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Who should pay? Alberta says Calgary Fire Department medical response is voluntary

Calgary firefighters respond to roughly 29,000 medical calls annually. It’s pre-hospital first response that’s a provincial responsibility.

Alberta Health said they’ve never paid for the service and that it’s provided voluntarily by the province’s municipalities.

The question is: Who should pay? And if Calgary isn’t being compensated, should the service still be provided?

Calgary’s fire Chief Steve Dongworth was asked by Coun. Jeff Davison specifically about provincial responsibilities downloaded to the Calgary Fire Department – ones where there’s no fee recovery.

“The biggest one of course, that council is very familiar with, is medical calls,” Dongworth told councillors during the One Calgary budget adjustments in the last week of November.

Calgary fire department response times, medical care

Earlier in the budget proceedings, Chief Dongworth described the challenges Calgary firefighters were having in meeting council-mandated response time targets, and the impact potential budget cuts would have on the city’s firefighting brigade.

Dongworth said that they’d previously been a part of the medical response when EMS was a city service. That switched in 2009 when the province took control of pre-hospital care.

“Now, pre-hospital care is a provincial responsibility. We still provide the same service as we did before, which I believe is a valuable service and, in fact, a necessary service,” Dongworth told councillors.

According to a 2018 CBC article, a council committee directed that the mayor send a letter to the province asking for help with this kind of emergency response.

“It is part of the medical system and so we have the medical system free-riding a little bit on the great work that our first responders do and we should probably be compensated for that,” Mayor Nenshi said in the CBC piece.

Dongworth told the November budget meeting that they’d also been asked to send a letter making that request this year. He said they’ve had a conversation about it with the province.

“Which they followed up in writing, that they view that as a voluntary exercise for the Calgary Fire Department to be going to those medical calls, despite the fact that the service deterioration that Calgarians would see if we weren’t doing that, in terms of getting the first person there who can make a difference,” Dongworth said.

“It would be a huge detriment, but they view that as voluntary if the municipality wants to do that, therefore they won’t pay. Simple as that.”

2018 report on Calgary Fire Department medical calls

In June 2018, a report was delivered to the city’s Intergovernmental Affairs committee on CFD’s medical service delivery. In it, it showed that Calgary’s firefighters were able to respond within seven minutes of being dispatched to a call, “while AHS EMS can take as long as 10 minutes to arrive,” the report said.

Attach 1 – IGA2018-0830 by Darren Krause on Scribd

The report points out that in early 2018, AHS EMS response for life-threatening calls at the 90th percentile was 15 minutes or more.

However, since that peak in response time breached the 15-minute mark, response times have steadily declined over the past two years and settled around the 12:30 mark, according to AHS data.  SEE BELOW.  

Ahs Data Ems Event Calgary by Darren Krause on Scribd

Tom McMillan, acting Assistant Director of Communications for Alberta Health, confirmed they met with the City in late September. He said that all cities develop their own plan for fire response based on municipal needs, including how they respond to calls like car crashes and rescue situations.

McMillan said that Calgary isn’t currently enrolled in the Municipal First Response (MFR) program, which he said streamlines communication and coordination of response to emergency situations. He added that it clarifies the relationship between Alberta Health Services (AHS) EMS units and city units.

“The Calgary Fire Department is not currently enrolled in the MFR Program operated by AHS. Despite this, Calgary Fire Department continues to respond to EMS calls because Calgary operates a satellite dispatch centre (Calgary 911) that provides EMS, fire, and police dispatch services,” McMillan said.

In 2016, Calgary lobbied for, and won, the right to retain control of its ambulance dispatch system.

McMillan said at the Sept. 30 meeting, Chief Dongworth was made aware that no funding would be made available for medical response calls.

EMS responds to all medical calls: AHS

According to AHS, the participating MFR groups provide it as a public service, without compensation.

“When assistance is needed, MFR partners are requested by EMS dispatch,” read a statement from AHS. They also said that regardless of fire department medical first response, EMS responds to all Calgary medical calls.

The MFR enrolment may not be an antidote for helping reduce medical response call volume for fire departments.

According to information provided by Edmonton Fire Rescue Services, they responded to 53,126 emergency response incidents in 2018. More than 36,000 were medical first response, and 3,412 were for fire suppression.

They are enrolled in the MFR program.

CFD says medical call response ‘a value-added service’ for Calgarians

The Calgary Fire Department confirmed in an email to LiveWire Calgary that they’re currently in the process of enrolling in the MFR program.

When asked why, when EMS currently responds to all calls, Calgary Fire Department also responds, they said they’re able to provide “trained, competent, personnel, who are well positioned within the community and able to provide critical, time sensitive, medical interventions.” [sic]

“Calgary Fire Department personnel do not replace paramedic care, but Calgary firefighters are often able to provide critical and timely care to patients in the instances where EMS services are delayed in responding,” an email response read.

They said they only respond to the most serious calls (referred to as echo and delta response calls).

“In these cases, the Calgary Fire Department believes it is critical that when someone calls 9-1-1, someone responds quickly, again, not as a replacement for EMS but as a support in the emergency response environment,” they wrote.

“The Calgary Fire Department believes this is a value-added service that they are able to provide to Calgarians both extremely economically and efficiently, using personnel and equipment that already provide for protection from fires and many other emergency situations.”

In the recently approved budget adjustments, the 1.5 per cent tax increase scenario was approved. Roughly $24 million will be provided from corporate savings to keep the effective tax rate at zero per cent. (Because of the tax shift adjustment, a typical Calgary homeowner will actually pay 7.5 per cent more.)

Under that scenario, the Calgary Fire Department will defer a $3.4 million temporary fire station, planned for the community of Livingston, to 2021.