THE CORPORATION OF THE COUNTY OF HASTINGS EMERGENCY SERVICES COMMITTEE AGENDA. November 9, 2016, 10:30 am.

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1 THE CORPORATION OF THE COUNTY OF HASTINGS EMERGENCY SERVICES COMMITTEE AGENDA November 9, 2016, 10:30 am Council Chambers County Administration Building, Belleville, Ontario HASTINGS COUNTY VISION STATEMENT People and businesses thrive in Hastings County because of its support for individuals and families, strong communities, its natural beauty, and respect for its history and traditions Page Call to Order Disclosure of Interest (a) Disclosure of Interest at the November 9, 2016 meeting Review of Minutes 3-6 (a) Review of the Minutes of the October 12, 2016 meeting Business Arising from the Minutes 7-9 (a) Report outlining PCP vs ACP Skill Set Account Vouchers and Year to Date Expenditure Report (a) Review of the Year to Date Expenditure Reports dated to September 30, 2016 and Cheque Register Summary Reports dated November 2016 Communications 1 Information Correspondence (a) Report of Highlighted Calls 2 Action Correspondence and Recommendation to County Council 19 (a) Emergency Management Program Committee (b) 2017 Ambulance Vehicle Purchases Page 1 of 26

2 Statistical Report (a) Statistical Report - January 1 - September 30, 2016 Health and Safety Other Business Next Meeting (a) Date of next meeting - December 14, 2016 Adjournment (a) Adjournment of the November 9, 2016 meeting Page 2 of 26

3 THE CORPORATION OF THE COUNTY OF HASTINGS EMERGENCY SERVICES COMMITTEE County Administration Building Belleville, Ontario, October 12, 2016 A meeting of the Hastings/Quinte Emergency Services Committee was held with the following members present: Warden Rick Phillips, Councillors Bernice Jenkins and Wanda Donaldson (Hastings County), Councillors Karen Sharpe, Dave McCue, and Keith Reid (City of Quinte West), Councillor Janice Maynard (Prince Edward County), Councillors Egerton Boyce, Paul Carr, Kelly McCaw, and Garnet Thompson (City of Belleville) Also in attendance were: Doug Socha, Chief of Hastings/Quinte Paramedic Services, Sue Horwood, Director of Finance, Shaune Lightfoot, Director of Human Resources, Jim Duffin, Deputy Clerk, Jim Pine, CAO, Cathy Monzon-Bradley, Executive Assistant to the CAO & Warden, and Sharon Christopher, Administrative Assistant Call to Order (a) The Chair called the meeting to order Disclosure of Interest (a) Disclosure of Interest at the October 12, 2016 meeting There was no disclosure of interest at the October 12, 2016 meeting Review of Minutes (a) Review of the Minutes of the August 10, 2016 meeting Moved by Councillor Dave McCue; Seconded by Councillor Kelly McCaw; THAT the Minutes of the August 10, 2016 meeting be approved CARRIED Business Arising from the Minutes Account Vouchers and Year to Date Expenditure Report (a) Review of the Year to Date Expenditure Reports dated to August 31, 2016 Review of the Minutes of the October 12, 2016 meeting Page 3 of 26

4 and Cheque Register Summary Reports dated August, September and October, 2016 Moved by Councillor Wanda Donaldson; Seconded by Councillor Keith Reid; THAT the Year to Date Expenditure Reports dated to August 31, 2016 and Cheque Register Summary Reports dated August, September and October, 2016 be approved CARRIED Communications 1 Information Correspondence (a) Letter from the Quinte Living Centre - re: Downtown Core Evacuation (b) (c) Letter from the County of Lennox & Addington - re: Support at the LODD Funeral Service Report of Highlighted Calls Councillor Egerton Boyce requested a breakdown of the different skill sets of ACP (Advanced Care Paramedic) and PCP (Primary Care Paramedic) Moved by Councillor Kelly McCaw; Seconded by Councillor Dave McCue; THAT Information Correspondence items a) through c) be received CARRIED 2 Action Correspondence and Recommendation to County Council (a) Published Scientific Letter by Defence Research and Development Canada Moved by Councillor Keith Reid; Seconded by Councillor Dave McCue; THAT the Joint Emergency Services Committee receive the Scientific Letter titled, "Successful Paramedic position within Defence Research and Development Canada - Centre for Security Science", and further that a letter be written to the Federal Government to acknowledge the mutual benefit of the Interchange Agreement Review of the Minutes of the October 12, 2016 meeting Page 4 of 26

