NOW THEREFORE BE IT RESOLVED THAT the Alberta Urban Municipalities Association urge the Province of Alberta to provide a means by which local municipalities may recover costs from Alberta Health Services for assistance to ground ambulance personnel for patient care, specifically calls for lift assists.
WHEREAS Alberta Health Services is responsible for the delivery of pre-hospital care in accordance with the Emergency Health Services Act;
WHEREAS local municipalities are responsible for and establishing the service levels of municipal fire protections and rescue services;
WHEREAS Emergency Medical Services crews request assistance from local municipal fire protection and rescue personnel specifically for the provision of patient lifting;
WHEREAS Alberta Health Services has a mandate and policy directed towards the billing of individuals requiring pre-hospital care;
WHEREAS local municipalities recover no costs associated with the provision of services assisting EMS personnel.
Alberta Health Services is responsible for the provision of pre-hospital care including ground ambulance services. In many cases ground ambulance (EMS) crews arrive at a medical scene and require assistance removing a patient from a location into a waiting ambulance. Due to lack of EMS resources or EMS resources attached to other incidents, the ground ambulance crew contacts the local fire department to assist with the lift.
Most municipal fire departments provide medical first response services to assist EMS with patient care for their citizens; however, these services are intended to manage situations of dire need or when an ambulance does not arrive within a certain response time.
EMS crews on scene that call out fire departments to assist with medical lifts due to lack of other EMS resources impact fire departments, specifically volunteers. Volunteers many times are called away from their workplace for a lift assist, which impacts them as many do not receive compensation from their employer while away on fire calls.
There is a cost associated with every type of fire call a municipality attends. In the case of medical calls, Alberta Health Services has the mandate and policy to recover costs from the patient requiring the service and in those situations where a fire department was contacted, specifically for lift assists, the local fire department should be able to recoup some if not all its costs as well.
MFR agencies such as fire departments work with Alberta Health Services Emergency Medical Services (AHS EMS) to provide initial medical aid to Alberta communities. AHS EMS aids MFR agencies through a provincial registry program where registered MFR agencies have access to a number of supports and services. Through this program, each municipality is responsible for determining the level of MFR service they will provide, including the types of medical calls, if any, to which they will respond.
In addition to this voluntary MFR role, fire departments also serve a municipal public safety role (as defined by each individual municipality). The public safety role includes the provision of services in situations where patient extrication is required (such as patient extrication from motor vehicles), low or high-angle rescue, patient entrapment, or any other situation in which patient removal is required. This includes lift assists. The Ministry of Health has no plans to develop a cost recovery arrangement for MFR agencies.
The Minister notes that providing lift assists falls under a fire department’s municipal public safety role. This role includes providing services in situations where patient extrication is required (such as patient extrication from motor vehicles), low- or high-angle rescue, patient entrapment, or any other situation in which patient removal is required, including lift assists.
Regardless of whether lift assists are categorized as pre-hospital care or patient extrication, the resolution highlights that there is a cost associated with every type of fire call a municipality attends. However, it should be noted that EMS also provides support to municipal firefighters in several situations free of charge. For example, EMS typically remains on the scene of any fire in progress to check firefighter vitals, even when general public safety is not at risk. EMS also accompanies firefighters at their request to prolonged patient rescues and extrications, as resources allow.
There is a risk that continued advocacy for AHS to provide a cost recovery model for lift assists could lead to AHS implementing another model to recoup costs from municipalities for services that are currently provided free of charge.