Yup, our EMS is definitely understaffed. The island is roughly 600-ish sq miles, approx 1 million population on island at any given time, and they have 22 ambulances at full staffing. Compared to HFD which has 43 fire stations (and 63 companies)..
More often than not, they're actually only running ~18 ambulances as staffing shortages means it's more common to shut down units for a day than it is to run every unit they have.
In 2023, they published a call volume of more than 95,000 responses. While that averages out to like 11-12 calls per day per unit, the EMS guys I've talked to says that's usually closer to their 12 hour shift average (I guess between not always running even 20 ambulances and the town units getting more of those calls than the country ones, but it's said that even the North Shore units aren't slow anymore...)
EMS Response Honolulu's Paramedics and Emergency Medical Technicians respond and provide emergency medical treatment 24 hours a day, 7 days a week. In 2023, Hon
emergencyservices.honolulu.gov
So, purely anecdotally speaking from the handful of EMS guys I've had a chance to talk to a little about it (my regular station doesn't have an EMS unit, I mostly only see them on calls, so mostly get a chance to chit chat a couple minutes when I'm working OT at a station where they like to go fuel up) it seems that:
Yes, by and large, all the EMS who have offered an opinion want to merge with Fire. The thought seems to be if they do so, they won't have to down units each day, because any staffing shortages, they'll have us FF serve as EMTs driving the ambulances. That makes a large degree of sense, and would be relatively easy to implement with our current staffing system
More problematic is the idea some seem to have that we'd automatically field more ambulances. Someone once suggested we would end up with an ambulance at every single station. Now I don't know what conversations are going on in Chiefs Land, but nothing that I've heard coming down from the White Shirts would imply that at all, not even adding a couple more ambulance units...
Another big staffing issue with that, is that we, HFD, are only National Registry EMT level. State of Hawaii EMT is an expanded scope over National (they can start IVs and administer a few meds.... we can't even do a finger stick for a BSG reading). So we'd have to have basically the whole Dept to go through the bridge/upgrade program to become State Licensed. (And now you're going to run into issues with the Union who is almost certainly not going to let the Dept just send guys to the training and serve in a whole new role on top of already existing ones without some sort of raise being offered
We also have no Paramedics. Well we have a couple guys who had their Paramedic when they joined, and the Dept has had them keep up that license, mostly to help the Med Section out during CEs and the like) but no one who can just step in and fill an open MICT spot on the actual ambulance... So the existing Medics are still running all the calls they currently are. Joining with HFD won't do much of anything in the near term to cushion that.
Obviously, I think if a merge does happen, they'll have to add those roles, and the training of FFs to State EMT and MICT to staff the ambulances. Which means the Union is going to need to negotiate with the City for the new positions, ad appropriate compensation levels, and get that into our contract (so yeah, a super easy, nice quick process right there.............)
www.ems1.com