5 CARRIED (b) 2017 Response Time Standard Notification Moved by Councillor Dave McCue; Seconded by Councillor Kelly McCaw; THAT the Joint Emergency Services Committee ratify the actions of the Paramedic Chief for the submission to the Ministry of Health and Long-Term Care performance plan for the 2017 calendar year respecting response times CARRIED Statistical Report (a) Statistical Reports - January 1-July 31, 2016 and January 1-August 31, 2016 Moved by Warden Rick Phillips; Seconded by Councillor Garnet Thompson; THAT the Statistical Reports dated January 1-July 31, 2016 and January 1-August 31, 2016 be received CARRIED Health and Safety Other Business (a) Staff Training Update - verbal Doug Socha, Chief of Emergency Services, advised that peer support training was recently provided to paramedics in psychiatric first aid as a way to support colleagues (b) (c) Picton Base Update - verbal Chief Socha informed Committee that the Picton Base opened on September 27, 2016 Breast Cancer Awareness - verbal Chief Socha advised that the Paramedics will be wearing pink epaulettes, gloves and carrying pink pens in support of Breast Cancer Awareness Month Review of the Minutes of the October 12, 2016 meeting Page 5 of 26

6 (d) Code Stroke Video - verbal A YouTube video by Gerry Fraiberg called "Code Stroke - Race Car Pit Stop Model of Care at Belleville General" was shown which illustrated the support which can be provided to potential stroke victims Moved by Councillor Janice Maynard; Seconded by Councillor Wanda Donaldson; THAT the information items a) through d) be received CARRIED Next Meeting (a) Date of next meeting - November 9, 2016 Adjournment (a) Adjournment of the October 12, 2016 meeting Moved by Councillor Kelly McCaw; Seconded by Councillor Egerton Boyce; THAT the October 12, 2016 meeting be adjourned CARRIED Chair Date Review of the Minutes of the October 12, 2016 meeting Page 6 of 26

7 Date: October 31, 2016 Report to : Report from: Subject: Hastings-Quinte Joint Emergency Services Committee Doug Socha, Chief-Hastings-Quinte Paramedic Services Primary and Advanced Care Paramedic Scope of Practice Recommendation: That the Joint Hastings-Quinte Emergency Services Committee receive and file the attached report outlining the scope of practice between Primary Care Paramedics (PCP) and Advanced Care Paramedics (ACP) Financial Impact: Does recommendation have a budgetary impact: Yes No If yes, what is the anticipated impact? $ + taxes If yes, has it been budgeted for this year? Yes No If no, provide an explanation as to how these costs would be accommodated in the current year s budget: Has Treasury provided analysis? Yes No Background: At the October committee a chart outlining the scope of practice for both levels of paramedics was requested Hastings County has committed to providing one Advanced Care Paramedic (ACP) in each ambulance Currently, our full time compliment of ACP s is at 86% There are 3 ACP open positions that we are in the process of filling which would increase that level to 93% There would only be 3 ACP spots remaining to reach 100% Additional skills have been added this past year to the Primary Care Paramedic scope of practice including the administration of Naloxone, Trauma Bypass Protocols and the service will be participating in the C-Spine Study starting in the New Year The Community Paramedic scope of practice was established for the study period These Advanced Care Paramedics had additional skills and training for the study period Currently, the final report is working its way through the publishing process Report outlining PCP vs ACP Skill Set Page 7 of 26

