EMERGENCY AND PROTECTIVE SERVICES COMMITTEE

The Emergency and Protective Services Committee met on February 20, 2002 at 9:43 a.m., in the Council Chambers, Regional Administrative Headquarters, 10 Peel Centre Dr., Brampton.

Councillor Palleschi presided.

1. DECLARATIONS OF CONFLICTS OF INTEREST

2. APPROVAL OF AGENDA

RECOMMENDATION EPSC-1-2003:

That the agenda for February 20, 2003, Emergency and Protective Services Committee meeting be approved.

3. DELEGATIONS/PRESENTATIONS

a)	Tony Campeau, Senior Field Manager, GTA Field Office, Ministry of Health and Long Term Care Regarding the Funding and Delivery of Land Ambulance Service

Received

Tony Campeau, Senior Field Manager, GTA Office, Ministry of Health and Long Term Care gave a brief update of the Provincial contributions to Land Ambulance Services in the Region of Peel.

Councillor Mullin raised two issues for discussion with Mr. Campeau: the difference between the Region's and the Province's understanding of 50 per cent funding for the land ambulance program committed to by the Province and , and the definition of "approved" funding; and the timing of funding in the context of the Region's attempt to budget effectively. Mr. Campeau responded that the provision of 50 per cent funding for the program from the Province was a response to pressures identified by municipalities after the transfer from the Province.

Councillor Palleschi expressed concern that the Ministry's approved funding is based on 1999 data. He further highlighted the increased cost of the program borne by the municipalities considering that the Ministry was not able to meet its own guidelines when it operated the land ambulance program. Mr. Campeau noted that the Province works within its own funding limitations and that his section of the Ministry was currently appealing for more funding.

Regional Chair Kolb raised the issue of increased population growth in Peel and the impact this has on the land ambulance program. He noted that this has not been taken into account in the allocation of funding from the Province, nor has the increased population in Peel relative to other areas of the Province. Mr. Campeau responded that he would take the issue back to the Ministry for consideration. He recognized the impact of hospital offloading delays and noted that the Ministry would be requesting new business cases from municipalities in the spring for funding assistance related to this issue.

Councillor Prentice highlighted the lack of control municipalities have on several key aspects of the land ambulance program, specifically the Province's control of the Central Ambulance Communications Centre (CACC) and the Province's position on setting standards that municipalities are required to meet. She requested information on the Province's justification for placing the land ambulance program on the property tax base. She further requested that Mr. Campeau respond to the Committee's concerns in writing. Mr. Campeau stated that the decision to move the land ambulance program to the municipal level was part of an overall government downsizing initiative and that he was not a participant in that decision.

Councillor Prentice stated that policies and standards related to the program needed to be updated in order to manage the service effectively. She noted the trend toward upgrading paramedic service to the Advanced Care Paramedic (ACP) level in this context. Mr. Campeau indicated that he would convey this suggestion to the Ministry.

Kent Gillespie, Commissioner of Corporate Services and Regional Solicitor, picked up on an earlier comment regarding the timing of funding and noted the challenge to Peel's Land Ambulance Program of not being notified of the funding amounts from the Province until well into the operating year. Mr. Campeau discussed the funding constraints of the Ministry of Health and

Long Term Care in regard to the Province's fiscal year and that the Ministry itself does not become aware of its funding levels until after the start of the operating year.

Councillor Seglins suggested that Mr. Campeau meet with the Emergency and Protective Services Committee on a more frequent basis. She noted that Advanced Care Paramedics (ACPs) are needed in rural areas due to longer response times, and that this higher level of care at the entry point into the system may benefit the Province through improving the operation of the overall health care system. She asked whether the Province had a standard percentage of ACPs to be in the system. Mr. Campeau noted that the Province's paramedic standard was Primary Care Paramedics (PCPs), and noted that the contribution of ACPs to patient survival is not clear from statistical evidence. Councillor Seglins suggested that the Province encourage research in this area.

Councillor Seglins asked Mr. Campeau about the Province's view of the City of Toronto's initiatives with regard to decreasing the impact of ambulance offload delays in hospital emergency rooms. Mr. Campeau indicated that the Province was trying to encourage a cooperative solution to the problem by convening meetings between his section and that area of the Ministry dealing with hospital administration.

Councillor Morrison noted that there is a high expectation of paramedics with respect to training.

Councillor Palleschi requested that Mr. Campeau describe his background for members of the Committee. Mr. Campeau highlighted achievements of his 20-year career in ambulance service in Ontario, specifically his experience in ambulance services in Brampton.

Councillor Palleschi spoke to some of the challenges faced by the Region since taking over the land ambulance program, including: the quality of ambulances the Region was able to obtain from the Province; the wage rates approved by the Province for funding; population growth and the challenge of implementing a Regional ACP standard; and the level service provided by the CACC which is controlled by the Province. Mr. Campeau noted that the Ministry was attentive to dispatch problems.

