HEALTH Office of the Minister MLA, Calgary-Acadia AR 176263 His Worship Naheed Nenshi Mayor, City of Calgary Historic City Hall 8069, 700 Macleod Trail S Calgary AB T2P 2M5 Dear Mayor Nenshi: Attached, you will find a letter from Alberta’s Chief Paramedic Darren Sandbeck that I have sent to all Calgary MLAs and City Councillors detailing the rationale for the consolidation of EMS dispatch in Lethbridge, Red Deer, Wood Buffalo, and Calgary announced on August 4th. As you know, the decision to consolidate EMS dispatch has been thoroughly examined and researched over the last decade and has been recommended by both the Ernst and Young AHS Review and by the Health Quality Council of Alberta. The consolidation of most of Alberta’s EMS dispatch happened nearly a decade ago. Right now, AHS dispatches ambulances for 60% of the population of Alberta, including large centres like Edmonton and Medicine Hat. EMS data shows that fears of service delays that stemmed from the first wave of consolidation were unfounded. AHS reports that EMS calls are answered within 10 seconds, 95% of the time and that no calls to 911 have ever been left waiting. The first transition was successful and this one will be too. There will be no delays in emergency response and Albertans who request EMS will notice no change. A borderless and consolidated dispatch system will in fact provide better patient care. Chief Paramedic Sandbeck has my full confidence, and I trust that he will not only maintain patient safety throughout this process, but improve it. Sincerely, Tyler Shandro, Q.C. Minister of Health Attachment: Letter from AHS cc: Calgary Caucus cc: Calgary City Council 423 Legislature Building, 10800 - 97 Avenue, Edmonton, Alberta T5K 2B6 Canada Telephone 780-427-3665 Fax 780-415-0961 Classification: Protected A On August 4, AHS announced its plan to consolidate EMS dispatch in Calgary, Lethbridge, Red Deer and the Regional Municipality of Wood Buffalo, aligning these centres with the rest of the province. I’d like to take this opportunity to further clarify the rationale for this decision, provide factual information and help you understand why we are consolidating EMS dispatch. As always, patient safety is at the core of every decision we make at AHS. This includes our approach to dispatching of EMS services across Alberta. I can assure you that patient care and ambulance response times will not change as a result of this transition and 911 callers will notice absolutely no change. 911 calls that are currently being answered in the affected municipalities will be transitioned to either the Northern Communications Centre (NCC, in Peace River), the Southern Communications Centre (SCC, in Calgary) and Central Communications Centre (CCC, in Edmonton), as is the way calls are answered throughout the rest of the province. The decision to consolidate EMS dispatch has been thoroughly researched, and analyzed and the municipalities that are the last to transition have been consulted repeatedly over the years since the rest of the province moved to EMS dispatch nearly a decade ago. That change has been successful, and AHS currently already dispatches ambulances for approximately 60% of the population of Alberta, including other large centres like Edmonton and Medicine Hat. Callers to 911 will notice absolutely no change to service or delay in response. This transition affects EMS 911 dispatch services only; all local municipal fire, police and Medical First Responders (MFR) will continue to be dispatched by the local municipalities. That means that if both a fire crew and EMS are dispatched, both will continue to arrive, even following this transition. Implementing a province-wide EMS dispatch system will allow for better efficiency and better co-ordination of all resources, allowing EMS to send the nearest available ambulance to a patient regardless of any geographic boundaries. AHS EMS is well equipped to respond to any and all emergencies, and answers tens of thousands of 911 calls each month. AHS will maintain the Computer Assisted Dispatch (CAD) interfaces with each of the communities to ensure seamless dispatching of Medical First Response (MFR) resources. Currently in Calgary, Red Deer, Lethbridge and the Regional Municipality of Wood Buffalo, when a 911 call comes in it is answered by a municipal call taker. If the caller is requesting an ambulance that call is transferred by the push of a button across the room to another EMS-trained dispatcher who is employed by the municipality. That employee uses AHS computer resources and EMS tools to dispatch an AHS ambulance. When the transition is complete instead of that call being transferred across a room to a municipal employee, the calls will be transferred with that same touch of a button to one of the EMS dispatch centres. This happens instantly. Classification: Protected A What we have now is a duplicate system where municipal call takers are duplicating the work we already do for the rest of the province in our AHS dispatch centres and have done successfully for a decade. This duplication costs over $6 million dollars every year; money which is better spent on patient care. Conversations regarding the consolidation of EMS dispatch services have been ongoing, and in the past some municipalities were opposed, suggesting service delays, decreased