# Fire-based EMS



## mariomike

TORONTO, June 26, 2013 /CNW/ - The Toronto Paramedic Association strongly supports the majority of recommendations concerning EMS in the 'City of Toronto/Pomax report on Toronto EMS and Fire Services' released on June 25, 2013. The majority of findings are in line with what the Toronto Paramedic Association has been advocating for years. 
http://www.newswire.ca/en/story/1190393/toronto-paramedic-association-pleased-with-pomax-consultants-report-on-toronto-ems-fire-services-encourages-city-council-to-rapidly-accept-and-impleme

City of Toronto/Pomax report recommendations:

1) "Do not consolidate TFS and TEMS. Consolidation of TFS and TEMS is not well suited for Toronto given the maturity of its fire and paramedic services."

2. "Do not consider implementing a firefighter-paramedic model of pre-hospital emergency medical care in either an organizationally consolidated entity or in the existing separate organizational design."

No Johnny and Roy for Toronto.

3. "There has been a 28% increase in emergency call demand for paramedics over the last ten years." 

4. "Implement dynamic staging  and use predictive modeling and pre-emptive traffic controls to better predict demand and more effectively deploy fire resources and apparatus."

I don't imagine Dynamic Staging will be a popular recommendation with the Firefighters, especially since they switched to the 24-hour tour city-wide. 

5. "Demand for fire response has remained flat or declined over the last ten years and the number of actual fires in Toronto has declined even though the population has increased."


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## pbi

Mariomike: What are your views on other cases (Canadian and US) where the two services have been combined?

I'm aware of two in Canada: Calgary attempted it while I was stationed there in the 1990's, but it was very unpopular with both sides and eventually it failed. (Don't know the status today: I think they're still separate).

Winnipeg has had a "Fire-Paramedic Service" for some time now (it existed when I lived there 2002-2005). It seemed to work (more or less), but I got the impression that there may still have been some friction and unhappiness.

In the US, the provision of paramedic services by large, well-established city FDs is quite common. Sometimes the FD is the sole provider of public EMS, sometimes there are other providers, but in any case this practice isn't really news in the US.

It actually might be a wise move by FDs with an eye on the future, since the number of calls to actually fight fires seems to be dropping in most places (except Detroit, maybe...). When I was a VFF in suburban Virginia (just outside DC) I would say that 60-70% of our runs were non-fire.

Cheers


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## mariomike

Pbi, this is the report. "A Service and Organizational Study of Toronto's Emergency Medical Services and Fire Services":
http://www.toronto.ca/legdocs/mmis/2013/ex/bgrd/backgroundfile-59903.pdf

It's a lot of reading, but it discusses much of the above. 

Cheers


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## pbi

Aaaaah! 320 pages!!!! You're killing me!!

OK...I will have a look and get back to you.

Cheers


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## Scott

I think the Winnipeg FireMedic example is still one of growing pains, least from what I hear rumbling online and through some acquaintances.

Some great examples would be Red Deer and Ft. McMurray - both medium sized cities who have had established combined services for some time now. I have good friends serving, or who have served, with both and they say it works - save for the arguments and short straw draws over who has to run on the medic unit for the shift >

I do not, however, see it working in a place such as Nova Scotia where the paramedic service is "nationalized" with a strong component of enhanced FA services rendered by fire. One of the issues I have seen with the separation of services (including dispatch) is that sometimes through stage shifts the medics responding do not know the area and there is a time loss when either they, or their dispatch, do not push the button to have fire co-respond. But that's nothing that better comms on both sides hasn't fixed (until next time)

My experience with EHSNS has been pretty much positive. I dealt with them as a fire officer overseeing MFRs (mine lapsed and I have zero interest in regaining that cert) and found them to be nothing but positive in dealing with issues such as above, training sessions, debriefs, etc. I also found that when we lucked out with crews we knew we suffered zero sense of overlap and everyone worked with one another.

I digress. Personally I don't promote or decry the idea. I think it works who it works for and those it isn't working for, either model, are the ones who look for a change. It is not something simply for the good idea fairy, that is for certain. Neither is it for the lobbyists looking solely to save positions in X service.
There are benefits and drawbacks to each model and what they are largely depend on your area.

Just my opinion.


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## pbi

OK: I skimmed the report, but read the Fire-EMS model part pretty thoroughly. The conclusions I find interesting are:

-Alberta tried it but is moving away from it quickly;

-Winnipeg has it, but it tgook 15 years to sort out so that it worked well;

-there isn't any conclusive evidence that a combined model is necessarily better, or even cheaper than an effective FD and an effective EMS working in a coordinated and cooperative way. It might be a good idea if one (or the other) service has a particular weakness, but otherwise it migt just be change for change's sake.

Maybe this is like that idea that was popular in the 1950s in the US and parts of Canada (Esquimalt, Fort Garry, etc) of a combined Fire-Police service. This was touted as being more "efficient" and, of course cheaper (Amazing how some of the worst ideas have the characteristic of supposedly saving money...). As far a I know it has largely vanished, although Esquimalt was still doing it when I was stationed there in 1983-86.

Cheers

DJB


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## Scott

pbi said:
			
		

> -there isn't any conclusive evidence that a combined model is necessarily better, or even cheaper than an effective FD and an effective EMS working in a coordinated and cooperative way. It might be a good idea if one (or the other) service has a particular weakness, but otherwise it migt just be change for change's sake.



This is about where I stand on the whole thing.


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## mariomike

Scott said:
			
		

> Some great examples would be Red Deer and Ft. McMurray - both medium sized cities who have had established combined services for some time now. I have good friends serving, or who have served, with both and they say it works - save for the arguments and short straw draws over who has to run on the medic unit for the shift >



Scott, that would not be a concern in Toronto.  

"TFS does not require a PCP level of training, and instead, relies upon an appropriate, but less qualified level, similar to an emergency medical responder (EMR)."

"...the training does not provide eligibility to practice or work in a patient care capacity in a land ambulance service in the Province of Ontario."


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## Scott

Mike, I know. I was referring to buddies of mine relating their own experiences in places outside of TO.


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## mariomike

pbi said:
			
		

> In the US, the provision of paramedic services by large, well-established city FDs is quite common. Sometimes the FD is the sole provider of public EMS, sometimes there are other providers, but in any case this practice isn't really news in the US.
> 
> It actually might be a wise move by FDs with an eye on the future, since the number of calls to actually fight fires seems to be dropping in most places (except Detroit, maybe...). When I was a VFF in suburban Virginia (just outside DC) I would say that 60-70% of our runs were non-fire.
> 
> Cheers



That's what their General President was saying ten years ago.

"Our next frontier is Canada.":
http://www.iaff.org/03News/061203has.html

"But as one of this union's most fundamental responsibilities, our involvement in EMS has also helped us create and save jobs for our members."

