Body: Council Type: Agenda Meeting: Regular Date: March 18, 2020 Collection: Council Agendas Municipality: Frontenac County
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Document Text
Frontenac County Council Meeting Wednesday, March 18, 2020 – 9:00 a.m. County Administrative Building, Frontenac Room, 2069 Battersea Road, Glenburnie Council will resolve into Closed Meeting and will reconvene as regular Council at 9:30 a.m.
Agenda Page Call to Order Closed Session a) Resolved That Council resolve itself into Committee of the Whole closed session as authorized under Section 239 of The Municipal Act, to consider:
- Adoption of Closed Minutes of Meetings held December 18, 2019
- Labour relations or employee negotiations - as it relates to attendance management
- Litigation or potential litigation, including matters before administrative tribunals, affecting the municipality or local board as it relates to mediation/arbitration with the City of Kingston.
- Personal matters about an identifiable individual, including municipal or local board employees - as it relates to the salary grids of employees of the Corporation Resolved That Council rise from Committee of the Whole closed session with/without reporting Approval of Addendum Disclosure of Pecuniary Interest and General Nature Thereof
10 - 22
Adoption of Minutes a) Minutes of Meeting held February 19, 2020 Resolved That the minutes of the regular Council meeting held February 19, 2020 be adopted.
23 - 25
b)
Minutes of Special Meeting held January 29, 2020 Resolved That the minutes of the special Council meeting held January 29, 2020 be adopted.
Page Deputations and/or Presentations a)
Mr. Marc Moeys, Verona District ATV Club will address County Council regarding their Verona ATV Petition. [See Communications k)]
Proclamations Move into Committee of the Whole a) That Council adjourn and meet as Committee of the Whole Council, with the Deputy Warden in the Chair. Briefings a) Mr. Kelly Pender, Chief Administrative Officer, will provide Council with his monthly CAO briefing. 26 - 44
b)
Mr. Joe Gallivan, Director of Planning and Economic Development, will provide Council with a Communal Services Update.
Unfinished Business
45 - 47
Recommend Reports from the Chief Administrative Officer a) 2020-028 Emergency and Transportation Services 2019 Legislated Response Time Standard Performance Plan Reporting to the Ministry of Health and Long Term Care (MOLTC) Recommendation Resolved Thatthe Council of the County of Frontenac receive the Emergency and Transportation Services - 2019 Legislated Response Time Standard Performance Plan Reporting to Ministry of Health and Long Term Care (MOHLTC) for information, And Further That the 2019 Response Time Standard Performance Plan outcomes for the County of Frontenac be reported to the Director, Emergency Health Regulatory and Accountability Branch, Ministry of Health and Long Term Care as required by legislation.
Page 2 of 134
Page 48 - 50
b)
2020-031 Corporate Services Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program Recommendation Be It Resolved That the Council of the County of Frontenac receive for information the Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program report; And Further That County Council authorize the Warden and Clerk to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program
Page 3 of 134
Page 51 - 54
c)
2020-032 Corporate Services Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a OneWindow Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”) Recommendation Be It Resolved That the Council of the County of Frontenac receive for information the Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”); And Further That County Council authorize the Warden and Clerk to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”).
55 - 59
60 - 70
Information Reports from the Chief Administrative Officer a) 2020-029 Corporate Services 2019 Remuneration and Reimbursement of Expenses to Council Members and Non-Council Appointees Report b)
2020-030 Corporate Services Amend Pay Equity Plan
Page 4 of 134
Page 71 - 128
c)
2020-033 Frontenac Paramedics Ambulance Service Review Final Report
Reports from Council Liaison Appointees a) Emergency and Transportation Services - Councillor Higgs b)
Long Term Care (Fairmount Home) - Councillor Martin
c)
Corporate Services - Councillor MacDonald
d)
Planning and Economic Development - Councillor Revill
Reports from External Boards and Committees a) Kingston Frontenac Library Board Update - Councillor Revill b)
KFL&A Public Health Board Update - Councillor Doyle
c)
Housing and Homelessness Committee Update - Warden Smith
d)
Food Policy Council of Kingston, Frontenac, Lennox and Addington Councillor Higgs
Reports from Advisory Committees of County Council Return to Council a) That Council revert from Committee of the Whole Council, to Council.
Adoption of the Report of the Committee of the Whole Council a) That the report of the Committee of the Whole Council be adopted and that the necessary actions or by-laws be enacted. Motions, Notice of Which has Been Given
Page 5 of 134
Page a)
Food Policy Council for KFLA request for Financial Support [See Communications s)] Moved by: Councillor Higgs Seconded by: Councillor MacDonald Whereas the County of Frontenac has been represented on the Food Policy Council since its inception in 2011, and, Whereas the Food Policy Council supports and advocates for our regional food system, including a strong relationship between our rural and urban communities, and, Whereas the Food Policy Council has set priorities for 2020 in the areas of food security and support for the regional food and agriculture economy, and, Whereas the Food Policy Council supports initiatives throughout the Frontenacs that help create a resilient, ecologically and economically sustainable food and agriculture system; Now Therefore be it Resolved That the Council of the County of Frontenac provide funding in the amount of $500 to the Food Policy Council for KFL&A to help cover costs of general expenses such as website hosting, printing, literature, letter writing, mailing and advertising, to be expensed from the Stabilization Reserve; And Further That a copy of this resolution be forwarded to the City of Kingston and the County of Lennox-Addington.
