HONOLULU (KHON2) — Changes are in the works that could cost patients more if they ever need an ambulance. Lawmakers are moving forward with a proposal to let the City control its own funding for Honolulu Emergency Medical Services (EMS).

The Department of Health has oversight and controls the funding of EMS even though it is a county service. The bill being considered at the Legislature would hand that authority to the city.

Part of the reason is the State is dealing with a massive budget shortfall. Lawmakers were not able to fully fund EMS in 2020 and they do not expect things to get better anytime soon.

“So, going forward, we think at least for the next four years that will continue to be a problem,” said Rep. Sylvia Luke, House Finance Committee Chairwoman.

Honolulu EMS asked for nearly $48.2 million and received under $47 million from the State. Lawmakers point out the State pays $100 million for EMS statewide.

EMS is able to bring in revenues because it charges for ambulance services, but it is only able to earn about half of that amount. The City would have to make up for that by charging more for EMS services.

Honolulu EMS has had problems with its ambulances breaking down because they are old. Luke says the proposal should help with that because it allows the City to control its own funding.

“We do see this as a positive and we do see this as a potential expansion for all the counties,” said Luke.

The bill calls for phasing in the transfer of authority over a four-year period starting in 2021. Honolulu Mayor Rick Blangiardi testified he is willing to embrace the concept but needs more time to do his due diligence.

“As an operation that’s clearly in a deficit model, I really want to fully understand what we’re getting ourselves into. But I want to be clear that we are not pushing back on this, but we want a chance to do our work,” said Mayor Blangiardi.

The proposal only applies to Honolulu for now, but Luke says the plan is to eventually have all counties control their EMS funding. Honolulu EMS is also skeptical, however.

The acting director said in its testimony, “The city expresses serious concerns, and is unable to support the measure given the absence of fully informed discussions.”

The City Council Chairman also sent a statement saying, “We share the Administration’s concerns that more information is needed regarding the financials and regulatory framework of this proposal before we can consider any kind of transfer from the State to the City.”