The long awaited City of Toronto/Pomax report recommendations one month ago are clear on that subject.

In yesterday's paper.

"Toronto firefighters question changes to 911 protocol regarding medical calls 
Toronto firefighters are worried that patient safety is at risk after they were removed from dozens of urgent medical calls.":
http://www.thestar.com/news/gta/2013/08/02/toronto_firefighters_question_changes_to_911_protocol_regarding_medical_calls.html

"Based on the data, the medical experts recommended that firefighters only be dispatched to types of urgent medical calls where they intervened (or could have intervened) in at least one per cent of cases, a threshold Schwartz called “medically quite reasonable and ethical.”

Dr. Brian Schwartz is co-chair of the city's tiered response committee. 

"John MacLachlan, executive officer of the EMS committee for the union that represents Toronto firefighters, was concerned about the changes, and asked area captains to keep him abreast of any medical calls where they believed that they had not been dispatched soon enough — or at all."


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## 241

Red Deer Alberta currently has fire-medics and from what I have heard it is very practical and convenient as it means there are always extra bodies available at the scene, they are all trained the same of course. With Alberta Health Services apparently taking over all ambulance service that will end soon.


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## mariomike

241 said:
			
		

> Red Deer Alberta currently has fire-medics and from what I have heard it is very practical and convenient as it means there are always extra bodies available at the scene, they are all trained the same of course. With Alberta Health Services apparently taking over all ambulance service that will end soon.



That may be very practical and convenient ( or used to be ) in Alberta, but not here.

"New ( TFS ) recruits therefore receive a total of approximately 120 hours of EMR training."

That can be compared to PCP training on page 115: "Skills and Knowledge Guide for Pre-hospital Skills in Ontario"
http://www.toronto.ca/legdocs/mmis/2013/ex/bgrd/backgroundfile-59903.pdf

The cost - assuming it was even possible - of upgrading Toronto's 3,100 full-time firefighters to just a PCP level would be enormous.

To put just one PCP into each of the city's 82 firehouses would require training 411 "fire-medics".

 "Therefore, the estimate to train 411 firefighters to the PCP level would be approximately $6.16 million for tuition, books, and other requirements, plus a direct replacement wage cost of $67.11 million (411 complement, minus 100 [current trained EMCA complement *] multiplied by $107,896). This calculation assumes a 100 percent success rate in both the program and the provincial certification examination, which has not been the actual experience. Prudence would suggest at least a 10 percent remediation rate, further increasing the cost."

They would be assigned to fire trucks, not ambulances. Patients would not be arriving at hospitals any sooner than they do now.

Because there are no "fire-medics" at this time, the salary for their new job classification, if it could not be negotiated, would have to be decided by an arbitrator. 

*The estimated 100 EMCAs currently employed by TFS may already be certified which might reduce the costs of training or the duration of the tuition option.


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## pbi

241 said:
			
		

> Red Deer Alberta currently has fire-medics and from what I have heard it is very practical and convenient as it means there are always extra bodies available at the scene, they are all trained the same of course. With Alberta Health Services apparently taking over all ambulance service that will end soon.



True, but from what I understand, as mariomike says, AB is abandoning that system.


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## 241

pbi said:
			
		

> True, but from what I understand, as mariomike says, AB is abandoning that system.



Yeah, as I stated in the last sentence.



			
				mariomike said:
			
		

> That may be very practical and convenient ( or used to be ) in Alberta, but not here.
> 
> "New ( TFS ) recruits therefore receive a total of approximately 120 hours of EMR training."
> 
> That can be compared to PCP training on page 115: "Skills and Knowledge Guide for Pre-hospital Skills in Ontario
> 
> ....



Sorry didn't read any of the links, was just responding to earlier where pbi had mentioned that there were 2 cities that were doing this and was just mentioning that there were at least 3.


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## HTFUAlberta

I'm currently working for an integrated Fire/EMS system in one of the cities adjacent to Edmonton and can offer up my $0.02.

For smaller sized cities the integrated Fire/EMS system seems to work really well. The IAFF put out a really interesting  position paper on integrated services which shows a solid argument http://www.iaff.org/tech/PDF/FB%20EMS%20Whitepaper%20FINAL%20July%205%202007%20.pdf 

In the smaller sized cities outside of Calgary and Edmonton integrated services are generally the norm and seem to work very effectively. Larger cities would have way bigger challenges compared to smaller ones implementing and integrated service. IMHO it seems to work really well for our city and we provide great value and high service. After all most fire services seem to have a high ratio of medical calls regardless. We're all certified to at least PCP level so we're able to start up a lot of interventions and treatments before a transport crew arrives. It's always funny to see an out of town crew show up and we (the knuckle dragging firefighters) already have a pt. tubed with a line.

As far as AHS goes we're still waiting on our contract after 17 months of negotiations. We just dropped $500,000 on new medics and the contract will be for 7 years so it's looking like we're still getting our ambulances (which are generally sent outside of our are due to roving deployment, hence the outside crews coming in to cover our red alerts). AHS is having a lot of growing pains as far as the provincial EMS roll out and I'm of the opinion that there is still a long way to go before fire/ems systems in Alberta get split up. With that being said the AHS EMS system has some great advantages too (don't want to sound negative) but it is costing more $$$ than they ever expected which is no suprise. 

We don't have enough units to begin with and when your doing calls from CFB Edmonton, then downtown then to a nearby reserve in one day you know that your service is overstretched.

Like I said before only my $0.02


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## mariomike

HTFUAlberta said:
			
		

> We're all certified to at least PCP level so we're able to start up a lot of interventions and treatments before a transport crew arrives.



TFS does not require a PCP level of training, and instead, relies upon an appropriate, but less qualified level, similar to an emergency medical responder (EMR).

The cost of training their 3,100 firefighters to a PCP level would be enormous, if not impossible. As "fire-medics" ( no such job classification exists now ), they would also receive a salary increase.  

None of this expense would put any more ambulances on the street.


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## Scott

Toronto is not the centre of the universe. What works/does not work there might not work/not work somewhere else.

I did not gather that the post made by HTFU was reasoning towards TFS moving in this fashion. Rather, I gathered that he was stating his experience from a combined service in Alberta - one of the talking points here.


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## HTFUAlberta

I agree 110% 3,100 guys and gals to retrain would be an impossible challenge. I know when we went integrated (which I wasn't around for) all new hires had to have a PCP ticket to come on. A lot of other services in AB hire PCP/ACP and train them to the 1001 standard. As someone who started out Fire I have to say its easier to put a fit, willing PCP/ACP through a 4 month 1001 course than going the other way around. Now that we are so overwhelmed with EMS calls we are using ALS pumps to respond to all calls coded Charlie or higher. Once we arrive on scene we start treatment and assist the transport crew. On some bigger calls like a big trauma or code we will actually hop in the back and drive to the hospital with the transporting crew! 