Giving Notice of Motion Communications That Council consent to the following communications of interest to Council listed below be received and filed: a) Kingston & Frontenac Housing Corporation February 24, 2020 Agenda Package [Distributed to Members of County Council February 21, 2020] b)
Letter to Minister Hardeman from the Township of Madoc expressing its support for Bill 156 [Distributed to Members of County Council February 21, 2020]
c)
Resolution from Northumberland County regarding support for Conservation Authorities [Distributed to Members of County Council February 21, 2020]
Page 6 of 134
Page d)
Resolution from the County of Haliburton regarding Tourism Oriented Destination Signage Fee increases [Distributed to Members of County Council February 21, 2020]
e)
Resolution from the Township of Madoc regarding its support for 911 misdials [Distributed to Members of County Council February 21, 2020]
f)
Resolution from the Township of Madoc regarding its support for Conservation Authorities [Distributed to Members of County Council February 21, 2020]
g)
Resolution from the Township of Puslinch regarding support for AMO’s position on Bill 132 [Distributed to Members of County Council February 21, 2020]
h)
Resolution from the Township of Puslinch regarding Support for Electronic Delegation [Distributed to Members of County Council February 21, 2020]
i)
From the City of Vaughan acknowledging receipt of County of Frontenac Resolution supporting Conservation Authorities [Distributed to Members of County Council February 28, 2020]
j)
From the Honourable Steve Clark, Minister of MMAH regarding the release of the Provincial Policy Statement (PPS) 2020 [Distributed to Members of County Council February 28, 2020]
k)
Petition from the Verona District ATV Club regarding to permit ATV’s access on the K&P Trail between Craig Rd and Bellrock Rd [Distributed to Members of County Council February 28, 2020]
l)
Resolution from the County of Peterborough regarding support for Bill 156 Security from Trespass and Protecting Food Safety Act [Distributed to Members of County Council February 28, 2020]
m)
Resolution from the Municipality of South Huron regarding enforcement for safety on family farms [Distributed to Members of County Council February 28, 2020]
n)
Letter from the Corporation of the Municipality of West Nipissing Regarding Provincially Significant Wetlands Designation [Distributed to Members of County Council March 6, 2020]
o)
Memorandum from the Strategy Corp Regarding Frontenac Service Delivery Review [Distributed to Members of County Council March 6, 2020]
p)
Letter from the Corporation of the Township of Tyendinaga Regarding New Business – Motion of Support for a peaceful conclusion on the ongoing rail disruptions and encouragement for ongoing discussions for a solution to the costal GasLink Project [Distributed to Members of County Council March 6, 2020]
Page 7 of 134
Page q)
Letter from the Town of Ajax Regarding Supporting Conservation Authorities [Distributed to Members of County Council March 6, 2020]
r)
From the Town of Kirkland Lake regarding resolution in support of Bill 156 [Distributed to Members of County Council March 13, 2020]
s)
Request for financial support from the Food Policy Council of KFL&A [Distributed to Members of County Council March 13, 2020]
t)
From the County of Norfolk regarding Issues respecting the mapping of Provincially Significant Wetlands
Other Business Public Question Period By-Laws – General By-laws and Confirmatory By-law a) First and Second Reading Resolved That leave be given the mover to introduce by-laws a) through d) that have been circulated to all Members of County Council and that by-laws a) through d) be read a first and second time. b)
Third Reading Resolved That by-laws a) through d) be read a third time, signed, sealed and finally passed. By-Laws
129
a)
To amend By-law No. 2018-0032 (Council Remuneration Bylaw) as it relates to Per Diems for attendance at conferences, training and workshops [Proposed By-law No. 2020-0013]
130 - 131
b)
To authorize the execution of an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a OneWindow Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”). [Proposed By-law No. 2020-0014]
Page 8 of 134
Page 132
c)
To authorize the execution of an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program [Proposed By-law No. 2020-0015]
133 - 134
d)
To confirm all actions and proceedings of County Council on March 18, 2020 [Proposed By-law No. 2020-0016]
Adjournment
Page 9 of 134
AGENDA ITEM #a)
Minutes of the Regular Meeting of Council February 19, 2020 A regular meeting of the Council of the County of Frontenac was held in the Kingston Frontenac Rotary Auditorium of the County Administrative Office, 2069 Battersea Road, Glenburnie on Wednesday, February 19, 2020 and was called to order at 9:30 AM Present: Warden Fran Smith, Deputy Warden Ron Vandewal, Councillors Ron Higgins, Denis Doyle, Bruce Higgs, Bill MacDonald, Gerry Martin and Alan Revill Regrets:
Councillor Higgins
Also Present:
County: Gale Chevalier, Chief/Director of Emergency & Transportation Services Joe Gallivan, Director of Planning and Economic Development Susan Brant, Director of Corporate Services/Treasurer Lisa Hirvi, Administrator-Fairmount Home Jannette Amini, Manager of Legislative Services/Clerk Marco Smits, Communications Officer Richard Allen, Manager of Economic Development Megan Rueckwald, Manager of Community Planning
Closed Session Approval of Addendum Disclosure of Pecuniary Interest and General Nature Thereof There were none. Adoption of Minutes a)
Minutes of Meeting held January 15, 2020
Motion #: 25-20
Moved By: Seconded By:
Councillor Revill Councillor MacDonald
Resolved That the minutes of the regular Council meeting held January 15, 2020 be adopted. Carried
Page 10 of 134 Minutes of Meeting held February 19, 2020
AGENDA ITEM #a)
Deputations and/or Presentations Proclamations a)
2020 International Year of the Nurse and the Midwife
Motion #: 26-20
Moved By: Councillor Martin Seconded By: Councillor Higgs Whereas the World Health Organization designated 2020 – the 200th anniversary of Florence Nightingale’s birth – as the International Year of the Nurse and the Midwife; and, Whereas nurses are leaders and part of a strong multi-disciplinary health care team at Fairmount Home; and, Whereas nurses are part of our local community and shape and deliver effective interventions to meet the needs of our residents, families and communities; Therefore Be It Resolved That the Council of the County of Frontenac hereby proclaims 2020 as International Year of the Nurse and Midwife in Frontenac County. Carried Move into Committee of the Whole Motion #: 27-20
Moved By: Deputy Warden Vandewal Seconded By: Councillor Doyle That Council adjourn and meet as Committee of the Whole Council, with the Deputy Warden in the Chair. Carried Briefings a)
Ms. Susan Brant, Director of Corporate Services/Treasurer provided Council with the monthly CAO briefing. Unfinished Business
Regular Meeting of Council Minutes February 19, 2020
Page 11 of 134 Minutes of Meeting held February 19, 2020
Page 2 of 13
AGENDA ITEM #a)
Recommend Reports from the Chief Administrative Officer a)
Consultant Briefing: Mr. Jamie Cook, Watson and Associates, provided County Council with a briefing on the Population, Housing and Employment Projection Study and responded to questions on same. [See Recommend Reports from the Chief Administrative Officer, Clause b)]
b)
2020-019 Planning and Economic Development Population, Housing and Employment Projection Study
Motion #: 28-20
Moved By: Seconded By:
Councillor MacDonald Councillor Revill
Resolved That the Council of the County of Frontenac receive and endorse the Population, Housing and Employment Projections Study dated January 20, 2020; And Further That the Council of the County of Frontenac direct staff to: Present an overview of the population, housing and employment forecasts and projections to each of the four Township Councils in the first quarter of 2020; and To amend the County of Frontenac Official Plan to recognize the updated population allocation applied across the County as part of the forthcoming County Official Plan update to commence in 2021. Carried c)
