RELATING TO AIR MEDICAL SERVICES.

HB2508

HOUSE OF REPRESENTATIVES

H.B. NO.

2508

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

RELATING
TO AIR MEDICAL SERVICES
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

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SECTION 1.
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The legislature finds that air medical
services are an essential component of Hawaii's emergency medical systems of
care, healthcare infrastructure, and all-hazards disaster preparedness.
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Hawaii's geographic isolation, multi-island
structure, rural communities, and limited access to specialty and tertiary care
on neighbor islands make timely air medical transport critical to providing equitable
access to lifesaving care.

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The
legislature further finds that demand for emergency aeromedical and
interfacility air medical transport services has increased substantially over
the past decade, with annual flight volumes exceeding pre-2020 levels by more
than one thousand transports.
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However,
statutory authority, governance structures, and department of health staffing
dedicated to air medical services have not kept pace, resulting in fragmented
coordination, prolonged transport times, and inefficient systems.

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The
legislature recognizes that the emergency medical services and injury prevention
systems branch of the department of health lacks permanent, dedicated air
medical staffing to support statewide coordination, regulatory oversight,
quality improvement, data governance, and disaster readiness.

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The
legislature further finds that statewide air medical performance data
demonstrate persistent delays that exceed nationally recognized benchmarks for
rural and remote emergency care, reflecting structural gaps in coordination and
governance rather than performance issues with isolated providers.

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The
legislature acknowledges that nationally recognized best practices emphasize
centralized governance, clinically driven coordination, continuous quality
improvement, and integration with trauma, stroke, cardiac, acute care,
emergency medical systems, and disaster response.
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In an island state, air medical services are a
core public health, public safety, and emergency preparedness function.

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Accordingly,
the purpose of this Act is to:

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(1)
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Establish permanent, dedicated air
medical staffing within the emergency medical services and injury prevention
systems branch of the department of health;

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(2)
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Strengthen statewide governance,
coordination, and oversight of emergency aeromedical and interfacility air
medical services;

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(3)
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Support data-driven quality
improvement, accountability, and performance monitoring;

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(4)
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Enhance disaster preparedness and
multi-island response through clearly defined authority and coordinated air
medical operations; and

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(5)
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Promote health equity by improving timely
access to emergency medical care for rural and neighbor island communities.

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SECTION
2.
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Chapter 321, Hawaii Revised Statutes,
is amended by adding a new section to part XVIII to be appropriately designated
and to read as follows:

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"
�321-
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Statewide air medical services program; staffing and authority.

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(a)
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There is established within the department's emergency
medical services and injury prevention system branch, a statewide air medical
services program to provide governance, coordination, oversight, quality
improvement, and disaster readiness for the State's emergency aeromedical and
interfacility air medical transport services.

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(b)
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The department shall establish and maintain
permanent positions to administer the program, including:

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(1)
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A state air medical director, who
shall be a physician licensed in the State and having experience in emergency
medicine, trauma care, or critical care transport, who shall provide statewide
clinical and medical oversight of air medical services;

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(2)
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A state air medical program manager,
who shall be responsible for program administration; policy development; system
planning; interagency coordination; and integration of air medical services
with emergency medical services, trauma systems, and healthcare facilities; and

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(3)
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An air medical coordinator, who
shall support operational coordination, data oversight, compliance monitoring,
performance improvement activities, and coordination with licensed air medical
providers, county emergency medical services agencies, hospitals, and emergency
management partners.

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(c)

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The positions established pursuant to
subsection (b) shall be permanent and recurring and shall not be contingent
upon temporary programs, pilot projects, or time-limited funding.

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(d)

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The statewide air medical services
program, under the direction of the director of health, may:

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(1)
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Provide statewide clinical
governance and medical direction for emergency aeromedical and interfacility
air medical services;

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(2)
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Develop, adopt, and implement
statewide air medical policies, procedures, and clinical protocols consistent
with nationally recognized standards;

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(3)
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Coordinate emergency aeromedical and
interfacility air medical transport services across counties to improve
timeliness, health equity, and access to care;

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(4)
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Oversee the participation of
licensed air medical providers in data-based quality improvement programs;

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(5)
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Support statewide disaster
preparedness, response, and recovery activities involving air medical
transport, including multi-island and mass-casualty incidents; and

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(6)
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Coordinate with county emergency
medical services agencies, hospitals, trauma centers, stroke centers, acute
care facilities, emergency management agencies, and other public and private
partners.

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(e)

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The department may adopt rules pursuant
to chapter 91 necessary to implement this section.

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(f)

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As a condition of licensure, all air
medical providers operating within the State shall cooperate with and
participate in statewide air medical coordination, data reporting, and quality
improvement activities as required by the department.

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(g)

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The statewide air medical services
program shall coordinate with the state emergency medical services advisory
committee and may establish advisory or quality improvement committees as
necessary to fulfill its statutory responsibilities.

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(h)

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The department shall establish and
assess annual air medical ambulance licensure and accreditation fees for all
air medical providers operating within the State.

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The
fees shall be reasonable, non-refundable, and sufficient to fully cover the
costs associated with:

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(1)
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Administration and oversight of the
statewide air medical services program;

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(2)
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Licensure, accreditation
verification, compliance monitoring, and enforcement activities;

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(3)
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Statewide air medical coordination
and quality improvement initiatives;

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(4)
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Data collection, analysis, and
reporting requirements; and

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(5)
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Coordination and integration with
state and county emergency management, emergency medical services, and disaster
preparedness partners.

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The
fees collected pursuant to this subsection shall be deposited into the
emergency medical services special fund established pursuant to section 321-234
and shall be used solely for the purposes of administering and supporting the
statewide air medical services program and staff, and its emergency management
coordination functions.
"

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SECTION

3
.
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Section
321-234, Hawaii Revised Statutes, is amended by amending subsection (b) to read
as follows:

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"(b)
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The moneys in the special fund shall be
distributed as follows:

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(1)
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Beginning with fiscal year 2021-2022,
$3,500,000 shall be distributed each fiscal year to a county operating a county
emergency medical services system pursuant to part XI of chapter 46 for the
operation of that system; [
and
]

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(2)
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Fees remitted pursuant to section
321-
�
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shall
be used solely for the purposes of administering and supporting the statewide
air medical services program and staff, and its emergency management
coordination functions; and

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[
(2)
]

(3)
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The remainder shall be distributed to
the department for operating the system established pursuant to this chapter,
including enhanced and expanded services, and shall not be used to supplant
funding for emergency medical services authorized prior to July 1, 2004."

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SECTION 4.
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Statutory material to be repealed is bracketed and stricken.
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New statutory material is underscored.

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SECTION 5.
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This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

DOH;
State Emergency Medical Services System; Statewide Air Medical Services Program;
Emergency Medical Services Special Fund

Description:

Establishes
the Statewide Air Medical Services Program within the Department of Health, Emergency
Medical Services and Injury Prevention Systems Branch to coordinate and
strengthen air medical services.
�

Provides for an air medical director, an air medical program manager,
and an air medical coordinator.
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Provides
for annual licensure and accreditation fees to be deposited into the Emergency
Medical Services Special Fund for costs of the program.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.