THE REGIONAL MUNICIPALITY OF PEEL

EMERGENCY AND PROTECTIVE SERVICES COMMITTEE

M I N U T E S
   EPSC-2006-1

The Emergency and Protective Services Committee met on Thursday, February 23, 2006 at 9:40 a.m., in the Council Chamber, Regional Administrative Headquarters, 10 Peel Centre Dr., Brampton.

Members Present:
   E. Kolb¨; D. Lyons; Councillor G. Miles*, on behalf of Councillor Palleschi; M. Morrison; P. Mullin*
Members Absent:
   P. Palleschi, due to vacation
Also Present:
   D. Szwarc, Acting Chief Administrative Officer; R. K. Gillespie, Commissioner of Corporate Services and Regional Solicitor; D. Labrecque, Treasurer and Commissioner of Finance; Dr. H. Kassam, Medical Officer of Health; J. Smith, Acting Commissioner of Health; P. Dundas, Director of Ambulance and Emergency Programs; A. L. Beauregard, Supervisor, Regional Emergency Management; T. Irwin, Fire Chief, City of Brampton; J. McDougall, Deputy Fire Chief, City of Mississauga; Dr. B. Schwartz, Director, Sunnybrook-Osler Centre for Prehospital Care and Chair, Hospital Emergency Department and Ambulance Effectiveness Working Group; S. Jurrius, Acting Legislative Co-ordinator

_____________________________________
*See text for arrivals
¨See text for departures

Chaired by Vice-Chair Councillor M. Morrison


1. DECLARATIONS OF CONFLICTS OF INTEREST


2. APPROVAL OF AGENDA

RECOMMENDATION EPSC-1-2006:

That the agenda for February 23, 2006 Emergency and Protective Services Committee meeting be amended to include an item under Other Business regarding a news release from the Province of Ontario announcing the additional funds for municipal land ambulance services;

And further, that the agenda for February 23, 2006, Emergency and Protective Services Committee meeting be approved, as amended.


3. PEEL REGIONAL AMBULANCE SERVICES

a) Update on Deployment Strategy

Received

Peter Dundas, Director of Ambulance and Emergency Programs, provided an update on the deployment strategy set up by the Region of Peel in December 2005. The strategy involves locating paramedics in areas with historical high call demand and response times. This requires deploying resources into areas or posts without paramedic stations. A meeting with the paramedic working group has been scheduled for February 28, 2006. The paramedic working group consists of seven frontline paramedics as well as representatives from Central Ambulance Communications Centre (CACC), area emergency services, the Ministry of Health and Long Term Care and Base Hospital.

Councillor Lyons inquired if the deployment strategy will impact the offload delays.

Peter Dundas responded that offload delays and the deployment strategy affect the current system by tying up resources within the hospitals and the deployment plan is designed to optimize available resources within the system.

Councillor Morrison asked if the large geographical area of Caledon was considered in the deployment strategy.

Peter Dundas replied stating that the entire geographical area of Caledon was included in the strategy and that the Region partnered with York EMS and Dufferin County Ambulance Service to provide sufficient resources to cover the vast area of Caledon.

Councillor Mullin arrived 9:43 a.m.

In a recent ride-along with the Town of Caledon paramedics, Councillor Morrison observed the severity of some of the medical emergencies that the paramedics deal with. Councillor Morrison suggested that the Region work with the Province of Ontario to raise awareness to the general public how to use the emergency departments and the 9-1-1 system appropriately.