2020-014 Corporate Services Authorization to enter into an Agreement with the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) for the Rural Economic Development Program (RED) funding – “Open for Business South Frontenac: Streamlining Development Approvals for Rural Economic Growth”
Motion #: 29-20
Moved By: Seconded By:
Councillor Higgs Councillor Martin
Resolved That the Council of the County of Frontenac receive the Corporate Services – Authorization to enter into an Agreement with the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) for the Rural Economic Development Program (RED) funding – “Open for Business South Frontenac: Streamlining Development Approvals for Rural Economic Growth” report for information; And Further That the Warden and Clerk be authorized to execute a Contribution Agreement with the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) and the Township of South Frontenac for the Rural Economic Development Program (RED) funding – “Open for Business South Frontenac: Streamlining Development Approvals for Rural Economic Growth”. Carried Regular Meeting of Council Minutes February 19, 2020
Page 12 of 134 Minutes of Meeting held February 19, 2020
Page 3 of 13
AGENDA ITEM #a)
d)
2020-015 Corporate Services 2019 Frontenac Howe Islander Petition for Subsidy
Motion #: 30-20
Moved By: Seconded By:
Councillor Doyle Warden Smith
Resolved That the Council of the County of Frontenac accept the Corporate Services – 2019 Frontenac Howe Islander Ferry Petition for Subsidy report; And Further That Council authorize the Clerk to petition the Ministry of Transportation for $912,820.41. Carried e)
2020-016 Corporate Services Amendments to By-law 2019-0039 to declare lands Surplus for the purpose of transferring portions of the K&P Trail to the Township of South Frontenac to aid the Township’s development of affordable seniors’ housing
Motion #: 31-20
Moved By: Seconded By:
Councillor Revill Councillor Martin
Be It Resolved That the Council of the County of Frontenac accept the Corporate Services – Amendments to By-law 2019-0039 to declare lands Surplus for the purpose of transferring portions of the K&P Trail to the Township of South Frontenac to aid the Township’s development of affordable seniors’ housing report; And Further That the Clerk be authorized to bring forward a by-law later in the meeting to amend by-law 2019-0039 by deleting all reference to: lands legally described as Portland CON 1 PT Lots 1 and; 2 CON 2 PT Lots 2 AND 3 CON; 3 PT Lots 3 and 4 CON 4 PT; Lots 3 TO 7 CON 5 PT Lots 7; and 8 CON 6 PT Lot 7 CON 7; and replacing with: lands legally described as Portland Con 11 PT Lots 9 And 10, PIN #: 361460591 being Verona Street. Carried
Regular Meeting of Council Minutes February 19, 2020
Page 13 of 134 Minutes of Meeting held February 19, 2020
Page 4 of 13
AGENDA ITEM #a)
f)
2020-017 Fairmount Home Long-Term Care Home Service Accountability Agreement (LSAA) Schedule E - Form of Compliance Declaration
Motion #: 32-20
Moved By: Seconded By:
Councillor Doyle Warden Smith
Resolved That Council of the County of Frontenac receive the Fairmount Home LongTerm Care Home Service Accountability Agreement – Schedule E – Form of Compliance Declaration Report; And Further That the Council of the County of Frontenac direct the Clerk to sign the Long-Term Care Home Service Accountability Agreement Schedule E – Form of Compliance Declaration and return to the Local Health Integration Network as required under the Local Health System Integration Act. Carried g)
2020-021 Fairmount Home Long-Term Care Home Service Accountability Agreement (LSAA) Amending Agreement
Motion #: 33-20
Moved By: Seconded By:
Councillor Higgs Councillor MacDonald
Resolved That Council of the County of Frontenac received the Fairmount Home – Long-Term Care Home Service Accountability Agreement (LSAA) Amending Agreement for approval; And Further That the Council of the County of Frontenac authorize the Clerk and Chief Administrative Officer to execute the LSAA Amending Agreement and return to the Local Health Integration Network as required by the Local Health Integration Network (LHIN) and Ontario Health. Carried h)
2020-022 Planning and Economic Development Request to the Township of Central Frontenac for the conveyance of lands occupied by the Frontenac K&P Trail
Motion #: 34-20
Moved By: Seconded By:
Councillor Martin Councillor Doyle
Be It Resolved That the Council of the County of Frontenac direct staff to submit a request to the Township of Central Frontenac to convey Township owned lands occupied by the Frontenac K&P Trail to the County of Frontenac as described in this report. Carried
Regular Meeting of Council Minutes February 19, 2020
Page 14 of 134 Minutes of Meeting held February 19, 2020
Page 5 of 13
AGENDA ITEM #a)
i)
2020-023 Planning and Economic Development Support for Sharbot Lake Downtown Revitalization Project (RED Grant)
Motion #: 35-20
Moved By: Seconded By:
Councillor Revill Warden Smith
Be It Resolved that the Council of the County of Frontenac support the Township of Central Frontenac in the completion of an application to the Rural Economic Development (RED) Program for the purpose of conducting a Downtown Revitalization Program in the Village of Sharbot Lake; And further that the Council of the County of Frontenac agree to serve as co-applicant the project, sharing responsibility for project implementation; And further that Council allocate $2,000 from the Community Development Reserve towards the Downtown Revitalization project should the said application be successful; And further that the Warden and the Clerk be authorized to enter into an agreement with the Province of Ontario should the said application be successful. Carried j)
2020-024 Corporate Services Authorization for the use of the Municipal Modernization Fund for County costs associated with the Joint Service Delivery Review with the County’s Member Municipalities
Motion #: 36-20
Moved By: Seconded By:
Councillor MacDonald Councillor Higgs
Be It Resolved That the Council of the County of Frontenac receive for information the Corporate Services – Authorization for the use of the Municipal Modernization Fund for County costs associated with the Joint Service Delivery Review with the County’s Member Municipalities; And Further That staff be authorized to expense the additional $11,000 for the County’s share of the Joint Service Delivery Review project with Member Municipalities from the County’s Municipal Modernization Fund. Carried Information Reports from the Chief Administrative Officer a)
b)
2020-013 Corporate Services Southern Frontenac Community Services and Rural Frontenac Community Services Year End Transportation Statistical Reports 2020-018 Fairmount Home Quarterly Update Activity Report
Regular Meeting of Council Minutes February 19, 2020
Page 15 of 134 Minutes of Meeting held February 19, 2020
Page 6 of 13
AGENDA ITEM #a)
c)
2020-020 Corporate Services Updated Financial Implications regarding – Complaint Filed against a Member of Council Reports from Council Liaison Appointees
a)
Emergency and Transportation Services - Councillor Higgs
Councillor Higgs provided an overview of the Emergency and Transportation Services liaison activities since the last Council meeting. b)
Long Term Care (Fairmount Home) - Councillor Martin
Councillor Martin provided an overview of the Long Term Care (Fairmount Home) liaison activities since the last Council meeting. c)
Corporate Services - Councillor MacDonald
Councillor MacDonald provided an overview of the Corporate Services liaison activities since the last Council meeting. d)
Planning and Economic Development - Councillor Revill
Councillor Revill provided an overview of the Planning and Economic Development liaison activities since the last Council meeting. 14
Reports from External Boards and Committees a)
Kingston Frontenac Library Board Update - Councillor Revill
No report. b)
KFL&A Public Health Board Update - Councillor Doyle
Councillor Doyle provided an overview of the Kingston, Frontenac Lennox and Addington Board of Health activities since the last Council meeting. c)
Housing and Homelessness Committee Update - Warden Smith
No Report.
