September 30, 1999

To: Community Services Committee

From: Commissioner, Works & Emergency Services

General Manager, Toronto Ambulance Services

Subject: Update Regarding the Evolution of Ambulance Services Within the Greater Toronto Area

Purpose:

The purpose of this report is to inform members of Council of developments occurring within the ambulance service industry across the Greater Toronto Area. With the enactment of Bill 152, Upper Tier Municipalities (UTM) assumed the responsibility for the delivery of land ambulance services. The full effect of this legislation will take place on January 1, 2000, and this report is to provide members of Council with information concerning developments to date.

Financial Implications:

There are no financial implications associated with this report.

Recommendations:

It is recommended that this report be received for information.

Comment:

With the enactment of Bill 152 the responsibility for the delivery of land ambulance services was downloaded to Upper Tier Municipalities. The City of Toronto was the first municipality in Ontario to assume responsibility over land ambulance services effective January 1, 1998. Neighbouring municipalities within the Greater Toronto Area had opted to defer the assumption of responsibility of land ambulance service until January 1, 2000. Unlike the City of Toronto, which operated its ambulance service as a single unified service under the previous Metropolitan Toronto government, municipalities, both local and regional within the Greater Toronto Area had no involvement in the provision of ambulance services within their areas. Ambulance service within the Greater Toronto Area, exclusive of the City of Toronto was provided primarily by the Ministry of Health, Emergency Health Services Branch, hospital-based services and private services operating under the Ministry of Health. With the devolution of responsibility for land ambulance services, the regional municipalities have been studying how best to provide their services once they assume responsibility. The regions of Durham, York and Halton commissioned a major review in order to determine the structure of their ambulance service. The Regional Municipality of Peel is currently engaged in a similar review.

Effective January 1, 2000, the regions of Durham, York and Halton will assume responsibility for the provision of land ambulance service within their respective regions. The cities of York and Durham have opted to develop a municipal model similar to what is in effect in the City of Toronto. Both regions have structured their ambulance service to report through their Community Services and Public Health Units. This was based on a consultant's report, which identified the close linkages between community health, community services and the delivery of mobile health care both today and in the future.

The Regional Municipality of Halton has established a municipal reporting structure, however, has chosen to contract with existing providers to allow for a period of further study in order to determine how best their service should be operated. The Regional Municipality of Peel is currently engaged in a request for proposal process in order to seek information from various stakeholders regarding the best method of operation. Both internal and external options are being assessed through this process.

The regional municipalities surrounding the City of Toronto have established a working group compromised of the Department Heads responsible for the provision of ambulance services. Recently, the 905 ambulance working group expanded its representation to include the City of Toronto. The creation of the Greater Toronto Area Ambulance Co-ordinating Committee, inclusive of the four (4) regions and the City of Toronto was supported by the Greater Toronto Services Board (GTSB) and has enabled the Department Heads of each service to begin the process of co-ordinating the delivery of land ambulance service within the Greater Toronto Area. Issues of common interest include exploring opportunities for joint purchasing, disaster planning, mutual aid and cross border coverage and improved co-ordination of dispatch and patient movement within the Greater Toronto Area.

Conclusion:

Effective January 1, 2000, the Regional Municipalities of York and Durham will assume full responsibility for land ambulance service within the structure similar to what is currently in place within the City of Toronto. The Regional Municipality of Peel and Halton are continuing to assess the most appropriate delivery model for land ambulance services with an expectation that they will make their decision within the next 12-14 months. In the interim, they will meet on a formal basis to discuss issues of common interest and to improve the co-ordination of land ambulance services within the Greater Toronto Area.

Contact:

Ronald L. Kelusky, General Manager

Phone: 397-9240

Fax: 392-2115

Ronald L. Kelusky Barry H. Gutteridge

General Manager Commissioner

Toronto Ambulance Works & Emergency Services