Responsibility of Ambulance Service Delivery
IT IS THEREFORE RESOLVED THAT that the AUMA advocate for the Government of Alberta to immediately consult with municipalities and the Health Sciences Association of Alberta to develop a plan to make urgently needed improvements to the delivery and performance of the ambulance system where municipalities are recognized and compensated for the role they play in support of the provincial health care system.
WHEREAS the Province of Alberta took responsibility for the delivery of ambulance service as it was a provincial health responsibility;
AND WHEREAS at the time the ambulance service transitioned from a municipal responsibility to a provincial responsibility there was a commitment that there would be no degradation of service to citizens;
AND WHEREAS the entire provincial health system has been operating on overdrive because of the COVID-19 pandemic;
AND WHEREAS the number of code reds, where no ambulances are available in the Province is impacting the ability of Albertans, especially rural Albertans, to access emergency medical care;
AND WHEREAS municipalities continue to provide support to the provincial health care system with the operation of our fire departments;
AND WHEREAS the health and safety of citizens continues to be a priority for municipalities as we arrive on scene as first responders to medical calls approximately 40% if the time;
AND WHEREAS the length of time, fire is on scene until an ambulance arrives is trending upwards exponentially, in some areas up over 50% and some rural areas as much as a 200% increase in wait time for fire services over the last year or 2 years;
AND WHEREAS municipalities are acting as a stop gap in the provincial health system with no compensation, and it is impacting the ability of municipalities to meet their own operational requirements; and
AND WHEREAS everyday Albertans’ access to health is being compromised due to a lack of emergency health care.
When the province transitioned ambulance service from a municipal responsibility to a provincial responsibility there was a commitment that there would be no degradation in the capacity of these services. Since that transition and especially over the last several months the impact on municipal fire services include:
o Increasing need for fire services to be the first response and first to arrive on the scene;
o Increasing need for co-response when EMS are more than 10 minutes out;
o Municipal fire crews are tied up at incidents longer and are required to stay until they can pass the patient to someone with at least the same level of qualification or higher which means fire crews once on scene cannot leave until EMS arrives;
o Increasing number of concurrent calls, which is affected by increased response times for lower level incidents (more than 10 minutes) and results in fire being dispatched; and
o Increasing need for call outs to protect the municipality from other occurrences which increases staffing costs for over time and relies on the availability of off duty staff. There is no contractual requirement for staff to attend call outs outside of their scheduled hours.
The effects on municipal staff include:
o Increasing stress on staff being exposed to more medical incidents;
o Dealing with patients and families concerned about delayed EMS transportation;
o Not being able to deliver the scope of practice of an Advanced Care Paramedic (ACP);
o Reduction of availability for other incidents, impacts capability, staffing and safety.
o Not being able to respond to other emergency situations.
o Experiencing delayed response of care for family members when seconds in response can affect long-term health outcomes;
o Potential increase in mental health issues; and
o Burn out.
Every citizen experiencing a medical crisis across Alberta is impacted, as the time of EMS response increases the survival rate of patient’s decreases. EMS are usually staffed with an ACP with a higher scope of practice than Firefighters Primary Care Paramedic (PCP), this restricts the care provided which could prove critical.
Ambulance service levels have become an urgent, emergent issue. As an example, in Okotoks, within the space of four days, July 28 – 31, two incidents required the use of the STARS helicopter. On one of these occasions, Okotoks did not have a ground ambulance available. On another occasion, August 3, dispatch informed the Incident Commander that EMS was 45 minutes out, eventually arriving from Strathmore. This is an unacceptable level of service provided by AHS and has shifted the burden substantially to municipalities across Alberta with dire health outcomes for citizens.
This resolution aligns with previous advocacy on emergency medical services and response times. This resolution has been forwarded to the Government of Alberta for response and further advocacy will be recommended to Alberta Municipalities' Board by the Small Communities Committee, within the context of related priorities and positions, and in coordination with any other related resolutions that are adopted.