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The Municipal Role in Paramedic Services During COVID-19 and Beyond

Backgrounder January 13, 2022

Municipal Implications

Paramedic services have been essential amid the COVID-19 pandemic. Paramedics have been testing, administering vaccines, transporting individuals to testing centres, and providing community paramedicine in addition to their regular emergency service responsibilities. Community paramedicine programs have also been crucial to individuals during the pandemic, especially for isolated seniors and those living in remote areas.

Prior to the pandemic, AMO provided written submissions to the provincial government’s Public Health and Emergency Health Services Modernization Consultations. Although the consultation was paused during the pandemic, AMO is asking for it to resume once the initial COVID-19 wave has subsided. It would be a lost opportunity to not reflect on the local and provincial health care challenges exposed by the pandemic and use these reflections to consider next steps in the modernization of paramedic services post-COVID-19.

AMO will also continue to ask for long anticipated improvements to the paramedic dispatch system, for which the provincial government has 100% funding responsibility.

AMO and the Ontario Association of Paramedic Chiefs (OAPC) submitted a joint paper in June 2021 on the need for a Community Paramedicine Policy Framework. Currently there are more than 250 community paramedicine pilot projects without permanent ,100% provincial funding – even though the programs provide primary health care which is a provincial responsibility. Community paramedicine fills an urgent need to provide clinical support to vulnerable populations in their own homes. It keeps our residents living well and improves their quality of life while reducing pressure on the health care system.

Our primary ask is for the Ministries of Health and Long-Term Care to establish a working group with AMO, OAPC, and the City of Toronto to develop a Community Paramedicine policy framework that could be implemented starting in fall 2022 with enabling legislation.


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 are contributing to municipal fiscal challenges. Municipal governments currently contribute well beyond the 50-50 cost sharing arrangement.


Monika Turner
Director of Policy