall be the director of transportation, the adjutant general, the
executive director of the Hawaii 9-1-1 board, and the administrator of the
state health planning and development agency, or the designated representatives
thereof, and [seventeen] nineteen members representing all
counties of the State who shall be appointed by the governor subject to section
26-34 as follows:
(1) Five members who shall be physicians experienced in the conduct and delivery of emergency medical services; provided that at least two shall be engaged in the practice of emergency medicine and be board-eligible or board-certified by the American Board of Emergency Medicine, and provided further that at least one physician shall be engaged in the practice of pediatrics and be board-eligible or board-certified by the American Board of Pediatrics;
(2) Four members who shall be consumers of health care and who shall have no connection with or relationship to the health care system of the State and who shall be representative of all counties;
(3) Four
members of allied health professions related to emergency medical services; [and]
(4) Four
members, one from each county, who shall be mobile intensive care technicians
or emergency medical technicians engaged in the practice of pre-hospital
emergency medical [service.] services; and
(5) Two members who shall be surgeons or clinicians experienced in the conduct and delivery of trauma or acute care services.
(c)
The members of the advisory [committee] council shall
serve without compensation, but shall be reimbursed for necessary expenses
incurred in the performance of their duties, including travel expenses. The chairperson of the advisory [committee]
council shall be elected by the members from among their numbers. A majority of the members of the advisory [committee]
council shall constitute a quorum for the conduct of business of the
advisory [committee.] council. A majority vote of the members present at a
meeting at which a quorum is established shall be necessary to validate any
action of the [committee.] council.
[(c)] (d) The advisory [committee] council
may adopt rules for its governance.
[(d)] (e) The department of health shall provide
necessary staff and other support required by the advisory [committee] council
for the performance of its duties."
SECTION 6. Section 321-228, Hawaii Revised Statutes, is amended to read as follows:
"§321-228 Emergency medical services; counties. The department shall determine, in
consultation with the advisory committee under section 321-225, the levels of
emergency medical services that shall be implemented in each county within the
state service area. The department may
contract to provide emergency medical services, including emergency [aeromedical]
air-medical services, or any necessary component of the emergency [services
system of] medical systems of care within a county within the
service area in conformance with the state system. If any county within the service area shall
apply to the department to operate state emergency medical ambulance services
within the respective county, the department may contract with the county for
the provision of those services. The
department shall operate emergency medical ambulance services or contract with
a private agency in those counties within the service area that do not apply to
it under this section. Any county or
private agency contracting to provide emergency medical ambulance services
under this section shall be required by the department to implement those
services in a manner and at a level consistent with the levels determined under
this section."
SECTION 7. Section 321-230, Hawaii Revised Statutes, is amended to read as follows:
"§321-230 Technical assistance, data collection,
evaluation. (a) The department may contract for technical
assistance and consultation, including categorization, data collection, and
evaluation appropriate to the needs of the statewide emergency medical [services
system.] systems of care. The
collection and analysis of statewide emergency medical [services] systems
of care data, including pediatrics, trauma, cardiac, stroke, burn,
medical, and behavioral medical emergencies, shall be for the purpose of improving
the quality of services provided.
The department may implement and maintain a trauma registry for the collection of information concerning the treatment of critical trauma patients at state designated trauma centers, and carry out a system for the management of that information. The system may provide for the recording of information concerning treatment received before and after a trauma patient's admission to a hospital or medical center. All state designated trauma centers shall submit to the department periodic reports of each patient treated for trauma in the state system in the manner as the department shall specify.
For the purposes of this subsection, "categorization" means systematic identification of the readiness and capabilities of hospitals and their staffs to adequately, expeditiously, and efficiently receive and treat emergency patients.
(b) The department shall establish, administer,
and maintain an [aeromedical] emergency [medical] air-medical
services system designed to collect and analyze data to measure the efficiency
and effectiveness of each phase of the statewide emergency [aeromedical]
air-medical program.
The department shall monitor [aeromedical]
air-medical emergency ambulance service flights statewide to include
date of service, patient demographics, transport diagnosis, and medical
outcomes. The department medicom
center shall work with each air-medical service provider and health
care facility as the intermediary to arrange emergency transport of [bariatric]
patients by licensed air-medical service providers, or by the United
States Coast Guard, and maintain a registry of all emergency transports provided
[by the United States Coast Guard]. All statewide [aeromedical] air-medical
providers shall submit their data to the department as specified and requested
by the department.
The statewide [aeromedical]
emergency [medical] air-medical
services system shall serve the emergency health needs of the people of
the State by identifying:
(1) The system's strengths and weaknesses;
(2) The allocation of resources; and
(3) The
development of [rotary-wing] emergency [aeromedical] air-medical
services standards;
provided
that emergency helicopter use, including triage protocols, shall be based on
national [aeromedical] air-medical triage and transport
guidelines established by the Association of Air Medical Services, the American
College of Surgeons, the National Association of Emergency Medical Service
Physicians, or other department-approved national [aeromedical] air-medical
accreditation agency. The department, in
the implementation of this subsection, shall plan, coordinate, and provide
assistance to all entities and agencies, public and private, involved in the
statewide system.