A big service like Toronto couldn't make this practical but for the small to medium sized cities it seems quite doable. Back in the late 80s early 90s a lot of fire services in AB saw that going dual service was good value for money. I'm not in a position to speculate on what a big city like Hogtown should do but I know that it always boils down to how much (or in this case little) $$$ there is to go around.

As the old adage goes at the end of the day the doors go up, the truck rolls out and hopefully everybody goes home!

Or you can come out to AB and come swimming in the money pool! Leduc just recently settled at $92,000 for first class FF, Strathcona salary matches and Fort McMurray issues you an oil sand size dumpy truck to drive your pay checks home! 

But in all seriousness I know that the days of Johnny and Roy won't appear in TO anytime soon. In the meantime keep your head down, good luck and stay safe.

Regards, HTFU


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## Scott

HTFUAlberta said:
			
		

> I agree 110% 3,100 guys and gals to retrain would be an impossible challenge. I know when we went integrated (which I wasn't around for) all new hires had to have a PCP ticket to come on. A lot of other services in AB hire PCP/ACP and train them to the 1001 standard. As someone who started out Fire I have to say its easier to put a fit, willing PCP/ACP through a 4 month 1001 course than going the other way around.



This!

Oilsands FDs seem to see the writing on the wall. Either come in as a trained medic or nurse THEN go through fire, or come with both sides. DO NOT apply as a firefighter without the med side. I have always agreed with this rationale for those departments wishing to do so. Because it makes sense.


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## HTFUAlberta

Scott said:
			
		

> Toronto is not the centre of the universe. What works/does not work there might not work/not work somewhere else.
> 
> I did not gather that the post made by HTFU was reasoning towards TFS moving in this fashion. Rather, I gathered that he was stating his experience from a combined service in Alberta - one of the talking points here.



You can make it work in small to medium cities. I don't think it's doable for T.O. An oil tanker can't be combined with a cargo ship while sailing through rough seas right? Everybody has the best intentions on the floor but as you move up the totem pole there's less interest in playing together in the sand box. Edmonton tried back in the 90's and it fell apart over a $5,00,000 supplemental pension deal that would have to be offered to the oncoming EMS division. Amongst other things mind you. And the Fire/EMS split there has been entrenched ever since.

That old line if it ain't broke don't fix it may apply here. And in response to the Margaret Wente article: Emergency Services are like insurance. Don't ask if you can afford it, ask if you can afford NOT to!


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## mariomike

HTFUAlberta said:
			
		

> But in all seriousness I know that the days of Johnny and Roy won't appear in TO anytime soon.



The City decided: 

1) "Do not consolidate TFS and TEMS."

2) "Do not consider implementing a firefighter-paramedic model of pre-hospital emergency medical care in either an organizationally consolidated entity or in the existing separate organizational design."

3) "Increase TEMS response capacity by 223,451 staffed vehicle hours to meet demand."

4) "Continue the Community Paramedicine program as part of a strategy to provide the most appropriate patient treatment and reduce emergency medical response call volume demand."


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## Sheerin

HTFUAlberta said:
			
		

> I agree 110% 3,100 guys and gals to retrain would be an impossible challenge. I know when we went integrated (which I wasn't around for) all new hires had to have a PCP ticket to come on. A lot of other services in AB hire PCP/ACP and train them to the 1001 standard. As someone who started out Fire I have to say its easier to put a fit, willing PCP/ACP through a 4 month 1001 course than going the other way around. *Now that we are so overwhelmed with EMS calls we are using ALS pumps to respond to all calls coded Charlie or higher.* Once we arrive on scene we start treatment and assist the transport crew. On some bigger calls like a big trauma or code we will actually hop in the back and drive to the hospital with the transporting crew!
> 
> A big service like Toronto couldn't make this practical but for the small to medium sized cities it seems quite doable. Back in the late 80s early 90s a lot of fire services in AB saw that going dual service was good value for money. I'm not in a position to speculate on what a big city like Hogtown should do but I know that it always boils down to how much (or in this case little) $$$ there is to go around.
> 
> As the old adage goes at the end of the day the doors go up, the truck rolls out and hopefully everybody goes home!
> 
> *Or you can come out to AB and come swimming in the money pool! Leduc just recently settled at $92,000 for first class FF, Strathcona salary matches and Fort McMurray issues you an oil sand size dumpy truck to drive your pay checks home! *
> 
> But in all seriousness I know that the days of Johnny and Roy won't appear in TO anytime soon. In the meantime keep your head down, good luck and stay safe.
> 
> Regards, HTFU



The two bolded lines above are exactly the reason why fire based EMS doesn't make sense.  It is a massive waste of resources to send a pumper with 4 or 5 firefighters to a medical call, each of which are earning nearly 100k a year.  If you shift that money to EMS it's far more efficient.  For that one pumper you could get 2 transports and possibly a response unit.  

Also what happens when there (albeit rare) fire, what happens to medical response times?  What calls would take priority?  Would an ALS pumper be diverted from a paediatric VSA for a smoke condition call?  I really, REALLY hope that it wouldn't but I suspect that it would.  

Municipalities need to get away from the mindset that fire needs to have as many resources as they current have.  The simple question is, if fire is having such great difficulty making use of their man hours, then why do they have so many man hours to begin with?


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## PuckChaser

Code5 said:
			
		

> The simple question is, if fire is having such great difficulty making use of their man hours, then why do they have so many man hours to begin with?



Unions, and our fire prevention methods have moved into the 21st century in most cities.


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## mariomike

Code5 said:
			
		

> The two bolded lines above are exactly the reason why fire based EMS doesn't make sense.  It is a massive waste of resources to send a pumper with 4 or 5 firefighters to a medical call, each of which are earning nearly 100k a year.  If you shift that money to EMS it's far more efficient.  For that one pumper you could get 2 transports and possibly a response unit.



This came out two days ago on that subject. 

"As ‘emergency’ changes its meaning, some critics are arguing it’s time to revisit a century-old system. Is there such a thing as too many heroes?":
http://www.bostonglobe.com/ideas/2013/09/07/plenty-firefighters-but-where-are-fires/isCPrIPauX078UKHdixu0K/story.html?s_campaign=sm_tw

"Whether or not this shift in purpose is a good thing has lately been the subject of intense debate in Toronto, where a third-party review of the fire department in 2012 led the city to stop dispatching firefighters to 40-some types of medical emergencies that they used to respond to alongside ambulances. While firefighters there argue that the move has jeopardized people’s safety, EMS workers contend that there are only a handful of situations when the firefighters’ presence actually helps victims."


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## mariomike

Update.

Fraser Institute
May 7, 2015 
"Number of firefighters in Ontario balloons while number of fires drops dramatically"
https://www.fraserinstitute.org/research-news/news/news-releases/Number-of-firefighters-in-Ontario-balloons-while-number-of-fires-drops-dramatically/

"from 1997 to 2012, the number of reported fires in Ontario fell by 41.4 per cent while the number of firefighters increased by 36.3 per cent."


