Q U A R T E R L Y N E W S L E T T E R

J U N E 2 0 1 7

Hello Everyone:

As you will know, the Ministry of Health and Long-Term Care released its much-

anticipated plans to modernize the Ambulance Act on June 5th.  This

announcement can only be described as a “mixed bag” for the enhancement of

paramedic services in Ontario.  

The OPAC has commended the Government of Ontario on the intent to update the

Act, specifically on the proposed changes to allow paramedic services to:

• treat and release;

• treat and refer; and,

• transport patients to alternative destinations.

We are pleased that the government has recognized OAPC’s efforts to have the

scope of practice for paramedics expanded.  This will go a long way to recognize

the world-class education and skill set that Ontario’s 8,000 paramedics bring to

their jobs every day.

The OAPC is also pleased that the Province has taken our advice to improve land

ambulance dispatch triaging. However, further technological improvements still

need to be made.  OAPC has been clear with the government that fixing dispatch

is the priority for paramedic services, and this must be done prior to enhancing

the technology fire services will be afforded if they are to respond to medical

calls.  

President's ReportNeal Roberts

What does concern us is the proposed changes to the Ambulance Act to allow paramedics employed by fire services to respond to low acuity medical calls. There is no evidence that expanding medical responses by certified paramedics while on fire service would in any way improve patient outcomes.  Firefighters are already trained in CPR and public access defibrillation which provides the necessary skill set for responding to a sudden cardiac event call (CTAS-1).  

The Board strongly believes that by rapidly moving forward to grant Fire Fighters who currently hold Paramedic certification the ability to work as paramedics for Fire Services, the Province creates potential risk for patients in Ontario.  

Of lesser, but still significant concern, the OAPC believes that this model is a duplication of services that will unjustifiably increase the cost of delivering emergency health care.  Municipal taxpayers fund fire services to fighting fires, not for medical treatment and hospital transport. Shifting EMS work from paramedics to firefighters would end up shifting some of the cost of health care from the province to municipalities and force taxpayer to pay for the same service twice.

Stakeholder consultations on the amendments to the Act are scheduled to conclude in mid- August.  We expect the proposed legislation will be tabled as an omnibus bill in mid-to-late September and passed by the end of this year.  It is anticipated that the two pilot projects will begin sometime after February 2018 and run for at least one year.  

Details of the pilot projects have yet to be determined. This includes the process for selecting the pilots and host municipalities, funding levels and the expected outcomes.  At the suggestion of the OAPC, the Province has indicated a willingness to consider engaging a third party to independently evaluate the process to medically and clinically examine the pilot projects.    

Ambulance Act Revisions:

The Board struck a Working Group comprised of board representatives from each Zone as well as the Senate.  This group is currently reviewing the legislation, associated regulations and any potential scenarios that could impact public safety during the pilot projects. This information will be discussed with the Ministry during the consultation process.  It is my commitment to keeping you informed and consulted as much as possible during this process, which begins July 14th.

The Policy Committee has held several meetings and discussions with officials on both the bureaucratic and political sides of government since the announcement.  This includes discussions the Ministry of Health and Long-Term Care and the Chief of Staff to the Premier. We also participated in the Association of Municipalities of Ontario (AMO) Memorandum of Understanding (MOU) table discussion with the Ministry.

During these meetings, we have advised of our ongoing and serious concern that the Province is considering implementing this proposal as early as February of 2018.  To do so would mean that the pilot projects will begin before:

• implementing the new provincial medical triage tool, Medical Priority Dispatch System; • introducing any advanced technology in any of the Provincial Central Ambulance Communication Centres;

• overhauling of the Policy and Operation Manuals for the Provincial AmbulanceCommunication Centres; • providing any necessary training for Paramedic Services; and, • the Province replacing the current Bell Mobility Legacy Radio System, which currently does not allow Paramedics to communicate with Police or Fire Services.