(c) The department shall use an emergency [aeromedical
services] air-medical quality improvement committee comprised of
representatives of trauma, emergency, and tertiary care physicians and
providers to analyze information collected from the [aeromedical] air-medical
quality improvement performance measures as established by the [American
College of Surgeons,] department, and to recommend system standards
and resources to maintain and improve [the] Hawaii emergency [aeromedical]
air-medical services [system]."
SECTION 8. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 9. This Act shall take effect upon its approval.
|
INTRODUCED BY: |
_____________________________ |
|
|
BY REQUEST |
Report Title:
Department of Health; Emergency Medical Services Systems of Care
Description:
Modernizes Hawaii's emergency medical services statutes to align with current best practices.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
|
Date
|
Status
|
|---|---|
| Jun 4, 2026 | Act 085, on 06/04/2026 (Gov. Msg. No. 1185). |
| Jun 4, 2026 | Act 085, 06/04/2026 (Gov. Msg. No. 1185). |
| May 8, 2026 | Received notice of passage on Final Reading in House (Hse. Com. No. 888). |
| May 7, 2026 | Transmitted to Governor. |
| May 6, 2026 | Received notice of Final Reading (Sen. Com. No. 816). |
| May 6, 2026 | Passed Final Reading as amended in CD 1 with none voting aye with reservations; none voting no (0) and none excused (0). |
| May 6, 2026 | Passed Final Reading, as amended (CD 1). Ayes, 25; Aye(s) with reservations: none . 0 No(es): none. 0 Excused: none. |
| Apr 29, 2026 | 48 Hrs. Notice (as amended CD 1) 05-06-26 |
| Apr 29, 2026 | Reported from Conference Committee as amended CD 1 (Conf. Com. Rep. No. 53-26). |
| Apr 29, 2026 | Forty-eight (48) hours notice Wednesday, 05-06-26. |
| Apr 29, 2026 | Reported from Conference Committee (Conf Com. Rep. No. 53-26) as amended in (CD 1). |
| Apr 24, 2026 | The Conference committee recommends that the measure be PASSED, WITH AMENDMENTS. The votes of the Senate Conference Managers were as follows: 2 Aye(s): Senator(s) McKelvey, Chang; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella. |
| Apr 24, 2026 | The Conference Committee recommends that the measure be Passed, with Amendments. The votes were as follows: 4 Ayes: Representative(s) Takayama, Grandinetti, Keohokapu-Lee Loy, Alcos; Ayes with reservations: none; 0 Noes: none; and 0 Excused: none. |
| Apr 23, 2026 | Bill scheduled for Conference Committee Meeting on Friday, 04-24-26 3:15PM in conference room 329. |
| Apr 23, 2026 | Received notice of Senate conferees (Sen. Com. No. 725). |
| Apr 22, 2026 | Senate Conferees Appointed: McKelvey Chair; Chang Co-Chair; Fevella. |
| Apr 20, 2026 | Received notice of appointment of House conferees (Hse. Com. No. 786). |
| Apr 20, 2026 | House Conferees Appointed: Takayama, Grandinetti Co-Chairs; Keohokapu-Lee Loy, Alcos. |
| Apr 17, 2026 | Received notice of disagreement (Hse. Com. No. 780). |
| Apr 16, 2026 | House disagrees with Senate amendment (s). |
| Apr 14, 2026 | Returned from Senate (Sen. Com. No. 679) in amended form (SD 1). |
| Apr 14, 2026 | Report adopted; Passed Third Reading. Ayes, 25; Aye(s) with reservations: none . Noes, 0 (none). Excused, 0 (none). Transmitted to House. |
| Apr 10, 2026 | One Day Notice 04-14-26. |
| Apr 10, 2026 | Reported from JDC (Stand. Com. Rep. No. 3759) with recommendation of passage on Third Reading. |
| Apr 7, 2026 | The committee(s) on JDC recommend(s) that the measure be PASSED, UNAMENDED. The votes in JDC were as follows: 4 Aye(s): Senator(s) Rhoads, Gabbard, Chang, San Buenaventura; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Awa. |
| Apr 1, 2026 | The committee(s) on JDC will hold a public decision making on 04-07-26 10:15AM; Conference Room 016 & Videoconference. |
| Mar 25, 2026 | Report adopted; Passed Second Reading, as amended (SD 1) and referred to JDC. |
| Mar 25, 2026 | Reported from HHS (Stand. Com. Rep. No. 3178) with recommendation of passage on Second Reading, as amended (SD 1) and referral to JDC. |
| Mar 18, 2026 | The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 5 Aye(s): Senator(s) San Buenaventura, McKelvey, Kanuha, Keohokalole, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none. |
