Grande Prairie city council will be advocating to the province for additional funding with the hopes of returning local EMS service levels to what they were before Alberta Health Services (AHS) took over their delivery.
If the additional funding is granted, the Grande Prairie Fire Department (GPFD) would implement a Fire Paramedic Response Unit that would include an advanced life support paramedic and a firefighter deployed in a SUV vehicle to provide care and critical interventions while awaiting EMS arrival.
“This is not replacing our EMS service,” said Grande Prairie Fire Chief Mark VanWerkhoven.
“This would be providing a means to keep our core firefighter resources and fire trucks available for other calls, while potentially awaiting EMS arrival on scene and allow stabilization on scene.”
Mayor Jackie Clayton said medical first response has long been a priority of current and past councils.
“This was two motions that were to support further advocacy priorities and advocacy initiatives, asking the province to continue to fund medical first response and fund that missing piece that currently is an expense to the residents of Grande Prairie, and the second one being an option for consideration of a somewhat tweaked delivery model, and asking the province to fund that delivery model,” she said.
GPFD currently receives some provincial funding, about $130,000, for its Medical First Response (MFR) program, that sees firefighters provide advanced first aid when EMS is delayed more than 15 minutes.
“(The province) committed to a three-year funding cycle that is providing some level of subsidy for our firefighters and our fire trucks responding to medical instances,” said VanWerkhoven.
“What we’re finding on occasion is when the EMS system is challenged, and that the demand is exceeding the available EMS resources, or those resources are responding from places outside of the city, then we find our fire trucks and our firefighters are on scene for an extended period of time providing that initial care.”
He said the fire-paramedic crew could also provide a higher level of care.
City public and protective services officer Dan Lemieux said the fire paramedic response unit could be costly, which is why the city is looking to province for funds for the program.
“We have to remember that EMS responsibility is a provincial responsibility,” he said.
“We probably don’t want to take that on as a municipality, but certainly we’re always prepared to partner with the province.”
According to a city report, the initial capital costs could range from $250,000 to $500,000, with an annual operating budget of about $1.2 million to $1.6 million.
Under the current AHS EMS model, it takes 12 minutes or less for urban responses to high-acuity incidents. In comparison, a city report says local EMS response times for high-acuity incidents were eight minutes or less before the provincial model.
VanWerkhoven said the new unit would be unable to transport patients.
“They would have the skills and equipment to provide critical intervention, stabilize and care for the citizen while awaiting EMS,” he said, which in some instances could lead to where patients may not even need an ambulance.
Lemieux said the city will monitor similar fire-paramedic pilot projects in Spruce Groove and Strathcona to see how successful their outcomes are.
VanWerkhoven said the benefits of having a fire paramedic unit include not having fire suppression resources, such as a fire truck, at a medical call if needed at a fire.
“This doesn’t mean that fire trucks no longer respond to medical calls, it simply means that in the event that EMS is delayed, that fire truck can be redeployed if a fire or other high-acuity incident was to come in, and that that crew of two in the SUV would remain on the scene with the patient,” he said.
Other advantages of having a fire-paramedic unit include the ability to have HAZMAT and Tactical EMS support, the resources of which are currently closest in Edmonton.
VanWerkhoven said he is in talks with Grande Prairie Police Service Chief Dwayne Lakusta about options for a tactical EMS, but more discussions are still needed.
EMS delays
Last year, a report from GPFD said EMS ambulance wait times increased 80 per cent from 6.5 minutes to 11.5 minutes. It also noted delays that exceeded 60 minutes.
In February last year, AHS told city council that staffing, increased call volumes and supply chain issues are among the issues facing local EMS.
VanWerkhoven said his latest data on local wait times have decreased, but GPFD time on tasks is still higher than two to three years ago for medical calls.
City council has previously asked for more information on an integrated fire and EMS service, which was included in a report to the public and protective service committee on Sept. 17.
An integrated model would see a contract between AHS EMS and GPFD, where AHS would set contract terms, staffing and service levels, according to the report.
“Conversations with comparator municipalities indicated 60 paramedic full-time employees would be required, who would be dual trained as firefighters,” reads the report. It notes that an additional 10 full-time employees for administrative duties would also be needed.
It also noted about nine ambulances would be needed and the cost of an ambulance is about $500,000 each.
Clayton said the motions from Monday’s meeting are not a move to a traditional integrated approach.
Spruce Grove, Red Deer, Leduc, St. Albert, Leduc, Medicine Hat, Strathcona County, and the Regional Municipality of Wood Buffalo operate with an integrated fire and EMS service.
History of EMS in Grande Prairie
From about the 1970s to the early 1990s, the Grande Prairie Ambulance Service served the city and County of Grande Prairie and was operated under QEII hospital administration, said VanWerkhoven.
By the late 90s the Grande Prairie Regional Emergency Medical Services (GPREMS) was created and operated as a non-profit, funded by the participating municipalities.
In 2009, the province assumed responsibility for EMS service delivery province-wide, while local municipal fire departments also assisted with MFR programs.
VanWerkhoven says the reason for the change to a provincial model were made “to bring a minimum service level of EMS to all corners of the province; it likely accomplished this in some areas, but it could be argued in other areas that may have had the opposite effect.”