Compensation for Municipalities Participating in the Medical First Response Program
IT IS THEREFORE RESOLVED THAT the Alberta Urban Municipalities Association requests the Government of Alberta to provide direct financial compensation on a full cost-recovery basis to all Alberta Medical First Response agencies for every call responded to.
WHEREAS the Province of Alberta is responsible for providing ambulance service in Alberta;
WHEREAS the Province of Alberta, through Alberta Health Services, offers the “Alberta Medical First Response Program” which is a voluntary program which Alberta municipalities can participate in to provide medical first response service;
WHEREAS no compensation is provided to municipalities participating in the program, other than for a very limited amount of equipment and training; and
WHEREAS the service provided by the municipalities participating in this program is very valuable and saves lives.
The Province of Alberta, through Alberta Health Services, is responsible for providing ambulance service in Alberta. Previously, ambulance service was community based. Fire services remain a municipal responsibility. This separation between emergency services can pose a challenge to communities wanting to provide an integrated service in the times of greatest need.
The “Alberta Medical First Response Program” is a voluntary program which works towards closing this separation. Under this program, municipalities may voluntarily commit to providing emergency medical first response. There are five levels of service that can be provided by the participating municipalities which run the range from providing Standard First Aid up to and including Advance Life Support.
For participating in this program, municipalities are provided with access to equipment, training and other support through Alberta Health Services. Under the terms and conditions of the program any such support isn’t guaranteed. Currently, the monetary value of the support provided is $3,000 per Medical First Response agency per year. This provides things such as training and equipment. There is currently no direct monetary compensation provided by the Province to these volunteer agencies.
The program requires dedication from the participating municipalities in the form of reports and data submission and they must follow a number of protocols and procedures established by Alberta Health Services.
While many municipalities participate in the program as to do so can save lives and provide for a better level of care to patients than ambulance service alone (which can, at times be delayed due to call load or other reasons), providing this service places a burden on municipal resources both through responding to medical emergency calls as well as for filing the requisite documentation.
The City of Wetaskiwin has noted an inequity that exists in this program in that there is no monetary compensation provided to municipalities for providing this service. This is counterintuitive, we feel, as it discourages participation in the program, especially for the smaller municipalities of which there are many.
We believe that there should be monetary compensation provided by the Province for delivering this service and that the compensation should be full cost-recovery based. Not only will this put the service more in reach of municipalities of meager means but providing this compensation is simply fair and equitable as municipalities participating in this program are providing a service that is truly part of the Province’s mandate.
The Minister’s response to the 2017 resolution reiterates that the MFR program is voluntary, and that the agreement for enrolment in the program states that the program will not reimburse MFR agencies. The Minister also notes that fire departments play a role in municipal public safety as per section 7(a) of the Municipal Government Act, and providing MFR is another means by which municipalities can promote public safety.
AUMA members passed a similar resolution in 2016 that called for the Government of Alberta to provide a means by which local municipalities may recover costs from AHS for assistance to ground ambulance personnel for patient care, specifically calls for lift assists. The provincial response to the 2016 resolution indicated that the province had no plans to develop a cost recovery arrangement for MFR agencies, given the voluntary nature of the program. The response to the 2017 resolution reiterates that that the province’s policy on reimbursement has not changed.
In considering this response, as well as AUMA’s strategic priorities, AUMA identified a risk that continued advocacy for AHS to provide cost recovery for MFR agencies could lead to AHS to recoup costs from municipalities for health services that are currently provided free of charge. Additionally, at the time, AUMA had been advocating for the province to invest significant amounts of funding in a new Municipal Sustainability Initiative, as well as sharing a large portion of cannabis excise tax revenue. Additional requests for funding by AUMA during a period of economic restraint may have been perceived as unreasonable. The AUMA Board therefore approved accepting the response to the resolution. However, AUMA will continue to highlight concerns around the issue of downloading healthcare onto municipalities in our advocacy and budget submissions.