Regular Meeting of Council Minutes February 19, 2020
Page 16 of 134 Minutes of Meeting held February 19, 2020
Page 7 of 13
AGENDA ITEM #a)
d)
Food Policy Council of Kingston, Frontenac, Lennox and Addington Councillor Higgs
Councillor Higgs provided an overview of the Food Policy Council of Kingston, Frontenac, Lennox and Addington activities since the last Council meeting. Reports from Advisory Committees of County Council a)
Report of the Community Development Advisory Committee
Motion #: 37-20
Moved By: Seconded By:
Councillor Revill Councillor Doyle
That the Report received from the Community Development Advisory Committee be received and adopted. Report of the Community Development Advisory Committee The Community Development Advisory Committee reports and recommends as follows: 2020-012 Community Development Advisory Committee The Royal Winter Fair Be It Resolved That the County of Frontenac participate in the Royal Winter Fair’s 2020 Spotlight on Local, pending the availability of free exhibition space and the interest of Frontenac Ambassadors. Carried Return to Council Motion #: 38-20
Moved By: Seconded By:
Councillor Martin Warden Smith
That Council revert from Committee of the Whole Council, to Council. Carried Adoption of the Report of the Committee of the Whole Council Motion #: 39-20
Moved By: Seconded By:
Deputy Warden Vandewal Councillor Higgs
That the report of the Committee of the Whole Council be adopted and that the necessary actions or by-laws be enacted. Carried
Regular Meeting of Council Minutes February 19, 2020
Page 17 of 134 Minutes of Meeting held February 19, 2020
Page 8 of 13
AGENDA ITEM #a)
Motions, Notice of Which has Been Given a)
Increase in Councillor Per Diems when attending Conferences, training and Workshops
Motion #: 40-20
Moved By: Seconded By:
Deputy Warden Vandewal Councillor Revill
Whereas attendance at conferences, such as AMO, ROMA and FCM provide a valuable opportunity for elected officials to connect with municipal colleagues from across Ontario as well as receive presentations from expert keynote speakers, attend concurrent educational sessions, meet political leaders, and gain access to Provincial Ministers; and, Whereas attendance at conferences require Councillors to be away from their families and take time off from their regular employment, in many cases without pay; and, Whereas Councillors are provided with a $4,000 annual expense account to cover expenses such as the cost of attendance at conferences, including a daily per diem; and, Whereas By-law 2018-0032 limits the daily per diem for members of Council to $150 per meeting day, which in many cases does not cover the cost of lost wages to attend conferences; Therefore Be It Resolved That By-law 2018-0032 be amended to add to Schedule A, section 1 a clause d) that being: d)
b)
A per diem of $250 may be claimed by members of Council against their annual expense account when attending conferences, training and workshops. Carried Resolution of Support for Conservation Authorities
Motion #: 41-20
Moved By: Seconded By:
Councillor Revill Deputy Warden Vandewal
Whereas the County of Frontenac has been well served by Quinte Conservation, Cataraqui Conservation, Rideau Valley Conservation and Mississippi Valley Conservation Authorities; And Whereas we value the efforts of the Conservation Authorities to monitor floods, to manage Source Water Protection and to ensure the integrity of the watersheds within our County and conserve our natural environment; And Whereas the province of Ontario is currently reviewing the mandate and operations of conservation authorities;
Regular Meeting of Council Minutes February 19, 2020
Page 18 of 134 Minutes of Meeting held February 19, 2020
Page 9 of 13
AGENDA ITEM #a)
And Whereas Conservation Authorities provide essential services to municipalities in their watersheds; And Whereas smaller municipalities do not have the capacity or the financial resources to employ staff with the technical expertise that conservation authorities provide; Therefore Be It Resolved That the County of Frontenac encourages the province to continue to support the principle of planning on a watershed basis in the ongoing review and prioritize the allocation of adequate funding to support the core mandate of conservation authorities; And Further That the provincial government will maintain and not diminish the core mandate of Conservation Authorities; And Further That a copy of this resolution be forwarded to the Honourable Doug Ford, Premier of Ontario, the Honourable Jeff Yurek, Minister of the Environment, Conservation and Parks, the Honourable John Yakabuski, Minister of Natural Resources and Forestry, Conservation Ontario, the Association of Municipalities of Ontario and all Ontario municipalities. Carried Giving Notice of Motion Councillor Higgs advised that he will be bringing forward a motion to the March 18, 2020 County Council meeting requesting that Council provide funding in the amount of $500 to the Food Policy Council of Kingston, Frontenac, Lennox and Addington. Communications That Council consent to the following communications of interest to Council listed below be received and filed: a) b) c)
d) e) f)
Letter from the Eastern Ontario Wardens’ Caucus (EOWC) Regarding Rising Flooding Level across Eastern Ontario [Distributed to Members of County Council January 17, 2020] Email from Joy Vileneuve, Citizen Regarding Funding for Frontenac Transportation [Distributed to Members of County Council January 17, 2020] Email from Kevin Farrell, Manager of Continuous Improvement, providing Council with a Planning Applications - Process Improvement Update, as requested at the January 15 County Council Meeting [Distributed to Members of County Council January 22, 2020] Notice of Kingston Dock Design and Construction Report [Distributed to Members of County Council January 24, 2020] Letter from the Kingston Frontenac Public Library Regarding the Elected Chair and Vice Chair [Distributed to Members of County Council January 24, 2020] Invitation from University Hospitals Kingston Foundation - Circle of Care
Regular Meeting of Council Minutes February 19, 2020
Page 19 of 134 Minutes of Meeting held February 19, 2020
Page 10 of 13
AGENDA ITEM #a)
g) h) i) j) k) l) m) n)
o) p)
q) r) s) t) u) v)
Luncheon - Monday, March 2, 2020 [Distributed to Members of County Council January 24, 2020] Email from Strathroy-Caradoc Regarding Watershed Management Programs [Distributed to Members of County Council January 31, 2020] Email from The Town of Orangeville Regarding Environmental Awareness and Action [Distributed to Members of County Council January 31, 2020] From SFCSC providing a copy of Reporting Summary for Transportation Services Q4 [Distributed to Members of County Council January 31, 2020] From the City of Sarnia providing resolution regarding Ontario Power Generations Deep Geologic Repository Project [Distributed to Members of County Council January 31, 2020] From the Ontario Farmland Trust regarding invitation to the 2020 Farmland Forum [Distributed to Members of County Council January 31, 2020] Letter from the Town of Collingwood Regarding Conservation Authorities [Distributed to Members of County Council January 31, 2020] Letter from the Corporate of the Township of Madoc Regarding Joint and Several Liability Consultation – Town of Amherstburg Support [Distributed to Members of County Council January 31, 2020] Letter from Rainy River District Municipal Association Office of the SecretaryTreasurer Regarding Resolution to Address Fair and Equitable Property Taxation Revenue on Railway Right-of Ways Collected by Municipalities in Ontario [Distributed to Members of County Council January 31, 2020] Letter from the Town of Collingwood Regarding Conservation Authorities [Distributed to Members of County Council January 31, 2020] Email from AMO Association of Municipalities Ontario Regarding the dates and times of regional roundtable discussion regarding the re-composition of OPP Detachment Boards [Distributed to Members of County Council February 7, 2020] Letter from KFL&A Public Health Regarding 2020 Ontario Budget Consultation [Distributed to Members of County Council February 14, 2020] From The County regarding resolution in support of Bill 156 Safety on Family Farms [Distributed to Members of County Council February 14, 2020] From the Municipality of Chatham Kent regarding resolution supporting Bill 156 Trespass and Protecting Food Safety Act [Distributed to Members of County Council February 14, 2020] From the Municipality of Chatham Kent regarding resolution supporting the Role of Conservation Authorities [Distributed to Members of County Council February 14, 2020] From the Township of South Glengarry regarding Resolution In Support of Bill 156 [Distributed to Members of County Council February 14, 2020] From the Township of Wellington North to the Hon. Ernie Hardeman
Regular Meeting of Council Minutes February 19, 2020
Page 20 of 134 Minutes of Meeting held February 19, 2020
Page 11 of 13
AGENDA ITEM #a)
w) x) y) z)
