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Report finds issues with ambulance funding model

Chris Marchand

Chris Marchand served as editor of the Dryden Observer from August 2009 to April 2018.

By Jon Thompson

An independent assessment of Kenora District Services Board (KDSB) non-emergent ambulance transfer woes has found the region is held to different and more costly standards than the rest of the province.

According to consultants, Performance Concepts Consulting Inc., rural and northern residential taxpayers face a “significantly higher tax burden” for non-emergent ambulance services.

In urban Ontario, non-emergent Code 1 and 2 patient transfers are funded 100 per cent through provincial hospital budgets and outsourced to private, non-paramedic contractors. In Northwestern Ontario, Emergency Medical Services (EMS) bears the costs of Code 1 to 4 transfers through the KDSB, whose budget is 50 per cent funded by residential taxes. The report called for a design overhaul of KDSB’s “non-system,” which would be contingent on increased provincial funding.

“The funding restructuring recommendations are critical. They are the glue that holds the entire restructuring package together. All other non-financial recommendations presupposed the new funding recommendation being implemented in a meaningful fashion by the Ministry of Health and Long Term Care,” said Dan McNeill, the KDSB’s chief administrative officer. “Either we’ll have to fund it directly or the participants will have to fund it directly. We have no incremental money. The hospitals have no money. He’s (the consultant) saying the ministry should fund it as an independent third party.”

Five per cent of the region’s emergent calls overlap non-emergent calls, meaning paramedics are called in at time-and-a-half wages to satisfy staffing complements. The impact on emergency services is most pronounced in Kenora, where 297 or 10 per cent of emergent calls have overlapped non-emergent transfers to Winnipeg.

Seeing its nurses stranded in the Manitoban capital for hours at a time and increased strain on its emergent system, the Lake of the Woods District Hospital balked at a KDSB attempt to send non-emergent transfer bills to the hospital in 2012. When the ministry backed the hospital, health care providers across the Kenora and Rainy River Districts submitted to the consultant’s review.

Although the review found EMS bears the responsibility, it also noted the province has treated the KDSB uniquely in making it responsible.

“Not only are we not funded well enough, we’re treated differently from a regulatory perspective,” McNeill said. “They tell us that non-emergent transfers are our regulatory, legislative and legal obligation. The consultant says, urban EMS deployment plans provided by the same department that tells us that we have to do it, allows them not to do it.”

Performance’s assessment is the fifth such study conducted on transfers over the past decade. The Northwestern Ontario Municipal Association (NOMA), the Federation of Northern Ontario Municipalities (FONOM) and the Northern Ontario Service Deliverers Association (NOSDA) have all passed resolutions calling for Queen’s Park to address the issue.

KDSB chair Barry Baltessen is hopeful this report can clarify the board’s situation.

“It’s not fair, which results in a different way of funding those types of calls,” said KDSB chair, Barry Balthessen. “We’ve been asking for a change for 10 years.”

 

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