August 2019
Backgrounder

The 2019 provincial budget announced the Ontario’s ambulance services and provincial dispatch services would be streamlined and integrated. The province also announced that it will be exploring new models of care and delivery for emergency health services to improve care for patients and reduce duplication. Following the budget, the Province announced that it would freeze its share of ambulance grants at 2018 levels. Due to the yearly funding lag, the 2018 levels are in fact based on the province’s 2017 funding allocation. Therefore, growth in service costs contained in the municipal 2019 budgets would fall on municipal taxpayers.

After listening to the concerns of municipal leaders across the province, on May 27, 2019, Premier Ford and Minster Steve Clark announced a deferral of the in-year cuts to paramedic services along with public health and childcare, to January 2020. As of August 7, 2019, revised EMS funding letters have not been provided to municipal governments.

The Province also has clarified that “streamlining and integration” indicated in the Budget 2019 document will result in restructuring the 52 ambulance services in to just 10 regional entities. AMO and its members are deeply concerned with this news and have asked the province for more information on the government’s restructuring plan and details on the provincial-municipal cost sharing ratio. Municipal governments currently go well beyond the 50-50 cost sharing arrangement and contribute about $720 million, whereas the province contributes about $580 million annually.

AMO is advocating to ensure that as the province reviews the delivery of paramedic services in Ontario that it reflects the knowledge, experience and financial contributions of municipal governments.

AMO expects that the Ministry of Health to work directly alongside its municipal funders to mitigate any unintended outcomes associated with the restructuring of paramedic services and to ensure continued high-quality service for residents. AMO continues to advocate for “local say for local pay” on the behalf of its municipal governments. Throughout, AMO will also continue to ask for long-anticipated improvements to the paramedic dispatch system for which the province has 100% funding responsibility.

Designated upper-tier and single-tier municipal governments co-fund and deliver essential paramedic services locally.  In the north, ambulance services are primarily provided by District Social Service Administration Boards (DDSABs) financed by municipal governments. However, the property tax base is not the best funding source for a provincially regulated health service. Rising call volumes and costs add strain to the property tax base and contribute to municipal fiscal challenges.