EMERGENCY AND PROTECTIVE SERVICES COMMITTEE

MINUTES EPSC-2008-3

The Emergency and Protective Services Committee met on Thursday, November 27, 2008 at 9:33 a.m., in the Council Chamber, Regional Administrative Headquarters, 10 Peel Centre Drive, Brampton.

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* See text for arrivals
¨See text for departures

Chaired by Councillor Morrison.

1. DECLARATIONS OF CONFLICTS OF INTEREST - Nil

2. APPROVAL OF AGENDA

RECOMMENDATION EPSC-4-2008:

That the agenda for the November 27, 2008 Emergency and Protective Services Committee meeting be approved.

3. DELEGATIONS/PRESENTATIONS - Nil

4. REPORTS

a) Dedicated Offload Nursing Project

Received

Peter Dundas, Director, Peel Regional Paramedic Services provided an overview of the Dedicated Offload Nursing Project report.

Peter Dundas reported that in the spring of 2008 as part of an overall emergency room strategy, the provincial government announced grant funding for 14 designated municipalities to provide dedicated offload nurses. The Region of Peel, as one of the pilot municipalities, will provide funding to the three local hospitals for dedicated offload nurses. Staffing for the offload nurse will be from 11:30 a.m. to 11:30 p.m., seven days per week. The dedicated offload nurse will receive up to four patients at any one time which are triaged by the hospital to be at an acuity level based on the Canadian Triage Acuity Scale (CTAS) of a 3, 4 or 5. CTAS 1 and 2 patients, most critically ill patients, will continue to be managed by paramedics. Patients who remain with the offload nurse at the end of their shift are the responsibility of the hospital and will not be assigned back to paramedic crews. All three local hospitals have agreed to triage patients within 15 minutes of arrival and will move them to the dedicated nurse within 5 minutes.

Peter Dundas stated the anticipated outcomes of this project are to reduce paramedic offload wait times while the dedicated offload nurse is on duty. As a result, those ambulance service hours will be returned back to the system to respond to emergences in the community, address community impacts such as delaying responses to lower priority calls and provide improved workplace conditions for paramedics. Paramedic Services project the dedicated nurse program will recover 10,000 hours of paramedic time and return it to the emergency system.

Peter Dundas reported that effective Monday December 1, 2008, the dedicated nurse program will be launched at the Trillium and Credit Valley hospitals. The program launch date for the Brampton Civic hospital will be Monday December 8, 2008.

Councillor Mullin requested additional information on the timing of the initial funding of $375,000 and the section of the report identifying a need for an additional $80,000 from the approved Paramedic Program budget to support the program.

Peter Dundas responded that the $375,000 funding will be pro-rated as the dedicated nurse program will be launched on December 1, 2008. The pro-rated amount will be enough to fund the program until March 31, 2009 which is the end of the fiscal year for the provincial government. Peter Dundas indicated that as the provincial funding is pro-rated, the Region will have to cover the shortfall in funding to the end of the provincial fiscal year of March 31, 2009 which will amount to $80,000.

Councillor Adams expressed concern that if the public becomes aware they will be triaged in 15 minutes if they arrive at a hospital by ambulance, that this will put an additional strain on emergency services.

Peter Dundas reported the triage details related to the dedicated nurse program will not be made widely available to the public but Paramedic Services will be monitoring the level of emergency calls in order to determine if there is an increase.

Councillor Adams requested information on any reciprocal agreements with other regions that would provide the same level of service should a Peel Region resident arrive at an emergency room in a Toronto hospital.

Peter Dundas stated that the offload nurse program is in place in Toronto and residents of Peel who arrive by ambulance will be covered by the program there.

Councillor Paterak asked if the dedicated nurse program will produce cost savings as Paramedic staff will have fewer sick days due to the stress caused by the offload situation.

Peter Dundas responded that a reduction of sick days is one of the anticipated results of the dedicated nurse program.

Councillor Paterak asked how Paramedic Services deal with staff who call in sick.

Peter Dundas responded that when staff call in sick, Paramedic Services have staff resources for last minute book offs. Should there continue to be a shortage in staff, the next step is to contact part-time staff to determine their availability. Should additional staff still be required, Paramedic Services will extend current shifts to overtime hours.

Councillor Morrison thanked Peter Dundas for the presentation.

b) Paramedic Services – Facility Implementation Update
Presentation by Peter F. Dundas, Director, Peel Regional Paramedic Services

Received

Peter Dundas provided a facility implementation update on the Mississauga Reporting Station at Tomken Street and Pacific Gate which will be a co-location with Mississauga Fire Station 116. Ground breaking for the project will take place in March, 2009 and the station will become operational in the Summer of 2010.

Peter Dundas reported that the Brampton Reporting Station at Queen Street and Kimbark Drive, a co-location with the new Brampton Fire Headquarters is progressing to the design state and it is anticipated the site will be operational in the Fall of 2010.

Councillor McFadden requested details on plans for the current Mississauga Fire Station 116 when the new facility is completed.

Councillor Adams responded that there is a current lease arrangement for the property with the City of Mississauga and when the new Fire Station 116 facility opens the property containing the old station will be sold.

Councillor Adams reported that in response to the downturn in the economy, the City of Mississauga is considering an acceleration of capital projects in order to provide employment. She requested staff to look at the 2009 capital projects to determine which ones could be accelerated in order to help the regional economy.

