The City Council of Honolulu held a Special Budget Briefing on March 8, 2025, focusing on proposed increases in funding for various emergency services. The meeting outlined budget requests for the administration, emergency medical services (EMS), and health services, highlighting significant financial needs and operational expansions.

The administration presented a request for a 3.5% budget increase, amounting to an additional $257,000. The EMS division sought a 4.6% increase, translating to approximately $1.8 million, while the health services branch requested a 5.4% increase, totaling $75,000. Notably, the EMS budget includes funding for a new 12-hour ambulance unit and over $3 million earmarked for remounting existing ambulances, a cost-effective strategy to maintain the fleet.

The briefing detailed the financial implications of ambulance procurement, noting that a new ambulance costs nearly half a million dollars, while remounting an existing unit can be done for about half that price. The council was informed that last year's budget allowed for the completion of six new ambulances and twelve remounted units, with eight of the remounted units expected to be operational soon.

In terms of budget allocation, 82% of the EMS budget is dedicated to salaries, with the remaining funds covering current expenses and equipment. The health services branch is also expanding its workforce, with plans to add a part-time physician to assist with hiring and health assessments for first responders.

The meeting addressed staffing challenges, revealing 40 current vacancies within the department, with 55 candidates in the hiring pipeline. The council noted that 20 new hires would start this month, with additional hires expected by July 1.

Overtime requests were also discussed, with EMS seeking $5.8 million to cover staffing needs, particularly for after-hours operations related to DUI blood draws in collaboration with the Honolulu Police Department.

Revenue sources for the EMS were outlined, including $3.5 million from state car registration fees and an estimated $45.5 million from billing, reflecting an anticipated increase in call volume. However, the council acknowledged that reimbursement from Medicare and Medicaid would not necessarily align with the projected revenue growth.

The briefing concluded with plans for capital improvement projects, including renovations to the Kahuku Ambulance Facility and the Waipio ambulance training facility, which will enhance operational capacity and training capabilities.

Overall, the meeting underscored the critical need for increased funding to support emergency services in Honolulu, ensuring that the city can effectively respond to the growing demands of its community.