City of Red Deer

March 15, 2005 12:00 ET

City holds Province's feet to fire over delay of ambulance transfer

Attention: Assignment Editor, City Editor, Health/Medical Editor, News Editor, Government/Political Affairs Editor RED DEER, ALBERTA--(CCNMatthews - March 15, 2005) - The City of Red Deer launched a major public appeal today, urging citizens to contact their MLA, the Premier, and the Minister of Health and Wellness to voice their dismay over the delay of the province-wide transfer of ambulance services from municipalities to Regional Health Authorities.

"A partially fulfilled promise is still an unfulfilled promise," said Mayor Morris Flewwelling, The City of Red Deer. "We believe the Province has wronged Red Deer citizens by backing out of its commitment to fund ambulance services fully starting April 1. Without the full commitment of provincial funding as promised, our citizens will face a 3.58 per cent tax rate increase in 2005."

The City has spent the past year working cooperatively with the David Thompson Health Region to ensure the transition proceeded as planned on April 1, 2005. The City also made budget decisions based on provincial direction, which stated that, "On April 1, 2005, municipalities are free to reallocate funding previously directed to ambulance services to other priorities."

The Province's decision to delay the transfer of ambulance service funding came just four weeks before the planned transfer date and after The City's 2005 budget was approved. The City budgeted no funds for ambulance service after April 1. Even with the partial funding announced March 8, The City of Red Deer is $1.6 million short of the funding committed for 2005 and $4.1 million short for 2006.

The Province has stated that further decisions about the transfer elsewhere in the province will be based on what is learned from the two pilot projects in Palliser and Peace Country Health Regions. The pilots are expected to last for 12-18 months. There is no reference to an ongoing commitment to ambulance funding.

The City stresses that the delayed transfer is a funding issue between the two levels of government. Ambulance service will continue to run in Red Deer after April 1.

Q&A Backgrounder

1. What is the background on the Province's commitment to transfer ground ambulance services from municipalities to health regions?
Municipalities have been advocating that the provision of ground ambulance service is a health service, not a municipal service for the past several years.

In 2001, the Province initiated a review of Ambulance Service Delivery. The Draft Report entitled, Patient-Focused Emergency Medical Services MLA Review of Ambulance Service Delivery 2001 prepared by Harvey Cenaiko, MLA Calgary Buffalo and Luke Ouelette, MLA Innisfail-Sylvan Lake concluded that ambulance service has evolved into an integral component of a comprehensive health care system. The report recognizes municipalities' strong historical commitment to providing ambulance service, and recommends that the Minister of Health and Wellness provide leadership in restructuring governance by creating formal partnerships between municipalities and Regional Health Authorities.

An information release dated May 14, 2004 says, "Government has identified ground ambulance service as a health service... Global budget allocations to each health authority will include an item for ground ambulance service delivery, and will be announced as part of the provincial budget in 2005. On April 1, 2005 municipalities are free to reallocate funding previously directed to ambulance services to other priorities."

2. Why is the Province backing away from the transfer of ground ambulance service?
The Province has announced that it is delaying the transfer of ambulance services to regional health authorities in order "to determine whether the transfer is both operationally and financially feasible." Instead of proceeding with the transfer as planned, the Province is conducting two pilot projects in the Palliser and Peace County Health Regions. Evaluation and lessons learned from the pilots will guide decisions on further future transfers elsewhere in the province. There is no reference to an ongoing commitment to ambulance funding.

This direction does not align with the Province's acknowledgement that ground ambulance service is a health service. As a health service, ground ambulance services should be provincially funded.

3. Why is the Province concerned about costs of the planned ambulance transfer?
The Province had budgeted $55 million to fund ambulance services in the 2005/2006 budget year. However, costs submitted by health regions through the budgeting and transition process are significantly higher, closer to $128 million.

The numbers coming forward from health regions are in line with the original projections provided in the Patient-Focused Emergency Medical Services MLA Review of Ambulance Service Delivery 2001 draft report, which states "annual expenditure for ambulance service is $106 million…an additional $8.7 million per year is paid by the federal government and First Nations…"

The City believes that the Province did inadequate research in determining the figure of $55 million to provide ambulance services within Alberta. It is not a realistic reflection of the true costs of providing ambulance services across the province.

4. Why isn't $55 million enough to cover ambulance services within Alberta?
When one looks at the cost to provide services within municipalities on an individual basis, one can see that $55 million is not nearly enough to fund services for the entire province.

For example, The City of Red Deer's annualized ambulance costs are $4.1 million, 13.4 per cent of what the Province had budgeted to fund the entire provincial transfer. When you consider that Red Deer is one of five mid-sized cities in Alberta, and then factor in the needs of Edmonton and Calgary, plus all towns, counties and municipal districts, you can see that the estimate is flawed.

Our sense is that the costs have not ballooned, as the Province has suggested. Our sense is that the Provincial allocation of $55 million was not founded on solid research, including discussions with municipalities, and is therefore grossly inadequate to begin with.

Again, it is important to note that the Patient-Focused Emergency Medical Services MLA Review of Ambulance Service Delivery 2001 draft report pegs the annual expenditure for ambulance service at $106 million, with an additional $8.7 million per year paid for by the federal government and First Nations.

