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Medical first response is municipal responsibility, says Alberta Health

Athabasca-Barrhead-Westlock MLA Glenn van Dijken relayed message to Town of Barrhead council Nov. 22
Athabasca-Barrhead-Westlock MLA Glenn van Dijken admitted to Town of Barrhead councillors during their Nov. 22 meeting that the response regarding municipal compensation for fire department medical assistance responses is confusing and needs clarification.

BARRHEAD – It wasn't exactly the response Town of Barrhead councillors were hoping for or expected. 

During a visit to the Nov. 22 Town of Barrhead council meeting, Athabasca-Barrhead-Westlock MLA Glenn van Dijken delivered a statement from Alberta Health saying that the municipality is responsible for the costs of Barrhead Regional Fire Service (BRFS) firefighters responding to medical assistance calls. 

In the last year, Town of Barrhead councillors have been vocal about their concerns that volunteer firefighters are being called upon to respond to an influx of medical assistance calls due to inadequate ambulance service coverage levels, an issue that become exceedingly worse throughout the province through the pandemic.  

Councillors have also stated on multiple occasions that the province needs to compensate municipalities for providing medical first response service, which they believe is the province's responsibility.  

As part of their question about what the province is doing to improve ambulance service and when municipalities would start to be compensated for the extra costs involved with the fire department providing first responder service, council noted that over the last year medical assistance calls accounted for 20 per cent of firefighters’ time and that BRFS crews arrived before the ambulance half of the time. 

van Dijken said Alberta Health's position is that "medical first response is part of municipalities' public safety responsibility rather than the health system." 

"While there are no current plans to compensate municipalities for medical first response activities, it is a priority to reduce the reliance on medical first response as part of our government's commitment to reform EMS to improve response times," van Dijken said, reading from a statement from Alberta Health. 

In the statement, Alberta Health noted that ambulance services provincewide, over the last two to three years, have seen a significant increase in call volume. As a result, Alberta Health said municipalities that choose to provide medical first responder service are seeing an uptick in medical assistance calls and "longer time on the task". 

However, van Dijken said he was confused by Alberta Health's response, noting it was contrary to the province's actions. 

"The fact that Alberta Health took over the ambulance service (from the municipalities) does not coincide with that statement," he said. "At one time, municipalities used to have their own ambulances and were responsible for emergency medical responses, but to be more efficient with the resources available Alberta Health." 

van Dijken added he could not recall the circumstances that led to the change but said, at the time, it seemed like a top-down decision from the province. 

He said that in 2015 when he was first elected, he still heard complaints from municipalities that had lost their ambulance station and were concerned about the increase in ambulance response times. 

In the spring of 2008, Progressive Conservative government led by Premier Ed Stelmach, announced Alberta Health would take over responsibility and announced the newly formed super health board, Alberta Health Services (AHS), would take over and fund EMS services from the municipalities. 

van Dijken said if Alberta Health is indeed "passing medical first response responsibilities to municipalities" then, in his opinion, the government needs to have further discussions with municipal governments on "how it all transpires." 

"I understand your frustration," he said. "When I first read (the Alberta Health statement), I thought if that is the case, let (municipalities) have their ambulances back," he said, adding that, in reality, few municipalities, if any, would want to take that responsibility back. 

van Diken then went over some of the efforts the government is making to resolve the issue through a 10-step plan announced in January 2022, and how in the last two years the province has increased the ambulance service budget by $20 million and increased the number of EMS staff by more than 200, including 167 paramedics. 

He also noted that 19 additional ambulances are now on the road in Edmonton and Calgary. 

"Increasing capacity in these areas will help impact surrounding communities and the system as a whole," van Dijken said. 

He added the province has also commissioned an independent contractor to look at the ambulance dispatch system, and on Nov. 17, announced its AHS reform plan. 

"The plan identifies immediate government actions to improve patient care and accountability while setting clear measurements for success. One of the elements of reform is to improve EMS response time," van Dijken said. 

He added one of the issues is that the mindset in AHS bureaucracy has been not to have excess capacity to control costs. 

"But in the situation we've had for the last two years, we needed to have that excess capacity, because without it, you're bogged down," he said. "You can see that in our ICU and right across our health system." 

Coun. Rod Klumph said Barrhead is fortunate because BRFS has several firefighters with advanced medical qualifications but he noted if the province has mandated that first responders are a municipal responsibility, they need a lot more guidance. 

"The Alberta Government needs to give us proper direction," he said. "If we are mandated to handle medical assistance calls, then we need to have policies in place. Right now, our policies cover fire service and not much else. Not only do the policies have to be in place, but we need to budget for that." 

Coun. Ty Assaf, who appeared via teleconference, said the issue for Barrhead is not that they don't have a properly trained fire department, with members willing and able to go to calls. 

"If the province is going to hoist this on us, they can't do it without giving municipalities adequate compensation. That is where we are at as a council," he said.  

van Dijken reiterated that getting compensation for municipalities might be an uphill battle. 

"It all stems from Alberta Health's belief that the medical first response is the municipality's responsibility as part of providing public safety," he said. "So, if it is a responsibility, it might not be compensated for." 

Assaf responded, "Alberta Health is saying that municipalities, it is your responsibility, deal with it. If that is the case, we might have to re-evaluate the type of service our fire department provides. Where do we draw the line, so municipalities can continue to operate and not (overtax our firefighters?)" 

van Dijken said again he understands council's frustrations and promised to bring their concerns to Minister of Health Jason Copping. 

"One way or another, we need to narrow down whose responsibility (medical first response) truly is. If it is Alberta Health's responsibility, then there is a case for compensation," he said. 

Barry Kerton

About the Author: Barry Kerton

Barry Kerton is the managing editor of the Barrhead Leader, joining the paper in 2014. He covers news, municipal politics and sports.
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