Eastern Ontario Paramedic Situational Review

Jan 08, 2020

A major portion of Frontenac County Chief Administrative Officer Kelly Pender’s report to Frontenac County Council, at their final meeting of 2029 on December 18, was devoted to the findings of a statistical review of paramedic services in the region.

The review was prepared in the context of a provincial initiative to combine paramedic services in Ontario. There are currently 47 services and the Province intends to reduce that to 10. In Eastern Ontario (from City of Kawartha Lakes to Stormont-Dundas and Glengarry) there are 13 county operated systems serving a population of 1.19 million people. The Frontenac County service, which serves the City of Kingston, is the largest in the region, with Peterborough County a close second.

According to Pender, the study showed that one of the major cost factors in the system relates to the protocol for dispatch.

“68% of calls are dispatched at the highest urgency, when in reality only 26% are actually of the highest urgency. It would be more effective, if a call for a broken ankle, for example, had a lower priority than a life-threatening call. Urgent calls would have faster response times, and it would make the system more efficient.”

Offload delays, the time that paramedics spend waiting in hospital for under-staffed emergency rooms to take over responsibility for care, effectively keeping an ambulance off the road. These delays “cost $4.8 million in Eastern Ontario last year” according to the report. It also represents a hidden provincial download to municipalities. If the province provided more funding for emergency room staff, which 100% provincially funded, it would save costs for Paramedic Services (which are 46% funded by a provincial operating subsidy with most of the rest coming from municipal taxes – 51%).

The third overall finding of the report is that, in Pender’s words, “community paramedicine must be funded.” He said that “seniors are only 22.8% of the population but account for 55% of ambulance response. Community Paramedicine is an effective program to reduce call volume and ER visits.

Most of the results of the study place the cost of service in Frontenac County in a moderately positive light as compared to the other services. The cost per call for Frontenac is lower than the average, partly a function of the high call volume for the Kingston based calls. Call volumes are increasing at a higher rate than average and projected budget increases, 4.6% per year over the next 5 years are slightly lower than the 4.8% average projected budget increase in the study.

The study’s release may be fortuitous for Frontenac County in two ways. It provides a context for Frontenac Paramedic Services to play a lead role in the provincially mandated reconfiguration that is being developed, and in the short run it provides ammunition that Frontenac County can take to Kingston City Council when presenting final budget numbers for 2020.

Kingston City Council balked at paying the levy for ambulance service that was submitted to the City by the County in 2019, and have refused to pay a small portion of that levy, $200,000. They also indicated they are expecting all outside agencies to bring in 2% increases in their budgets in 2020, well less than the county will be presenting to them sometime in the next two months.

Information in the report will make it harder for Kingston City Council to argue that their residents are being overcharged for paramedic services when the fees are comparable, or lower, than those in the rest of Eastern Ontario.