Land Ambulance Dispatch:

We acknowledge and support the pending transition to Medical Priority Dispatch System (MPDS) on a provincial basis; however, we have urged caution as follows:

• To date, the contract has yet to be signed and the first implementation site date has been delayed three times (December 2017, March 2018, and now July 2018);

• OAPC has and continues to caution the Ministry of Health and Long-Term Care that careful planning, execution of the transition from the Dispatch Priority Card Index to Medical Priority Dispatch System requires a strategic approach. This is particularly necessary in the areas of training, cultural changes and change management for Ambulance Communication Officers and Paramedics;

• Failure by the Province to move forward with MPDS Accreditation in all provincial dispatch centres will result in system failures, creates inequities in service delivery across the Province, and is a waste of tax payer funds; and, 

• Another concern that has been raised is the “up coding” of calls outside of the DPCI II protocols.  If this practice continues in the absence of any robust quality assurance andremediation programs, patients and municipalities will be unnecessarily exposed to risk.

Technology:

The Ministry of Health and Long-Term Care and the IT Cluster have collectively failed to recognize the lack of technology within the provincial Land Ambulance Dispatch System.  This unaddressed issue has and continues to lead to critical errors in the system throughout the Province.  These errors and lack of technology result in unnecessary additional costs due to inefficient and ineffective dispatch practices and resource utilization.

Part of this ongoing legacy continues to be the negative impact on the patients we serve.  Yet, the Ministry fails to implement province-wide the technological advancements that Niagara and Toronto have been using for many years.

Reports on this issue have been presented to the Province but not acted upon.  These include:

• Niagara Ambulance Communication Service Pilot Evaluation, and • Provincial Municipal Land Ambulance Dispatch Working Group Report delivered to Minister of Health and Long-Term Care.

Despite these reports, the only advancement is the pending implementation of the Medical Priority Dispatch System.

ADRS and Real Time Data:

For more than a decade, municipalities have expressed ongoing concerns with the lack of real time data (dispatch) to better understand how their local paramedic services are performing. Given that the Ministry owns and directly operates 11 of the 22 provincial Central Ambulance

Communications Centres, there continues to be a separation of land ambulance operations from the communications centres.

This significantly contributes to inefficiencies and an inability for services to fully analyze, plan and implement change.

The OAPC, along with most municipal associations, continues to advocate strongly for the Ministry to provide real time data access (similar to Toronto and Niagara).  We are not seeking new technology – simply an expansion of existing technology.  

In the interim, the Ministry of Health and Long-Term Care continues to provide Municipalities with data from the Ambulance Dispatch Reporting System (ADRS).  This dispatch data is several months old by the time it is made available to paramedic services and is often flawed. Furthermore, it often does not provide an accurate description of municipal paramedic system performance.  

What is most concerning is that the Ministry data is running from Tri-Tech CAD Platform, which is a system in use world-wide and can produce real time reports (apart from Ontario).

Simultaneous Notification:

The Province’s commitment to expanding Simultaneous Notification to Fire Services in advance of implementing any Land Ambulance Dispatch Technology is extremely concerning and indicates that the Province continues not to meet or address their core mandate and responsibility.  For years, municipalities have advocated for changes to technology, and they still await a decision by the Province.  Advancing the Simultaneous Notification as a priority when provincial reports indicate very little advantage, is troublesome.  

We have asked the Province to hold any move forward on this initative until all areas of Land Ambulance Dispatch (provincially) have been fully addressed and resolved.

To that end, we believe the most pressing problem facing paramedic services in Ontario is the lack of technology currently in place for land ambulance dispatch.  

We continue to coordinate our efforts on these issues with AMO, the Large Urban Mayors Caucus of Ontario (LUMCO), Mayors and Regional Chairs of Ontario (MARCO), the Emergency Services Steering Committee of Ontario (ESSC) and Toronto Paramedic Services.  Rest assured that AMO and all our municipal partners remain resolute in their collective opposition to the recent announcement.