Globe and Mail  May 19, 2015 
http://www.theglobeandmail.com/globe-debate/why-firefighters-are-underworked-and-overpaid/article24459593/

"Municipalities that resist the union’s demands can go to arbitration. But they virtually never win. Arbitrators simply hand the union whatever the last guys got. “When the municipalities lose 100 to zero, there’s something wrong,” the mayor argues. “The arbitration system has to change.”

"In big cities, only a small number of the calls to the fire service are for actual fires. (In Toronto, only 9.9 per cent of calls to the fire service in 2013 were about fires; in Calgary it was just 3.4 per cent.)"


‘Fire-Medic’ proposal 
Star Jul 07 2015
http://www.thestar.com/news/gta/2015/07/07/fire-medic-proposal-pits-firefighters-against-paramedics.html

"According to van Pelt, 20 hours of training is not enough to equip firefighters with the skills they need to make life-saving decisions."

I've been retired for over six years, so operational decisions no longer affect me.  But, as a civilian who may need help one day,  Paramedics are worth the investment ( in my opinion ). 
To apply, candidates must first must graduate the mandatory two-year Paramedic Diploma program, followed by 500 hours of on-the-job training. If hired, for the rest of their career they must recertify their skills annually. 

That is just for PCP. ACP involves more training. As does HUSAR, Marine SAR, Emergency Task Force (ETF - Tactical ), PSU, ESU-MPU, CBRNE, CCTU, etc.


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## Towards_the_gap

The Fraser Institute report has been debunked as using incorrect data on the actual number of firefighters. 

Margaret Wente only seems to post articles like those in election years. Never mind her journalistic credibility is junk anyways.

*Retracted*


Just my 2c.


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## mariomike

Towards_the_gap said:
			
		

> As for the Fire-Medic proposal, it's a shame no one has asked the base hospitals or MOHLTC for comment. Not surprisingly, they are all behind it.



That's interesting. Would you mind sharing any ( non Firefighter union or Paramedic union ) sources you may have that support "fire-medics" in Ontario? I have never seen any ( except from the Firefighter union ). But, would like to read them, if they exist.

If you don't mind me asking, are you now in the firefighters union? I'm no longer a member of any union. My opinions are ( now ) only those of a potential future patient of the "fire-medics".

"But as one of this union's most fundamental responsibilities, our involvement in EMS has also helped us create and save jobs for our members."

"Most people expect to need EMS some time in their lives while they don't necessarily expect their homes to catch fire. Local municipal officials know the public criticism and fallout from fire department cuts will be much more severe when EMS is involved in the equation. And they know that EMS operations certainly increase the clout of our local unions in their campaigns to fight those cuts."

"Our next frontier is Canada. That is why we have more than three dozen of our Canadian brothers and sisters here at this conference. Although most of Canada is still locked into a third-service EMS system with workers represented by Canada's largest public employee union, our Winnipeg local's success in integrating EMS into its fire department has shown that fire-based EMS can and, if I have my way, will work in Canada, too."
http://www.iaff.org/03News/061203has.html

Remarks by International Association of Firefighters ( IAFF ) General President Harold A. Schaitberger 
June 12, 2003


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## Towards_the_gap

mariomike - I retracted my statement about the MOHLTC/Base Hospitals being on board. It was told to me secondhand by someone and when called out by you, couldn't find any statements (from a third party) that confirmed it.

First off, yes I am in the IAFF/OPFFA, HOWEVER.... I pay the dues, and that is it. I'm not a big fan of labour organisations, and to be quite honest, I think the OPFFA has picked the wrong fight on this issue. 

But, I do see some merit in the proposal, if you remember that no one in the IAFF/OPFFA is advocating replacing EMS with firefighters with 20 hours of training. Far from it. It is only seeking to train FF's to administer ventolin/nitro/epinephrin/aspirin and glucose, IF IT IS INDICATED in accordance with *medical direction*, as a stop gap until EMS is on scene. 

A perfect example is this - ''Dave'', a middle aged, severe diabetic in my district. We typically receive 2-3 calls per week for him coming in as uncon-seizure. He goes into a full blow diabetic seizure and his wife calls 911, due to the threat of violence (unintended from him I might add) police are tiered as well. We arrived on scene over half the time before paramedics and all we can do is monitor and take vitals until the paramedics arrive. If we had the symptom relief training we could administer the glucose gel  and start levelling out his blood sugars, and thus freeing up the ACP/PCP crew and bus who have been dispatched to the call, seeing as 'Dave' always refuses to go to the hospital.

I want to reiterate that I personnally am not advocating this fire-medic idea. As I said, I think it's pissing off the wrong people and I only hope it won't affect the great working relationship I have with the professional medics in this city. I just hate how it has already, in less than a month, descended into alot of mutual ill-feeling and s**t slinging...on both sides I'd like to emphasize. My side of the table has been no better, that's for sure.


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## mariomike

Thanks TTG.

The three attachments below ( click to enlarge ) are from the Base Hospital Physicians of Ontario. Dated 8 July, 2015. 

"Base Hospitals have not been involved in the ( OPFFA ) proposal, yet explicit references to the role of Base Hospitals and their Medical Directors occur throughout the   ( OPFFA  ) document."

"In our opinion, in order to achieve the most benefit for the patient, while balancing the risk of treatment, these skills should only be provided by fully certified and current paramedics." 

Thanks again for your post!


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## mariomike

I saw an interactive map of Toronto Fire Service recruiting, 2000-14:
http://globalnews.ca/news/1872085/slowly-toronto-firefighters-become-more-diverse/

I'll post it here in case anyone is interested in joining. 

The report says, that 72 per cent of those hired by TFS are from out-of-town. 

I'm not sure about now, but in the past, I believe the ratio was similar at Toronto Police and Paramedic Services. 

When I hired on, there was a Residency Requirement. But, that ended years ago. It has been a hot topic ever since.


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## mariomike

Make sure you have travel insurance. Know what it does, and does not, cover. 
Even in Canada, the fee for ambulance service varies from one province to another.

If you've seen one service you've seen one service — because no two are alike.

12 Aug 2016

City of Gloucester, MA

What does it cost to be transported via Gloucester Fire Department ambulance? 
All rates are per trip:

Basic life support: $1,513.84

Advanced life support: $1,797.44

Advanced life support, Level 2: $2,601.58

Mileage rate (applies to all): $46.08/mile

Supplies (oxygen, IV fluid etc.): $425

Extra EMT aboard: $600

Schultz conceded some patients are stunned when they get a bill for ambulance services.

What a ride will cost you,

Schultz’s memo outlines the city’s transport policies and fee schedules, with no proposal to alter the charges. The city’s ambulance rates, in general, range from a base of $1,513.84 per trip for basic life support services, plus $46.08 per mile, to a rate of $2,601.58 per trip for advanced life support with added costs for the use of supplies such as oxygen, or an additional EMT if needed.