Peter Dundas informed Councillor Morrison that educating the public was one of the key recommendations in the report of the Hospital Emergency Department and Ambulance Effectiveness (HED&AE) Working Group released by the Ministry of Health and Long-Term Care (MOH&LTC) in the summer of 2005. Peel Regional Paramedic Services is actively promoting the proper use of the 9-1-1 systems and emergency departments by sending out literature, holding information sessions and campaigning the slogan "Use It, Don't Abuse It" throughout the Region.


b) 2006 Fleet Planning

RECOMMENDATION EPSC-2-2006:

That the purchase of 2006 Ambulance fleet requirements be awarded to Paul Demers & Sons Inc. in the amount of $728,522 (excluding applicable taxes) being the most cost effective solution in accordance with Purchasing By-law 62-2001;

And further, that the 2006 fleet purchases be made through the Ministry of Health and Long Term Care's (the Ministry) Ambulance Conversion Vendor of Record (VOR) as qualified through the Ministry's Request for Proposal 2005-24 in accordance with Purchasing By-law 62-2001;

And further, that funds in the amount of $837,800 from Capital Projects 06-7802, 06-7803 and 06-7804 be used to fund the 2006 purchases;

And further, that subject to future annual budget approvals, the future annual fleet requirements be purchased from Paul Demers & Sons Inc. for the five-year term of the Ministry VOR arrangements, as the Region's primary vendor, to be funded through the approved budgets for the applicable year.

Peter Dundas briefly summarized the recommendation and emphasized that the contract is not to purchase additional ambulances or response units but to replace aging ambulance and emergency vehicles.


c) Ambulance Off Load and Emergency Department Wait Times

RECOMMENDATION EPSC-3-2006:

Whereas unduly long Ambulance Off-load Times at Hospital Emergency Departments have been delaying Peel ambulances from returning to the street to respond to emergency calls;

And whereas, ambulance off-load delays cost Region of Peel taxpayers about $3.6 million annually in lost service to the community or the equivalent of 3 ambulance crews running 24 hours a day, 7 days a week;

And whereas, on January 30, 2006 the Minister of Health and Long Term Care released the report of the Hospital Emergency Department and Ambulance Effectiveness (HED&AE) Working Group dated Summer 2005, as part of his announcement on Ambulance Off-Load and Emergency Department Wait Times;

And whereas, the HED&AE report made many recommendations involving all aspects of the health care system that result in off-load delays;

And whereas, part of the Minister's announcement included the establishment of the Emergency Department and Ambulance Quality Implementation Team;

Therefore be it resolved, that the Minister of Health and Long Term Care be advised that the Council of the Region of Peel supports the Minister's intent to implement the recommendations in the report of the HED&AE Working Group dated Summer 2005;

And further, that the Minister of Health and Long Term Care be requested to include representation from the Region of Peel on the Emergency Department and Ambulance Quality Implementation Team;

And further, that the Minister of Health and Long Term Care be requested to implement all of the recommendations of the HED&AE Report without delay.

R. Kent Gillespie, Commissioner of Corporate Services and Regional Solicitor, provided an overview of the recommendation contained in the subject report to reduce ambulance off-load delays in emergency departments.

He indicated that the Region was not invited to participate in the Urgent Care Centres Demonstration Pilot Project initiated by the Ministry of Health and Long-Term Care. The project will allow hospitals and ambulances to transport selected patients with minor conditions to two Urgent Care Centres in Toronto: North York General Hospital - Branson Site and Sunnybrook and Women's College Hospital Site, instead of the emergency departments.

With the rapid population growth of the Region, Councillor Mullin expressed her disappointment that the pilot project did not include the two hospitals in the City of Mississauga: Credit Valley Hospital and Trillium Health Centre - Mississauga Site. She questioned the criteria used in selecting the hospitals.

Peter Dundas responded that the Credit Valley Hospital and Trillium Health Centre - Mississauga Site do not have urgent care centres and that he was not fully aware of the criteria used by MOH&LTC. Dr. Brian Schwartz, Director, Sunnybrook-Osler Centre for Prehospital Care and Chair, Hospital Emergency and Ambulance Effectiveness Working Group, provided a brief summary of the pilot project. He stated that one of the criteria in choosing the urgent care facility was that it had to be associated with a hospital corporation. Further, he told the subcommittee that the Working Group considered urgent care facilities that were once emergency departments; are still managed by emergency physicians and nurses; that have access to vital equipments such as CT scans while they are open; and that have various laboratory supports.

