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	Corporate Report
DEPARTMENT/	CAO's Office
DIVISION	Emergency Medical Services	REPORT NO.	2007.093
DATE PREPARED	April 24, 2007	FILE NO.
MEETING DATE	April 30, 2007
SUBJECT	EMS HQ Report

RECOMMENDATION

THAT with respect to Report No. 2007.093 (Emergency Medical Services), we recommend that closure of Beck and Roland Street EMS stations, the renovation of the Selkirk Station and relocation of the Superior North EMS Headquarters be approved in principle pending the acquisition of suitable property for a new EMS station;

AND THAT the Facilities and Fleet Department be authorized to issue an RFP for consulting services for the design and construction of a new EMS station;

AND THAT the Mayor and Clerk be authorized to execute any necessary documentation;

AND THAT any necessary by-laws be presented to Council for ratification.

This report outlines the need to replace the Beck and Roland Street EMS Station with a more ideally located station to improve response times in the north ward. Attempts to replace this station have occurred in 1995, 2000, 2003, and now in 2007. The facility has served the community for 29 years as the central EMS station during periods of major growth and change. To address poor response times in the north ward, the station needs to be located north and east of its present site.

The location of EMS stations is a critical factor in achieving call response times that meet provincial standards. Superior North EMS currently operates three EMS stations in the City of Thunder Bay. Unfortunately two of those stations are poorly located relative to the areas of high call volumes, those being the Beck and Roland street locations. The Selkirk Street location is well positioned and its response are close to the standard.

The Report reviews the need to close the operations at Beck and Roland Street is favour of a new location that is better situated relative to the call volumes in the north ward of the City. The following points highlight the criteria used to evaluate a potential station location:

When choosing a location for a new station, two of the most important factors to consider are where the call volume is and how quickly paramedics located nearby can be dispatched to it. Thunder Bay is very fortunate to have two distinct zones of high call volumes concentrated in each of the City’s cores, making it much easier to plan station locations.

The following criteria, in order of importance, are used to assess each location:

• located in the centre or close to the centre of the high call zone
• size of property
• double lane road access and egress
• access to major arteries north, south, east and west
• speed limitations if any
• ownership of land (i.e existing facilities owned by the City)
• zoning
• adjacent uses



Beck and Roland street stations fail to meet the first two, and most critical, criteria and the call response times from these stations are unacceptable. It is the opinion of EMS administration that a new station should be located on property north of Oliver Road, west of High Street, south of River Street and east of Junot Street. To further take advantage of a new station it will also be recommended that the EMS headquarters, currently located in a City owned facility on Donald Street East be incorporated in the new station building.

Should a new station be constructed in the target zone some paramedic staff will also be reassigned to the Selkirk station, requiring some renovations to accommodate the additional crews. A consultant will need to be engaged to provide advice on the design and construction of the proposed new station, and the renovations to the Selkirk station.

This report discusses only the Code 4 calls (life and death emergency) dispatches as assigned by the Central Ambulance Communication Centre operated by the Ministry of Health and Long-Term Care. In Thunder Bay, Code 4s now represent 74% of the total call volume. This is up from 56.7% when the system was operated by the province. In 2006, there were 13,080 code 4s in Thunder Bay. Response times are the direct result of interactions between the number and location of paramedic stations, call volumes, hospital location and overall geography.

As shown in Attachment B, a large portion of the north ward is above the 10:14 response time. This is not acceptable for an urban community and studies have shown increased EMS response times have a detrimental impact on patient survival and quality of life. There are two main reasons for these lengthy responses: our Roland and Beck Street stations are at the periphery of their call areas; and emergency call volumes have increased 81% since 1996, the year when the province established our legislated response time requirement.

It should be noted that the location of the Thunder Bay Regional Health Sciences Centre, and the earlier closure of the Port Arthur and McKellar Hospitals is immaterial to the location of the EMS stations.


Call Distribution

A review of where the majority of the calls are, and from which station paramedics are dispatched to them, confirmed where the bulk of service demand is and which station is performing those calls.

In the south ward, the major call areas are located south of Southern Avenue and east of the railway. The station located at Selkirk serves this area well.

