County officials and others affected by the cuts say the closures will hurt emergency response time.
State health officials, forced to cut $665,846 from the department's Emergency Medical Service 1996-97 budget, are recommending closure of:
Christoffel acknowledged, however, that there are few options at this point and that he doesn't know where alternative cuts or savings would come from to make up the difference.
"It's not something we wanted to do," Christoffel said.
The recommendations were made based on the least likely potential impacts for the community.
The aeromedical service has been "an expensive operation and the number of calls really didn't warrant that activity," he said.
The three ground units on the chopping block all have fewer annual service calls than comparable areas, Christoffel said.
The total budget for emergency medical services was between $31 million and $32 million, he said.
Hawaii County fire Capt. Paul Paiva urged Big Islanders to call the governor and legislators to stop the proposed cuts.
The Fire Department has the state contract to handle ambulance service on the Big Island. On Oahu, the contract is with the city. A private contractor runs emergency medical services on Maui and Kauai.
Big Island fire officials have pleaded with Donna Maiava, chief of the Emergency Medical Services Systems Branch, to keep the stations open, Paiva said.
They say the aeromedical unit is vital because of the continuing growth in West Hawaii and recent increase in international flights into West Hawaii.
"We need all the services we currently have," said Paiva, who heads emergency services on the Big Island.
The same arguments were made for keeping the Waikoloa ground ambulance unit, which is in the middle of the growing South Kohala hotel district.
The administration of Mayor Jeremy Harris admitted to being "caught off guard" at the news that the Hawaii Kai unit appears lost, city spokeswoman Carol Costa said.
While there was talk six months ago about potential cuts, the Health Department had not given any indications recently that closures would be forthcoming.
Harris said closure of the Hawaii Kai station would be "unacceptable" and that he will urge Cayetano to not make the cut.
Ambulances would need to come from either Wailupe or Waimanalo to service Hawaii Kai residents. "This move would leave members of the Hawaii Kai community vulnerable in case of serious health emergencies," the mayor said.
Rep. Gene Ward (R-Aina Haina, Hawaii Kai), who led the fight to get the Hawaii Kai station to 24-hour status three years ago, also objected to the proposal.
Eliminating or reducing the level of service at Hawaii Kai "would take East Honolulu residents back to Third World status in terms of service to our sick, injured and aged," Ward wrote in a latter to Health Director Lawrence Miike.
Members of the Hawaii Kai Neighborhood Board say they too are worried about the potential cuts and have called on Christoffel to explain the proposals at their next meeting Tuesday night.
An official with the contractor that operates emergency services on Kauai also is unhappy with the prospects of losing an ambulance unit.
Zack Octavio, station manager for the Poipu station and International Life Support's county supervisor, said the area needs the unit's services.
"Koloa is a pretty fast growing area," Octavio said. "The hotels are beginning to open up, a lot of tourists are coming to Kauai."