“Some people think that, because it’s out of the Fire Department, it’s free,” Schultz said. “Also, people are surprised at the costs.” He noted that an ambulance transport is not a ride, but more akin to treatment in a mobile emergency room, with medical personnel on board.
http://www.gloucestertimes.com/news/local_news/city-owed-k-in-fees-for-ambulance-services/article_99181b0f-2280-563b-823a-7b1c03f06969.html

They even charge extra ( $425 ) for oxygen.


----------



## mariomike

One of the reasons I wish the GTA had been allowed to separate from Ontario years ago, 

Ontario firefighters slam paramedics in bid to take on medical emergencies
http://www.cbc.ca/news/canada/windsor/paramedics-fire-fighters-response-times-1.3867522
Video criticizes slow response times and rising costs of Ontario paramedics
In a campaign that criticizes the province's paramedics, Ontario firefighters say they have a plan to improve response times for medical emergencies.

Ontario Professional Fire Fighters' Association released a video this week that slams the province's paramedic system, saying response times are too slow, while costs continue to rise.

Not enough fires! Prevent layoffs!


----------



## mariomike

A NSFW graphic video of a jumper down - not a traumatic arrest, he is still alive - in New York City, but it's not about that. It's about patient care. Some say ...it's not so good. 

Warning - Man jumping from Brooklyn Bridge possible suicide attempt might contain content that is not suitable for all ages.
https://www.liveleak.com/view?i=3ba_1506035907
He was alive. They tossed him onto the stretcher like a sack of potatoes. The c-collar was useless in this case.

I bet their Bureau of Investigations and Trials ( BITS ) are licking their chops over this one. 

Doing a call like that would have been career suicide where I used to work.

Speaking of career suicide,

Firefighter ripped down U.S. flags put up for the 16th anniversary of 9/11.
http://www.wfaa.com/news/local/denton-county/fw-firefighter-accused-of-ripping-down-flags-that-had-been-raised-for-911-rememberance/482067823


----------



## mariomike

Saw this in another thread.


lenaitch said:


> I remember the media coverage of that policy debate.  As I recall, the FD union was concerned that each truck would have to give up a (union) crew member to accommodate the EMS and argued for funding to raise the qualifications of its members.  I don't know enough of the pros and cons to have much of an opinion.  While it might improve initial care, you still need an ambulance if you have to transport.


Fortunately, they dodged the bullet.








						Report pans potential merger of fire services and EMS
					

A third-party consultant is advising the city against merging its fire department and paramedic service in an effort to cut costs.




					www.cp24.com
				




If you really want to do a deep dive into the subject,


> A Service and Organizational Study of Toronto's Emergency Medical Services and Fire Services





			https://www.toronto.ca/legdocs/mmis/2013/ex/bgrd/backgroundfile-59903.pdf
		

320 pages.

Yes, I understand that is only one municipality among many others, and each province / territory does things differently.

Amalgamation may, or may not, be a fantastic idea in some of those other municipalities,  and provinces.


----------



## Colin Parkinson

With the high level of OD's here in the Lower Mainland, it was overwhelming the combined response by EHS/Police/Fire/Social workers and volunteers. Some of the Fire halls despatch a Pickup truck with two guys to medical calls and the remainder stay with the pumper. This cuts down on wear and tear on the main appliances and would allow the pumper to respond to a fire and get setup while the other team is enroute. I think that is the way to go for halls with high medical call outs.


----------



## lenaitch

mariomike said:


> Saw this in another thread.
> 
> Fortunately, they dodged the bullet.
> 
> 
> 
> 
> 
> 
> 
> 
> Report pans potential merger of fire services and EMS
> 
> 
> A third-party consultant is advising the city against merging its fire department and paramedic service in an effort to cut costs.
> 
> 
> 
> 
> www.cp24.com
> 
> 
> 
> 
> 
> If you really want to do a deep dive into the subject,
> 
> 
> 
> https://www.toronto.ca/legdocs/mmis/2013/ex/bgrd/backgroundfile-59903.pdf
> 
> 
> 320 pages.
> 
> Yes, I understand that is only one municipality among many others, and each province / territory does things differently.
> 
> Amalgamation may, or may not, be a fantastic idea in some of those other municipalities,  and provinces.



As you are probably aware, Ontario went through a lot of municipal amalgamations in the '90s under the Harris government.  One problem with any amalgamation that involves a larger centre with more rural surroundings is the larger centre can become a bit of a money pit with the rural areas seeing their taxes go up with little to show for it; seemingly more chronic with wider density spreads.  I hear little about it now but I don't know if the growing pains have been sorted out or rural politicians have simply given up tilting at the windmills.

In my area, EMS is run by the county.  More locally, there was some talk of amalgamating the fire services of several municipaliites (3 volunteer and one hybrid).  While there seemed to be some positives financially, many volunteers stated a lack of interest in serving the larger entity (less 'community-based) and the concern that equipment and resources would be drawn to the centre.  Law enforcement has already seen that with the OPP closing or downgrading many smaller detachments.  Having said that, the prairie provinces have geographically large 'rural municipalities' that seem to work (if 'Hellfire Heroes' is any indication - my sole source of information) so might be worth further study.  The size and shape of many Ontario counties don't seem to favour county-wide fire services. The municipal governance structure in Ontario is a bit of a dog's breakfast.


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## Remius

Anytime government tries to “merge” anything it doesn’t do it well.


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## Booter

Remius said:


> Anytime government tries to “merge” anything it doesn’t do it well.


It amazing to me how EMS is neglected- it’s a constant shell game of units and geographic areas.

in Alberta last year when I was still there they merged, amalgamated, and “shifted” some EMS stations and the result was actually quite scary.

the patch work coverage and constant who’s paying the bill, has created a really unwieldy beast as soon as you leave any major centre.

and in major centres, EMS is still the “have not” service.

it’s always boggled my mind


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## mariomike

They say, "If you know one Paramedic service, you know one Paramedic service."

We had something like 50 in Ontario, last time I looked.

And, in the rest of Canada, Paramedics are regulated by their provinces.

What I know of Ontario is that in 1968, the Ministry of Health began to take an interest in how ambulance service was provided. In addition to the establishment of regulations and standards, the MoH began to operate ambulance services in Ontario, either directly, or under contract.
Ontario was under the direction of Dr. N.H. McNally.

In Metro, the Goldenberg Report of 1966 led to the creation of The Department of Emergency Services on 1 Jan., 1967, under the direction of Commissioner John Pollard, a retired army colonel.

The "differences of opinion and philosophies" between Ontario's Dr. McNally ( a medical doctor ) and Metro's Commissioner Pollard ( a retired army colonel ) were highlighted in a Toronto Star article on 5 July, 1973.

