Thank you for all for providing this platform to hear my testimony and for your persistent attention to ensuring the best possible prehospital care for our community.
I have had the privilege of serving Maui County as a EMT/Paramedic for the past 20 years, and I have flown on the Medevac since the program’s inception. My contribution to this process is simply that I have years of experience in the field, and will speak to that. My concern is that if the 911 air and ground entities are managed by separate companies, the patient will be the first to suffer.
When a patient’s care is transferred from one provider team to another, or one facility to another, it is time consuming and complex. Although there are standards in the care provided, the logistical side of a transfer, especially when dealing with independent private entities, can be time-consuming and complicated. There are different provider roles and protocols in each private company, different equipment such as IV Pumps, ventilators, heart monitors and patient moving devices. And all of the aforementioned devices require manufacturer-specific tubing, electrodes, invasive components, etc. Each one of these factors adds time with a transfer - changing IV tubing, changing monitoring equipment, entering settings on a machine, understanding how to find vital information on someone else’s patient chart. In a stable patient where time is not necessarily of the essence, we have the luxury to provide or receive a thorough verbal and written report, and ensure that the transfer of equipment is done completely and correctly. In the prehospital setting, with time-sensitive cases, increased stress amongst patient and providers, and involving noisy heavy equipment like a rotor-craft, medical errors are more likely to occur, provider safety can be jeopardized, and taking more time than is necessary may translate to poor patient outcomes.
The current model works really well. There is a synergy and familiarity amongst the paramedics and the protocols we adhere to, a smooth and swift transfer of life-savings interventions because both air and ground use the same equipment and medications, and easy information exchange as the documentation program is universal.
Again, thank you for your time, and I urge the State DOH to allow a new procurement process that combines both 911 air and ground.
With Respect,
Jessica S B Mendonsa
MCHS, Paramedic, PA-C
Dear Maui County Council Members,
Re: WASSP-1(8) Rule 7(B): Department of Health’s new Procurement Process for Emergency-Medical Services in the County of Maui
Hello, I am Mona Arcinas, the Operations Manager of American Medical Response. I want to express my gratitude to the council members for taking the time to listen to our testimonies. I also appreciate the WASSP committee for persistently pursuing and questioning the process of a fair bid that includes community input.
Some of our concerns regarding the new bid include:
1. The need for our Medevac (rotor-wing) and ground ambulances to be combined.
2. The installation of a new and operating, second advanced life support ambulance station on Molokai.
3. That there be no confusion regarding the level of care required (ALS vs. BLS)
Although we were given a 9-month extension to our contract, a longer extension would benefit the community we serve, allowing us to fulfill our commitment to them.
Thank you again for your commitment to the health and safety of all Hawaii’s residents.
Sincerely,
Mona Arcinas
I would like to thank all of you for your support recently with the Resolution for the Maui County EMS contract. I believe it played a huge role in the cancellation of the previous bid and the ability to move forward with another more conscientious bid. I appreciate this meeting and the information you seek, as we all are wondering how the process will go this next time around. Some of the important issues that should be addressed are:
1. The Maui Medevac should continue to be linked with the EMS ground contract for continuity of care for the people of Maui County.
2. There should be due diligence pursuing this next RFP including site visits and the companies history of contract compliance in Maui County.
3. Assurance that the new Molokai ambulance station is included as it is sorely needed.
4. Assurance that Maui's medics/staff will not be replaced with mainland workers as they are part of Maui County's community.
Again, thank you for your time and your involvement in the process this time around. Your input, as the representatives of Maui County, is so appreciated and valuable.
Sincerely,
Candace Lahm
Operations Supervisor
American Medical Response-Maui County
it is absolutely MANDATORY that the needs, yes, needs of your maui county people continue to receive the best possible prehospital medical and trauma service. the best would also mean no reduction (unfathomable in anyones mind) in the present service. The west side hospital didn't happen. Maui Memorial Medical center's ER is frequently overrun. the medics are the tip of the spear, and with their ability to provide advanced care, can alleviate that hospital burden.. If they remain advanced. The bigger point is that for your people of maui county (including the tourists, which make up a great deal of our daily call volume) will suffer greatly with a reduction in the scope of practice of the medics and any reduction of aeromedical support (rotor wing). include a Paramedic on every ambulance. Include aeromedical (retorting) to continue to serve maui county. include these items as mandatory for any bidder for the service contract. it is negligent, if its not... mahalo. Doug vant groenewout. Paramedic, licensed in 1991
Please consider keeping the EMS ground and air services as a package deal for Maui County. As a paramedic in Maui county, I think that the knowledge base and teamwork with Fire and Police is a vital part of taking care of the people of Maui. There are cases where the helicopter is able to get on scene before the EMS ground units. Local knowledge and a cohesive approach the air and the ground is what often leads to the best outcomes in very remote parts of our county. Currently, all of the flight paramedics staffing Medevac have worked every station in the County. They all have at least a decade on the ground ambulances in Maui and their data bank of experience helps our pilots, fellow crew members and patients.
I hope everyone will consider how unique Maui county is, with multiple islands, only 1 trauma hospital, the remote nature of many of our residents and the very limited resources of our rural clinics/hospitals. We rely on the ground paramedics and flight paramedics to work together and support one another, for the good of the community. While I understand separating the contracts, there is a chance with introducing a non local option without the specific knowledge base, we lose a layer of connection.
