REQUESTING THE GOVERNOR AND THE DEPARTMENT OF HEALTH TO ENGAGE WITH THE UNITED STATES DEPARTMENT OF DEFENSE AND OTHER FEDERAL AND MILITARY PARTNERS TO EXPLORE ESTABLISHING A MILITARY-CIVILIAN TRAUMA PARTNERSHIP TO STRENGTHEN THE HAWAII TRAUMA SYSTEM.

SR177

THE SENATE

S.R. NO.

177

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

SENATE RESOLUTION

requesting the GOVERNOR AND THE Department of health to
engage with the United States Department of Defense and other federal and
military partners to explore establishing a military-civilian trauma
partnership to strengthen the HAWAII Trauma System
.

����
WHEREAS, trauma
remains a leading cause of death and disability in the State, particularly for
residents of the neighbor islands, where geographic isolation and limited
access to specialty trauma services may delay timely access to definitive
trauma care; and

����
WHEREAS, severe
traumatic injuries, including traumatic brain injuries, are time-sensitive
medical emergencies requiring rapid stabilization, evaluation, and access to
specialized trauma care to prevent death and long-term disability; and

����
WHEREAS, timely
transfer of severely injured patients to a level I or level II trauma center
with specialty surgical capabilities is essential to improving survival,
preventing disability, and reducing long-term health care costs; and

����
WHEREAS, the
State has made important progress in strengthening its trauma system through
trauma center designation, emergency medical services coordination, and the
development of statewide trauma registry infrastructure; and

����
WHEREAS, Tripler
Army Medical Center, has facilitated the State's progress in strengthening its
trauma system but does not function as a routine receiving trauma center for
civilian trauma transfers within the Hawaii Trauma System; and

����
WHEREAS, despite
its advances in trauma care, the State continues to face trauma system capacity
challenges related to geographic isolation, limited specialty trauma resources,
and trauma center bed availability, which often results in prolonged transfer
times exceeding five hours for critically injured patients before they are able
to reach definitive trauma care; and

����
WHEREAS, Tripler
Army Medical Center is designated as a level II trauma center and possesses
highly trained trauma teams, surgical specialists, and critical care
capabilities developed through military trauma training and combat casualty
care experience; and

����
WHEREAS, the
State serves as a critical hub for the United States Indo-Pacific Command,
which coordinates defense operations and disaster response throughout the
Pacific region; and

����
WHEREAS, strengthening
military-civilian trauma collaboration in the State would support both civilian
trauma care and national medical readiness; and

����
WHEREAS, collaboration
between military and civilian trauma systems has been successfully implemented
in other states through initiatives such as the Military-Civilian Partnership
for Trauma Readiness, strengthening trauma system capacity while supporting
military medical readiness; and

����
WHEREAS,
increased collaboration between Tripler Army Medical Center, the Department of
Health, and civilian trauma centers would improve trauma system capacity,
reduce delays in accessing definitive trauma care, and enhance disaster and
mass casualty preparedness across the State; and

����
WHEREAS, the Hawaii
Trauma System within the Department of Health has not received a significant
increase in dedicated trauma system funding for more than twenty years, despite
population growth, rising health care costs, and increasing demands on trauma
system infrastructure; now, therefore,

����
BE IT
RESOLVED by the Senate of the Thirty-third Legislature of the State of Hawaii,
Regular Session of 2026, that the Governor and the Department of Health are
requested to engage with the United States Department of Defense and other
federal and military partners to explore establishing a military-civilian
trauma partnership to strengthen the Hawaii Trauma System; and

����
BE IT FURTHER
RESOLVED that the Department of Health is requested to collaborate with Tripler
Army Medical Center, emergency medical services providers, and other trauma
system stakeholders to identify operational pathways to support integration of
military trauma resources into the Hawaii Trauma System; and

����
BE IT FURTHER
RESOLVED that the Governor and the Department of Health, through their
engagement with the United States Department of Defense, are requested to evaluate
the following:

����
(1)
�
Opportunities for Tripler Army Medical Center
to participate as a receiving trauma center for civilian trauma patients within
the Hawaii Trauma System;

����
(2)
�
Opportunities to increase dedicated funding,
including funding necessary for uncompensated civilian trauma care when
provided by Tripler Army Medical Center as part of the Hawaii Trauma System, to
support trauma system coordination, trauma readiness initiatives, and
collaboration with military medical partners;

����
(3)
�
Legislative and regulatory changes that may be
necessary to allow Tripler Army Medical Center to receive reimbursement for
civilian trauma patients, including Medicaid reimbursement mechanisms similar
to those implemented in states such as Texas, that allow military medical
facilities to receive reimbursement for civilian trauma care; and

����
(4)
�
Development of statewide military and civilian
tele-trauma consultation capabilities to support rural and community hospitals
with trauma assessment, stabilization guidance, and triage decision-making; and

����
BE IT FURTHER
RESOLVED that the Department of Health is requested to submit a report of its
findings and recommendations, including any proposed legislation, to the
Legislature no later than twenty days prior to the convening of the Regular
Session of 2027; and

����
BE IT FURTHER
RESOLVED that certified copies of this Resolution be transmitted to the United
States Secretary of Defense, Commander of the United States Indo-Pacific
Command, Commander of Tripler Army Medical Center, members of Hawaii's
congressional delegation, Governor, and Director of Health.

OFFERED BY:

_____________________________

Report Title:
�

DOH;
United States Department of Defense; Tripler Army Medical Center; Hawaii Trauma
System; Trauma Care; Emergency Medical Services; Military-Civilian Partnership;
Report