These are early days, and I am confident that the OAPC can continue to advance our profession and the important role of paramedic services in Ontario.  

In the meantime, please do not hesitate to contact your Zone Directors or me with any questions, concerns or comments you may have.

ZONE REPORTSEastern

From our Services:

Hamilton Paramedic Services's 2016 Annual Report was printed and reported to Council. Community paramedicine (CP) funding was approved by the Hamilton Niagara Haldimand Brant (HNHB) LHIN for two full-time equivalent positions. The LHIN has also seconded Hamilton Paramedic Service’s Community Paramedic lead, Brent McLeod, for a 12-month period to facilitate integration of CP activities with health partners and other paramedic services within the LHIN. The services also had a very successful Paramedic Services week, including a media day, two staff appreciation BBQ’s (150 served!), launching of a promotional video and interviews onCable 14 and CHCH.  

Muskoka Paramedic Services received its draft ASR report and is currently waiting on the final report.  The Service is also working with ORH on a 10-year comprehensive deployment plan, which should be completed by October 2017. Muskoka Paramedic Services is still waiting on its funding amount for its community paramedicine programs; however, it has moved forward with staff training all of all staff in CREMS. This is exciting for Muskoka as this is a new program for them, and the Service is looking forward to moving other aspects of its program forward once funding is received.  A new facility located in Bracebridge and shared between Bracebridge Fire Service and Muskoka Paramedic Service will go operational in December of 2017.  This new facility is on time and on budget. Chief Jeff McWilliams notes that he had the honour and privilege to attend the Ontario Award for Paramedic Bravery on May 31st at Queen’s Park with Muskoka Paramedics Neil Hebb and Mark Verbeek as they received their awards. It was a very proud moment for Muskoka!!

Central ZoneThe Eastern Zone held its Spring meeting on June 22nd, which was hosted by Chief Mike Nolan and Renfrew Paramedic Services.  The guest speaker was Dr. Manuela Joannou, who provided a well- received overview of Project “Trauma Support,” which is a peer support residential treatment program for military and first responders with PTSD.  This week-long program challenges participants with physical and debrief- style counselling and has been endorsed by many police services (RCMP, OPP) and military personal.  Dr. Joannou also addressed the need for this treatment to be recognized and fully funded by the WSIB for paramedics experiencing mental health issues and PTSD. Representatives of iMedic provided a presentation on improved tracking documentation for community paramedic initiatives.  The role out of BLS standards for eLearning was also discussed.  

Eastern Zone

Northern ZoneThe Northern Zone members met on June 9th, 2017 in North Bay during the Northern Ontario Service Delivery Association (NOSDA) Annual General Meeting. All of the Paramedic Services in the Northern Zone had representation in person or via teleconference, including MOHLTC and Ornge.

Discussion topics included:

• An update on non-urgent transportation projects (both in the North West and the North East) and RFP from the NELHIN

Eastern•Non-urgent transport continues to be a priority in Northern Ontario with several services changing their  deployment plans to reflect emergency coverage and setting this as a priority, limiting EMS access for non-urgent transport

• Community Paramedic Project – commitment from NELHIN that the current project will continue, this has proved difficult as Services have yet to receive funding with the NELHIN review the projects and reporting templates

• OAPC update to members as per previous board meetings and spring conference

• Trauma Transfer via Air – some areas have difficulty transporting patients via Ornge due to being a few kilometres within boundaries – Ornge to look at options and review case by case

• WSIB Cost for Students – Colleges provide their own coverage, all services should have a release of liability orcontract with the colleges

• Encouraged members to provide feedback on Land Ambulance Act regarding EMA, Volunteers, vehicle standards, OAPC website and Equipment Standards

• Received a presentation on the Nipissing Symposium with details of the event to be help October 11 and 12, 2017 in North Bay. All are encouraged to attend.  A Northern Zone meeting will take place during the symposium.