regarding support of Bill 156 [Distributed to Members of County Council February 14, 2020] From the Village of Merrickville-Wolford to Premier Doug Ford regarding resolution on Provincially Significant Wetlands [Distributed to Members of County Council February 14, 2020] Resolution from The County regarding support for Quinte Conservation Authority [Distributed to Members of County Council February 14, 2020] Resolution from The County regarding support for Review of Regulations on Consumer Packaging on Single Use Wipes [Distributed to Members of County Council February 14, 2020] Resolution from the Township of North Frontenac regarding ANSI’s and the County Official Plan Review [Distributed to Members of County Council February 14, 2020] Other Business Public Question Period By-Laws – General By-laws and Confirmatory By-law
a)
First and Second Reading
Motion #: 42-20
Moved By: Seconded By:
Councillor MacDonald Councillor Martin
Resolved That leave be given the mover to introduce by-laws a) through f) that have been circulated to all Members of County Council and that by-laws a) through f) be read a first and second time. Carried b)
Third Reading
Motion #: 43-20
Moved By: Seconded By:
Councillor Revill Councillor Martin
Resolved That by-laws a) through f) be read a third time, signed, sealed and finally passed. Carried
Regular Meeting of Council Minutes February 19, 2020
Page 21 of 134 Minutes of Meeting held February 19, 2020
Page 12 of 13
AGENDA ITEM #a)
By-Laws a)
b)
c) d) e)
f)
To authorize the execution of an Agreement with the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) for the Rural Economic Development Program (RED) Funding – “Open for Business South Frontenac: Streamlining Development Approvals for Rural Economic Growth”. [Proposed By-law No. 2020-0008] To amend By-law No. 2019-0039 (to declare lands Surplus for the purpose of transferring portions of the K&P Trail to the Township of South Frontenac to aid the Township’s development of affordable senior’s housing) [Proposed By-law No. 2020-0009] To authorize the execution of an Amending Agreement with the Local Health Integration Network (LHIN) [Proposed By-law No. 2020-0010] To authorize the execution of an Amending Agreement with the Local Health Integration Network (LHIN) [Proposed By-law No. 2020-0010] To authorize the execution of an Agreement with Province of Ontario should the application to the Rural Economic Development (RED) Program for the purpose of conducting a Downtown Revitalization Program in the Village of Sharbot Lake be successful [Proposed By-law No. 2020-0011] To Confirm all Actions and Proceedings of County Council on February 19, 2020 [Proposed By-law No. 2020-0012] Adjournment
Motion #: 44-20
Moved By: Seconded By:
Councillor Higgs Councillor Doyle
That the meeting hereby adjourn at 10:44 a.m. Carried
Frances Smith, Warden
Regular Meeting of Council Minutes February 19, 2020
Page 22 of 134 Minutes of Meeting held February 19, 2020
Jannette Amini, Clerk
Page 13 of 13
AGENDA ITEM #b)
Minutes of the Special Meeting of Council January 29, 2020 A special meeting of the Council of the County of Frontenac was held in the Kingston Frontenac Rotary Auditorium of the County Administrative Office, 2069 Battersea Road, Glenburnie on Wednesday, January 29, 2020 and was called to order at 5:00 p.m. Present:
Warden Fran Smith, Deputy Warden Ron Vandewal, Councillors Denis Doyle, Ron Higgins, Bill MacDonald, Gerry Martin and Alan Revill
Regrets:
Councillor Bruce Higgs
Also Present:
County: Kelly Pender, Chief Administrative Officer Joe Gallivan, Director of Planning and Economic Development Susan Brant, Director of Corporate Services/Treasurer Kevin Farrell, Manager of Continuous Improvement/GIS Marco Smits, Communications Officer Jannette Amini, Manager of Legislative Services/Clerk
Disclosure of Pecuniary Interest and General Nature Thereof There were none. Eastern Ontario Regional Network Cell Gap Coverage Project Ms. Lisa Serverson, EORN Communications/Stakeholder Relations Officer provided all Member Councils with an overview of the Cell Gap Coverage project, including working assumptions, process and timing. Council recessed at 5:45 p.m. Council reconvened at 6:10 p.m.
Page 23 134 29, 2020 Minutes of Special Meeting heldofJanuary
AGENDA ITEM #b)
Regional Roads Consultant Presentation: Mr. Bruce Peever of KPMG, presented the Frontenac Regional Roads Network Final Report and responded to questions on same. A copy of Mr. Peever’s presentation is attached to the record in the Clerk’s Office. 2020-009 Office of the Chief Administrative Officer Regional Roads Network – Report from KPMG Motion #: 21-20
Moved By: Seconded By:
Councillor Doyle Councillor Vandewal
Be It Resolved that the Office of the Chief Administrative Officer – Regional Roads Network – Report from KPMG report be received; And Further That the report of KPMG be received; And Further That County Council direct staff to engage KPMG Canada to complete a second phase of the Regional Roads Network project at an upset cost of $26,000; And Further That this be expensed from the Municipal Modernization Fund and/or the Stabilization Reserve. Carried 5.
Public Question Period
By-Laws – General By-laws and Confirmatory By-law First and Second Reading
Motion #: 22-20
Moved By: Seconded By:
Councillor MacDonald Councillor Martin
Resolved That leave be given the mover to introduce by-law a) that has been circulated to all Members of County Council and that by-law a) be read a first and second time. Carried
Special Meeting of Council Minutes January 29, 2020
Page 24 134 29, 2020 Minutes of Special Meeting heldofJanuary
Page 2 of 3
AGENDA ITEM #b)
Third Reading Motion #: 23-20
Moved By: Seconded By:
Councillor Doyle Councillor Martin
Resolved That by-law a) be read a third time, signed, sealed and finally passed. Carried By-Laws a)
To Confirm All Actions and Proceeding of County Council at its special meeting on January 29, 2020 [Proposed By-law No. 2020-0007] Adjournment
Motion #: 24-20
Moved By: Seconded By:
Councillor MacDonald Councillor Martin
That the meeting hereby adjourn at 6:37 p.m. Carried
Frances Smith, Warden
Special Meeting of Council Minutes January 29, 2020
Page 25 134 29, 2020 Minutes of Special Meeting heldofJanuary
Jannette Amini, Clerk
Page 3 of 3
Pageof26 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Communal Services in Frontenac County Update
AGENDA ITEM #b)
C ou n t y C o u n c i l Ma r c h 1 8 t h , 2 0 2 0
Pageof27 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof28 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Frontenac – Villages and Hamlets • No municipal water or sewer services. • Historical settlement areas – building lots in village cores too small. • Significant Public Infrastructure Investment • Majority of Commercial Assessment AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof29 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Frontenac – Villages and Hamlets
• “Lack of municipal services in our villages challenges future community viability.”
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof30 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof31 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Communal Services Advantages • Better environmental protection and public health than private on-site services • •
Fewer malfunctions, longer life Regular maintenance – measure performance, monitor impact, fix problems early
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof32 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Communal Services Community Planning Advantages • Smaller lots = better fit into village/hamlet • Strengthen local economy • “walkable communities” AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof33 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof34 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof35 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Council Direction – June 19th, 2019 • Council of the County of Frontenac direct staff to: Present an overview of the recommendations of the communal services study to each of the four Township Councils; Initiate before the end of 2019 an Official Plan Amendment to the County Official Plan to recognize that development on communal services for residential, commercial, and industrial land use can be applied across the entire Frontenac region; AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof36 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Council Direction
Frontenac County Council – March 18th, 2020
AGENDA ITEM #b)
Investigate financial models and utility models that can be used to significantly reduce the municipal financial risk of approving development on communal services and entering into a Municipal Responsibility Agreements (MRA) and report back to Council; and Research funding opportunities from the Provincial and Federal Governments that can be used for new communal services, in particular communal services in existing villages and hamlets.
Pageof37 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof38 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Mission To strengthen and reinforce the benefits and value of onsite and decentralized waste management through education, advocacy for sound policies and practices Vision To be the driving force and leading source of knowledgeable professional expertise for onsite and decentralized wastewater management.
