The city Emergency Medical Services division is set to receive a record $29.3 million budget that officials say will improve the reliability and availability of ambulance services for Honolulu's 900,000-plus residents.

The money — nearly $4 million more than the current year's funding — marks the fourth consecutive year of higher budgets for EMS and positions the agency for significant improvements to its system.

By the time the fiscal year is over next June, a new ambulance unit will be operating in Central O'ahu and — with the help of money saved from two previous years — EMS will have replaced half of its fleet of 30 ambulances, officials said.

For an agency that has been dealing with a growing call load and aging equipment, the money is a much-needed shot in the arm, officials said.

"Fiscally we're in better shape than we've been in years," said EMS chief Patty Dukes, crediting state and city officials. "It enables us to better respond and provide better care. The call volume is continuing to go up every year. ... Any additional resources for EMS is just going to benefit the entire Island."

EMS personnel responded to more than 64,000 calls last year, up nearly 10 percent from 2004, according to the agency.

Honolulu Mayor Mufi Hannemann and Dr. Libby Char, director of the Honolulu Emergency Services Department, publicly complained early this year that the state had been underfunding the city's Emergency Medical Services division, resulting in aging ambulances and medical equipment.

The state is charged with administering emergency medical services and pays the city to provide those services on O'ahu. EMS is O'ahu's primary 911 emergency medical services provider.

WEAR AND TEAR

A half-dozen of EMS' fleet of 30 ambulances have logged more than 200,000 miles on the road, with the majority of ambulances with more than 100,000 miles, Char said in a Jan. 22 commentary for The Advertiser.

EMS' contract calls for ambulances to be retired when they reach 200,000 miles or seven years, whichever comes first, Dukes said. Running ambulances beyond that requires state approval.

But it appears that many of those issues are being taken care of.

Using money saved from two previous years' budgets, EMS recently replaced six ambulances with the highest mileage. Among them was the Makakilo unit's ambulance, which retired with 270,000 miles on it, Dukes said.

And with a larger budget for the coming year, EMS also plans to purchase nine new ambulances to replace older ones, as well as new medical equipment. Dukes said EMS will order five vehicles "right off the bat," and order four more toward the end of the year.

"There's still quite a few that need to be replaced, and that's what this funding for the new ambulances is going to do: start replacing those that are getting real close or eking up over that 200,000-mile mark," she said.

EMS also will expand with the addition of a new Central O'ahu unit, which Dukes said will improve response times to areas including lower Mililani, Waipi'o and Waikele.

In addition, the department will receive about $2.5 million in construction money for a building to house two Honolulu ambulance units that are based in trailers, Dukes said.

The appropriation for the coming fiscal year that begins July 1 is "a real boost" for EMS, said Senate Ways and Means Committee chairwoman Rosalyn Baker, D-5th (W. Maui, S. Maui).

"If you're an EMS unit and you don't know whether your ambulance is going to make it to the site and back, that's additional stress you don't need," she said. "And you want to make sure that you have the appropriate equipment on there that's up to date so that they can perform their mission."

NEW UNIT IN WORKS

The Central O'ahu unit should be operating around Jan. 1 and will be based — at least for now — at Kaiser Permanente Hawaii's Waipi'o clinic, Dukes said. She said Kaiser is allowing the city to occupy the space rent-free and called it a "good strategic location" because of its proximity to the H-2 and Kamehameha Highway.

The addition of the unit follows immense growth in the region, especially with communities such as Mililani Mauka. While the population in those areas rose, residents in other Central O'ahu neighborhoods such as Wahiawa and Mililani have grown older.

"The call volume is starting to move from not only being busy Downtown, but it's spreading this way," Dukes said.

The new unit should quicken response times in the area, which are currently within the 15-minute parameter mandated by the state, Dukes said.

But adding the unit will also benefit other communities — especially those in Wahiawa and Waipahu — because their ambulances will be able to remain available for medical emergencies in their own regions, Dukes said.

The Central O'ahu ambulance unit will likely operate for 16 hours a day — from 7 a.m. to 11 p.m. — for at least six months, after which hours may grow if needed.

State Rep. Ryan Yamane, who pushed for the Central O'ahu unit, said saving just minutes can make a difference in severe cases.

"Every minute it takes for them to get to the emergency room for appropriate care can have devastating effects," said Yamane, D-37th (Waipahu, Mililani).

The Central O'ahu EMS unit will be the city's 19th unit on O'ahu. The city also has two "Rapid Response" paramedic units that provide emergency medical services but do not transport patients.

It follows recent expansions in other areas, including the addition of a Makiki EMS unit and a Nanakuli unit in January 2005, Dukes said.

In the years ahead, the division will likely look at further expansion with another ambulance unit for the Downtown Honolulu area, she said.

Reach Lynda Arakawa at larakawa@honoluluadvertiser.com.