Manitoba’s municipalities want to stop sending their firefighters to move patients. Failing that, they want to charge the province for their services.
Medical and lift assists were among the topics pushed by local council representatives during the recent Association of Manitoba Municipalities conference in Brandon. Two interconnected resolutions earned debate on the floor: one to lobby for an end to lift assists, and the other to push for reimbursement when firefighters are summoned to medical calls. Both passed.
Why it matters: Local governments say the growing number of medical and lift assists provided by firefighters passes health care costs inappropriately onto municipalities.
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“Lift assists” are generally defined as instances where a patient calls emergency services for help getting up, but where no medical treatment is provided on site.
Municipalities say firefighters are being called when emergency responders do not have the resources to lift the patient by themselves, and that “lifting and mobilizing a patient for transport is a core function and responsibility of emergency medical services.”
Further, the resolution’s sponsors argued, municipalities are not supposed to be paying for health care, including EMS.
“We’re not talking about mutual aid. We’re talking about artificially putting more, just depending on municipalities to provide these responses,” said Duane Nicol, chief administrative officer for the City of Selkirk.
Selkirk was one of the resolution’s sponsors, alongside Morden and Steinbach.
Nicol estimated that it costs the city $1,800 every time their fire department rolls. It is staffed on a volunteer/paid on-call basis.
In one case, he said, their department was called to a lift assist inside the hospital.
“With staff running all over the place … they called our department to come lift and transfer a person,” he said. “That is unacceptable, and it cost the municipality money.”
He said the demand sours the fire hall’s relationship with local employers if volunteer firefighters are called during work hours.
Other municipal leaders shared their own stories.
RM of Alexander deputy mayor Mac Kinghorn noted his region has three fire departments, two of which are remote.
“This is something that does happen somewhat too frequently,” he said. “The ambulance attendants in a lot of situations aren’t physically capable of doing a lift that needs to be done and they need the assistance.”
Kinghorn said he has seen some assists that required extra hands to get a patient out of a bedroom or house. When a page goes out, however, everyone in the department answers, even if not all are needed.
“They might want four people, but everyone answers it,” Kinghorn said. “So, you’ll end up going out with eight or 10 people that are getting two to three hours of pay for responding to that call.”
Distance to medical facilities makes firefighter calls important for his area, he said, but fire departments have responded to calls at the hospital to help unload patients.
Paid for what they put in
Another resolution, sponsored by the town of Stonewall, would lobby for a reimbursement system similar to the agreement with Manitoba Public Insurance, which covers calls to a vehicular accident.
Kinghorn expressed support for such a system.
“I would really like to see something set up where Shared Health puts something in place where we can actually bill when we have to do it [respond to medical assist calls], because I know it’s not going to stop,” he said.
Caution needed
Other councillors were leery of ending lift assists. Steven Stein of the RM of Tache, who is also a firefighter with the local department, worried about the impact to Manitoba’s interwoven emergency services.
“Both ambulance and fire work as a team,” he said.
Ending the practice might having a cooling effect on ambulance attendance to fire calls, he suggested, which would add risk for firefighters. However, the call for a reimbursement system earned his support.
“We should be asking for reimbursement from Shared Health when they request our fire department,” he said.
‘HR tool’
At the heart, Nicol said, the two resolutions ask for emergency medical services to be adequately staffed rather than relying on the municipality to fill the gap.
“When there’s an emergency situation, it’s all hands on deck and everyone should respond and we understand that,” he said. “We’re not saying you should never go. We’re saying, ‘stop using it as a tool, an HR tool, in hospitals and EMS service and downloading the costs and responsibilities.’”