R. Kent Gillespie informed the subcommittee that Regional staff will still submit the recommendation to MOH&LTC. However, he suggested as part of the submission to the Ministry, that a letter from the Regional Chair could be prepared and sent to Minister George Smitherman expressing disappointment in the selection process.

Councillor Mullin requested the Commissioner of Corporate Services and Regional Solicitor to present a draft letter to General Committee at its meeting on March 2, 2006. The letter should convey the serious concerns of the Region with the urgent care facility selection process conducted by MOH&LTC. Councillor Mullin also requested staff to indicate why the Region should be part of the pilot project with supporting documents or statistics to justify the request.

Regional Chair Kolb requested Dr. Hanif Kassam, Peel Medical Officer of Health, prepare a report that will describe why the Credit Valley Hospital and Trillium Health Centre should be considered in any future pilot projects for a future General Committee meeting.

Regional Chair Kolb departed 10:20 a.m.

d) Paramedic Services Master Plan (Oral)
Presentation by Mic Gunderson, President and Todd Hatley, Chief Operating Officer, HealthAnalytics

Received

Mic Gunderson, President and Todd Hatley, Chief Operating Officer, HealthAnalytics provided an overview of the services provided by HealthAnalytics and the scope of analysis involved in the Paramedic Services Master Plan project. The purpose of the project is to cover the present and future needs for paramedic services in Peel and to provide a capital plan that will support the overall system direction. A final report and recommendations will be submitted to the Emergency and Protective Services Committee (EPSC) on June 15, 2006.

Councillor Miles arrived 10:47 a.m.

Councillor Mullin expressed concern with the recommendation of HealthAnalytics to purchase lands to accommodate future base facilities in the Region of Peel. She cautioned the consultants that the Region is not in a position to buy land and should instead look at using existing facilities to accommodate future needs. Councillor Mullin also inquired if the consultants took into account the type of calls received by emergency services.

Mic Gunderson responded that HealthAnalytics has all the necessary information from the Central Ambulance Communications Centre (CACC) and will consider the call severity and its impact upon response times in the project. With regards to the use of existing facilities, Mic Gunderson assured Councillor Mullin that the use of current facilities in the Region would be a focus of the project.

Councillor Miles commented that the majority of the members of Council believe fire and ambulance should be housed in the same facility. She noted that the City of Brampton Council is in favour of locating fire and ambulance in the same facility. Councillor Miles stated that ambulance services have the same needs and requirements as the fire department.

Councillor Lyons asked the consultants to include in their report, any data that will show if there were situations where it was not possible to house the ambulance and fire department in one area.

Councillor Morrison noted that the Town of Caledon is the first municipality in the Region of Peel to build a joint facility for ambulance and fire departments. Councillor Morrison stated that planning in the future to house fire and ambulance in the same facility would be desirable.

City of Brampton Fire Chief Terry Irwin, commented that he has been a strong supporter of shared facilities acknowledging that there are cultural differences between fire and ambulance but expressed his confidence that they could work together.

Deputy Fire Chief John McDougall, City of Mississauga, concurred with Fire Chief Irwin that the Mississauga fire department will help in any way to accommodate the current situation in Peel.


4. EMERGENCY PROGRAMS

a) Emergency Management: Pandemic Planning (Oral)
Presentation by Dr. Hanif Kassam, Medical Officer of Health and Andre Luc Beauregard, Supervisor, Regional Emergency Management, Ambulance and Emergency Programs

Received

Dr. Hanif Kassam, Medical Officer of Health, provided members of the subcommittee with the World Health Organization (WHO) Avian Influenza Update for the week of February 9 to 15, 2006. The data showed the cumulative number of confirmed human cases of Avian Influenza A/(H5N1) reported to the WHO from 2003 to 2006. Dr. Kassam pointed out that the number cases are increasing for avian influenza and the mortality rate is 50 per cent or higher. Dr. Kassam informed the members of the EPSC about the current phase of alert in the WHO global influenza preparedness plan as of February 15, 2006. The world is presently at Phase 3, meaning "no or very limited human-to-human transmission". Dr. Kassam stated that there have been various cases of avian influenza or bird flu but there is no confirmation of active human-to-human transmission at this time.

