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Preamble:
WHEREAS public health is a provincial responsibility, and emergency medical services (EMS) and ambulance response are the authority of Alberta Heath Services (AHS) and its contractors; and
WHEREAS AHS centralized and assumed responsibility for EMS from municipalities and at that time promised no degradation of EMS services in rural communities; and
WHEREAS many municipalities operate a fire service utilizing volunteer firefighters or paid on-call firefighters who participate in the Medical First Response program but are not trained paramedics; and
WHEREAS these volunteers often serve as first responders in the absence or delay of Emergency Medical Technicians and paramedics within their service area; and
WHEREAS AHS has, through its ambulance and paramedic processes and policies, significantly reduced the services provided to rural Alberta; and
WHEREAS as a result, ambulance personnel are not always available to attend as first responders thereby leaving that responsibility to the volunteer firefighters; and
WHEREAS many volunteer firefighters are experiencing an increasing level of stress or burnout and reduced capacity to respond because of these additional duties; and
WHEREAS many jurisdictions, due to unbudgeted rising costs, may need to contemplate reducing service levels to no longer respond to medical assist calls, even though it places its own residents in further jeopardy;
Operative Clause:
THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta advocate to the Government of Alberta to compensate municipalities that operate a fire service with volunteers or employees that are qualified as Medical First Responders in instances when those volunteers or employees respond to emergencies due to the absence or delay of provincial emergency medical technicians and paramedics in their service area.
Member Background:
Ambulance services have deteriorated considerably in the past several years. Specifically, this year (to date) our firefighters have been first on scene for medical assist calls 23 times and in 15 of them the wait time exceeded 20 minutes before an ambulance arrived. During that period, responding firefighters are often placed in a compromising position. If this continues, we fear that we may lose excellent personnel and, equally troubling, will have serious difficulty recruiting new members.
RMA Background:
RMA has no active resolutions directly related to this issue.
Alberta Health Services
Thank you for your letter of November 29, 2022 outlining some of the recent Resolutions from the RMA’s Fall Session.
I appreciate you sharing the concerns that many of your members have regarding the provision of health services. Alberta Health Services strives to ensure that all Albertans have access to high quality health care in a timely fashion.
The Resolutions in question however fall more within the realm of government policy direction in Health and Advanced Education. I understand that these resolutions have also been provided to the Government of Alberta and I anticipate that they will respond to you directly.
Alberta Health
As background, in Alberta, the EMT designation is no longer used by the Alberta College of Paramedics or in provincial legislation. The EMT designation has been replaced by the primary care paramedic (PCP) designation. The other two designations for regulated members of the Alberta College of Paramedics are emergency medical responder (EMR) and advanced care paramedic (ACP), with EMR as the entry-level qualification, PCP as the middle qualification, and ACP as the highest qualification.
Alberta’s government understands that the ongoing strain on emergency medical services (EMS) has had a major impact on medical first responders, and we sincerely value the partnership we have with municipalities that provide this important service.
Under the Alberta Medical First Response (MFR) Program, administered by Alberta Health Services (AHS), MFR agencies made up of municipal fire-rescue services may join AHS’ MFR Program and respond to requests from AHS EMS dispatch to provide MFR services prior to the arrival of EMS. This voluntary agreement also allows MFR agencies to choose which types of EMS events they wish to respond to.
As MFR services are an optional responsibility for Alberta municipalities that are part of a public safety role, Alberta Health does not provide direct funding to MFR agencies to cover operational costs. However, the department does cover the cost of some training, equipment and supports, including the development and administration of provincial medical control protocols for medical first responders.
As you are aware due to your involvement with the Alberta EMS Provincial Advisory Committee (AEPAC), I was provided with a number of recommendations regarding the important role of medical first responders in assisting EMS to provide emergency health care to Albertans. These recommendations also speak to supports, including funding.
In his role as Parliamentary Secretary for EMS Reform, R.J. Sigurdson, MLA, Highwood, and former AEPAC co-chair, will be leading efforts to develop an implementation plan for AEPAC’s recommendations, while keeping a strong focus on Premier Smith’s direction to reduce EMS response times and wait times for EMS crews in hospital emergency departments. Both are significant factors in increased time on task and ongoing pressures on medical first responders in Alberta.
It is important to note that the implementation of initial recommendations from AEPAC included pilot projects involving MFR agencies and an exemption permitting EMRs to work on emergency ambulances. Budget 2022 includes $64 million in funding for EMS. This is in addition to $600 million that was added to Alberta Health’s operating expenses budget in 2022/2023, growing to $1.8 billion by 2024/2025.
Development:
The Government of Alberta has made several announcements about Medical First Response (MFR) in recent months, including:
The latter announcements were made in Fall 2024 as part of the Rural Health Action Plan.
While these funding programs are adjacent to this resolution’s intent, they do not include the introduction of an ongoing “bill per response” system to remunerate fire departments for their MFR costs. RMA is concerned that not only do new funding sources not properly support municipal MFR programs for responding to emergencies within provincial jurisdiction, they incentivize a download by encouraging the expansion of municipal MFR capacity without corresponding operational support. For this reason, RMA assigns this a status of Intent Not Met.
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