4. PEEL REGIONAL AMBULANCE SERVICES

a) Disposal Policy for Decommissioned Ambulances

RECOMMENDATION EPSC-2-2003:

That future disposal of Region of Peel ambulances and Emergency Response vehicles be completed in accordance with the Regional by-laws and the disposal process outlined in the report of the Commissioner of Corporate Services and Regional Solicitor dated February 20, 2003, entitled "Disposal Policy for Decommissioned Ambulances".

b) Peel Regional Ambulance Services 2002 Annual Report

Received

Councillor Morrison inquired about the effect of traffic on response times. Peter Dundas, Director of Ambulance and Emergency Programs, noted that traffic gridlock has an effect on response times at peak traffic times depending on the location of the incident. He further noted that traffic is a problem at hospital emergency rooms due to the number of ambulances waiting to transfer patients to the hospital.

Councillor Morrison further inquired about the possibility of allowing one ambulance team to oversee patients waiting to be transferred instead of numerous ambulances from the same service waiting for transfers to occur. Peter Dundas stated that the transfer of care protocol could address this and is close to completion and agreement among all parties. He noted that there are liability issues associated with the possible solution Councillor Morrison described.

c) Service Review Update

RECOMMENDATION EPSC-3-2003:

That given the essential nature of the Land Ambulance Service to the health and safety of people living and working in Peel and the potential for adverse affects on system performance that could occur should any system changes be made without proper planning and implementation, that a Service Delivery Model and Implementation Plan for Land Ambulance Services be developed as the basis for the delivery of Land Ambulance Services at such time as the current Service Performance Agreements with the Region's contract providers come to an end, including any extensions that may be granted;

And further, that the development of the Service Delivery Model include the active participation of all members of Regional Council through a series of four workshops;

And further, that Regional Council take appropriate steps to ensure that Peel's paramedic workforce remain stable during the planning and implementation of the Service Delivery Model.

Peter Dundas, Director, Ambulance and Emergency Programs, presented an update on Service Review for the Region's Ambulance Service, including the Operator Review and the review in progress from Internal Audit. He noted that a series of four workshops, each approximately two hour sessions, were contained in the recommendation, with the dates scheduled by staff as follows: March 27, 2003, April 17, 2003, May 15, 2003, and June 5, 2003. The operators require 180 days notice of Council's decision with regard to the contract.

Regional Chair Kolb suggested that the first two workshops, held on Regional Council dates, could be scheduled from 9:30 to 11:30 a.m. with an attempt to keep the Council agenda light, which would follow the workshop. Councillor Palleschi indicated that the time reserved for the EPSC meeting on May 15 would be used for workshop discussions.

Councillor Mullin advised that there will be a Credit Valley Conservation workshop on June 5, and as many members of EPSC are required to attend, another date for the final workshop should be sought.

Item 4f was dealt with.

f) Paramedic Work Force Stability (Oral)

Received

For the benefit of the paramedics in attendance, Councillor Palleschi stated that whichever system the Region chooses for the land ambulance program, the Region wants to ensure that the rights paramedics currently have will be protected in the future. He noted that the value of the paramedic work force is of prime concern to the Region of Peel. Regional Chair Kolb echoed Councillor Palleschi's words, noting that the Region has invested in paramedic training and values the paramedics who work for Peel Regional Ambulance Services (PRAS).

d) IBI Group - EMS Operator Report

Received

Kent Gillespie, Commissioner of Corporate Services and Regional Solicitor advised that representatives from the IBI Group are expected to delegate at the March 6, 2003 Regional Council meeting.

e)	Communication: Malcolm Bates, Director, Emergency Health Services Branch, Ministry of Health and Long Term Care, Letter dated November 1, 2002, Responding to Acting Regional Chair, Rhoda Begley's Correspondence Concerning Land Ambulance Services in the Regional Municipality of Peel

Received

Additional Item

f) Paramedic Work Force Stability (Oral)

This item was dealt with earlier in the meeting

5. EMERGENCY PROGRAMS

6. POLICE SERVICES BOARD PROTOCOL

Received

Received

Referred to Corporate Services

7. IN CAMERA MATTERS

Committee moved In Camera at 11:36 a.m.

a) The receiving of advice that is subject to solicitor-client privilege, including communications necessary for that purpose

Chair Kolb departed at 12:05 p.m.
Councillor Dale departed at 12:10 p.m.

Additional Item

b) The receiving of advice that is subject to solicitor-client privilege, including communications necessary for that purpose

Committee moved out of In Camera at 12:20 p.m.

8. SCHEDULE OF FUTURE MEETINGS

Thursday, May 15, 2003 - 9: 30 a.m.
Regional Council Chambers
5th Floor
10 Peel Centre Dr., Brampton, Ontario

9. OTHER BUSINESS

10. ADJOURNMENT

The meeting adjourned at 12:23 p.m.