| Mar 13, 2026 | The committee(s) on HHS has scheduled a public hearing on 03-18-26 1:00PM; CR 225 & Videoconference. |
| Mar 12, 2026 | Referred to HHS, JDC. |
| Mar 12, 2026 | Passed First Reading. |
| Mar 12, 2026 | Received from House (Hse. Com. No. 395). |
| Mar 10, 2026 | Passed Third Reading as amended in HD 2 with none voting aye with reservations; none voting no (0) and Representative(s) Kong, Pierick excused (2). Transmitted to Senate. |
| Mar 6, 2026 | Forty-eight (48) hours notice Tuesday, 03-10-26. |
| Mar 6, 2026 | Reported from CPC (Stand. Com. Rep. No. 1064-26) as amended in HD 2, recommending passage on Third Reading. |
| Mar 3, 2026 | The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 10 Ayes: Representative(s) Matayoshi, Grandinetti, Chun, Ilagan, Ichiyama, Iwamoto, Kong, Lowen, Marten, Tam; Ayes with reservations: none; 0 Noes: none; and 1 Excused: Representative(s) Pierick. |
| Feb 27, 2026 | Bill scheduled to be heard by CPC on Tuesday, 03-03-26 2:00PM in House conference room 329 VIA VIDEOCONFERENCE. |
| Feb 18, 2026 | Passed Second Reading as amended in HD 1 and referred to the committee(s) on CPC with none voting aye with reservations; none voting no (0) and none excused (0). |
| Feb 18, 2026 | Reported from HLT (Stand. Com. Rep. No. 361-26) as amended in HD 1, recommending passage on Second Reading and referral to CPC. |
| Feb 11, 2026 | The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 9 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Hartsfield, Marten, Olds, Takenouchi, Alcos, Garcia; Ayes with reservations: none; Noes: none; and Excused: none. |
| Feb 6, 2026 | Bill scheduled to be heard by HLT on Wednesday, 02-11-26 9:00AM in House conference room 329 VIA VIDEOCONFERENCE. |
| Jan 30, 2026 | Referred to HLT, CPC, referral sheet 5 |
| Jan 28, 2026 | Introduced and Pass First Reading. |
| Jan 26, 2026 | Pending introduction. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| May 6, 2026 | Final Reading | House Floor |
Passed |
|
| May 6, 2026 | Final Reading | Senate Floor |
Passed |
|
| Apr 14, 2026 | Third Reading | Senate Floor |
Passed |
|
| Apr 7, 2026 | The committee(s) on JDC recommend(s) that the measure be PASSED, UNAMENDED | Senate Standing Committee on Judiciary |
Passed |
|
| Mar 18, 2026 | The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS | Senate Standing Committee on Health and Human Services |
Passed |
|
| Mar 10, 2026 | Third Reading | House Floor |
Passed |
|
| Mar 3, 2026 | The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS | House Standing Committee on Consumer Protection & Commerce |
Passed |
|
| Feb 11, 2026 | The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS | House Standing Committee on Health |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| AMR | *** Support | Mar 18, 2026 |
| Emergency Medical Services Advisory Committee | *** Support | Feb 11, 2026 |
| Hawaiʻi Emergency Management Agency | *** Support | Feb 11, 2026 |
| Hawaiʻi Emergency Management Agency (HIEMA) | *** Support | Mar 18, 2026 |
| Kauai County EMS | *** Support | Feb 11, 2026 |
| Leahi Hospital | *** Support | Feb 11, 2026 |
| Oahu County EMS | *** Support | Feb 11, 2026 |
| Office of Hawaiian Affairs | *** Support | Apr 6, 2026 |
| State Health Planning and Development Agency | ** Support | |
| State of Hawaii Department of Health | *** Support | Apr 6, 2026 |
| University of Hawaiʻi Community Colleges | ** Support | |
| University of Hawaiʻi System | *** Support | Mar 3, 2026 |
| University of Hawaiʻi System - University of Hawaiʻi Community Colleges | *** Support | Mar 18, 2026 |
STAND. COM. REP. NO. 1064-26
Honolulu, Hawaii
, 2026
RE: H.B. No. 2314
H.D. 2
Honorable Nadine K. Nakamura
Speaker, House of Representatives
Thirty-Third State Legislature
Regular Session of 2026
State of Hawaii
Madame:
Your Committee on Consumer Protection & Commerce, to which was referred H.B. No. 2314, H.D. 1, entitled:
"A BILL FOR AN ACT RELATING TO EMERGENCY MEDICAL SYSTEMS OF CARE,"
begs leave to report as follows:
Your Committee received testimony in support of this measure from the Department of Health; University of Hawaiʻi Community Colleges; Office of Hawaiian Affairs; and State Health Planning and Development Agency. Your Committee received comments on this measure from one individual.