5. How does this delay impact The City of Red Deer?
This delay puts Red Deer under considerable financial pressure.

When The City approved its 2005 operating budget on February 1, 2005, there was no indication that this transfer would not proceed as planned. In fact, in the second week of February, Premier Ralph Klein confirmed to the President of the Alberta Urban Municipalities Association (AUMA) that the transfer was proceeding as planned.

The Province's withdrawal just four weeks before the planned transfer, after The City's 2005 budget has been approved, puts Red Deer in a significant financial deficit position as only funding for the first quarter of ambulance service was budgeted for 2005. The position gets even more difficult in 2006, as no funds have been budgeted for ambulance services. The Province has given no indication of if, or how, they may assist municipalities with the ambulance issue in 2006.

The City has also invested considerable resources over the past year to plan for this transition. It has worked collaboratively with the David Thompson Health Region to accurately project costs, define services and set up a relationship for a smooth transition. These efforts and resources will be wasted if the transfer does not proceed as planned.

6. What is The City's annual cost of providing ambulance services?
The City's annual cost of providing ambulance services is $4.1 million. We have done extensive due diligence to confirm that this figure is an accurate and fair representation of the true cost of providing ambulance service in Red Deer. Our figure has been evaluated and confirmed by our external auditors, Collins Barrow, as well as by an independent consultant hired by the David Thompson Health Authority as part of our planning of this transition.

We feel that much of the work that the Province is suggesting to undertake next is redundant with our due diligence processes. They plan to retain an independent consultant to work with municipalities, health regions, and Alberta Health and Wellness to ensure that costs are accurate and fair. We know that our cost estimates are accurate and fair. It is unfair to suspend the transfer of ambulance services while that work is being done again.

The Province has agreed that ambulance services are a health service, which means that they should be provincially, not municipally, funded. The next step is for the Province to follow through on its commitment to deliver funding for ambulance services to municipalities as committed in May 2004.

7. Why didn't The City budget for ambulance services for all of 2005?
We did not budget for ambulance services because we trusted the Province's commitment to deliver on ambulance funding for municipalities. In May 2004 the Province said, "On April 1, 2005 municipalities are free to reallocate funding previously directed to ambulance services to other priorities." We acted accordingly and budgeted for the cost of ambulance services for the first three months of 2005. We then reallocated funds that were previously dedicated to ambulance services to other priorities.

8. What was the money formerly used to fund ambulance services used for?
The City of Red Deer is working hard to meet the needs of its growing community while keeping tax rates competitive and fair for our citizens. The freed up funding provided much needed relief to meet service and maintenance demands identified in our 2005 operating budget. It also provided additional dollars to put toward our projected infrastructure shortfall.

9. Hasn't the Province provided funding to municipalities to help ease the financial burden of the delay?
The Province's withdrawal of funding, then reinstatement of partial funding, still leaves Red Deer with a $1.6 million deficit in its 2005 budget. In 2006, the shortfall climbs to $4.1 million, the full amount required for ambulance service.

The Province has stated, "Our priority is to ensure all municipalities are treated fairly and help them address their immediate funding issues."

We do not believe that the Province is living up to this commitment. The municipalities selected for the pilot project are receiving 100 per cent of their ambulance service costs, while cities like Red Deer are being forced to absorb significant deficits.

The fair action would be to fund ambulance services fully starting April 1, 2005 as promised. On the same day that the province announced its delay of the transfer, it also announced a $4.3 billion unexpected addition to its surplus. Reallocating 2.3 per cent of that surplus to fund ambulance services would allow the Province to fulfill its commitment.

We see the distribution of the $55 million as only step one toward meeting its promise. Now the Province needs to move on to step two - giving Minister Evans adequate funds to cover the remainder of the funding for ambulance costs, not just in 2005-2006 but ongoing. The pilots can proceed and will provide information for adjustments in the future. By taking step two, the Province will have kept their promise and will be seen as fair.

10. How will Red Deer's citizens be impacted by the Province's unfulfilled commitment to fully fund ambulance services?
If the province does not deliver on its commitment, our citizens will face a 3.58 per cent tax rate increase in 2005. Further tax impacts will be felt in 2006 and beyond if ongoing funding is not established.

11. What can I do about the impact of this decision on me?
Contact your MLA, the Premier and the Minister of Health and Wellness today.

Victor Doerksen, MLA Red Deer South
Toll Free dial 310-0000 then (780) 427-2294
reddeer.south@assembly.ab.ca

Mary Anne Jablonski, MLA Red Deer North
Toll Free dial 310-0000 then (780) 422-3882
reddeer.north@assembly.ab.ca

Ralph Klein, Premier
Toll Free dial 310-0000 then (780) 427-2251
premier@gov.ab.ca

Iris Evans, Minister of Health & Wellness
Toll Free dial 310-0000 then (780) 427-3665
ievans@assembly.ab.ca

/For further information: Contact: Norbert Van Wyk, City Manager (403) 342-8154 or Jilaire Wagner, Communications Coordinator (403) 342-8147. Additional information available on The City of Red Deer Web site at www.reddeer.ca./ IN: FINANCE, HEALTH, MEDIA, POLITICS

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