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		September 22, 1999 To:Community Services Committee From:Barry Gutteridge, Commissioner, Works and Emergency Services Ron Kelusky, General Manager, Toronto Ambulance Subject:Toronto Ambulance Services to the Greater Toronto Airport Authority Property Purpose: To obtain Council's direction on a course of action with regard to options in the continuance or discontinuation of routine day-to-day ambulance service in the Region of Peel on the lands of the Greater Toronto Airport Authority. Recommendations: It is recommended that: a)City Council advise the Region Municipality of Peel that Toronto Ambulance will discontinue the provision of routine day-to-day emergency and non-emergency services to the GTAA effective June 30, 2000, while maintaining Toronto Ambulance's lead role in disaster and mass casualty services on the GTAA site. b)That the appropriate municipal officials be given the authority to give effect thereto. Council Reference/Background/History: For some years, Toronto Ambulance has provided EMS services for Pearson International Airport due to the lack of sufficient local ambulance service. These services have included routine day-to-day emergency response to individual patients, disaster services, and non-emergency medical transport services. At present, Toronto Ambulance provides all ambulance service to the airport. Lands in Peel Region adjacent to the GTAA are in most cases serviced by other ambulances co-funded by Peel and the Ministry of Health. Although Toronto has not had any formal obligation to provide these services, Toronto Ambulance has previously done so in the interests of public safety. With the downloading of ambulance service by the province to the regional municipal governments, the Regional Municipality of Peel is now creating their own ambulance service to cover all parts of the region. Toronto currently responds to about 1,500 calls within the GTAA's grounds, and transports about 1,000 patients. These calls are placing a significant drain on the protection Toronto Ambulance provides to the northern Etobicoke neighbourhoods, degrading our response times and delaying non-emergency transportation provided to the area's hospitals and nursing homes. The GTAA is currently engaged in a major expansion of its facilities and passenger capacity. In order to meet the increase in demand which will arise from this expansion, and to reduce the impact of such services on Toronto Ambulance service in Etobicoke, an ambulance station dedicated to serving the airport lands is now essential. Accordingly, the issue is being brought to Council for instructions, and, if necessary, for allocation of funds sufficient to continue service to the GTAA, should Council so decide. Comments and/or Discussion and/or Justification: Two kinds of EMS services are being provided by Toronto Ambulance to the GTAA: a)Routine day-to-day emergency and non-emergency ambulance service to individual patients on the grounds. b)Disaster response services in the event of a major mass casualty incident at the GTAA, ranging from minor events such as large scale in-flight food poisoning, producing 10-20 patients, to a full scale air crash with the potential of 500 or more patients. Toronto Ambulance remains fully committed to providing the GTAA with all disaster services as described in "b)" above. We are the only EMS agency in Southern Ontario capable of mounting a comprehensive response to such incidents, and our services will remain at the disposal of the GTAA. The issue addressed by the report is confined to the provision of routine single-patient emergency and non-emergency services, consistent with normal municipal ambulance service. Toronto Ambulance has been engaged in discussions with the Region of Peel and with the Greater Toronto Airport Authority on the subject. These discussions revealed the following: - The Greater Toronto Airport Authority's position is that its lands are fully within the Regional Municipality of Peel. It is also the GTAA's position that it is entitled to the same level of municipal services (including ambulance service) as other parts of the Region, and for this reason, is unwilling to purchase such services from the City of Toronto. - In recent discussions, ambulance program staff from the Region of Peel have indicated that Peel Region itself is not willing to contract for the cost of the provision of these services by the City of Toronto. Since Peel has not yet formally assumed full control over ambulance services, Peel staff have referred the matter to the Ministry of Health. (The MOH and Peel currently co-fund service delivery within the Region). In combination, these positions afford the City of Toronto a limited number of options including: (1)Council could decide to continue to provide services to this portion of the Region of Peel from the existing general City of Toronto funds allocated to Toronto Ambulance through the annual budget process. As the level of demand arises at the GTAA, service in Etobicoke could be seriously affected. (2)Council could increase funding to Toronto Ambulance to permit it to negotiate with the GTAA to obtain an ambulance station on the airport grounds, and to staff that station with both advanced life support and basic paramedics. The cost of this option would be approximately $1.0 million in capital for construction (excluding the cost of land), and about $1.2 million in annual staffing and equipment costs. (3)Council could direct the General Manager, Toronto Ambulance, through the Commissioner, Works and Emergency Services, to obtain full funding for the services described in option (2) from the Regional Municipality of Peel or the Greater Toronto Airport Authority, or both, notwithstanding the parties' original positions on the issue. Failing this, the Commissioner would report back to Council for further instructions. (4)Council could advise the Regional Municipality of Peel that Toronto Ambulance will discontinue the provision of routine day-to-day emergency and non-emergency services to the GTAA effective June 30, 2000. This long-lead notice will permit the Region of Peel and the Ministry of Health to develop an appropriate plan for integrating the GTAA lands into its plans for service to the balance of the Region. The General Manager, Toronto Ambulance, recommends that Council adopt option (4) as it best conforms with the new municipal/provincial funding arrangements for ambulance service, and redirects current City of Toronto to badly needed services within the boundaries of the City. For greater clarity, it is restated that Toronto Ambulance will remain committed to providing a full range of disaster services to the GTAA, regardless of the final configuration of the delivery of routine day-to-day ambulance services on the site. Conclusion: Toronto Ambulance's historical role in service to Pearson International Airport requires review due to changes in the provincial funding mechanisms for ambulance service, and the growth of demand on Greater Toronto Airport Authority lands. Since the GTAA lands are part of the Regional Municipality of Peel, the continued use of City of Toronto funds to provide all routine ambulance services to the airport remains problematic. Contact Name: Ronald L. Kelusky General Manager, Toronto Ambulance Telephone: (416) 397-9240 Ronald L. KeluskyBarry Gutteridge General ManagerCommissioner Toronto AmbulanceWorks and Emergency Services
		Please note that council and committee documents are provided electronically for information only and do not retain the exact structure of the original versions. For example, charts, images and tables may be difficult to read. As such, readers should verify information before acting on it. All council documents are available from the City Clerk's office. Please e-mail clerk@toronto.ca.

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