Outstanding issues currently actionable in the Northern Zone: • Non-urgent transportation strategy for Northern Ontario • CP funding limited and not yet received

Dufferin has converted all ambulances to Stryker power system, received their Community Paramedic funding from LHIN/MOH and was able to have all new tiered response agreements signed with all Fire departments.

Lambton is busy working with Bluewater Health Lambton on their Community Paramedic pilot, which is being modeled after the program in Chatham-Kent and which will run for nine months.

Guelph Wellington has officially changed their name to Guelph Wellington Paramedic Service. They are waiting on a decision from the LHIN regarding their Community Paramedic program funding (their three- month unfunded program may be discontinued), and they are anxiously awaiting the Ministry’s action regarding automatic notification of calls and mapping (as being trialed in Essex Windsor).

Bruce County merged their Paramedic Services Department with their County Long Term Care Homes in January of this year, and they are excited to announce that

Southwestern Zone

The OAPC Southwest Zone has many exciting things to announce. From PTSD planning and awareness, to new Management to power stretchers – there’s a lot going on in the South!

From our Services:

Perth County is working on implementing and strengthening a PTSD action plan, developing new education strategies to support their new sim lab and participating in a County wide benchmarking and operational review.

ZONE REPORTS

Southwestern Zone

EasternMichael McKeage has taken on the role of Director of Health Services. Mr. McKeage comes to them from New Brunswick.

Norfolk County is very excited to announce that they have just received approval to outfit their fleet with Stryker power stretchers and loads! They will start with six (6) for 2017 and will phase the rest in over the next three (3) years. They have also added a full time Regulator Compliance and Education Officer to their Leadership Team.

Essex Windsor EMS has commenced negotiations with CUPE. Peer Support training included hospital, Fire and communications staff. Partnered with Public Health and other community groups on a Mental Wellness grant application and has received funding from the LHIN for the VPN (CP) program. Dougal base construction is well underway, on schedule and budget.

Grey County will be re-starting the EPIC program after receiving funding from the Southwest LHIN for the 2017-2018 Ministry budget cycle. Mike Muir, Director/Chief of Paramedic Services has announced his retirement effective September 30, 2017 – allowing his team to defend their title at this year’s Chief’s Challenge in Ottawa.  

ZONE REPORTS

Treasurer's ReportMichel Chrétien

Another Spring Meeting has come and

gone, and I am pleased to report that we

met our financial objectives for the event.

I also wanted to thank everyone who took

the time to complete our participant

survey on the Spring Meeting.  

You told us that you enjoy the labour

review and discussion on bargaining

trends and find the Meeting to be a good

networking opportunity.  The survey also

gave us several good suggestions for

program content

year, ensuring future events are even

more relevant to you in your day-to-day

operations. We are changing venues for

next year’s Spring Meeting to the Holiday

Inn Toronto International Airport. 

Our Annual Chiefs’ Golf Challenge will be

held at The Meadows in Ottawa on

September 26th.  As you may know, The

Meadows is the largest public golf and

country club in Eastern Ontario.  Come out

for a day of camaraderie and philanthropy

as we raise funds for our official charity,

the Make-A-Wish Foundation. 

I look forward to seeing you on the

greens!

One of the highlights for the Senate over the past few months has been our participation in the Selection Committee for the Ontario Paramedic Bravery Awards.  All six of our Senators, along with a representative of the Base Hospitals and the Ontario Association of Paramedics, met to review the applications for the Award and to make the final determination on this year’s recipients.  The Awards Ceremony was held on the main staircase at Queen’s Park on May 31st of this year, and it was a lovely evening that showcased the best our profession has to offer.

The Senate responded to the Paramedic Community College Education Review conducted by the Ministry of Education and Training.  Our submission, which was very well received by the review panel, concentrated on the need for appropriate psychological and strength pre- screening and training for students of paramedicine. It is our understanding that all other submissions related to academics.  A copy is available on the OAPC website under the Position Papers tab.