AGENDA ITEM #b)
Pageof39 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
OOWA Annual Conference – March 1st – 3rd, London
AGENDA ITEM #b)
Pageof40 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Financial Implementation Plan RFP • create FINANCIAL MODEL to reduce financial risk to municipalities to support communal service development. •Recommend GOVERNANCE STRUCTURE that looks for collective risk reduction. Options include:
Frontenac County Council – March 18th, 2020
AGENDA ITEM #b)
Municipal Service Corporation (s. 203 Municipal Act) Municipal Services Board (ss. 195-202 Municipal Act) Contract with Existing Utility (e.g., Utilities Kingston) In-house or contract services Combination thereof
Pageof41 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Financial Implementation Plan RFP Expected that the Study will review different models of ownership: • Publically owned and installed (e.g., business parks) • Privately installed where Township / utility eventually assumes ownership • Privately owned and installed systems (e.g., waterfront development) AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof42 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
AGENDA ITEM #b)
Frontenac County Council – March 18th, 2020
Pageof43 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Communal Services Symposium October 2020 Expected Attendees
Frontenac County Council – March 18th, 2020
AGENDA ITEM #b)
• Township Councillors • Municipal Staff • Developers • Installers • Provincial Government • Engineers • Financial Experts
Pageof44 of 134and Economic Development, will pr… Mr. Joe Gallivan, Director Planning
Questions?
AGENDA ITEM #b)
AGENDA ITEM #a)
Report 2020-028 Recommend Report to Council To:
Warden and Council of the County of Frontenac
From:
Kelly J. Pender, Chief Administrative Officer
Prepared By:
Gale Chevalier, Chief of Paramedic Services/Director of Emergency & Transportation Services
Date of Meeting:
March 18, 2020
Re:
Emergency and Transportation Services - 2019 Legislated Response Time Standard Performance Plan - Reporting to the Ministry of Health and Long Term Care (MOHLTC)
Recommendation Resolved That the Council of the County of Frontenac receive the Emergency and Transportation Services - 2019 Legislated Response Time Standard Performance Plan Reporting to Ministry of Health and Long Term Care (MOHLTC) for information, And Further That the 2019 Response Time Standard Performance Plan outcomes for the County of Frontenac be reported to the Director, Emergency Health Regulatory and Accountability Branch, Ministry of Health and Long Term Care as required by legislation. Background At its meeting held September 19, 2018 County Council passed the following resolution: Resolved That the Council of the County of Frontenac accept this Emergency and Transportation Services - 2019 Legislated Response Time Performance Plan report; And Further That Council direct the Clerk to introduce a by-law later in the meeting adopting the response time standards as outlined in this report. Carried
Page 45 of 134 Services 2019 Legislated Response … 2020-028 Emergency and Transportation
AGENDA ITEM #a)
The County of Frontenac set the following criteria under Regulation 257/00, as amended, for its response time targets for 2019: For the calendar year of 2019, from January 1 to December 31, i. Designated Delivery Agent (DDA) - Sudden Cardiac Arrest: 48% of the time, within 6 minutes from the time ambulance dispatch conveys the call information to the paramedic, the County of Frontenac will endeavor to have a person equipped and ready to use an AED at the location of a patient determined to be in sudden cardiac arrest. ii. EMS Designated Delivery Agent - CTAS 1: 70% of the time, within 8 minutes from the time ambulance dispatch conveys the call information to the paramedic, the County of Frontenac will endeavor to have a Paramedic as defined by the Ambulance Act and duly equipped at the location of a patient determined to be CTAS 1. iii. EMS Designated Delivery Agent - CTAS 2, 3, 4, 5: The County of Frontenac will endeavor to have a PARAMEDIC as defined by the Ambulance Act, duly equipped at the location of a patient determined to be CTAS 2, 3, 4, 5 within a period of time determined appropriate by the DDA and noted below in Table 1, or as resources permit (level of effort): Table 1, CTAS 2, 3, 4, 5 EMS Delivery Agent Commitment CTAS
Target time from paramedic received until on scene
% Target
2
10 minutes
75%
3
10 minutes
75%
4
10 minutes
75%
5
10 minutes
75%
Recommend Report to Council Emergency and Transportation Services – 2019 Legislated Response Time Standard Performance Plan - Reporting to MOHLTC March 18, 2020 Page 2 of 3
Page 46 of 134 Services 2019 Legislated Response … 2020-028 Emergency and Transportation
AGENDA ITEM #a)
Comment The County of Frontenac met and exceeded all of the response time targets set under our 2019 Response Time Standard Performance Plan.
Sustainability Implications Good stewardship of the County’s financial resources allows for the most appropriate care of our residents and visitors when in need of paramedic services. Financial Implications None at this time. Organizations, Departments and Individuals Consulted and/or Affected Marc Goudie, Deputy Chief of Performance Standards
Recommend Report to Council Emergency and Transportation Services – 2019 Legislated Response Time Standard Performance Plan - Reporting to MOHLTC March 18, 2020 Page 3 of 3
Page 47 of 134 Services 2019 Legislated Response … 2020-028 Emergency and Transportation
AGENDA ITEM #b)
Report 2020-031 Recommend Report to Council To:
Warden and Members of County Council
From:
Kelly J. Pender, Chief Administrative Officer
Prepared by:
Jannette Amini, Manager of Legislative Services/Clerk
Date of meeting:
March 18, 2020
Re:
Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program
Recommendation Be It Resolved That the Council of the County of Frontenac receive for information the Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program report; And Further That County Council authorize the Warden and Clerk to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program. Background At its regular meeting held November 20, 2019, County Council considered report 2019-145 which sought authorization from Council to complete an Expression of Interest for the Municipal Modernization Program to perform a third party review of the Frontenac County Economic Development program. A service delivery review focused on the existing regional approach to Economic Development in order to make best use of limited resources. The County’s Economic Development department has taken several new responsibilities in recent years including development and management of the Frontenac K&P Trail, tourism and visitor attraction, the Frontenac Brand and the Frontenac Ambassador program.
48Authorization of 134 2020-031 Corporate Page Services to enter into an Agreement wit…
AGENDA ITEM #b)
A third party review will establish benchmarks and key performance indicators as well as create a roadmap to achieving clear service priorities across the region, as well as the roles of the County, the Townships and other partners in achieving those goals. As a result, Council passed the following resolution, being Recommend Reports from the Chief Administrative Officer, clause g): g)
2019-145 Planning and Economic Development Authorization to Complete an Expression of Interest for the Municipal Modernization Program
Motion #: 200-19
Moved By: Seconded By:
Councillor MacDonald Councillor Higgs
Be It Resolved That the Council of the County of Frontenac receive for information the Planning and Economic Development – Authorization to Complete an Expression of Interest for the Municipal Modernization Program; And Further That County Council authorize staff to complete a submission of an expression of interest to the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program. Carried An application was submitted on December 6, 2019 to the Municipal Modernization Fund. Comment The County has received notice from the Ministry of Municipal Affairs and Housing (MMAH) that its application to the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program has been approved. Pending successful execution of an Agreement with MMAH, the initial payment of $33,750 will be made payable to the County of Frontenac no more than thirty (30) days after the execution of the Agreement.
