It’s tough being an island state for many logistical reasons, and the air ambulance situation underscores one life-or-death challenge.

Hawaii is now left with one major air ambulance service — Hawaii Life Flight, owned by American Medical Response Hawaii — after LifeSave KuPono was just closed by its parent company, Air Methods. The Colorado-based company cited inflation, “significant under-reimbursement from Medicare,” and a new federal law against surprise medical bills from out-of-network providers, which often happens when patients get emergency care.

For its part, AMR Hawaii says it’s already offering positions to former LifeSave KuPono staffers. It’s also good to hear that the company is “very confident” in its continued ability to provide statewide coverage and care.