Thank you for all for providing this platform to hear my testimony and for your persistent attention to ensuring the best possible prehospital care for our community.
I have had the privilege of serving Maui County as a EMT/Paramedic for the past 20 years, and I have flown on the Medevac since the program’s inception. My contribution to this process is simply that I have years of experience in the field, and will speak to that. My concern is that if the 911 air and ground entities are managed by separate companies, the patient will be the first to suffer.
When a patient’s care is transferred from one provider team to another, or one facility to another, it is time consuming and complex. Although there are standards in the care provided, the logistical side of a transfer, especially when dealing with independent private entities, can be time-consuming and complicated. There are different provider roles and protocols in each private company, different equipment such as IV Pumps, ventilators, heart monitors and patient moving devices. And all of the aforementioned devices require manufacturer-specific tubing, electrodes, invasive components, etc. Each one of these factors adds time with a transfer - changing IV tubing, changing monitoring equipment, entering settings on a machine, understanding how to find vital information on someone else’s patient chart. In a stable patient where time is not necessarily of the essence, we have the luxury to provide or receive a thorough verbal and written report, and ensure that the transfer of equipment is done completely and correctly. In the prehospital setting, with time-sensitive cases, increased stress amongst patient and providers, and involving noisy heavy equipment like a rotor-craft, medical errors are more likely to occur, provider safety can be jeopardized, and taking more time than is necessary may translate to poor patient outcomes.
The current model works really well. There is a synergy and familiarity amongst the paramedics and the protocols we adhere to, a smooth and swift transfer of life-savings interventions because both air and ground use the same equipment and medications, and easy information exchange as the documentation program is universal.
Again, thank you for your time, and I urge the State DOH to allow a new procurement process that combines both 911 air and ground.
With Respect,
Jessica S B Mendonsa
MCHS, Paramedic, PA-C
Dear Maui County Council Members,
Re: WASSP-1(8) Rule 7(B): Department of Health’s new Procurement Process for Emergency-Medical Services in the County of Maui
Hello, I am Mona Arcinas, the Operations Manager of American Medical Response. I want to express my gratitude to the council members for taking the time to listen to our testimonies. I also appreciate the WASSP committee for persistently pursuing and questioning the process of a fair bid that includes community input.
Some of our concerns regarding the new bid include:
1. The need for our Medevac (rotor-wing) and ground ambulances to be combined.
2. The installation of a new and operating, second advanced life support ambulance station on Molokai.
3. That there be no confusion regarding the level of care required (ALS vs. BLS)
Although we were given a 9-month extension to our contract, a longer extension would benefit the community we serve, allowing us to fulfill our commitment to them.
Thank you again for your commitment to the health and safety of all Hawaii’s residents.
Sincerely,
Mona Arcinas
Good Morning!
I would like to thank all of you for your support recently with the Resolution for the Maui County EMS contract. I believe it played a huge role in the cancellation of the previous bid and the ability to move forward with another more conscientious bid. I appreciate this meeting and the information you seek, as we all are wondering how the process will go this next time around. Some of the important issues that should be addressed are:
1. The Maui Medevac should continue to be linked with the EMS ground contract for continuity of care for the people of Maui County.
2. There should be due diligence pursuing this next RFP including site visits and the companies history of contract compliance in Maui County.
3. Assurance that the new Molokai ambulance station is included as it is sorely needed.
4. Assurance that Maui's medics/staff will not be replaced with mainland workers as they are part of Maui County's community.
Again, thank you for your time and your involvement in the process this time around. Your input, as the representatives of Maui County, is so appreciated and valuable.
Sincerely,
Candace Lahm
Operations Supervisor
American Medical Response-Maui County
it is absolutely MANDATORY that the needs, yes, needs of your maui county people continue to receive the best possible prehospital medical and trauma service. the best would also mean no reduction (unfathomable in anyones mind) in the present service. The west side hospital didn't happen. Maui Memorial Medical center's ER is frequently overrun. the medics are the tip of the spear, and with their ability to provide advanced care, can alleviate that hospital burden.. If they remain advanced. The bigger point is that for your people of maui county (including the tourists, which make up a great deal of our daily call volume) will suffer greatly with a reduction in the scope of practice of the medics and any reduction of aeromedical support (rotor wing). include a Paramedic on every ambulance. Include aeromedical (retorting) to continue to serve maui county. include these items as mandatory for any bidder for the service contract. it is negligent, if its not... mahalo. Doug vant groenewout. Paramedic, licensed in 1991
Please consider keeping the EMS ground and air services as a package deal for Maui County. As a paramedic in Maui county, I think that the knowledge base and teamwork with Fire and Police is a vital part of taking care of the people of Maui. There are cases where the helicopter is able to get on scene before the EMS ground units. Local knowledge and a cohesive approach the air and the ground is what often leads to the best outcomes in very remote parts of our county. Currently, all of the flight paramedics staffing Medevac have worked every station in the County. They all have at least a decade on the ground ambulances in Maui and their data bank of experience helps our pilots, fellow crew members and patients.
I hope everyone will consider how unique Maui county is, with multiple islands, only 1 trauma hospital, the remote nature of many of our residents and the very limited resources of our rural clinics/hospitals. We rely on the ground paramedics and flight paramedics to work together and support one another, for the good of the community. While I understand separating the contracts, there is a chance with introducing a non local option without the specific knowledge base, we lose a layer of connection.
Thank you for your time and consideration.