Not to say which of them was right. But, their "differences of opinion and philosophies" were profound.

Among other things, Metro ambulance were of a different type and color than the provincial units.

I worked for "the Colonel", so naturally, I was influenced by his opinions and philosophies. I guess being fresh out of high school, and a young reservist, I was pretty "moldable"

Those who worked in the rest of the province under Dr. McNally I am sure must have their own opinions.

The community colleges were not involved in training back then.

Ontario recruits were sent to CFB Borden, to be trained by provincial instructors.
Metro recruits were trained in Metro, by our own instructors.
Not to suggest one school was better or worse than the other. Just different.

One thing back then, Metro had a Residency Requirement to join. There were no "lateral transfers."

So, you never really learned of any other way of doing things.

For us probies, under the watchful eyes of the '46'ers  ( WW2 vets like Colonel Pollard ) it was, "Do it our way, or the highway.)


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## CBH99

Booter said:


> It amazing to me how EMS is neglected- it’s a constant shell game of units and geographic areas.
> 
> in Alberta last year when I was still there they merged, amalgamated, and “shifted” some EMS stations and the result was actually quite scary.
> 
> the patch work coverage and constant who’s paying the bill, has created a really unwieldy beast as soon as you leave any major centre.
> 
> and in major centres, EMS is still the “have not” service.
> 
> it’s always boggled my mind


Genuinely curious.  Would you mind expanding?

It boggles my mind also that (here in Alberta anyway) EMS is considered the have-not service, along with retention issues.  Seems like there are always job postings for EMS even in major centres, and members seem to pack up and leave at a decent rate also.  

I was privy to a ‘meeting’ (for lack of a better word) about a year and a half ago in which a 15 year member resigned, due to the constant petty nonsense coming from the top.  (In this case he had backed up an ambulance about 8ft without using a spotter - was disciplined, and summoned to a disciplinary board also, which is where he just decided to walk away from the job)

Not a Thank You.  No conversation about having him stay.  No effort to ‘be a team’.   Just a very insincere ‘cool, turn your stuff in by friday, thanks for coming out.’


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## CBH99

Colin Parkinson said:


> With the high level of OD's here in the Lower Mainland, it was overwhelming the combined response by EHS/Police/Fire/Social workers and volunteers. Some of the Fire halls despatch a Pickup truck with two guys to medical calls and the remainder stay with the pumper. This cuts down on wear and tear on the main appliances and would allow the pumper to respond to a fire and get setup while the other team is enroute. I think that is the way to go for halls with high medical call outs.


Here in Edmonton we have both ambulances as well as SUVs for EMS.  (Known as rapid response units.)

The idea is that one experienced ACP (advanced care paramedic) can handle a majority of calls that don’t require transport.  (Minor vehicle accident, call for minor incident at senior home, etc)

This allows the ambulances to be free for when they are needed, so they aren’t attending a call where the ambulance vehicle itself isn’t required.


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## Good2Golf

CBH99 said:


> Here in Edmonton we have both ambulances as well as SUVs for EMS.  (Known as rapid response units.)
> 
> The idea is that one experienced ACP (advanced care paramedic) can handle a majority of calls that don’t require transport.  (Minor vehicle accident, call for minor incident at senior home, etc)
> 
> This allows the ambulances to be free for when they are needed, so they aren’t attending a call where the ambulance vehicle itself isn’t required.


Hi CBH, I've heard FFs derisively call those EMS SUVs "clock stoppers."  Your explanation makes sense, re: balancing responsiveness with the required capability, but is there some element to affecting the performance measurement/numbers with the SUVs as well?  Not that the FFs don't have their own issues, as they as well seem to attract otherwise less-than-glowing nicknames from other services.

Regards
G2G


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## CBH99

Good2Golf said:


> Hi CBH, I've heard FFs derisively call those EMS SUVs "clock stoppers."  Your explanation makes sense, re: balancing responsiveness with the required capability, but is there some element to affecting the performance measurement/numbers with the SUVs as well?  Not that the FFs don't have their own issues, as they as well seem to attract otherwise less-than-glowing nicknames from other services.
> 
> Regards
> G2G


So what I’m about to say here is by no means ‘the definitive’ answer, so this does come with a grain of salt.  If anybody has any more accurate information, by all means I am open to being corrected.  

In Alberta, all EMS is run/operated by Alberta Health Services.  There are some private ambulance providers that are contracted by AHS to fill the odd gap, but a majority of the ambulances you see anywhere in Alberta will be AHS ambulances.  

That being said, even though EMS is provided by AHS, the way EMS is structured is different in each larger centre. For example the way it is structured just between Calgary and Edmonton has some noticeable differences.  

(Edmonton has a greater number of SUVs compared with Calgary, and has trialled an experiment to have an EMR stationed in the hospital ERs to help get ambulance crews back out the door and on the street faster, etc)


I have no doubt that one attractive aspect of the SUVs is a much faster response time - clock stopper is probably an accurate term.  But they do provide capability as well.  

In regards to traffic accidents, it allows for faster response times during rush hours.  It also helps to block traffic that is approaching the accident scene without an ambulance blocking an entire lane.  Etc.  

It’s primary purpose is to allow for EMS to respond quickly to calls that don’t require an ambulance for transport, as well as quickly supporting ambulances that may need an extra body or set of hands on a call.  

A lot of their calls are responding to 911 calls that either 

a) require someone there ASAP, and they can get there faster than an ambulance, or 

b) respond to a call that doesn’t take an ambulance offline 


Because of the way EMS is dispatched (here in Edmonton anyway) - crews don’t work in zones or districts.  They can be all over the city, only coming back to their home station at the end of shift.  Because of this, sometimes there aren’t many ambulance units near to a 911 call since they are dispatched all over the bloody place.  The SUV units allow for that gap in ALS units to be minimized.  


(CADS is the dispatch system used by EMS here, and it doesn’t really work as advertised.  It’s supposed to dispatch the closest ambulance to the scene of the incident, but it has plenty of bugs.  Because of this crews find themselves all over the place - daily.)

*I no longer work EMS here, but I haven’t been gone for that long yet.  Some of the above may be outdated or mistaken.*


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## mariomike

For CBH99.

I guess it depends on which province, and which municipality within each province.

This can be seen by the number of applicants to the colleges.





						Paramedicine | Joint Programs
					






					www.utsc.utoronto.ca
				



and, among those who graduate, how competive recruiting is. Especially since the Residency Requirement is no longer in effect.

Thanks to the union, they have things now that we never dreamed of.

Meal Allowance.
Meal Breaks.
Language in the collective agreement regarding Early and Late calls.
Stress Leave.
Wash up/Lock uo Time.
And a long list of other good things.