Recommend Report to Council Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program March 18, 2020
49Authorization of 134 2020-031 Corporate Page Services to enter into an Agreement wit…
AGENDA ITEM #b)
A final payment of up to $11,250 will be made payable to the County of Frontenac no more than thirty (30) days after the successful completion of the following:
Interim Progress Report
Draft Independent Third-Party Reviewer’s Report
Publishing of Independent Third-Party Reviewer’s Report on the County of Frontenac’s publicly accessible website
Final Report
Council authorization is required in order for the County to execute an agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program. Strategic Priority Implications Priority 1: Build community vitality and resilience Sub-Priority 1.2 focuses on refining and investing in efforts to accelerate economic development - to grow businesses, attract more visits and expand the tax base. Part of the operational direction for this priority is to continue with current economic development programs including Trail asset programs. Financial Implications Pending the execution of this agreement the County would be eligible to receive up to a maximum of $45,000 for this project. Organizations, Departments and Individuals Consulted and/or Affected Richard Allen, Manager of Economic Development Susan Brant, Director of Corporate Services/Treasurer Alex Lemieux, Deputy Treasurer
Recommend Report to Council Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program March 18, 2020
50Authorization of 134 2020-031 Corporate Page Services to enter into an Agreement wit…
AGENDA ITEM #c)
Report 2020-032 Recommend Report to Council To:
Warden and Members of County Council
From:
Kelly J. Pender, Chief Administrative Officer
Prepared by:
Jannette Amini, Manager of Legislative Services/Clerk
Date of meeting:
March 18, 2020
Re:
Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”).
Recommendation Be It Resolved That the Council of the County of Frontenac receive for information the Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a OneWindow Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”); And Further That County Council authorize the Warden and Clerk to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”).
51Authorization of 134 2020-032 Corporate Page Services to enter into an Agreement wit…
AGENDA ITEM #c)
Background The Eastern Ontario Leadership Committee submitted an application on December 6, 2019 to the Municipal Modernization Fund to review the possible cost savings in creating a OneWindow Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”). Comment The Eastern Ontario Leadership Council (EOLC) will retain an independent third-party review to conduct a joint service delivery and modernization review of a One-Window Permitting System for Freight Movement in Eastern Ontario. The project will investigate the potential for savings in the Municipalities’ staff time, improved compliance, and reduced infrastructure repair and maintenance costs. Specifically, this project would gather data, consults with the Municipalities and carrier stakeholders on the volume and types of permit requests that must be processed manually and quantify the potential for municipal savings. The Eastern Ontario Leadership Council will retain the independent third-party review to compile the findings and recommendations in the Independent Third-Party Review’s Report. The Eastern Ontario Leadership Council will submit a draft of the independent Third-Party Reviewer’s Report to the Province of Ontario by August 31, 2020. The draft will summarize the reviewer’s preliminary findings and recommendations for cost savings and improved efficiencies. The Eastern Ontario Leadership Council will submit the Independent Third-Party Reviewer’s Report to the Province and publish the report on their publicly accessible website by September 18, 2020. The report will summarize the reviewer’s findings and identify specific, actionable recommendations based on the analysis and findings that aim to identify cost savings and improved efficiencies. Freight carriers that move through Ontario, especially those with oversize and over limit loads, must obtain permission to use highways and must also pay requisite fees to each municipality they pass through. As a result, municipal staff must review planned routes in relation to suitability for purpose, potential conflict, and municipal policies. Staff must determine whether the certificate of permission will be issued, notify the carrier of the outcome, and secure payment. Recommend Report to Council Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”) March 18, 2020 Page 2 of 4
52Authorization of 134 2020-032 Corporate Page Services to enter into an Agreement wit…
AGENDA ITEM #c)
Ultimately, this project is key for forming a business case for a one-window service. In addition to municipal benefits, the project would assess the value proposition for freight carriers and the impact of the availability of a one-window system on the use of municipal roads and the ripple effect this could have on the total volume of permits. The analysis will consider whether a one-window permitting system would avoid additional staffing costs by increasing processing efficiency for permit applications. Further, the study would offer preliminary assessment of the potential for a one-window permitting system that could potentially lead to reduced infrastructure damage and save municipalities money by reducing repair and maintenance costs. In addition, the consolidation and digital preservation of applications, certificates and associated trip documentation could be helpful to municipalities in resolving responsibility to any difficulties relating to noncompliant trips. If this analysis demonstrates savings and efficiencies, a small pilot project with two or three adjacent municipalities would be executed to implement a prototype of the one-window permitting system. The pilot project is not included in the review. Council authorization is required in order for the County to execute an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete this project. Strategic Priority Implications Priority 3 Champion and coordinate collaborative efforts with partners to resolve complex problems otherwise beyond the reach of individual mandates and jurisdictions. 3.1 Work with the townships, other municipalities and levels of government on broad infrastructure issues — ranging from environmental concerns to regional transportation strategies for residential, social and economic purposes, and access to funding. 3.3 Continue to pursue collaborative opportunities to achieve service and cost efficiencies and other economies through cost-sharing and shared services. The EOWC, and subsequently, the EOLC are identified in Councils Strategic Plan as current and potential project partners
Recommend Report to Council Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”) March 18, 2020 Page 3 of 4
53Authorization of 134 2020-032 Corporate Page Services to enter into an Agreement wit…
AGENDA ITEM #c)
Financial Implications Pending the execution of this agreement the Eastern Ontario Leadership Committee would be eligible to receive up to a maximum of $23,914.00 for this project. There are no financial implications for the County associated with this report. Organizations, Departments and Individuals Consulted and/or Affected Eastern Ontario Leadership Council Susan Brant, Director of Corporate Services/Treasurer Alex Lemieux, Deputy Treasurer
Recommend Report to Council Corporate Services – Authorization to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”) March 18, 2020 Page 4 of 4
54Authorization of 134 2020-032 Corporate Page Services to enter into an Agreement wit…
AGENDA ITEM #a)
Report 2020-029 Council Information Report To:
Warden and Council Members of the County of Frontenac
From:
Kelly J. Pender, Chief Administrative Officer
Prepared by:
Kathie Shaw, Senior Financial Analyst Susan Brant, Director of Corporate Services/ Treasurer
Date of meeting: Re:
March 18, 2020
Corporate Services – 2019 Remuneration and Reimbursement of Expenses to Council Members and Non-Council Appointees Report