We also participated in the on-line review of the Award Application Process undertaken by the Office of the Governor General.   At the moment, the Senators John Cunnane and Bruce Farr are busy working with Deputy Chief JC Gilbert, of Simcoe County Paramedic Services, in his work as the Vendor Liaison for the OAPC Conference and AGM.   Senator Rick Armstrong is participating in the OAPC Ambulance Act Review Working Group and has  also taken on the task of updating the history of paramedicine in Ontario for our website.  

The Senate will continue to work with the Board to promote and support research, education, communication, and best practices to enhance the role of emergency medical services in Ontario.  

We will bring you updates of our work in this quarterly newsletter and in our blogs, which will be coming soon to the OAPC website.

Senate UpdateTom BedfordAppointments

Myles Cassidy becomes Chief of Ottawa Paramedic Services on July 10th.  Myles will continue in his roles as OAPC Eastern Zone Director and Chair of the Eastern Group.

Kevin McNab will assume the role of Director/Chief of Grey County Paramedic Services in mid-July.

Tim Waite becomes Chief of Haliburton County Paramedic Services.

Don Otterman has assumed the role of Deputy Chief, Operations of Haldimand County Paramedic Services.

Chief Carrie Hassberger is now the Board lead on the One Number to Call Working Group.

Chief Peter Dundas has become the Board lead on the Emergency Services Steering Committee.

Deputy Chief Ben Roth of Hamilton Paramedic Services is the OAPC representative on the Injectable Sodium Biocarbonate Recall and Shortage health system partner discussions.

Rob Crossan, Deputy Chief of Logistics and Support for Waterloo Paramedic Services joins the Ministry of Labour Section 21 EMS Sub- Committee.

Report from the Communications and Public Relations Working Group

The Communications and PR Working Group implemented its first coordinated social media campaign during Paramedic Services Week, which ran from May 8th to June 3rd.  

We established a daily message and sent a tweet and Facebook post based on that message at the same time each day for seven days.  Individual tweets were also sent out to congratulate the recipients of the Paramedic Bravery Awards, which were pre-programed to go out during the Awards ceremony.  

We kept the campaign very simple so that we could clearly understand how our followers respond to our messaging and how we could improve our use of the two platforms.

We could not have been happier with the results.

During Paramedic Services Week, our Twitter campaign made 28,783 impressions with 1,109 total engagements and 109 retweets.  It also garnered 246 likes.  

The month of May saw our tweet impressions more than double and our mentions increase by over 35 per cent.  The @OAPCMedia account followers increased by 71.  

Our results on Facebook were equally as strong.  In fact, we increased our page views by over 500 per cent!

Our campaign reached nearly 8,500 people, with 1,200 post engagements.  We also received 15 likes.

What is clear from this campaign is that there is a strong interest in what we, as the leaders in paramedicine in Ontario, have to say about the issues related to public health and the delivery of paramedic services.  

We will incorporate these finding into the digital media strategy, which we are currently finalizing.  I look forward to sharing that in detail with you in September.

Carrie Hassberger

Prescott Russell Medal Ceremony

Prescott Russell Paramedic Services held a ceremony during Paramedic Services Week to recognize 22 paramedics for more than 500 years of combined service to the community.

EMS Team Ontario, comprised of Chris Kirwan, Lance Huver, Mike Filiault and Shawn May, brought home the gold medal from the world's largest medical rescue competition for the second year in a row.  

EMS Team Ontario becomes the first ever back to back and double gold medal winners in the international paramedic division.

EMS Ontario brings back the Gold

Ontario Award for Paramedic BraveryThe 2017 Recipients are:

Russell Chase, Oxford Paramedic Services

Robert Glenn, Ottawa Paramedic Services (currently with Toronto Paramedic Services)

Rory O'Neill, Toronto Paramedic Services

Anna Rybalko, York Paramedic Services

Neil Hebb and Mark Verbeek, Muskoka Paramedic Services