City of Cranbrook council Dec. 6 endorsed a resolution to the Union of British Columbia Municipalities (UBCM) to push the provincial government to develop a fee-for-service framework to allow for community-based organizations that provide pre-hospital care services to bill the province for services rendered on its behalf.

The resolution from Cranbrook Fire and Emergency Services Chief Scott Driver:

“Whereas the pre-hospital care system in British Columbia lies within the jurisdictional responsibility of the Ministry of Health, however it relies critically on the delivery of service by Municipal, Regional and First Nations organizations;
“And whereas the Ministry is critically reliant on this partnership in delivery of pre-hospital care in the Province of British Columbia:
“Therefore, be it resolved that UBCM lobby the Province of British Columbia to work with the LGMA, FCABC and FNESS to develop a fee-for-service framework to bill the province on callouts that appropriately fund community-based organizations that provide pre-hospital care services in support of the ministry’s health care responsibility to the citizens of British Columbia.”

Council unanimously endorsed the resolution, though Coun. Wes Graham was absent from the meeting.

The resolution follows on the heels of a Dec. 3 Ministry of Health announcement it is expanding the care and treatment paramedics and first responders can provide to British Columbians in emergency situations.

“By increasing the care, information and support that both paramedics and first responders can provide in an emergency, we are taking action to ensure that patients get the best care possible from a team of emergency providers,” said Adrian Dix, Minister of Health. “For patients, this means that paramedics and first responders who respond to medical emergencies will be even better able to manage it all and get you through the most critical moment of your life.”

As these changes are implemented, paramedics and first responders will increasingly be able to better help patients on scene, a Ministry of Health media release stated.

For paramedics, this means the ability to provide more life-saving interventions, which at various licensing levels can include:

* needle decompression for major chest traumas to support breathing;

* using portable ultrasound to better assess patients and inform care decisions;

* enhancing airway management skills; and

* providing life supporting or sustaining medications during transport.

These changes are further supported by increases to the care that first responders can provide, including:

* additional diagnostic testing, such as blood pressure and blood glucose, that can better inform paramedics;

* administering epinephrine when needed for a life-threatening allergic reaction; and

* supporting the preparation or packaging of patients for transport by paramedics.

In making these changes, the province said it will work closely with training institutions, BC Emergency Health Services (BCEHS), Ambulance Paramedics of BC (CUPE 873), first responder agencies and the Fire Chiefs Association of BC to ensure the consistent and appropriate oversight, continuing competency, licenser and standardized training of paramedics and first responders.

“We hear gratitude from patients on a daily basis for the expert care they receive from our paramedics, and these practice changes will help support that work,” said Leanne Heppell, interim chief ambulance officer, BC Emergency Health Services. “We very much appreciate our important partnership with firefighters/first responders, and look forward to collaborating even more closely on the scope of practice changes announced today.”

The changes stem from recommendations made by the Emergency Medical Assistants Licensing Board (EMALB) to provide better outcomes for patients needing emergency health services. The EMALB is responsible for examining, registering and licensing all emergency medical assistants, including all first responders and paramedics.

“The scope of practice changes being adopted today represent a larger step forward than the cumulative changes over the past three decades,” said Ryan Sinden, chair, Emergency Medical Assistants Licensing Board. “This initiative is the culmination of significant efforts by all stakeholders under a demanding timeline. At all licence levels, emergency medical assistants will have their ability to assess and treat patients greatly expanded. The Emergency Medical Assistants Licensing Board will be active going forward to ensure that all licensees complete appropriate board-approved training and demonstrate competency with the new skills and equipment prior to their use.”

The recommendations have been made after input and consultation with stakeholders, including Ambulance Paramedics of BC (CUPE 873), the BC Professional Fire Fighters Association, the Fire Chiefs Association of BC, BCEHS, Emergency Medical Assistant training programs and paramedics in the industry.

BC Professional Fire Fighters’ (BCPFFA) president Gord Ditchburn said the changes will improve the delivery of care in the province.

“On behalf of the BCPFFA we thank the BC Government for making the highly anticipated changes in pre-hospital care and for seeing the value in enhancing the scope of practice for all fire fighters and paramedics. These changes will make a difference in the delivery of care for citizens across the province,” he stated.

The BCEHS and the Ambulance Paramedics and Dispatchers of BC (CUPE 873) have worked closely together on an immediate and a long-term plan to increase appropriate mental health supports and resources due to the nature of their work.

“We need to help our emergency responders, who we all rely on when we need help most. We know our emergency service providers will come face to face with challenging situations, and we need to be there to support them through that. That is why in July, I gave direction to the BCEHS to provide dispatch staff and paramedics with the mental health and wellness support they need. I thank the BCEHS and the Ambulance Paramedics and Dispatchers of BC (CUPE 873) for working on immediate actions and on a long-term plan to best support them,” Dix said.

Immediate actions to support the wellness of B.C.’s front-line staff include:

* increasing clinical supports and resources through the critical incident stress management program to better support and help front-line staff and their families navigate resources available to them and to make it easier to access important mental health services in a timely manner;

* adding resources for all BCEHS staff and their families to the network of trauma informed and occupationally competent counsellors who provide psychological care; and

* creating a BCEHS and Ambulance Paramedics and Dispatchers of BC (CUPE 873) joint committee to implement collaborative recommendations on a comprehensive, short-, medium- and long-term psychological health and safety strategy.

In addition, as announced in July 2021, BCEHS will conduct a joint workload review, with the Ambulance Paramedics and Dispatchers of BC (CUPE 873), to better understand and address optimal resource and workload levels, to support greater patient care and the wellness of the front-line staff who provide that crucial care.

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