Peter Dundas responded that staff will identify capital projects which could be accelerated.

Councillor Morrison stated that with possible future growth, the Town of Caledon is looking at land for a new Fire Station in the Bolton area. Councillor Morrison asked if Region of Peel Paramedics for Caledonia could be co-located in the new Bolton Fire Station, in order to reduce response times in Caledon.

Peter Dundas stated that any opportunity to work with municipal partners is something that would be considered. In the case of the new Bolton Fire Station, any co-location would require direction from Regional Council.

Councillor Mullin requested staff to provide more detailed information regarding delays in ambulance service in Caledon.

Peter Dundas responded that staff will provide that information at a future committee meeting.

c) Revised Response Time Standards

Received

Peter Dundas reported that the Ministry of Health and Long-Term Care (MOHLTC) recently announced legislative changes to existing response time performance standards. The new legislation requires that, as of October 2010, each municipality responsible for the delivery of land ambulance service will have to submit annually a performance plan for their response time targets based on the following criteria:

• Percentage of time that a person equipped to provide defibrillation to a sudden cardiac arrest within six minutes;
• Percentage of time paramedics have arrived on the scene within eight minutes for all cardiac arrests or other patients categorized as CTAS 1;
• The percentage of time that paramedics have arrived within the standard response time set by the Region to patients categorized as CTAS 2, 3, 4, and 5.

Peter Dundas stated that by the Summer of 2010, Paramedic Services will identify target percentages and response times based on the best available data provided by the MOHLTC. The percentages will then form the basis of a report which will be brought forward to the Emergency and Protective Services Committee (EPSC) for discussion and direction. After the initial year of reporting, annual reports will be submitted and direction sought through the EPSC to revise the performance markers from the previous year.

Councillor Adams asked if staff have a map of current response times within the Region.

Peter Dundas responded that staff will develop a map but cautioned that the information would be subject to change with evolving data collected each month.

Councillor Morrison enquired if under the new legislation the Region could set different response times for patients in each CTAS category from 2 through 5.

Peter Dundas stated that the new legislation does allow each municipality delivering land ambulance service to set different response times for CTAS categories 2 through 5 and in order to determine the appropriate times, the Region will seek input from the local base hospitals.

5. EMERGENCY MANAGEMENT PROGRAM

a) Emergency Management Program Pandemic Exercise
Presentation by Andre Luc Beauregard, Manager, Regional Emergency Management

Received

Andre Luc Beauregard provided an overview of the Operation Influ-Ex 2008 exercise. It is essential that the Region and its community partners are prepared for a pandemic influenza situation. Operation Influ-Ex brought stakeholders from across the Region together to discuss pandemic preparedness. The process also provided an opportunity for stakeholders to observe unique operational requirements necessary to deal with a pandemic outbreak. The exercise is an annual requirement of the Emergency Management and Civil Protection Act.

 Andre Luc Beauregard stated the purpose of the exercise was to allow participants to evaluate their influenza pandemic plans and gain an understanding of problems they and their organizations could possibly face in response to an influenza pandemic emergency. The objectives of the exercise were:

• Practice Regional and local decision making processes;
• Validate emergency and influenza pandemic response plans;
• Test the interface between regional, municipal, provincial agencies, federal agencies and private and public sector organizations;
• Enhance community awareness.

Andre Luc Beauregard reported that the design committee spent four months preparing for Operation Influ-Ex 2008 and 206 people participated. On the day of the exercise, participants were divided into three specific modules, Early Stages, Pandemic Intensifies and Pandemic Escalates/Recovery. Each sector received the identical scenario and answered questions that were sector focussed and specific to their area of expertise.

Andre Luc Beauregard stated there were four key lessons learned from the exercise:

• All organizations should develop a comprehensive corporate Business Continuity Plan in order to maintain essential services during emergencies;
• Every public and private sector entity involved in responding to an emergency should develop human resources policies to deal with issues such as extended sick leave, redeployment of staff and work from home;
• Establish the necessary alliances and relationships with other organizations that would be involved in a pandemic influenza crisis with particular focus on establishing formal communication links and developing the capacity to share resources;
• The collaborative effort shown through working with all levels of government, community agencies and private corporations in the planning and execution of the exercise further promotes the Region of Peel as a disaster resilient community.

Andre Luc Beauregard informed the committee that a Lessons Learned report is being prepared and will be made available to all participants.

Councillor Morrison congratulated Andre Luc Beauregard and the exercise design committee for their work on Operation Influ-Ex 2008. Having attended the exercise as a member at the Caledon table, Mayor Morrison stated it really did demonstrate where the gaps are.

6. COMMUNICATIONS - Nil

7. IN CAMERA MATTERS - Nil

8. OTHER BUSINESS - Nil

9. NEXT MEETING

Councillor Mullin requested staff look at changing the start time for future Emergency and Protective Services Committee meeting to 10:30 am.

Thursday, January 29, 2009
9:30 a.m. to 11:30 a.m.
Council Chamber, 5 th Floor
Regional Administrative Headquarters
10 Peel Centre Drive
Brampton , Ontario

10. ADJOURNMENT

The meeting adjourned at 10:48 a.m.