+ RMA Rural Municipalities
of Alberta

Resolution 9-23S

Rural Fixed Wing Medivac Services

February 23, 2023
Expiry Date:
March 1, 2026
Active Status:
MD of Spirit River
4 - Northern
Emergency Services
Intent Not Met
Vote Results:

WHEREAS rural Alberta is under-served by fixed wing medivac services; and

WHEREAS Alberta Health Services (AHS) has further  reduced fixed wing air ambulance services to three rural municipalities, and potentially more, throughout the winter seasons: and

WHEREAS these municipalities have maintained airports and runways for decades that have served fixed wing aircraft without incident; and

WHEREAS AHS has cited pilot inexperience as the rationale for eliminating fixed wing air medivac services to these and potentially other rural municipalities: and

WHEREAS AHS has further cited the need for municipalities to upgrade rural airports and runways at a huge cost to the municipality to compensate for the inadequacies of the contractors’ pilots: and

WHEREAS AHS claims that STARS Air Ambulance and ground transportation are suitable replacements for fixed wing service, and

WHEREAS many rural municipalities have a shortage of drivers to drive ground ambulance, resulting in extensive delays in rural patients accessing professional care, resulting in deaths and long-term health conditions; and

WHEREAS AHS has a contract with a service provider to provide fixed wing air ambulance services to rural municipalities year-round, and

WHEREAS the service provider is unable to provide adequately trained pilots to facilitate fixed wing medivac services ; and

WHEREAS the termination of rural fixed wing air ambulance services will result in deaths and long-term health issues for patients related to delays in accessing appropriate medical care:

Operative Clause:

THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta (RMA) request that the Government of Alberta ensure that air ambulance service providers adhere to their existing contract and restore air ambulance service  to the three municipalities that have recently lost this service either by compelling the contractor to subcontract the air ambulance service to a contractor with appropriately skilled pilots; requiring the contractor to train their existing pilots to achieve industry standards,  or by providing funding to municipalities to upgrade  airports to meet the new standard required for lower skilled pilots; and

FURTHER BE IT RESOLVED that the RMA request that the Government of Alberta compel Alberta Health Services (AHS) to provide any airport slated for discontinuance of any AHS transportation services a detailed analysis of necessary changes (within reason and based on industry standards) required to be made by the airport and a commitment that if those changes are completed, full transportation services will be reinstated.

Member Background:

Rural municipalities have seen a steady decline in health services in our communities. Several municipalities have been compelled to build medical centers in order to attract and retain physicians in their region.

Rural municipal health centers lack not only physicians but also all levels of nurses, physiotherapists, massage therapists, health care aides, and all other forms of healthcare professions.

Rural municipal health centers face regular closures of their emergency, most often on weekends but also for extended periods, due to a lack of health care professionals.

Rural emergency response teams are frequently absent or short staffed, making ground ambulances unavailable until a driver can be located in a neighboring town or city, further delaying patient care.

Rural fire departments, most often staffed by volunteers, are facing challenges in getting new recruits,  resulting in skeleton crews. As these volunteers are frequently the first responder to vehicular accidents, and can be the only responder, transportation of patients can be left in their hands.

Reliance of STARS Air Ambulance is dependent on their availability, and is restricted greatly dependent on weather.

AHS’s recent announcement to cease fixed wing air ambulance for the Spirit River, Ponoka and Two Hills airports based on pilot inexperience, is one more way that AHS is not providing equitable and quality healthcare to rural Albertans.

Fixed wing medivac services have been serving these municipalities for decades with no hint of this service being removed.

In 2017, AHS negotiated a new contract for fixed wing air service across the province with predominately one company. At that time, there was discussion that this would force competing service providers out of business and with that a loss of skilled pilots. This is the situation AHS faces and with that municipalities and their ratepayers are paying the price.

In November of 2022, the Town of Spirit River received a telephone call from AHS advising that the Spirit River Airport’s fixed wing medivac service is suspended for the winter and every winter moving forward. Simultaneously the towns of Ponoka and Two Hills received similar correspondence.

Reasons cited for the discontinuance were: pilot inexperience, length and width of the runway, and concerns with response times when alerting the airport of an incoming flight. The Town was further advised that the contractor’s pilots were not as experienced and therefore were apprehensive about landing in Spirit River in the winter.

The Municipal District of Spirit River took a lead role in advocating for a resolution to this and the region’s ratepayers’ lives are at risk. Letters were written to the Premier, ministers Copping, Jean and Loewen as well as AHS CEO Dr. John Cowell.

The MD has also put in a FOIP request for a copy of the contract between the fixed wing air ambulance provider and AHS. We have not yet received that.

Ministers, and AHS response to-date has been that pilot safety is a priority and rural municipalities continue to receive quality healthcare through STARS and ground ambulance.

It should be noted numerous municipalities and organizations have also written letters.

Airports without commercial flights have few if any grants available to sustain, repair or expand expensive runways and infrastructure. If the Province is changing the requirements needed by rural airports to benefit from fixed wing air ambulance, the province needs to develop funding for municipal airports so they can sustain AHS medivac service.

RMA Background:

RMA has no active resolutions directly related to this issue.

Government Response:

Alberta Health

Although RMA has not received a formal response to this resolution from the Government of Alberta at this point, developments on this issue an update.

On April 14, 2023, Alberta Health issued a Request for Proposals (RFP) to engage a consultant to analyze Alberta aircraft landing sites that are either in use now or have been used recently by the provincial air ambulance program. The RFP closed on May 8, 2023 and the successful bid will be selected in early June 2023.

The selected consultant will work with municipalities, aviation providers, emergency medical services (EMS) providers, ambulance operators, and other stakeholders to perform a detailed inventory assessment. This project will also include a review of winter operation considerations, a cost-benefit analysis of infrastructure upgrades, guidelines and protocols for airplane and helicopter landing sites, and clear guidance to municipalities responsible for maintaining the landing sites.

The RFP outlines the need for proponents that have a high-level of understanding to situations similar to Alberta aircraft landing sites, including:

  • Experience reviewing large air ambulance systems;
  • Experience working on projects requiring complex work groups, facilitation and the ability to present, engage and solicit input from a diverse group of stakeholders;
  • Experience conducting large EMS system reviews, with a particular focus on air ambulance within a health system composed of municipal and private partners; and
  • Experience applying standards and best practice in respect to airport and heliport planning or system improvements.

The evaluation is expected to be completed by January 15, 2024, but these timelines may change upon confirmation of the contract with the chosen proponent. The budget for this project is expected to be no more than $1.7 million.

The successful proponent is required to sign a non-disclosure agreement (NDA) upon starting the project. All findings from this project will remain confidential until the final report is released to the public in early 2024.


Depending on its outcomes, the air ambulance landing site review may represent a step in the right direction for effected airports to understand their gaps in services and what is needed to ensure they can safely operate as air ambulance landing sites. The RMA is listed as a key stakeholder in this consultation process and staff will ensure that all consultation includes the effected members.  However, the review may also pose a risk to small municipalities if outcomes include recommendations for airport standards that small municipalities may be unable to meet, particularly without targeted funding support from the Government of Alberta.

The RFP does not make up for the closure of air ambulance landing sites without consultation and does not restore services and adhere AHS to their existing contracts. There needs to be adequate training of contracted pilots working in these rural areas and the RFP does not account for this.

This resolution is assigned a status of Intent Not Met. RMA will continue to advocate for the complete restoration of air ambulance services.

Back to Resolutions Database