+ RMA Rural Municipalities
of Alberta

Resolution 14-19F

Provincial Funding for Regional Air Ambulance

November 1, 2019
Expiry Date:
December 1, 2022
Active Status:
Cypress County
1 - Foothills-Little Bow
Emergency Services
Vote Results:

WHEREAS all Albertans deserve access to emergency air ambulance services (both rotary-wing and fixed-wing), and

WHEREAS the Shock Trauma Air Rescue Society (STARS) provides emergency air ambulance services centered out of Edmonton, Calgary and Grande Prairie, and

WHEREAS response to outlying rural areas of Alberta is limited, and

WHEREAS regionally-operated air ambulance services perform a vital service that complements ground ambulance and STARS air ambulance, and

WHEREAS the Government of Alberta does not fund locally- or regionally-operated air ambulance services such as Helicopter Air Lift Operation (HALO) in southeastern Alberta, leaving them to rely wholly on funding from municipalities and donations of private individuals and responsible corporate partners;

Operative Clause:

THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta request that the Government of Alberta provide funds to locally- and regionally-operated emergency response air ambulance services at the same ratio as Shock Trauma Air Rescue Society (STARS) funding;

FURTHER BE IT RESOLVED that the Government of Alberta commissions an independent review, which includes engagement with  the public, industry stakeholders and municipalities acoss Alberta, of the helicopter emergency medical services system in Alberta.

Member Background:

Locally- or regionally-operated emergency response helicopter services are still needed in addition to Shock Trauma Air Rescue Society (STARS). In south-eastern Alberta, Helicopter Air Lift Operation (HALO) medevac rescue helicopter has operated out of Medicine Hat since 2007. HALO provides residents of Cypress County and surrounding communities, as well as vast remote areas, with improved patient care and decreased transport times for critically ill or injured people at no cost to the patient in coordination with the network of ground-based ambulances.

Negotiations between HALO and Alberta Health Services resulted in a one-year agreement, expiring October 1, 2019. The agreement includes “restricted funding” (meaning one-time) of $1,000,000. This agreement stipulates that a twin-engine helicopter be required, and HALO obtained the services of such a machine through Rangeland Helicopters in Medicine Hat. The operating costs of this helicopter including the extended daylight hours it is allowed to fly are certainly higher than HALO’s original machine, but it is more effective, and HALO’s budget is still considerably lower than other emergency response helicopter services.

These additional costs have put HALO in a difficult fiscal situation. In spite of substantial public donations in the summer of 2019, HALO currently has a $750,000 shortfall. HALO is a valuable resource to other public service departments and is an integral part of emergency response planning at the corporate, municipal, and regional levels. HALO is available to serve the community in a variety of ways including search and rescue, and disaster response. This program allows the communities within a vast response area the best possible access to rapid, advanced medical care in an emergency.

The availability of the helicopter decreases response times of paramedics to trauma victims in remote or inaccessible areas. Even with the new longer-range STARS helicopters, regional medical helicopters still provide a quicker response.

RMA Background:

RMA has no active resolutions directly related to this issue.

Government Response:

Alberta Health

Alberta Health recognizes the important role that the Shock Trauma Air Rescue Society (STARS), Helicopter Air Lift Operation (HALO) and other helicopter emergency medical services (EMS) agencies play as key partners in providing urgent medical care to. Albertans.

To improve helicopter EMS in rural and remote areas, AHS is currently conducting a review that will involve engaging with municipalities and the public. As part of the review, AHS will assess current funding relationships and commitments. The review began in November 2019 and is expected to take six to nine months.

Pending the outcomes of the review, the current funding system reflects the significantly different services provided by STARS and by locally and regionally operated emergency response air ambulance services, such as HALO and the Helicopter Emergency Response Organization (HERO). HALO and HERO provide medevac services to the Southern and Northern regions of Alberta respectively, transporting patients to health facilities. STARS provides 24 hours a day critical care level services (including night- flying capabilities) with their employed medical crew (advanced paramedics, nurse paramedics and emergency physicians). STARS also covers for HALO and HERO areas at night if the call meets the criteria for helicopter service. AHS has a 10-year affiliation agreement with STARS that provides core funding annually for critical care level EMS helicopter services across Alberta. AHS provides fee-for-service funding to HALO and HERO for advanced life support level of service. AHS provided a $1 million one-time grant to HALO to support its recent purchase of a BK117 helicopter, but has since returned to the fee for service funding model.

Alberta Treasury Board and Finance

Alberta Treasury Board and Finance has no input on this resolution, as it is solely within the mandate of Alberta Health.


Alberta Health Services (AHS) conducted a review of current services that provide helicopter EMS in rural and remote areas of Alberta. RMA provided feedback on the AHS helicopter ambulance review, emphasizing the important role helicopter ambulances play in rural healthcare.

Alberta Health released their Helicopter Emergency Medical Services (HEMS) report in June 2021. The report recommends that STARS become the sole provider of HEMS in Alberta, with HALO and HERO being phased out. However, recent announcements have committed funding to cover up to 50% of HALO and HERO operational costs for the next five years. This suggests this specific HEMS report recommendation will not be accepted. HEMS is also being considered as part of a 2022 EMS review – RMA will monitor this process for impacts on HEMS and ground EMS.

Air ambulance funding mechanisms vary across jurisdictions. In British Columbia, air ambulance services are fully funded by the province. Ontario’s ORNGE air ambulance service appears to be funded in a similar manner to STARS. Quebec began a pilot in September 2018 for two helicopter ambulances in partnership with a private operator.

As a result of recent operational funding agreements for HALO and HERO and the HEMS review this resolution is assigned the status of Accepted.

Provincial Ministries:
Treasury Board and Finance
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