levels of care and poor integration with other response agencies including medical first response. EMS research and data has shown this is not the case. In fact, our time-to-call-answer is measured by TELUS and is reported monthly. Calls to EMS are answered well over 95% of the time in less than 10 seconds, and AHS EMS has never had 911 calls waiting in a queue. In May 2020 alone, our EMS team managed over 23,000 911 events without any issues related to lost callers. You may have recently received correspondence from the Mayor of Calgary suggesting that a number of issues may arise out of this change. I’d like to take this opportunity to set the record straight on a number of these points:      There are no additional steps in the dispatch process post consolidation. In 2016 AHS moved all EMS dispatch, including the municipal satellite centers, onto our provincial Computer Assisted Dispatch (CAD) program, telephone system and voice logging system. This also standardized all policies and procedures. These municipal employees are using AHS provided equipment. After consolidation, calls transferred from the municipal 911 operator will be transferred, with a single button to an AHS EMS dispatcher instead of a municipal employee. Medical First Response (MFR) will not change in the consolidated model. Since 2016 we have used CAD to CAD technology to communicate directly with the Fire program in Calgary and the other municipal centers. This means that if MFR is required – our CAD communicates electronically and instantly with their CAD. There is no transferring of the caller and callers do not need to “tell their story multiple times.” The recent example of the June 13 hailstorm in Calgary of the “all hands on deck” requirement of dispatch is actually quite interesting. What actually happened that day, and happens with other significant weather and natural events, is that the Calgary 911 system became quickly overwhelmed and stopped processing EMS 911 calls, simply transferring them to our Southern Communications Center to manage those EMS calls that were occurring at the time. This has happened in the past during the unusual September snowfall and winter ice storm events. In fact, AHS EMS routinely does anywhere from 7% to 30% of the EMS call volume of these municipal centers. The Mayor of Calgary continues to make statements that “People are going to die” and quote AHS as saying this is “no big deal as few people die in the first few minutes anyway.” This is untrue and disrespectful. AHS has never made such a statement. AHS is a dedicated and committed healthcare organization, to suggest that we would do anything to put patients at risk is absolutely untrue. The City of Calgary does not appear to have an ongoing vested interest in EMS. Calgary was the first municipality to signal intent to transition EMS to the provincial health system when the transition was announced by the then government in 2008. The City of Calgary does not own or Classification: Protected A control the EMS resources in their city, and they appear to not understand or appreciate opportunities afforded by a health based EMS dispatch model. Other interesting facts:   Every single 911 call to RCMP in this province is answered by a municipal 911 call answer center and transferred to one of a number of RCMP dispatch centers. This happens thousands of times a day provincially. All of the existing municipal dispatch centers hold contracts to provide dispatch services to other municipalities. As an example, Red Deer dispatches the Airdrie Fire Department, while Calgary dispatches the Canmore Fire Department. AHS EMS dispatches EMS successfully in both of these communities. This dispatch transition is evidence based and supported by thorough research and investigation. Alberta Health first approved the province-wide consolidation plan in 2009 to help reduce the costs associated with running duplicate parallel contracted dispatch centres. In 2013, the Health Quality Council of Alberta also recommended consolidation. More recently consolidation was recommended by Ernst and Young during the recent AHS review. AHS EMS looks forward to continued collaboration with our municipal partners and the Government as we phase in this transition and I invite you to connect with me if I can be of further assistance. Kind regards, Darren Sandbeck M.A., ACP, CHE Senior Provincial Director & Chief Paramedic Alberta Health Services Classification: Protected A August 10, 2020 The Honourable Tyler Shandro Minister of Health 423 Legislature Building 10800 – 97 Avenue Edmonton, AB T5K 2B6 Re: Stopping the takeover to protect Calgary’s emergency response capabilities Dear Minister Shandro, I have appended the letter I sent today to all Calgary MLAs encouraging them to speak up about the AHS decision to consolidate the dispatch of Emergency Medical Services (EMS) over the next six months. I urge you to step in and reverse this decision. It is not in the public interest. The new story your administration is telling does not align with the well-established facts as this discussion has unfolded for the last decade. In particular, the new claims being made by AHS about the negligible impact to response times and that callers will not need repeat their story multiple times are simply not true for complex emergencies where multiple agencies