WHEREAS the renewed model for “Patient-Centered and Coordinated EMS” will have impacts on other municipal emergency services including the Fire Service and the 911 dispatch service; and

WHEREAS other jurisdictions in Canada that have moved to provincial EMS models have relied on fire services to provide medical first response programs to supplement EMS; and

WHEREAS approximately 95 per cent of fire services in Alberta are staffed by volunteer members who are employed elsewhere; and

WHEREAS the decline of volunteerism and lack of incentives to become a volunteer firefighter in a municipality is increasing the risk of losing key volunteers; and

WHEREAS the training demands placed on volunteer firefighter have increased drastically over the past 10 years; and

WHEREAS any move within Alberta Health to centralize and reduce the number of EMS dispatch centers will have an impact on the quality of service and options available to municipalities for dispatching other municipal emergency services including increased costs; and

WHEREAS the lack of information available from Alberta Health in these areas is creating unnecessary concerns and confusion;

THEREFORE BE IT RESOLVED that the Alberta Association of Municipal Districts and Counties request the Alberta Government Health and Wellness Department include the Alberta Association of Municipal Districts and Counties as a major stakeholder in all future consultations regarding the renewed model for patient-centered and coordinated EMS to allow input on decisions that may have a negative impact on other municipal emergency services or cause increased costs for delivering these other services.

Other jurisdictions, in particular British Columbia and Ontario, have found that medical first response is needed in many areas of these provinces to meet medical intervention targets. The medical first responders primarily come from fire services. They are used as follows:

– First response to pre-arrival of ambulance where there is immediate threat to life or limb
– First response in areas which are remote from EMS stations
– First response when EMS will be delayed due to call volume or transfers
– First response to large incidents that will tax the available resources of EMS

A pre-response system has been established and been operating in Alberta for long periods in both urban and rural areas. These systems are cooperative efforts of fire departments and EMS departments at local levels supported by municipal councils and administrations. First responders can intervene with immediate care in a critical time frame while ambulances often travel long distances – this intervention includes automated defibrillation and CPR and the treatment of traumatic injuries.

If the new system in Alberta follows the same models used in the other two provinces it will become increasingly necessary for these programs to be expanded and developed by municipal fire services with the costs incurred by the municipalities. In British Columbia the increased demand in training and response as first responders has had a negative impact on volunteer firefighter recruiting and retention. Many areas have seen the average career of a volunteer firefighter drop to as little as two and a half years.  With an average time to train a volunteer fire fighter at two years this is a significant investment of time and funding for a very limited return.

The EMS Transitional Handbook contemplates centralizing EMS dispatching at first into 9 dispatch centers and in the future even less. This will make many of the current 27 Public Safety Answer Points (911 centers) non viable as the revenue from the fees on telephone lines for this service is far from sufficient to fund their operations and most require the revenue fro EMS services, fire services and municipalities for emergency dispatch centers to survive. The transfer of EMS dispatching will not remove the need for municipalities to provide 911 service and fire service dispatching to their residents. The EMS shift will incur additional costs for municipalities and potentially require many municipalities to look for new service providers as PSAPs cease to operate and close their doors. The Province of Alberta does not provide any funding to municipalities for the provisions of 911 services to Albertans.

Further to the centralizing of EMS dispatch the British Columbia and Ontario experience has shown that in other than the very expensive fully computer controlled dispatch systems available in large metropolitan areas there has been major concerns about delayed dispatch of fire and police services to emergencies requiring multi-agency responses such as motor vehicle collisions, mostly due to increased call volumes in EMS dispatch centers as they were reduced in numbers.

The AAMDC participates in a monthly conference call with Ambulance Transition staff to keep up-to-date with arising issues.

Resolution 8-08S: THEREFORE BE IT RESOLVED that the AAMDC urge the Governments of Alberta and Canada to establish and operate emergency and medical response sites fully equipped and staffed in strategic locations along the Fort McMurray traffic corridors.

Resolution 13-06F: THEREFORE BE IT RESOLVED that the AAMDC work with SARM (Saskatchewan Association of Rural Municipalities), and the appropriate provincial departments to eliminate any barriers to having EMTs and paramedics cross provincial boundaries to provide first medical responses to residents on either side of the provincial boundary.

Resolution 22-05F: THEREFORE BE IT RESOLVED that the Alberta Association of Municipal Districts and Counties urge the Government of Alberta to develop Emergency Response Protocols and assume all liabilities arising from the attendance of provincial highway and roadway incidences for all responding emergency services personnel.

Health and Wellness:
Since the EMS transition announcement, Alberta Health and Wellness has communicated regularly with stakeholders, including the AAMDC, and this will continue.
The AAMDC has participated in monthly EMS transition teleconferences and met with the Minister of Health and Wellness on August 22, 2008 to discuss issues, including the EMS transition.
Alberta Health and Wellness also sent two draft regulations under the Emergency Health Services Act to the AAMDC for comment, and the association will be contacted regarding future regulations.

Alberta Health and Wellness does not anticipate any changes to the role of first responders, including fire services, in the delivery of EMS.  First responders will continue to have a key supporting role and will be consulted on any future regulation addressing that role.
A decision has been made to consolidate EMS dispatch to three centres in northern, southern, and central Alberta.  This will ensure the right resource is sent to the right patient without the restriction of geographical boundaries.

The association was included as a stakeholder both prior to and since the EMS transition to provincial control which occurred April 1, 2009. Staff were involved in decision-making and planning in consultation with Alberta Health and Wellness in order to represent the interests of Alberta municipalities. After the transition took place and the issues became local rather than provincial, the association stepped back from the table, as there was less of a role to play. The provincial consolidation of the EMS dispatch centers is still ongoing, and the AAMDC will work to be involved in this process as it proceeds. More recently, the AAMDC has agreed to participate on a medical first responder advisory panel. The panel’s purpose is to provide input, feedback and advice on key decision for a future model for Medical First Response within Alberta.  Our continued participation in initiatives such as these ensure the intent of this resolution continues to be met in an acceptably manner.