Changes made to the Peel Paramedics Divisional Model

January 31, 2019 · 0 Comments

Written By KIRA WRONSKA DORWARD and JOSHUA SANTOS

This is the second article in a three-part investigative series exploring the adoption of a different version of the original 10-Year plan proposed in the Health Analytics report from 2007, the recommendations of which stated that the Hybrid Model should be adopted for Peel Region, and advised that Caledon remain as-was with its Stand-Alone stations.

Part 1 of the series explored the introduction of the Hybrid Model in Peel Region in 2007, providing an overview of the services rendered by Health Analytics. It was designed to cover the present and future needs for Paramedic Services. Over the course of eight years, and through various motions and amendments, the original proposed plan changed. This is a breakdown of the Divisional Model that was eventually adopted in 2013 and why it happened.

The Changes to a Divisional Model are finally approved by Council in 2013

An update to the Ten-Year Facility Plan was presented to Regional Council on Oct. 17 2013. This was based on a report commissioned again by Jeanette Smith, commissioner of health services. The following recommendations for changes to the plan are outlined as follows:

“In 2013, staff initiated an in-depth assessment of the 2008-2017 Paramedic Services Capital Facility Plan. This assessment included an evaluation of facility designs and station locations (existing and proposed) in the context of all available data.

The following data were used in the assessment:

Travel time modeling for PRPS vehicles throughout Peel

Population distribution and planned growth areas

2012 Central Ambulance Communications Centre (CACC) data to identify the areas of highest call volume

Illustrative Program for PRPS Satellite Stations

Value Management report for PRPS Satellite Stations and related documents

Land availability and costs

Availability of co-locate opportunities, shared-use opportunities, and Regional lands.

An outcome of this assessment is the proposed deletion of two Satellite Stations from the 2008 – 2017 Facility Capital Plan. The removal of two satellite stations reduces the development and land acquisition costs with no reduction in service delivery. Staff also identified opportunities to defer five stations into future budget years based on the service demand. Staff will continue to review available service delivery data to revise the quantity and location of future stations.

As included in Table 1 (Appendix I) of this Report, the 25 stations comprising the 2013 Paramedic Services 10-Year Facility Capital Plan are distributed in the following manner:

4 Reporting Stations

21 Satellite Stations

6 Stations in Brampton

11 Stations in Mississauga

4 Stations in Caledon

The four stations in Caledon are located in Valleywood, Caledon East, Bolton and Caledon Village.

“Through ongoing dialogue with the Emergency and Protective Services Committee and Peel Regional Council the plan evolved to include four reporting stations and 21 satellite stations throughout Peel,” said Peter Dundas, chief and director of Paramedics services in an email interview. Satellite stations are where crews are positioned while they wait for calls or where they spend their breaks.

“The Valleywood and Caledon East Satellite Stations are complete,” said Dundas in the email. The Bolton Satellite Station is currently under construction and a Satellite Station in Caledon Village is in the planning stages. In the meantime, the existing stations in Bolton and Caledon Village are being maintained. Four stations help ensure we are ready as Caledon grows and requires more paramedic coverage. Three of the four stations in Caledon will be co-located with Caledon Fire and Emergency Services to allow for cost savings”

The 2013 facility plan is illustrated on a map that was distributed at the committee meeting.

Staff have successfully secured co-locate opportunities and shared land opportunities at 17 out of the 25 total Paramedic Stations, according to a Oct. 28 2013 Peel Region Report on proposed changes to the Peel Regional Paramedic Services 10 Year Facility Plan 2008-2017.

This is due in large part to the co-operation of colleagues in Fire and Emergency Services within all three municipalities, as well as the William Osler Health System and other Region of Peel departments with compatible uses. Co-locates and shared land developments result in significant financial savings to both the Region of Peel and our partners in the areas of land, site development, construction, and common area operating costs.

The Minutes from Council indicate that the report is received and approved, as follows:

“d) Paramedic Services 10 Year Facility Plan Update Presentation by Janette Smith, Commissioner of Health Services Received

RECOMMENDATION EPSC-8-2013:

That staff prepare a report to come back to an Emergency and Protective Services (EPSC) meeting with proposed recommendations on the modifications to the 10 Year Facility Plan, prior to the 2014 Budget Process.

A copy of the presentation is available from the Office of the Regional Clerk.

Janette Smith, commissioner of health services provided information regarding the Paramedic Services 10 Year Facility Plan and its current status.

She noted these changes were based upon the changing call volumes and growth patterns that have emerged since the plan was first approved in 2007, as well as maximizing co-locate opportunities. Currently 15 of 22 stations are co-locates.

Coun. Pat Saito directed staff to report back to the Committee prior to the 2014 Regional Council Budget process to ensure the EPSC can make the recommendations on the changes to the 10 Year Facility Plan to Regional Council with all the information available on why the modifications are necessary” (Minutes: The Council of the Regional Municipality of Peel; Oct. 17th, 2013).

EPSC-10-2013 was received and approved by Council on Nov. 28, 2013.

In this report, from Jeanette Smith, Commissioner of Health Services, the following recommendations for changes to the plan are explained as follows:

“In 2013, staff initiated an in-depth assessment of the 2008-2017 Paramedic Services capital facility plan. This assessment included an evaluation of facility designs and station locations (existing and proposed) in the context of all available data.

The 2013 facility plan is illustrated on a map that will be distributed at the committee meeting.