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9 Report outlining PCP vs ACP Skill Set Page 9 of 26

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11 Review of the Year to Date Expenditure Reports dated to Sept Page 11 of 26

12 Review of the Year to Date Expenditure Reports dated to Sept Page 12 of 26

13 Review of the Year to Date Expenditure Reports dated to Sept Page 13 of 26

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15 Nov 2016 Hastings/Quinte EMS Committee Cheque Register Summary Report The following list of the monthly cheques registers have been prepared for Committee ratification and approval Approved and verified by Committee Chairperson As per the Committee members request original vouchers and supporting source documentation, are available to Committee members Cheque Payment Month Cheque Numbers Total Monthly Register Method Start End Register EMS A/P Cheque Oct ,18986 (excluding SS a/p) EMS A/P EFT Oct ,22357 (excluding SS a/p) Total $ 461,41343 C:\Users\christophers\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\YS52UB5Y\[Nov 2016 EMS Committee mthly chq listxlsx]committee Review of the Year to Date Expenditure Reports dated to Sept Page 15 of 26

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17 Date: October 26, 2016 Report to : Report from: Subject: Hastings-Quinte Joint Emergency Services Committee Doug Socha, Chief-Hastings-Quinte Paramedic Services Highlighted Calls Recommendation: That the Joint Emergency Services Committee receive and file the following report which outlines a few interesting calls that occurred this past month Financial Impact: Does recommendation have a budgetary impact: Yes No If yes, what is the anticipated impact? If yes, has it been budgeted for this year? Yes No If no, provide an explanation as to how these costs would be accommodated in the current year s budget: Has Treasury provided analysis? Yes No Background: Multiple Casualty Incident (MCI) On October 14, 2016 there was a MCI on Hwy 28 west of Hwy 41 A bus of seniors on their way to Montreal became patients as their tour bus rolled off the highway onto its side shortly after 10:00 am The accident was responded to by a total of 13 ambulances and 4 emergency response vehicles from Lennox & Addington, Hastings-Quinte and Renfrew along with OPP and Fire A total of 47 people were assessed with 26 transported to area hospitals with non-life threatening injuries Of the 26 transported patients, 16 arrived at QHC North Hastings Hospital, 12 by ambulance Deputy Chief Slatter was deployed to the hospital to help support hospital staff in the event patients arriving needed to be transferred to other centres Hastings-Quinte Paramedic Services called in an additional crew to work out of the spare ambulance at Bancroft Base In addition, the Emergency Support Unit was offered to Lennox and Addington Paramedic Services I was in communication with the Director of Emergency Care at QHC and met with the CEO of QHC to keep lines of communication open Report of Highlighted Calls Page 17 of 26

18 Everyone involved worked in a seamless manner to ensure all patients were assessed, treated and if required transported for medical attention Call #2 On October 16, 2016 while responding to a life threatening emergency call ambulance 4505 was involved in a head on collision along Hwy 28 east of Bancroft around 4pm The damage to the ambulance and pickup truck was extensive Both airbags were deployed on the ambulance with damage done to the front end and potions of the box Both paramedics along with the driver of the pickup truck were transported to QHC North Hastings Hospital with serious but not life threatening conditions Thankfully, all patients were released that day Report of Highlighted Calls Page 18 of 26

