THE REGIONAL MUNICIPALITY OF PEEL

EMERGENCY AND PROTECTIVE SERVICES COMMITTEE

M I N U T E S
   EPSC-2005-1

The Emergency and Protective Services Committee met on Thursday, September 22, 2005 at 9:36 a.m., in the Council Chamber, Regional Administrative Headquarters, 10 Peel Centre Dr., Brampton.

Members Present:
   E. Kolb, D. Lyons, M. Morrison, P. Palleschi
Members Absent:
   P. Mullin due to vacation
Also Present:
   R. K. Gillespie, Commissioner of Corporate Services and Regional Solicitor; P. Dundas, Director of Ambulance and Emergency Programs, J. Payne, Legislative Coordinator

Chaired by Councillor P. Palleschi


1. DECLARATIONS OF CONFLICTS OF INTEREST


2. APPROVAL OF AGENDA

RECOMMENDATION EPSC-1-2005:

That the agenda for the September 22, 2005 Emergency and Protective Services Committee meeting be approved.

3. PEEL REGIONAL AMBULANCE SERVICES

a) Land Ambulance Program, 2004 Annual Report

Received


b) Adoption of Service Name

RECOMMENDATION EPSC-2-2005:

That the name "Peel Regional Paramedic Services" be adopted as the name for the services provided by the paramedics employed by the Region of Peel;

And further, that the marks (trademarks) of "Peel Regional Paramedic Services"; "Peel Regional Paramedic"; "Peel Paramedic Services"; and "Peel Paramedic" and the associated designs for paramedic shoulder flashes and vehicle decals be adopted as official marks of the Region of Peel;

And further, that the said marks be registered under the Trademarks Act to prevent use by services and organizations other than those of Peel Regional Paramedic Services or the Region of Peel.

Councillor Palleschi, Chair of the Emergency and Protective Services Committee (EPSC), expressed that the recommended change in name to Peel Regional Paramedic Services represents an important step in the evolution of the program and recognizes the level of training, dedication and professionalism of the women and men who provide this essential service to all residents in the Region of Peel.


c) 2004 Annual Report and Budget Update (Oral)

Received

2004 Annual Report Presentation

Peter Dundas, Director, Ambulance and Emergency Programs, provided a presentation to the Committee regarding the 2004 Annual Report for Peel Regional Ambulance Services. Information was provided that detailed ambulance response demand by code type, revealing that 98 per cent of calls were emergency responses:

Call Type/Code Call Volume  
 
Emergency (Codes 3 and 4) 57,397  

Emergency Coverage (Code 8)

 23,942  

(Emergency Call Sub total)

 81,339 (= 98% of calls)
 
Non-Emergency (Codes 1 and 2) 1,986  

(Total Calls: Emergency + Non-Emergency)

 83,325  

Peter Dundas noted that 2004 data includes the additional 35,040 hours of service added by Regional Council to the ambulance service. The additional resources (hours of service) were targeted to address peak call demand periods which have resulted in an improved average response time and an improved 90th percentile response time:

Response Time Average Response Time 90th Percentile
Year (Minutes : Seconds) (Minutes : Seconds)
2003 7:54 11:43
2004 7:40 (14 second improvement) 11:33 (10 second improvement)

Peter Dundas noted that staff is working with the Ministry of Health and the Base Hospital to improve upon the type and integrity of the data being collected related to ambulance call types, response times and outcomes to allow for more comprehensive analysis in the future. The data includes response times in the Region of Peel by services from outside of the Region; subtracting those responses by other services, the 90th percentile data for Peel Regional Ambulance Services further improves to 11 minutes and 17 seconds. He also noted that the Central Ambulance Communication Centre (CACC) has two minutes to dispatch a call and it is not clear from the data provided by the Ministry of Health and Long Term Care (MH&LTC) how much this dispatch time impacts upon the overall response time.

Chair Kolb asked if there was any data demonstrating that the Emergency Medical Responder (EMR) training funded by the Region of Peel for area municipal fire services staff, combined with the Advanced Care Paramedic (ACP) training, was having a positive impact upon medical call outcomes. Peter Dundas responded that the data currently collected is focused upon response times and not upon call outcomes. Staff is working with their counterparts at the Ministry of Health and the Base Hospital to collect the type of data that would assist in making a determination regarding the impact of the additional training being provided to both fire services and ambulance program staff. Chair Kolb inquired about the current initiatives by staff to address the provincial funding shortfall. Peter Dundas indicated that staff continue to write letters documenting the funding shortfall to the Minister and the Ministry of Health and Long Term Care. He noted that he was a member of a Task Force struck by the Minister, MH&LTC, to look at the issue of hospital delays and that group submitted its report and recommendations in June of this year. Work is also being done through the Association of Municipalities of Ontario (AMO) and other groups representing Heads of Councils and Chief Administrative Officers.

