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### ^ q STAT E O F HAWAI I DEPARTMEN TO F HEALT H P.O . BO X337 8 HONOLULU , H I 96801-337 8 Jun e 9 , 2011 LOREH AJ , FUDDY , A.M.W. , M.P.H . OnCTCnC rHEALT

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Mr . Denni s J . DeVan y Chief , Essentia l Ai rServic e Division , X-5 3 U . S . Departmen t o fTransportatio n Offic e o fAviatio n Analysi s Re : Essentia l Ai rServic e Openin g Fo rKalaupapa , Islan d o fMolokal , Hawai i Dea rMr . DeVany : Than k yo u fo rth e opportunit yt o commen t o n th e Essentia l Ai rServic e (HAS ) Reques t fo rProposa l (RFP ) openin g fo rKalaupapa , Islan d o fMolokal , Hawaii . Kalaupap a i s a remote , rura l locatio n tha t ca n onl yb e accesse d byairplan e o ra 2,00 0 foo t high , 2 6 switch-bac k

foo t trail . Th e Kalaupap a patien t populatio n range s i n ag e fro m 6 9 t o 8 7 an d man yresident s ar e unabl e t o us e th e trail . Therefore , ai rservic e i s critica l t o th e movemen t o fpeopl e t o an d fro m th e Settlement . Th e curren t provider's , Pacifi cWings' , increase d ai rfare s hav e worke d contrar yt o th e purpos e fo ra n EAS . Whil e the yd o no t currentl yreceiv e a n EA S subsidy , the yhave raise d thei rroun d tri p rate s fro m $14 6 t o $498 . Th e tota l passenge rloa d carrie d int o Kalaupap a ha s dwindle d fro m ove r3,00 0 annuall yt o a s lo wa s 90 0 thi s pas t year . Th e Departmen t o fHealt h pay s fo rai rtrave l cos t fo rpatient s requirin g medica l car e i n Honolulu . Increase d airfar e cos t ha s resulte d i n grea t Inconvenienc e t o th e patient s a s the yhave extende d thei rstay s i n Honolul u u p t o on e mont h t o consolidat e medica l visit s to sav e o n trave l cost . Thi s ha s resulte d i n a substantia l decreas e i n patien t medica l trave l fro m 10 7 roun d trip s i n 200 9 t o 7 1 i n 2010-11 . I n addition , assertion s hav e bee n mad e tha t fare s ar e unimportan t t o th e patient s sinc e th e Departmen t o fHealt h pays fo rthei rai rtravel . A s state d above , onl ytrave l fo r patien t medica l car e i s pai d b yth e Departmen t o fHealth . Kalaupap a resident s an d visitor s wan t lowe rairfare s simila rothe rairfare s t o an d fro m th e res t o fMoloka l Island . Departmen t o fHealt h ha s sustaine d budge t restriction s a s a resul t o flowe rstat e revenues , therefor e increas e i n trave l cos t wil l hav e a negativ e impact upo n servic e delivery . Trave l fo rpatients ' persona l business , thei rfamil yan d friend s trave l an d al l visitor s wh o com e int o th e settlemen t ar e pai d ou t o fthei row n pocket . Al l traveler s t o Kalaupap aRe : Essentia l Ai rServic e Openin g Fo rKalaupapa , Islan d o fMolokal , Hawai i

Pag e 2 have bee n negativel yimpacte d b yth e hig h far e nowcharged . Time s fo rschedule d flight s ar e a n importan t consideration . Th e selecte d provide rshoul d hav e a schedul e tha t permit s resident s t o g o ou t i n th e mornin g an d retur n i n th e lat e afternoo n fo r medica l appointment s an d shopping , plu s a mid-dayfligh t t o Honolul u t o accommodat e th e visito ran d busines s traffic . Servic e fro m a provide rtha t ha s a positiv e safetyrecord i n Hawaii , i s financiall ystable , abl e t o provid e EA S servic e fo rth e 2-yea rcontract period , an d a trac k record operatin g schedule d commercia l service s wit h positiv e on-tim e servic e record s I n Hawai i i s important . Th e provide rshoul d hav e aircraft capabl e o foperatin g withi n th e airport restriction s (9-passenge rmaximum ) wit h enoug h equipmen t t o kee p reliabl e an d on tim e servic e operatin g durin g al l season s o fth e year . Th e chose n provide rshoul d als o provid e necessities , lik e whee l chai raccessibl e equipmen t an d aircraft tha t ca n easil y accommodat e wheelchai rrestricte d passengers . Than k yo u fo rthi s opportunit yt o commen t o n th e EA S RF P fo rKalaupapa . Sincerely , Glen n Wasserman , M,D. , M.P.H . Chief , Communicabl e Diseas e Divisio n Stat e o fHawai i Departmen t o fHealt h c : Bria n Swanso n U.S . Departmen t o fTransportatio n Brian.swanson(a>dot.aov Lorett a Fuddy , ACSW , MP H Directo ro fHealt h Loretta.fuddvtSidoh.hawaii.go v Ala n Yamamot o Offic e o fSenato rDanie l Inouy e Ala n vamamoto(a).inouve.senate.aov Glen n Okimot o Director , Hawai i Departmen t o fTransportatio n Glenn.okimotofa)hawaii.qo v Margare t Cummisk

y(Appropriations ) Margare t cummiskv(a)appro.senate.go v Susa n Ker n Attorne yGenera l susan.r.kernfa>hawaii.gov Michae l Maruyam a Hansen' s Diseas e Branc h Michael.maruvamafa)doh.hawaii.go v Stephe n Proko p Kalaupap a Nationa l Par k Servic e Stev e prokODfainps.qov