The Government of Alberta is responsible for providing ambulance service throughout the province. But they only provide limited funding to the fire departments who participate in the Medical First Response program for basic training and equipment, leaving communities to pay the rest of the bills.
Alberta Health Services established the Medical First Response program in 2008 to bridge the gap between ambulance and fire services. The result is an integrated program that provides timely medical response to the residents of participating communities.
Municipalities who volunteer to participate in this program are provided support through Alberta Health Services, which amounts to $3,000 per year. However, this support is not guaranteed as participants must meet specific terms and conditions of the program.
Even with this support, funding for Medical First Response falls primarily on the municipality.
Chief Justin Andrew from the Olds Fire Department says that for an average sized department, between 30 to 40 members, $3,000 is nowhere near the realized costs of providing such service.
“That amount of money would hardly pay for us to maintain our basic first aid and CPR training and supplies per year, let alone any advanced treatments that we would provide,” he says.
The City of Airdrie spends $45,000 annually on training, certifications and supplies for the program. This cost does not reflect the salaries of the firefighters or the cost of maintaining equipment and machinery.
Despite being a crucial part of the program, the cost of maintaining fire trucks and compensating firefighters falls primarily under fire services.
Strain on Fire Departments
Participation in the Medical First Response program can put an added strain on fire departments.
Lucy Wiwcharuk, the director of corporate services at the City of Airdrie, says that sending their firefighters out has the potential to conflict with other firefighting duties. The program also takes an extra toll on the fire trucks and equipment used.
Firefighting equipment is costly and maintaining their fleet of vehicles is something Wiwcharuk can see the city funnelling their money back into if the Medical First Response program becomes fully compensated by the government.
The issue surrounding lack of funding for this program was initially voiced by the City of Wetaskiwin and has since been approved as a resolution for 2017 by the Alberta Urban Municipalities Association.
This resolution has been passed on to Health Minister Sarah Hoffman. It requests “direct financial compensation on a full cost-recovery basis to all Alberta Medical First Response agencies for every call responded to.”
The Alberta government has not responded to the resolution and did not reply to an interview request at the time of publication.
Benefits of the Program
Chief Andrew sees the value in having trained emergency providers that are dedicated to the locations they’re based in.
“Our volunteer firefighters don’t get taken away from the community for other EMS related duties,” he says. “There’s always a focused response available to the citizens, regardless day or night.”
Local fire departments also have the advantage of knowing their community and are therefore less likely to be delayed when responding to an accident.
Garth Rabel, chief of operations at the Airdrie Fire Department, says that the most important role for medical first responders is arriving on scene as quickly as possible.
First responders provide the initial link to what Rabel calls “the chain of survival.”
“It starts with the call of 911 and ends in a hospital. For some that’s very quick, and for others it can be challenging,” he says.
Rabel believes that more funding could create more accountability for the program and make budgeting more predictable.
A large part of the program’s costs is managing equipment, supplies and consumables, which can be hard since budgeting for the program is chosen by each municipality.
In the past, Rabel says that they could fill their trucks with medical supplies from the ambulances, but because of the current funding structure, there is now “more stringent management on supplies and consumables and they’re not given up as readily.”
A consumable, like gauze, would have been supplied by ambulances in the past, but now first response participants are responsible for purchasing and providing their own gauze. Rabel says it’s something they choose to do since the patient deserves that level of care.
Their main concern is treating the patient well no matter the situation, but more funding would go a long way in managing different costs of the program according to Rabel.
“The same money I buy bandages with, I also have to buy fire hoses with.”
Compensation would be beneficial
Another benefit to receiving direct financial compensation is the potential for smaller volunteer agencies to take on the Medical First Response program.
Smaller, rural locations require the program to be able to provide quick medical care since paramedics with more advanced training may take a while to arrive on scene.
“Those smaller departments require MFR support and funding at a very entry level just to be able to get a truck to a scene and provide some of those immediate lifesaving interventions,” says Rabel.
“We’re not stomping our feet and saying we need more,” adds Rabel. “We’re making our system work effectively and with great support from Alberta Health Services at numerous levels we hope that our other partners can find their level of support and provide care to their communities.”
Mike Pirie, platoon captain at the Airdrie Fire Department, agreed with Rabel during a discussion the two were having about the benefits of receiving government support.
“Compensation of first response will help ensure that it still occurs in the future as budgets shrink and are challenged, which in turn puts even more pressure on EMS,” Pirie says to Rabel. “A more streamlined funding model that’s equitable will keep the relevance to the initiatives and keep us moving forward in the future.”
The current state of funding for medical responders in Alberta is not only affecting participants of the Medical First Response program. A recent article by the CBC describes the current strain on ambulance service, which leaves Albertans in need of medical assistance in a risky position.