Councillor Lyons noted that the Region and the area municipalities are accepting responsibility for the provincial shortfall in funding by taking money out of the ambulance system to provide EMR training to fire services staff. Kent Gillespie noted that tiered response was always part of the system and that prior to downloading, the Province paid for certain medical supplies provided to fire services. When the Province withdrew this funding, the Region undertook to provide these supplies to the area municipal fire services. Currently these programs cost about $200,000 per year. The current EMR training program provided to area municipal fire services and paid for by the Region costs roughly $50,000 per year. Unfortunately, the data currently available does not answer the question as to whether the training is providing better call outcomes or greater efficiencies for the overall system.

Councillor Morrison noted that the provincial funding shortfall for ambulance services is a significant drain on the Regional budget and thus a substantial burden upon the taxpayers of the Region of Peel. Given the current situation, massive amounts of additional tax dollars would be required to meet the provincially mandated response times, yet the Province continues to ignore its commitment for 50 per cent funding made when the service was offloaded to municipalities.

Peter Dundas addressed the issue of hospital offload delays which experienced further increases at the 90th percentile in 2004, being 1 hour 43 minutes as compared to 2003 at 1 hour 42 minutes. Overall hospital offload delay for 2004 was 25,979 hours (Overall Hospital Time - hours greater than 20 minutes). These delays are amongst the longest in the Province, on average 10 minutes longer then those experienced in Toronto hospitals. Peter Dundas expressed optimism that the recommendations of the Ministers' task force on offload delays, if implemented, would result in significant efficiencies.

The final portion of the 2004 Annual Ambulance Report addressed the overall cost of the program. The cost per service hour for 2004 was $137.48. Peter Dundas noted that this compared reasonably to other services within the GTA. Salary, benefits and training account for approximately 77 per cent of program costs.

Councillor Morrison requested that a summary of the key challenges facing the system be provided to her so that she can undertake to write the Minister, MOH&LTC, and keep the residents of Caledon fully informed.

Peter Dundas concluded by highlighting three key factors which shaped the 2004 service year for Peel Regional Ambulance Services:

Ambulance and Emergency Programs 2006 Budget Update Presentation

Peter Dundas identified four major program accomplishments for 2004 as follows:

Peter Dundas explained that the proposed 2006 program budget is flat, in part because of Councils' decision not to implement one additional 24/7 unit and related staffing in 2005. There are no additional Full Time Equivalents (FTEs) or service hours proposed in the 2006 budget. He noted that the level of funding from the MOH&LTC, which does not recognize current wages and Advance Care Paramedic (ACP) accreditation, is projected to be at 29 per cent of program costs. The MOH&LTC recognizes only a two per cent annual wage increase, and has done so since offloading the service, thus provincial funding of the wage portion of the service has fallen behind actual collective agreements and arbitrated settlements across the Province. The two per cent wage increase passed along by the Province for 2006 will increase provincial funding by $152,000. Further, the Province does not recognize the wage differential for ACPs or the cost of providing Emergency Medical Responder (EMR) training to area municipal fire services.

Peter Dundas noted that a 10 year capital plan is commencing in 2005 with recommendations being available for the 2007 budget cycle. A technology plan, a human resources plan and a BEST improvement plan will also be initiated in 2006. He also spoke to significant service improvements projected in 2006 resulting from the following factors:

Councillor Morrison requested that staff ensure the population projections used for evaluation purposes in developing the 10 year capital plan are realistic and do not simply reflect optimistic planning projections.


4. EMERGENCY PROGRAMS


5. IN CAMERA MATTERS

Committee moved In Camera at 11:07 a.m.

a) Labour relations or employee negotiations

Committee moved out of In Camera at 11:20 a.m.


6. SCHEDULE OF FUTURE MEETINGS

Thursday, November 3, 2005 - 9:30 a.m. to 12:00 p.m.
Council Chamber
5th Floor
10 Peel Centre Dr.
Brampton, Ontario


7. OTHER BUSINESS


8. ADJOURNMENT

The meeting adjourned at 11:22 a.m.