and first responders are involved. There is no pressing need to undertake this risky change and no real upside for Calgarians or your government. There is no harm in taking the time to review this file more fully to determine if another course of action is more appropriate. I would be pleased to offer the City of Calgary’s assistance to ensure you have all the information necessary to review this decision. Sincerely, Naheed K. Nenshi MAYOR cc: The Honourable Jason Kenney, Premier, Government of Alberta City Council 11 August 10, 2020 Re: Stopping the takeover to protect Calgary’s emergency response capabilities Dear , I am writing because Calgarians need your help. Unless you raise your voice in public and behind the scenes, Calgary’s emergency response capabilities will be significantly diminished at a time when we need them more than ever. On August 4, 2020 Alberta Health Services (AHS) announced its intention to centralize, takeover and consolidate the dispatch of Emergency Medical Services (EMS) over the next six months for Lethbridge, Red Deer, Wood Buffalo and Calgary. This is a very bad idea and the mayors in all four of these communities are steadfast in our opposition to this thoughtless change. Consolidation of EMS dispatch would create needless red tape and inefficiencies, with no benefit to the public or the Government of Alberta. When a citizen phones 9-1-1 they are experiencing one of the worst days of their life. Their emotions are heightened and they need the best help we can provide when seconds count. Under the current integrated, tri-service model, Calgarians who call 9-1-1 immediately access a coordinated response from EMS, fire, and police first responders which is critical to addressing complex, high risk or dangerous situations more effectively. Our current integrated emergency dispatch model ensures that callers do not have to repeat their story multiple times to receive help from multiple agencies, which would be the case in all but the simplest emergencies under the new dispatch model AHS intends to move to. The justification for this change, presented without any evidence, is that it will supposedly save $6 million across Alberta. This represents 0.0004% of AHS’s $15.4 billion allocation in Budget 2020. Calgary does not accept that any savings will materialize. Indeed, The City of Calgary currently subsidizes the cost of the tri-service model under the dispatch service agreement in place because of the benefit to our citizens. The Calgary Fire Department’s (CFD) medical first responders are rapidly dispatched as part of the current model. CFD attends over 34,000 calls each year and are on scene first in almost half of all critical events. This medical first response by CFD is also subsidized – $7.3 million annually in City property taxes is used to ensure better outcomes in medical emergencies where CFD attends alongside EMS. Calgarians should be rightly proud of this coordination which undoubtedly saves lives. 12 Any cost reductions generated from the announced takeover would only result from significant, permanent reductions in the quality of the services and our capability to respond to complex emergencies. AHS has committed to hiring 25 new Emergency Communications Officers to support this consolidation for the entire province while The City of Calgary will lose 45 employees in these jobs. Our police and fire first responders will already face a new barrier to coordinating with EMS through this decision to de-integrate 9-1-1 but will also have less resources available to do so. Every time this terrible idea has been proposed over the last twelve years the health minister has intervened to protect the public interest by maintaining Calgary’s emergency response capabilities. There is a clear opportunity for Minister Shandro to do the same. Through these numerous takeover attempts, AHS has repeatedly admitted (up until last Monday) that changes to the current dispatch model will result in longer response times to medical emergencies but has suggested that longer response times are “no big deal” since “few people die in the first few minutes anyway.” This is unacceptable. Longer response times and adding unnecessary steps in the process of reporting a complex emergency will drastically impact patient outcomes and even lead to deaths in certain emergencies. Calgary 9-1-1 has been dispatching EMS since its inception. The proposed takeover would be the first time that the Calgary tri-services model has ever been fractured. This integrated tri-service dispatch model reflects the industry best practice, a model that many agencies are trying to replicate around the world. Responding to emergencies during this COVID-19 pandemic is becoming more complex. The June 13 hailstorm again reinforced the value of the all-hands-on-deck, integrated dispatch model as significant damage and flooding occurred extremely quickly. The need to maintain our emergency response capabilities as we confront an increasingly uncertain and unpredictable world is critical. Calgarians will be worse off if this change proceeds. Please advocate strongly in all forums available to you to stop this senseless proposal. Calgarians would expect no less of the people they have entrusted to protect their interests. Sincerely, Naheed K. Nenshi MAYOR cc: City Council Calgary MLAs 13