19 Date: October 31, 2016 Report to : Report from: Subject: Hastings/Quinte Emergency Services Committee Doug Socha Chief/Director of Emergency Services Emergency Management Program Committee Recommendation: THAT the Hastings-Quinte Joint Emergency Services Committee recommend to Hastings County Council that the Emergency Management Program Committee include the CEMC and a senior municipal official, and further that Council appoint the CEMC as the Chair of the Program Committee, as per Section 11 of the Emergency Management and Civil Protection Act Financial Impact: Does recommendation have a budgetary impact: G Yes No If yes, what is the anticipated impact? $ If yes, has it been budgeted for this year? G Yes No If no, provide an explanation as to how these costs would be accommodated in the current year s budget: Has Treasury provided analysis?: G Yes No Background: Every municipality must complete an annual review of their emergency management program under the Emergency Management and Civil Protection Act RSO 1990 and Ontario Regulation 380/04 Each year the emergency management program committee reviews the hazard identification risk analysis, the critical infrastructure, and other program requirement Hastings County has completed this review and as per Section 11 of the Emergency Management and Civil Protection Act, has identified that the Program Committee must include the CEMC, a senior municipal official, and further that the Chair must be appointed by Council Currently, we have been using the Joint Emergency Services Committee for this function which has all the key positions present during the meeting but requires some specific members identified by legislation By establishing the program committee as recommended above all legislated requirements would be filled in compliance with the Emergency Management and Civil Protection Act Emergency Management Program Committee Page 19 of 26

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Date: October 26, 2016 Report to : Report from: Subject: Joint Emergency Services Committee Doug Socha Chief/Director, Emergency Services 2017 Ambulance Vehicle Purchases Recommendation: That the

21 Date: October 26, 2016 Report to : Report from: Subject: Joint Emergency Services Committee Doug Socha Chief/Director, Emergency Services 2017 Ambulance Vehicle Purchases Recommendation: That the Joint Hastings-Quinte Emergency Services Committee approve the order of 5 new Crestline ambulances as part of the annual replacement for the fleet for the year 2017 Financial Impact: Does recommendation have a budgetary impact: Yes No If yes, what is the anticipated impact? $ 150,000 + taxes or $750,000 If yes, has it been budgeted for this year? Yes No If no, provide an explanation as to how these costs would be accommodated in the current year s budget: Will be included in the 2017 budget This recommendation is for the approval to purchase these vehicles prior to the 2017 budget Has Treasury provided analysis? Yes No Background: The County has a replacement schedule for ambulances based on 250,000 km Lead time is required by manufacturers to meet delivery dates The regular vehicle replacement schedule has been based on 4 vehicles per year However, based on the number of kilometers driven by the fleet and a replacement schedule of 250,000 kilometers, the number of ambulances needing to be replaced to be replaced in 2017 is 5 In 2014, only 3 ambulances were replaced which is contributing to the increased mileage on the current fleet The recommendation is to order the vehicles for 2017 from Crestline Coach Ambulances are required to meet Ministry of Health and Long-term Care specifications and there are a limited number of vendors that meet these specs The County chose Crestline as the Vendor for ambulances based on a competitive process and has continued to purchase from Crestline in order to maintain a consistent fleet for the benefit of for both paramedic s and mechanical/maintenance and repair purposes 2017 Ambulance Vehicle Purchases Page 21 of 26

22 Based on current accumulation of mileage the following vehicles are projected for replacement in 2017 Vehicle Current KMs Replacement Date ,537 Spring ,074 Spring ,226 Spring ,571 Fall ,242 Fall Ambulance Vehicle Purchases Page 22 of 26

Emergency Services Committee Hastings Quinte Paramedic Services Hastings County - Monthly Performance Report January 1, 2016 September 30, 2016 Target Target Achieved Total Call Volume Sudden Cardiac