Dr. Kassam gave a brief summary of the Pandemic Planning in the Region of Peel. He stated that to ensure an effective response plan, the Region must maintain a good working relationship with the community stakeholders in the event of an emergency. In addition, he noted that good communication plays an integral role in an emergency situation.

As outlined in the Ontario Health Pandemic Influenza Plan, the municipal government and local public health authorities are responsible for coordinating the local response. The Region has established pandemic planning groups and its roles are as follows:

Dr. Kassam informed the subcommittee that Peel Public Health will host a physicians' forum in the area municipalities as follows:

Along with Dr. Kassam and Peel Health staff, representatives from MOH&LTC and Infection Diseases Specialists will make presentations at the forum to educate, raise awareness and canvass physicians about the Region of Peel Pandemic Influenza Task Force.

Andre Luc Beauregard, Supervisor, Regional Emergency Management, Ambulance and Emergency Programs, outlined the roles of the corporate-wide Regional Emergency Management Program as follows:

Dr. Kassam informed the subcommittee that he will present a letter and a package to the members of the Regional Council which will include an updated response plan and an outline of the activities and presentations made by Peel Public Health staff.

Dr. Kassam outlined the roles of the Region of Peel Pandemic Influenza Task Force:

The Task Force will involve the following sectors: health care; government; emergency services; community emergency response; mortuary services; essential services/private business/utilities; education; children/social services; travel/transportation; religious groups and multicultural services.

Dr. Kassam informed the subcommittee that the Task Force will deal with the following issues:

Councillor Mullin requested the Medical Officer of Health to prepare a clear and concise information sheet for Councillors' newsletters to inform the residents about the current bird flu situation and the pandemic plan of the Region. Councillor Mullin further requested that the proposed article be provided to all members of Regional Council. Dr. Kassam undertook to work with the Corporate Services Department to prepare an article for the Councillors' newsletters.

Councillor Morrison thanked Dr. Kassam and Andre Luc Beauregard for the presentation and inquired as to whether it will be presented to Regional Council. Dr. Kassam indicated that once Peel Public Health staff has gathered enough information from the Task Force and the Physicians' Forum, a report or an updated presentation will be provided to Regional Council.

Councillor Morrison requested the Medical Officer to ensure that the materials on Pandemic Planning dealt with at the February 23, 2006 EPSC meeting be provided to the members of Regional Council.


5. IN CAMERA MATTERS


6. SCHEDULE OF FUTURE MEETINGS

R. Kent Gillespie suggested that the subcommittee schedule another EPSC meeting on June 15, 2006 to consider the final draft of the master plan from HealthAnalytics before it is formally presented to Regional Council.

Councillor Morrison informed the subcommittee that there is a Waste Management Subcommittee meeting scheduled on June 15, 2006. She therefore suggested that the EPSC meeting be held at 9:30 a.m. on that day.

Councillor Mullin requested that the meeting scheduled for May 25, 2006 commence at 9:30 a.m. rather than the originally scheduled time of 1:00 p.m.

The subcommittee members agreed to meet at 9:30 a.m. on May 25, 2006.

a) Thursday, May 25, 2006
9:30 a.m. to 12:00 p.m.
Council Chamber, 5th Floor
Regional Administrative Headquarters
10 Peel Centre Dr.
Brampton, Ontario

Additional Meeting Scheduled

b) Thursday, June 15, 2006
9:30 a.m. to 12:00 p.m.
Council Chamber, 5th Floor
Regional Administrative Headquarters
10 Peel Centre Dr.
Brampton, Ontario


7. OTHER BUSINESS

Additional Item - 7a

a) News Release: Office of the Premier of Ontario, dated February 21, 2006, Announcing the Commitment of the Province of $300 Million to Achieve True 50-50 Sharing of the Cost of Municipal Land Ambulance Services by 2008

Received


8. ADJOURNMENT

The meeting adjourned at 11:19 a.m.