Staff have successfully secured co-locate opportunities and shared land opportunities at 17 out of the 25 total Paramedic Stations. This is due in large part to the co-operation of our colleagues in Fire and Emergency Services within all three municipalities, as well as the William Osler Health System and other Region of Peel departments with compatible uses. Co-locates and shared land developments result in significant financial savings to both the Region of Peel and our partners in the areas of land, site development, construction, and common area operating costs” (Peel Region Report: “Proposed Changes to the Peel Regional Paramedic Services 10 Year Facility Capital Plan {2008-2017}”; Oct. 28th, 2013).

The minutes from the Nov. 28th Council meeting also feature the role Peter Dundas played in proposing the changes from a Hybrid to completely Divisional Model for Peel Region:

“a) Proposed Changes to the Peel Regional Paramedic Services 10 Year Facility Capital Plan (2008- 2017) Presentation by Peter Dundas, Chief and Director, Paramedic Services and Renaud Campbell, Manager, Health Facility Planning

“The move to a full divisional model was the result of various factors including call volumes, said Dundas. The divisional model allows us to work more efficiently while maintaining paramedic coverage throughout Peel. Caledon continues to be a priority due to its large geographic size.”

Peter Dundas advised of proposed changes to the original Health Analytics consultants’ recommendations; notably two less satellite stations, and five deferred satellite stations from the 10- year plan.

a) Proposed Changes to the Peel Regional Paramedic Services 10 Year Facility Capital Plan (2008-2017) RECOMMENDATION EPSC-10-2013:

That the recommended changes to the 10 Year Facility Capital Plan, as outlined in the report of the Commissioner of Health Services, dated October 28, 2013, titled “Proposed Changes to the Peel Regional Paramedic Services 10 Year Facility Capital Plan (2008 – 2017)”, be approved.

In response to questions from Regional Coun. Saito, Peter Dundas advised that paramedic facilities are not connected to fixed coverage areas, but rather for maximizing mobility and responding to the highest need areas in the fastest time, during critical coverage period, according to Region of Peel Council Minutes from Nov. 28 2013.

He also noted that the number of facilities is based on coverage to ensure high-need areas have paramedics consistently stationed there and would reduce the need for increased mobility unless critical coverage needs emerge.

In January of 2019, the Office of the Regional Clerk stated in writing that the changes to Caledon were authorized in November of 2013. The changes to the 10 Year Capital Facility Plan were suggested by the EPSC. The report given to Council on that date outlines four reporting stations and 21 satellite stations across Peel, including four satellite stations in the Town of Caledon.

The November 2013 Report and Resolution to Adopt Amendments to the Ten-Year Plan

The Office of the Regional Clerk has identified this report, dated Nov. 7, 2013, and the subsequent resolution of Council 2013-1102 as the authorization to change the status of Caledon as identified under 2007-833. The proceedings of Council during 2013 Bylaw 100-212 state:

7. MOTION TO AMEND, RESCIND, OR CONTRARY IN SUBSTANCE TO A PREVIOUSLY DECIDED MOTION

(a) A motion to amend or rescind, or contrary in substance to a previously decided motion from a previous meeting:

(i) is amendable;

(ii) is debatable; and

(iii) can be reconsidered only if the motion was decided in the negative.

2007-833 “that the current station-based model in Caledon be maintained.”

Legalities aside, this is hardly a clear and transparent document. Caledon is implied, but not explicitly stated, as being part of this system, and states that:

“The details of the 2007 presentation included 29 total locations for paramedic facilities, distributed in the following manner:

• 6 new Reporting Stations

• 23 Satellite Stations

o 9 Stations in Brampton

o 10 Stations in Mississauga

o 4 Stations in Caledon”

Whether a typo or deliberate, this is not what Council approved in 2007 with resolution 2007-833 nor is it consistent with the 2007 presentation referred to which calls for 4 Stand-Alone stations in the Town of Caledon. Here they suddenly appear as satellite stations.

Furthermore, under the section “2013 Proposed Amendments to the Health Analytics Recommendations”, it states “in 2009 (EPSC 3-2009, Council Resolution 2009-1024), staff advised the Committee of a change in Reporting Stations from 6 to 4.” That is the only change noted in the minutes of the Sept. 17, 2009 meeting of the EPSC. This change may seem consistent, but the actual wording of the Sept. 17, 2009 meeting indicates that this was a recommendation, not an approved motion (2007-833).

The same section goes on to say that “In 2013, staff initiated an in-depth assessment of the 2008-2017 Paramedic Services facility plan. This assessment included an evaluation of facility designs and station locations (existing and proposed) in the context of all the available data.” Yet, according to this very report (dated Oct. 28, 2013) they did not do the assessment until 2013, yet they reported in 2009 that they required two less divisions. In 2011, the new Councillors of Peel Region were simply informed that there were only four divisions, and that Caledon always had to Satellite stations (again, inconsistent without what Regional Council had previously stated and approved).

The report continues “As included in Table 1 (Appendix I) of this Report, the 25 stations comprising the 2013 Paramedic Services 10-Year Facility Capital Plan are distributed in the following manner:

•4 Reporting Stations

•21 Satellite Stations

6 Stations in Brampton

11 Stations in Mississauga

4 Stations in Caledon”

This is the first time that the four “Reporting Stations” approved for Caledon in 2007 legitimately appear as a requested change to “Satellite Stations.” Despite the title of this report, there is no language explaining this discrepancy. However, in the 2011 orientation to new Council, they were already called Satellite Stations.

The series concludes in the Feb. 7 issue of the Caledon Citizen