I'm a transportation geek. So, I got on Truck and Bus division. ( We called ambulances cars. That goes back to the Cadillac era. I understand some other juricsictions refer to them trucks or buses. )

Enjoy boating? Transfer to the Marine Unit.

Urban EMS sucks? Transfer to the Islands and enjoy a quiet life in peaceful harmony with nature.

SWAT wannabe? Cross-trained paramedics provide medical support to the Toronto Police Emergency Task Force. ( ETF )

Or, you may be temporarily assigned to a Rescue Task Force RTF. Aka the sitting duck squad at an ASHE. It is not voluntary.

Enjoy rescuing people? Join Heavy Urban Search and Rescue. ( HUSAR )

Enjoy protests / riots? Don't want to settle for just watching them on TV? Join the Public Order Unit.

Can't get along with your partner? Join the Emergency Response Unit and work alone as a one-person "Clock-stopper".

Want to work underground in the subway system? An eight-minute delay can affect over 52, 000 riders. That was over a dozen years ago. Probably more now. Stationing paramedics underground inside  the system decreases response time, and gets the patient(s) out of the subway cars an onto the platform so the subway system can stay on schedule.

Enjoy community medicine? Join the Community Paramedic unit.

There's all sorts of programs. Or, if you prefer, you can stay on the same schedule, same station, same partner until you retire. As many are happy to do.

Want clean, inside work with no heavy lifting and a thermostat on the wall? Transfer to Communications.

Are 9-1-1 operations driving you crazy? Here's the deal:


> Employees who are placed in a permanent alternate position, due to an occupational injury/illness (as defined by the Workplace Safety & Insurance Board), will receive the wage rate of the position to which they are assigned. If the pre-injury rate of pay is higher than the relocated position rate, then the pre-injury rate is to be maintained. It is understood that the pre-injury rate is subject to all wage increases negotiated.



Pretty simple. Your end of the bargain is a little more interesting. HR will place you into a "suitable" job with the City. ( As there are no "comparable" jobs. )

Think of how many agencies, boards, commissions, departments and services there are in a big city.

And remember, Corporate HR decides what your  "suitable employment" will be. Not you.


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## CBH99

I don’t remember all of the different units we had in Edmonton, but I guarantee you guys have just a few more 😅

We call the tactical folks the Public Safety Unit.  We don’t have a marine unit, fire does though.  And the Community Paramedic program actually looked like the best gig out there - a lot of them even take their SUVs home with them at night.  (That way they can just start their rounds right away, I’m guessing?)


I enjoyed my fairly short time with AHS.  I worked an ALS unit (fancy pancy term for ambulance here) and occasionally an SUV, depending on where our shift supervisor put us that day.  

He was an actual leader (in AHS I’ve found that very lacking) and liked each medic to get some alone time taking ERU calls to get comfortable responding to calls by themselves.  


Lethbridge Fire Dept is integrated with EMS.  Not sure how they structured that, but Fire & EMS is amalgamated there.  Seems to work really well for them actually, but geographically they have a fairly small area.  And rush hour is like 10 cars.


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## mariomike

CBH99 said:


> I was privy to a ‘meeting’ (for lack of a better word) about a year and a half ago in which a 15 year member resigned, due to the constant petty nonsense coming from the top.  (In this case he had backed up an ambulance about 8ft without using a spotter - was disciplined, and summoned to a disciplinary board also, which is where he just decided to walk away from the job)
> 
> Not a Thank You.  No conversation about having him stay.  No effort to ‘be a team’.   Just a very insincere ‘cool, turn your stuff in by friday, thanks for coming out.’


Funny story. Out on the bus one day, they radioed a rather somber sounding message to bring xxx  xxx up to HQ for "a meeting". xxx was very close to retirement, and was a very quiet and obedient man. So, on the way there he starts crying! "What did I do?" "Will they take my pension?"
He was inconsolable.

Anyway, we delivered xxxx. The Chief was there. They gave him a 25-year wall plaque and certificate from the mayor and a warm personal letter from the Chief. Along with a gold watch and a ring, tie and blazer badge and cake. The photographer was there.
This is when they make you a member of the quarter-century club until the day you die.
Funny now. But, I thought he was going to have a heart attack.

We had this in our collective agreement. Gives a man a chance to cool off and come to his senses.


> Article 39 – RIGHT TO RESCIND RESIGNATION 39.01 An employee who resigns shall have the right to rescind their resignation, provided that they notify their immediate supervisor in writing, with a copy to the Division Head concerned, within five (5) working days of the date on which they tendered their resignation. Upon receipt of such written notification by the employee’s supervisor, the employee shall be reinstated to their former position upon the commencement of their next scheduled shift. It is understood that such time off shall be without pay, but with seniority and benefits.


----------



## CBH99

That’s a pretty slick provision in the agreement!  Someone had their thinking cap on that day 💡 

is it sad that when we get ‘called to the office’ our first thought is whether we are getting fired for looking at a cloud the wrong way?  😅   We really are the red headed step kids of emergency services!

Quarter century club for life?  That’s a cool tradition.  I don’t think I ever heard of that in my EMS days (which were relatively few)

Solgen, where I work now, has some cool things like that.  I think AHS was of the mindset like “congrats, sign here. Bye.”


----------



## mariomike

CBH99 said:


> Quarter century club for life?  That’s a cool tradition.  I don’t think I ever heard of that in my EMS days (which were relatively few)


The Toronto Paramedic Services Pioneers is a registered non-profit organization formed on May 24, 1989. The group's objectives are to provide social and informational support to senior Toronto Paramedic Services staff, including those who have retired, and to encourage members to participate in community activities.

The luncheons have been on hold since Covid. There are also informal local "coffee klatches". 

Membership is afforded to members of Toronto Paramedic Services that have 25 years of ( full-time ) service. 

Since membership is limited to the one department, everybody knows everybody from the old days. I didn't care for some of those guys back then, but now, I love every damn one of them. And it hurts when we go to their funerals.



> We really are the red headed step kids of emergency services!



I guess you are right. But, I never looked at it that way. We all had a job to do.

The three emergency services all offer an opportunity to make a contribution to society. Satisfaction in helping people. Of being a vital, important member of the community. I don't remember if any of those things were important to me half a century ago.

But, police officers, firefighters and paramedics get a job with a future, that is exciting, and far from routine. Careers with opportunities, as well as guaranteed security.



> That’s a pretty slick provision in the agreement! Someone had their thinking cap on that day 💡



Another far-sighted one was the Quaratine Agreement.

It was funny at union meetings. The executive would explain benefits they were trying to negotiate. But, a lot of the guys would say something like, "That's fine. But, how much of a pay increase?" That's important. But, it seemed like it was all some cared about.

Sometimes, the City would cry poor. So, they would negotiate something like Sick Pay Gratuity when you retire. Things like that meant very little to the taxpayers at the time they were negotiated. But, years later, after I retired, it boiled over as a major labour relations issue.