23 Emergency Services Committee Hastings Quinte Paramedic Services Hastings County - Monthly Performance Report January 1, 2016 September 30, 2016 Target Target Achieved Total Call Volume Sudden Cardiac Arrest- Defibrillator on-scene 35% of time within 6 min 29% (37% at 7 min) 38 CTAS 1 - Paramedic on-scene 50% of the time within 8 min 68% 223 CTAS 2 - Paramedic on-scene 65% of the time within 10 min 77% 2709 CTAS 3 - Paramedic on-scene 65% of the time within 15 min 88% 5398 CTAS 4 - Paramedic on-scene 65% of the time within 20 min 94% 1760 CTAS 5 - Paramedic on-scene 65% of the time within 25 min 95% 816 Prince Edward County - Monthly Performance Report January 1, 2016 September 30, 2016 Target Target Achieved Total Call Volume Sudden Cardiac Arrest - Defibrillator on-scene 35% of time within 6 min 0 4 (50% at 10 min) CTAS 1 - Paramedic on-scene 50% of the time within 8 min 47% 15 (67% at 11 min) CTAS 2 - Paramedic on-scene 65% of the time within 10 min 48% 163 (67% at 14 min) CTAS 3 - Paramedic on-scene 65% of the time within 15 min 77% 442 CTAS 4 - Paramedic on-scene 65% of the time within 20 min 82% 104 CTAS 5 - Paramedic on-scene 65% of the time within 25 min 90% 58 Report based on the best available information in the imedic Analytics software generated on October 28, 2016 Statistical Report - January 1 - September 30, 2016 Page 23 of 26

24 Statistical Report January 1, 2016 to September 30, 2016 Call Volume- Year to Date Call Volume January 1/2015 to September 30/2015 January 1/2016 to September 30/2016 Total Call Volume (Code 1-8) 23,021 24,151 Patient Contact Calls (Code 1-4) 15,988 16,520 Average Response Times for Code 4 Emergency Calls Location January 1/2015 to September 30/2015 January 1/2016 to September 30/2016 Town of Bancroft 4:35 min 5:04 min City of Belleville 6:14 min 6:14 min Central Hastings 8:35 min 9:15 min City of Quinte West 7:27 min 7:30 min Hastings County Total 8:06 min 8:06 min Prince Edward County Total 10:20 min 10:25 min Report based on the best available information in the MOHLTC Ambulance Data Reporting System database generated on October 28, 2016 Average Response Times for Patients Transported Code 4 to Hospital January 1/2016 to September 30/2016 Location Number of Calls Response Time to Scene Town of Bancroft 104 4:42 minutes City of Belleville 839 6:23 minutes Central Hastings 56 12:13 minutes City of Quinte West 590 7:36 minutes Hastings County :42 minutes Prince Edward County 131 9:40 minutes Report based on the best available information in the imedic Analytics software generated on October 28, 2016 Statistical Report - January 1 - September 30, 2016 Page 24 of 26

25 Patient condition based on Final Primary Problem Jan 1- Sept 30, 2016 Diabetic Emergencies Paramedic Interventions Improved 69% No Change 29% Worse 2% IV Dextrose Glucagon Oral Glucose Oxygen IV Fluids Total Calls to Date: 166 Congestive Heart Failure Paramedic Interventions Total Calls to Date: 38 Improved 64% No Change 32% Worse 4% CPAP Nitrates Oxygen Positive Pressure Ventilation Intubation Stroke/TIA Paramedic Interventions Improved 29% Oxygen Rapid Transport Worse 7% No Change 64% Total Calls to Date: 191 Statistical Report - January 1 - September 30, 2016 Page 25 of 26

26 Ischemic Chest Pain Paramedic Interventions ASA Improved 59% No Change 38% Nitrates Morphine Oxygen Gravol Total Calls to Date: 362 Worse 3% Respiratory Disease Paramedic Interventions Ventolin Better 60% No Change 39% Epinephrine CPAP Total Calls to Date: 143 Worse 1% Muskuloskeletal Trauma Better 25% Paramedic Interventions Morphine Worse 2% No Change 73% Midazolam Toradol Ibuprofen Acetaminophen Total Calls to Date: 1282 Report based on the best available information in the imedic Analytics software generated on October 28, 2016 Statistical Report - January 1 - September 30, 2016 Page 26 of 26

Ambulance Response 90th Percentile Times

Ambulance Response 90th Percentile Times Time Perth County Paramedic Services Perth County EMS Provincial Response Time Reporting: Prior to the downloading of land ambulance services in 2000 to the upper tier municipalities (UTM) and Designated