The Hawaii Department of Health (DOH) will receive $13 million from an initial $58 million federal award to acquire 34 new ambulances and upgrade emergency communication systems. The funding comes from the Rural Health Transformation Program.

The ambulance distribution across counties is as follows:

• Maui County: 16 ambulances, including rural 911, community paramedicine, and mobile "integrated health" ambulances, with one vehicle assigned to Maui island and one to Molokai.
• Kauai County: 10 ambulances.
• Hawaii Island: 4 ambulances.
• Honolulu: 4 ambulances.

The DOH plans to equip all ambulances with satellite power and high-speed internet to function as high-speed hotspots during emergency responses. Additionally, the department will modernise its MEDICOM system to align with the Hawaii Wireless Interoperability Network to bolster radio communications. The DOH also intends to create a MEDICOM CENTER to serve as a 24/7 hub for coordinating trauma and emergency ambulance transfers across the state.

For over 20 years, Hawaii’s MEDICOM radio and hospital base station system has primarily been maintained rather than upgraded, with limited investment in modernization, resulting in outdated infrastructure.

The remaining $45 million of the initial award has been granted to the University of Hawaii John A. Burns School of Medicine for workforce development programs. The U.S. Centers for Medicare and Medicaid Services has awarded Hawaii nearly $189 million for the first year of the program, with Governor Josh Green stating additional annual awards are expected through 2030. The Rural Health Transformation Program is a five-year, $50 billion initiative established through the Working Families Tax Cuts Act.