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Council reappoints Dr. James Ireland as Emergency Services director amid staff complaints and billing concerns
Summary
The Honolulu City Council confirmed James A. Ireland MD as director of the Emergency Services Department after public testimony both supporting and opposing the reappointment and council discussion about workplace culture, billing failures and staffing. Councilmember Okimoto recorded reservations at the time of the vote.
The Honolulu City Council on a recorded vote confirmed James A. Ireland MD as director of the City and County of Honolulu Emergency Services Department, adopting Committee Report 137 and Resolution 25‑11.
The reappointment drew praise for recent operational gains and new ambulances, and criticism from current and former EMS personnel who raised long-standing morale and billing problems. Supporters highlighted lower vacancy counts and new equipment; critics urged structural change and stronger administrative oversight.
Ireland told the council that the department’s vacancy level had improved and training academies are scheduled: “Our personnel is at the lowest vacancy rate…we're under 15 vacancies in EMS with a dispatch academy starting in June and an EMT academy starting in July,” he said. He also noted a recent fleet refresh, saying the department received 13 new or remounted ambulances and expects more within the next year.
Multiple registered speakers supported Ireland’s reappointment. Chu Lan Sherbert Kwok, who said she works in Chinatown, said Ireland’s work with CORE benefits that neighborhood. Melody Young of CARES praised his outreach and response work. Sonia Austin said she had worked with Ireland intermittently for 25 years and “our department has had the most growth under his direction.”
Other testimony and council discussion raised substantive concerns about administration and oversight. Eddie Fujioka, identified as a retired EMS district chief, testified in opposition and cited written testimony that the council posted. Council Member Okimoto said she would record a vote with reservations and described repeated testimony from EMS professionals alleging “a workplace culture marked by low morale, favoritism, and even retaliation,” plus operational consequences including unit closures and an overreliance on outside partners. Okimoto added that billing failures in 2022—caused by a vendor transition—resulted in a prolonged delay that “cost the city millions in lost revenue.” She said those problems point to larger structural issues and proposed considering a merger of EMS and the Fire Department to improve coordination.
Ireland and other supporters said steps have been taken to address staffing and equipment and that the department is pursuing an EMS pay differential to help retention. Ireland noted that paramedics do not have career “steps” in pay and are unique among first responders in that regard.
The council completed a roll-call vote after discussion. The clerk announced the final tally as eight ayes and one member absent. Council member Okimoto verbally stated she was voting “with reservations” during the roll call; the tally announced by the clerk recorded eight ayes and one absence.
The council’s adoption of CR137 and Resolution 25‑11 confirms Ireland’s appointment and allows him to continue as department director while questions raised in testimony about administration, billing and workplace culture remain on the public record. Council members and staff indicated they expect continued oversight dialogue and follow-up work on the billing issues and staffing proposals.
