November 21, 2016

The Ministry of Health and Long-Term Care (MOHLTC) has released a discussion paper (attached) on a controversial proposal by the Ontario Professional Fire Fighters Association (OPFFA). The proposal would allow full-time firefighters, who are also certified primary care paramedics, to provide patient care in a tiered response situation. The Province says this approach would be voluntary for municipalities. AMO flagged this consultation in our June 14th communique, Government to Consult on Expanding Medical Responses through Fire Services.

Premier Wynne, speaking at both the June OPFFA conference and the August AMO conference, clearly said that she and Cabinet want consultations before making an evidence-based decision on this proposal, which is expected early in 2017.

Municipal governments are deeply concerned about the direct and significant impact of the proposal on municipal emergency services, both financially and operationally. We will read the MOHLTC discussion paper carefully, but to date, there has been no evidence or cost-benefit analysis seen that shows such an approach would improve patient outcomes.

Given the lack of evidence, we don’t know why this proposal is now a provincial priority, especially as municipalities would bear all the costs, labour challenges, and risks. Fire services are 100% funded by municipalities and only an elected Municipal Council has the authority to determine the level and type of fire protection services needed by its community. We are also concerned that if any Municipal Council agrees to this proposal it would be replicated throughout Ontario by the current interest arbitration system.
Municipal governments strongly prefer to work with the Province to improve and modernize our cost-shared land ambulance/EMS services. Specifically, municipalities have been asking the Province for years now to make improvements to land ambulance dispatch that would directly improve patient outcomes.

The MOHLTC discussion paper provides a clear overview of Land Ambulance and Fire Services Workforce Capacity. It demonstrates both the rising demand for paramedic services and decline in fire-related calls. We are very concerned about using municipal fire services to provide paramedic care – a shared provincial-municipal funding responsibility.

Land Ambulance and Fire Services Workforce Capacity chart
AMO will fully review this discussion paper (attached) through its Task Force, which includes membership from Northwestern Ontario Municipal Association (NOMA), Federation of Northern Ontario Municipalities (FONOM), Emergency Services Steering Committee (ESSC), Ontario Association of Paramedic Chiefs (OAPC), and Ontario Association of Fire Chiefs (OAFC).

Over the next months, MOHLTC will hold separate meetings with municipal employers, unions and associations, as well as technical medical advisors and will also accept written submissions from these stakeholders. AMO will take the lead in organizing these MOHLTC consultation meetings for municipal employers, including ROMA, OSUM, NOMA, FONOM, LUMCO, MARCO, EOWC and WOWC, along with the municipal staff associations we have been working closely with on this matter.

AMO will update members as this matter develops.