When looking at the overall emergency call distribution in built up areas of the city, the north has 5,402 Code 4 calls, and the south 4,547. Attachment C indicates that the northern part of the city has only 14.2% of the calls answered in less than eight minutes while the south has 78.4% of the calls responded to in less than eight minutes. It is evident that, generally, the area north of Oliver Road has the longest response times in the city. Because of the growing call volume in the area, steps must be taken to resolve the issue.

An analysis of the use of the Roland Station reveals that the majority of the responses are in the same locations to which paramedics from the Selkirk and Beck Stations respond. The location of Roland in the intercity area has resulted in lower responses to the high call volume areas which are both located in the north and south cores. In 2004, Roland Station paramedics responded to 1,674 Code 4s in the south core versus 1556 in the north core. See Attachment C and D. This confirms the need to reallocate resources to where the calls are occurring.

By closing down the Beck and Roland Street stations and the District Headquarters at 401 Donald Street E., the EMS Division will generate savings of $143,751 per year from the lease payments on those properties. 401 Donald Stree East, however, will be retained by the Corporation for use by other departments.

Funding for the construction of the new station and headquarters is expected from the Province’s continued move towards 50/50 funding in 2008, and the correction to the funding for servicing First Nations.

Based on the cost of constructing similar facilities in other jurisdictions, the order of magnitude estimates for this project is approximately $7 million.

It is concluded that the closure of the Beck and Roland Street stations, together with the renovations of the Selkirk Street station should be approved, pending the acquisition of suitable property and funding for the construction of a new station and headquarters.

In 1978, the Ministry of Health funded the construction of a new central ambulance station at 1118A Roland Street through a leasing agreement with the private ambulance service operator. The building is privately owned and has been leased for EMS purposes since then.

In 1994 and 1995 two satellite stations were built in the north and south cores to reduce long response times. One station was located at the corner of Selkirk and Arthur Street and the other was located at Beck Street. Both stations are under lease from private companies. The location of the two satellite stations was premised on being close to the emergency call volumes of those areas. The location of the Selkirk station was ideal for the call volume in Thunder Bay south. The Beck Street station was on the edge of the call volume in Thunder Bay north and, as such, provided minimal impact on response times. The lower cost of land was a significant factor in locating at Beck Street. as a central location close to the call volume was viewed as prohibitively more expensive.

The Roland Street station is now 30 years old. Since its construction, the needs of the community it serves and the EMS administrative structure have evolved beyond the capacity of the building. After only 17 years, steps were taken to replace the station. Upon becoming Thunder Bay’s land ambulance service provider in the early 1990’s, the administration at Nipigon General Hospital realized that the facility was no longer meeting the needs of a modern EMS system and that it was poorly located. In the summer of 1995, the Hospital issued a tender to replace it. Over the next two years, the Hospital attempted to secure Ministry of Health and Long-Term Care funding to replace the station. In 1997, the Government of Ontario announced the Local Services Realignment initiative and all capital projects were frozen pending the outcome of this process.

In October of 2000, the City of Thunder Bay confirmed the need to replace the Roland Street station and a Request For Proposal was issued for that purpose. Due to the severe work load resulting from the transition of land ambulance to municipalities in 2001, the tender was not acted upon. A review was undertaken in the spring of 2002 to identify call volumes in each square kilometre area throughout the City of Thunder Bay. This early review which was based on 2001 data indicated that a station located in the north ward would be closer to the higher volume of emergency calls in that area. Subsequent attempts to secure a suitable location were not successful. As the construction of the TBRHSC began, it was deemed prudent to review what the impact on call data would be. It was determined that a full year of data would be required for an accurate picture of the impact of the closure of the Port Arthur and McKellar sites and the subsequent opening of the TBRHSC This data became available in late 2005, and the ideal location became available in mid 2006.

REFERENCE MATERIAL ATTACHED

(All Distributed Separately)

ATTACHMENT A Response Times and Call Volumes

ATTACHMENT B City of Thunder Bay 90^th Percentile Response Times

ATTACHMENT C Percentage of calls based on response times for urban areas of the City of Thunder Bay

ATTACHMENT D Distribution of Code 4s in 2006

ATTACHMENT E Roland Street Station Code 4s in 2006

ATTACHMENT F Oliver Road School Lot Map