Only a handful of ambulances met response time guidelines, and emergency responders made as much as $200,000 each a year due to overtime.
Those and other findings are in a city audit of the city's ambulance fleet and operations.
The city's EMS division says many of the concerns have already been addressed, with overtime down by millions of dollars, and response times significantly faster thanks to additional ambulance units.
According to the audit, the EMS contract with the state expects the city operator to meet response time guidelines 90 percent of the time but found only 3 of 21 ambulance units did so between fiscal years 2008 through 2010.
It found excessive leave, staff vacancies, turnover and shortages resulted in others working so much that some made as much as $200,000 a year but without breaks over extended periods. the audit said such a strained staffing level could impact critical patient care.
EMS responded it's been making major strides already, such as expanded ambulance service in central oahu and downtown.
"We had overtime in 2009 of 5.7 million and this year we're going to spend 3.6 million so it's down over 2 million in 2 years," says Dr. Jim Ireland, Emergency services director.
EMS says Kapiolani community college is increasing enrollment in EMT and paramedics courses that are prerequisites to the job, so more graduates of that will soon join the first responder workforce.