Your Committee finds that the State's existing emergency medical services laws were developed decades ago and no longer reflect the complexity or scope of modern pre-hospital and acute emergency care. Outdated statutory structures have resulted in gaps in coordination, uneven integration across islands, and barriers to accessing federal funding opportunities needed to strengthen rural and statewide emergency response capacity. This measure seeks to support an integrated systems-of-care model that improves patient outcomes and enhances statewide preparedness for time-sensitive emergencies.
Your Committee has amended this measure by:
(1) Amending the definition of "basic life support" under the laws relating to the county emergency medical services system to be consistent with the amendments under this measure;
(2) Clarifying that a county, under the laws relating to the county emergency medical services system, retains authority to determine its emergency medical services levels unless the Department of Health, in consultation with the Hawaii Emergency Medical Systems of Care Advisory Council, determines otherwise;
(3) Clarifying a paramedic under the Department of Health laws in this measure is licensed under the existing paramedic licensing statute;
(4) Amending the composition of the Hawaii Emergency Medical Systems of Care Advisory Council, formerly the State Emergency Medical Services Advisory Committee, by substituting the Adjutant General out for the Administrator of Emergency Management; and
(5) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.
Your Committee notes that the amendment substituting the Adjutant General with the Administrator of Emergency Management was made in light of House Bill No. 1752 and Senate Bill No. 2139, Regular Session of Hawaii 2026, to avoid duplication and conflicting statutory language. As this measure advances, the progress of those measures should be monitored to determine whether this amendment should be reversed.
As affirmed by the record of votes of the members of your Committee on Consumer Protection & Commerce that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 2314, H.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as H.B. No. 2314, H.D. 2.
Respectfully submitted on behalf of the members of the Committee on Consumer Protection & Commerce,
|
|
|
____________________________ SCOT Z. MATAYOSHI, Chair |
|
|
|
|
STAND. COM. REP. NO. 361-26
Honolulu, Hawaii
, 2026
RE: H.B. No. 2314
H.D. 1
Honorable Nadine K. Nakamura
Speaker, House of Representatives
Thirty-Third State Legislature
Regular Session of 2026
State of Hawaii
Madame:
Your Committee on Health, to which was referred H.B. No. 2314 entitled:
"A BILL FOR AN ACT RELATING TO EMERGENCY MEDICAL SYSTEMS OF CARE,"
begs leave to report as follows:
The purpose of this measure is to update the State's emergency medical services laws to establish a comprehensive, time-sensitive, emergency medical systems of care model.
Your Committee received testimony in support of this measure from the Department of Health; Hawaiʻi Emergency Management Agency; Office of Hawaiian Affairs; University of Hawaiʻi Community Colleges; Emergency Medical Services & Injury Prevention System Branch, Department of Health; State Health Planning and Development Agency; and two individuals.
Your Committee finds that the State's emergency medical services system has been instrumental in ensuring a degree of equity to critical health services for residents on all islands due to its comprehensive reach and one hundred percent full-time professional staffing. Technologies related to health care, communication, and transportation have evolved exponentially, but implementation has been uneven due to resource constraints and a cumbersome governance framework. A comprehensive modernization of emergency medical services-related statutes that aligns with national best practices and streamlines program governance is required to ensure that the State's emergency medical services system is managed more strategically. This measure therefore implements the essential task of modernizing the State's emergency medical systems of care laws.
Your Committee has amended this measure by:
(1) Amending the definition of "emergency medical services personnel";
(2) Changing the effective date to July 1, 3000, to encourage further discussion; and
(3) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.
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 H.B. No. 2314, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 2314, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.
Respectfully submitted on behalf of the members of the Committee on Health,
|
|
|
____________________________ GREGG TAKAYAMA, Chair |
|
|
|
|
|
Date
|
Testimony PDF
|
|---|---|
| Apr 6, 2026 | HB2314_SD1_TESTIMONY_JDC_04-07-26_.PDF |
| Mar 18, 2026 | HB2314_HD2_TESTIMONY_HHS_03-18-26_.PDF |
| Mar 3, 2026 | HB2314_HD1_TESTIMONY_CPC_03-03-26_.PDF |
| Feb 11, 2026 | HB2314_TESTIMONY_HLT_02-11-26_.PDF |
Discussed in Hearing
4MIN
Conference Committee
41SEC
Senate Standing Committee on Health and Human Services
1MIN
House Standing Committee on Consumer Protection & Commerce
1MIN
House Standing Committee on Consumer Protection & Commerce
5MIN
House Standing Committee on Health
16SEC
House Standing Committee on Health
Bill Author
Bill Co-Author(s):