Call 9-1-1! Emergency services burning through municipal budgets

Call 9-1-1! Emergency services burning through municipal budgets

With tight municipal budgets and little flexibility in generating new revenues, Ontario’s municipalities could generate savings by consolidating their emergency dispatch services, which include emergency medical services (EMS), emergency fire services (EFS), and police.

Municipalities across Ontario spent $6.2 billion for emergency services in 2010, and this number is rising quickly, outpacing the rate of inflation and the cost of other municipal services. The tabling of the Federal and Ontario budgets last month garnered significant attention. Now that the dust is settling, the Institute would like to draw some attention to municipal affairs. Ontario’s municipalities are facing increasing demand for emergency services and these services continue to represent a larger portion of municipal budgets; consuming over one third of the average annual property tax bill in Toronto.

In Toronto, an aging population, coupled with only a small increase to the EMS’s operating budget, has caused the demand for EMS to outpace the growth of new paramedics. In particular, Toronto EMS services are having difficulty meeting the 2 minute call receiving and dispatch standard, as well as satisfying the response time compliance of 9 minutes. Also, in 2013, a new standard was established for Toronto’s EFS to reduce the road response time from 4:47 down to 4 minutes.

Consolidation of emergency dispatch services has the potential to improve inter-agency coordination of deployment and field operations – this can reduce duplication and help dispatchers send the right service and the optimal number of responders to any emergency situation. Consolidation can also reduce call handling delays, as the 911 operator would no longer have to transfer the call to EMS or EFS, which could shave up to 1:16 minutes off response times. For example, Calgary’s consolidated service has an average answer time of 6 seconds, and the operator is trained to handle any emergency without transferring the call.  There are also costs to be saved over the long run through sharing communication and dispatch technologies, building facilities, and communication staff resources.

The City of Toronto spends over $24 million per year in emergency dispatching services for EMS and police, as well as over $29 million on EFS’s communications support (of which a potion is for dispatching).[1] In a 2011 City of Toronto core services review, KPMG recommended that Toronto EMS and EFS consider integrating organizationally. However, a more recent 2013 report by city commissioned consultants Pomax, recommended against such consolidation.

The Pomax report offered instead, many recommendations for the City of Toronto that are related to adopting new and improved methodologies and technologies. For example, Pomax recommends that Toronto emergency services implement: Lean (Six Sigma or ISO) processes; Business Intelligence reporting software; dynamic staging and predictive modelling; pre-emptive traffic controls; and mobile technology solutions. Such methodologies and technologies can exhibit economies of scale in implementation and may have the highest return if implemented for a consolidated communications centre (not just comprised of EMS and EFS, but police dispatch services as well). Economies of scale could be realized by training all dispatchers in unison and implementing similar technologies across all emergency services, thus improving the inter-operability of emergency communication equipment.  Also, consolidated dispatching services may help organizations adapt and absorb the costs of future technology demands.

There are several challenges to consolidation, including cross-training, navigating collective agreements, legal and labour challenges, technology, and differences in funding models. Many of these issues, however, do not present significant obstacles for the consolidation of dispatch services.

Challenge

Solution

Cross-training

Training costs should not be too significant. For example, in Calgary, dispatchers are able to handle all three types of emergencies with only 360 hours (9 weeks) of initial training.

Collective agreements, legal and labour challenges

This could stall consolidation, however, other municipalities have managed to work together to overcome these challenges.

Differences in funding models

EMS dispatching services are funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC), so funding issues may arise by consolidating EMS with city funded fire and police services (as is the case in Cambridge-Kitchener-Waterloo). To ensure that funding issues do not delay any consolidation efforts, the MOHLTC should establish a rule that guarantees a target level of provincial funding post-consolidation.

Technology

The most significant obstacle would be the upfront infrastructure, equipment, and technology/software costs associated with merging multiple organizations into one. Initial costs can be well in excess of $1 million. Although these costs are significant, they should be weighed against the benefits (shorter dispatch and response times, better service coordination, and cost savings associated with economies of scale in training, technology, etc.) to be reaped in the long run.

The City Manager and Deputy City Mangers in Toronto believe that the existing barriers to consolidation are not insurmountable and wish to further explore this opportunity. Other Canadian municipalities have pursued varying degrees of dispatch consolidation, for example: Calgary police, EMS and EFS; Sudbury police and EFS; Winnipeg EFS and EMS; Niagara EFS simultaneously dispatches with EMS; and Waterloo-Kitchener-Cambridge is pursuing police and EFS consolidation. With examples of different consolidation models popping up in different cities, more of Ontario’s municipalities should be studying their effects and assessing whether similar opportunities are suitable for them to adopt.

 

[1] $16.8 million on the central ambulance communication centre (funded by the MOHLTC) in 2013, $7.2 million on telephone and 911 services by the police in 2011, and a portion of $29.1 million (2012) of the EFS communications and operational support. No recent data was available.

Photo Credit: Jane_Kelly, Getty Images 

Category: Infrastructure, Productivity, Public Policy