----------



## CBH99

I enjoyed my time with EMS here in Alberta, very much so.  I wasn't with them for long enough to have any real feelings or thoughts about long-term career stuff, such as union agreements, etc.  And I think what you described about "How much of a pay increase?" is pretty much standard across the board - most folks were just focused on what affect it would have on their paycheques.  (And fair enough.)


Emergency services really is a great place to have a career


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## mariomike

CBH99 said:


> - most folks were just focused on what affect it would have on their paycheques.


And the voters were focused on their next property tax bill.

And the Metro Chairmen / mayors were focused on keeping wage increases low, so they could keep property taxes low, so they could get re-elected.

And far-sighted union negotiators understood that, and used it to their member's advantage.

I can tell you there were a lot more "goodies" in our collective agreement by the time I retired compared to when I hired on.



> I enjoyed my time with EMS here in Alberta, very much so.



If you don't mind me asking, what were the qualifations to apply in Alberta?

 It's a two-year college diploma here. Minimum.

 Some have the four-year Honours Bachelor of Science degree.


----------



## CBH99

There have been some recent changes to course names & resulting qualifications, so my info here is outdated slightly.  (But not in a way that really matters actually - they just changed some very minor and arbitrary things that actually, in the end, don’t change anything at all)

BUT…

We had to have our BLS, and then EMR.  Emergency Medical Responder.  Which is a few months long, but can be done in about 3 weeks if done full time.  (I did my EMR course in 3 weeks, a few years back.  Most schools now seem to offer it 2-3 days a week, so it’s dragged out.)

Write provincial exam for ACP.  Written and practical.  

If you pass, you are qualified to apply and start EMT.  That course is about a year.  Classroom for 6 months, then a 2 month hospital practicum and a 4 month ambulance practicum.  (In theory, but it’s based on ours and skills developed.)

Once finished EMT course, have to again write the ACP exams and practicums.  

If you succeed, that qualifies you to apply to AHS to work as an EMT.  Scope is useful, but can be limiting.  It does qualify you to apply to special units - albeit not as competitive as someone fully qualified.  


Final step is Primary Care Paramedic, which is the 2 year program.  It is one year of classroom, and one year of practicum.  

Write ACP exams, and if successful then you are licensed as a PCP.  

Being qualified as a PCP opens the most doors and significantly boosts an applicant’s competitiveness.  (A lot of folks get hired on as an EMT, and do their schooling for PCP on the side.)

Overall, if someone got started on their courses and really buckled down, they could be PCP qualified in about 2.5yrs or so.  



**ACP - advanced care paramedic, which some members continue to go to school for after becoming a PCP.  Just opens doors, but isn’t required to apply or for most units.  

**ACP - also stands for Alberta College of Paramedics. They are notoriously brutal to deal with, and are LOATHED throughout the province.  It really is a cash-grab, as it costs an applicant about $700 just to write their EMR exam.  And the cost goes up from there.  

Once qualified as an EMT or PCP, the costs of annual qualification renewal is pretty minimal, and Alberta Health used to cover it.  (I think they still do)


I hope that’s somewhat helpful?  We don’t have a dedicated EMS or Police college the way some provinces do.


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## CBH99

mariomike said:


> And the voters were focused on their next property tax bill.
> 
> And the Metro Chairmen / mayors were focused on keeping wage increases low, so they could keep property taxes low, so they could get re-elected.
> 
> And far-sighted union negotiators understood that, and used it to their member's advantage.
> 
> I can tell you there were a lot more "goodies" in our collective agreement by the time I retired compared to when I hired on.
> 
> 
> 
> If you don't mind me asking, what were the qualifations to apply in Alberta?
> 
> It's a two-year college diploma here. Minimum.
> 
> Some have the four-year Honours Bachelor of Science degree.


How does the application process work in Ontario, if you don’t mind me asking?


----------



## CBH99

CBH99 said:


> How does the application process work in Ontario, if you don’t mind me asking?


Actually I’ll PM you so we don’t take over this entire thread 😅🤦🏼‍♂️

Sorry folks!


----------



## mariomike

CBH99 said:


> How does the application process work in Ontario, if you don’t mind me asking?


The thread is about fire departments taking over paramedic departments. So, qualifications to apply for either in Ontario are relevant.



CBH99 said:


> Emergency services really is a great place to have a career


This may be of interest to young people considering careers in Ontario.

Firefighter

Must be 18 years of age or older at the time of application.
Legally entitled to work for any employer in Canada (citizen/landed immigrants).
Free of any criminal convictions for which a pardon has not been granted.
Possess an Ontario Secondary School Diploma (OSSD –Grade 12) or academic equivalency.
Ability to work on rotating shifts, including nights, weekends and holidays.
Speak, read and write English fluently, and communicate clearly and precisely under demanding, high-pressure.
Have a Standard First Aid certificate and a CPR level HCP (for Health Care Providers) dated not more than 12 months prior to the closing date of application and maintained current within 12 months throughout the recruitment and selection process.
Minimum Requirements to become a Firefighter in Ontario | Ontario Fire Administration Inc.
Paramedic


> Our 2021 recruitment is now closed. Thank you to those that applied. Please keep checking back here for future opportunities.



Successfully completed a MOHLTC-recognized course for Primary Care Paramedic provided by a College of Applied Arts and Technology or equivalent.
Successfully completed the Advanced Emergency Medical Care Assistant (AEMCA) examination or be AEMCA pending as specified in the Ontario Ambulance Act.
Must be able to achieve and maintain current certification in Symptom Relief and Defibrillation under the Ontario Base Hospital Group and meet cross-certification requirements with Sunnybrook Base Hospital.
Must produce proof of mandatory immunization and maintain all immunizations as required and specified by the Ontario Ambulance Act.
Must possess a Class F Ontario driver’s licence, or better, and meet all requirements for licence maintenance as set forth in the City of Toronto’s Fleet policy and be able to qualify for the City’s equipment operating permits.
Must not be convicted of any crime involving moral turpitude for which a pardon has not been granted.
Must meet all requirements for employment as a Paramedic in Ontario as per the Ambulance Act.
Must not have had driver’s licence suspended for two years prior to application, and not have more than three demerit points issued against his/her Ontario driver’s licence.
Ability to pass oral, written and physical examinations pertaining to procedures used in emergency patient care as set by the Division.
Thoroughly familiar with the Highway Traffic Act and Municipal Traffic By-laws.
Must be physically capable of performing required duties.
Must be available to work rotating shift/weekend/night/overtime/on call duty in all environmental conditions.
Must be familiar with the Occupational Health and Safety Act and the regulations that apply to this work.
Proficiency in a second language, would be an asset.
Relevant work experience (i.e. paramedic, RN, MD, military, policing, any medical field), would be an asset.
Relevant volunteer experience (i.e. crisis, community involvement, mental health, shelters, etc.), would be an asset.


----------