Recommendation This Report is for information purposes only. Background Section 284 (1) of the Municipal Act, 2001 S.O. 2001, Chapter 25, states: The treasurer of a municipality shall in each year on or before March 31 provide to the Council of the municipality an itemized statement on remuneration and expenses paid in the previous year to: (a) each member of Council in respect of his or her services as a member of the Council or any other body, including a local board, to which the member has been appointed by Council or on which the member holds office by virtue of being a member of Council; (b) each member of Council in respect of his or her services as an officer or employee of the municipality or other body described in clause (a); and (c) each person, other than a member of Council, appointed by the municipality to serve as a member of any body, including
552019 of 134 2020-029 Corporate Page Services Remuneration and Reimbursement of Expen…
AGENDA ITEM #a)
a local board, in respect of his or her services as a member of the body. 2001, c. 25, s. 284 (1). Comment By-law No. 2018-0032, and its predecessor By-law No. 2015-0042 outlines the remuneration to be paid to Councillors and Non-Council Appointees of the County as well as attendance at conferences and training opportunities. The following charts provide an itemized statement on remuneration and expenses paid in 2019 to members of Council and persons appointed by Council to serve on Boards and Committees. Council Members Ron Higgins, Warden Frances Smith, Deputy Warden Denis Doyle Bruce Higgs Bill MacDonald Gerry Martin Alan Revill Ron Vandewal
Compensation as Council Member or Appointee
Conference/Training Mileage and Travel and Other Per Diems Related Expenses
Total*
28,899.96
3,748.85
5,251.32
$ 37,900.13
14,280.00
1,811.56
2,783.88
$ 18,875.44
11,900.04 11,900.04 11,900.04 11,900.04 11,900.04 11,900.04
1,485.35 3,285.45 81.00 1,144.87 1,685.11 1,515.42
604.00 3,078.89 1,959.24 3,850.64 4,861.52 914.00
$ $ $ $ $ $
13,989.39 18,264.38 13,940.28 16,895.55 18,446.67 14,329.46
Council Information Report Corporate Services – 2019 Remuneration and Reimbursement of Expenses to Council Members and Non-Council Appointees Report March 18, 2020 Page 2 of 5
562019 of 134 2020-029 Corporate Page Services Remuneration and Reimbursement of Expen…
AGENDA ITEM #a)
Council remuneration includes representation on the following Boards and Committees: Frances Smith
Gerry Martin Ron Higgins
Bruce Higgs Alan Revill Ron Vandewal
Denis Doyle
Bill MacDonald
Planning Advisory Committee Rural Urban Liaison Advisory Committee (RULAC) Housing and Homelessness Advisory Committee Seniors Housing Task Force – Central Frontenac, no meetings CAO Performance Appraisal Review Committee, no meetings Joint Accessibility Advisory Committee Administrative Building Design Task Force Staff Liaison Meetings Rural Urban Liaison Advisory Committee (RULAC) Planning Advisory Committee CAO Performance Appraisal Review Committee, no meetings Seniors Housing Task Force, no meetings Food Policy Council of Kingston, Frontenac, Lennox and Addington Staff Liaison Meetings Kingston Frontenac Public Library Board Staff Liaison Meetings Administrative Building Design Task Force Planning Advisory Committee Rural Urban Liaison Advisory Committee (RULAC) CAO Performance Appraisal Review Committee, no meetings Planning Advisory Committee Community Development Advisory Committee KFL&A Public Health Board Administrative Building Design Task Force CAO Performance Appraisal Review Committee, no meetings Joint Accessibility Advisory Committee Administrative Building Design Task Force Staff Liaison Meetings
Council Information Report Corporate Services – 2019 Remuneration and Reimbursement of Expenses to Council Members and Non-Council Appointees Report March 18, 2020 Page 3 of 5
572019 of 134 2020-029 Corporate Page Services Remuneration and Reimbursement of Expen…
AGENDA ITEM #a)
Person, other than a member of Council, appointed by the County to serve as a member of any body, including a local board: Joint Accessibility Advisory Per Diem Committee
Mileage HST Total included
Neil Allen David Yerxa Margaret Knott Kurt Halliday Ed Schlievert
$ 300.00 225.00 225.00 75.00 225.00
$
Community Development Advisory Committee
Mileage HST included
23.20 186.18 139.20 44.08 323.64
$ 323.20 411.18 364.20 119.08 548.64
$ Barrie Gilbert Betty Hunter
116.00 566.08 No Payment By Request 45.24 295.80 87.00
Mary Kloosterman Lisa Henderson Gregory Rodgers Wilma Kenny Kingston Frontenac Public Library Board John Purdon (2018) Wilma Kenny (2018) Louise Moody Natalie Nossal Planning Advisory Committee Phil Leonard Lisa Henderson Barbara Sproule
Per Diem
Mileage/Parking HST included
$ $ 150.00 162.80 1,800.00 536.80 600.00 617.70 No Payment By Request Per Diem $ 150.00 150.00 150.00
Mileage HST included
Total
$ 312.80 2336.80 1217.70
Total
$ 71.92 30.16 411.80
$ 221.92 180.16 561.80
Council Information Report Corporate Services – 2019 Remuneration and Reimbursement of Expenses to Council Members and Non-Council Appointees Report March 18, 2020 Page 4 of 5
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AGENDA ITEM #a)
Strategic Priorities Implications Good governance and legislative compliance falls under Other Important and Continuing County Priorities, specifically: Respect the taxpayer and keep tax increases close to the rate of inflation Continually improve customer and financial services Financial Implications Amounts paid to County Council and other Board and Committee members were within budget. Organizations, Departments and Individuals Consulted and/or Affected Alex Lemieux, Deputy Treasurer Jannette Amini, Manager of Legislative Services/Clerk Angelique Cardinal, Executive Assistant, Administrative and Financial Services Nancy Elliott, Finance Clerk, Corporate Services
Council Information Report Corporate Services – 2019 Remuneration and Reimbursement of Expenses to Council Members and Non-Council Appointees Report March 18, 2020 Page 5 of 5
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AGENDA ITEM #b)
Report 2020-030 Council Information Report To:
Warden and Council Members of the County of Frontenac
From:
Kelly J. Pender, Chief Administrative Officer
Prepared by:
Barb McCulloch, Manager of Human Resources
Date of meeting:
March 18, 2020
Re:
Corporate Services – Amended Pay Equity Plan
Recommendation This Report is for information purposes only. Background The County is required to maintain pay equity compliance on an annual basis. C.P. Wilms Consulting was retained to independently analyze the non-union compensation practices and ensure Pay Equity was achieved in accordance with the legislative requirements of the Pay Equity Act, R.S.O. 1990. The County had maintained Pay Equity compliance up to the end of 2017. During 2018, the County undertook a non-union compensation study as part of a regular market review to identify the level of compensation competitiveness to other municipalities. Krecklo & Associates Inc. was retained to complete the compensation study for the County and compare to selected Ontario Municipalities.
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AGENDA ITEM #b)
Comment Pay Equity Following the market study, Mr. Clarence Wilms (C.P. Wilms Consulting) was engaged to complete the analysis of the non-union compensation to ensure pay equity compliance. The Amended Pay Equity Plan is attached as Appendix “A”. Strategic Priorities Implications The development of Pay Equity compliant compensation practices for the management/non-union group will ensure that risks are minimized and retroactive costs are avoided. Financial Implications As the County is pay equity compliant up to December 31, 2019, no adjustments are required. Organizations, Departments and Individuals Consulted and/or Affected Susan Brant, Director of Corporate Services/Treasurer Barb McCulloch, Manager of Human Resources Clarence Wilms, C. P. Wilms Consulting
Council Information Report Corporate Services – Amend Pay Equity Plan March 18, 2020
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Page 2 of 2
AGENDA ITEM #b)
AMENDED NON-UNION PAY EQUITY PLAN
County of Frontenac AMENDED Non-Union PAY EQUITY PLAN This amended plan is provided under the Ontario Pay Equity Act, 1990 as amended. Effective: January 1, 2020
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AGENDA ITEM #b)
Table of Contents
- The Employer
- The Establishment
- Job Classes Covered by the Plan
- Male Comparator Job Classes
- Method of Comparison
- Result of Comparisons
- Method of Determining Adjustment and Value of Job Classes
- Pay Equity Adjustments Required
- Differences 10.Implementation 11.Further Information
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AGENDA ITEM #b)
- Employer The County of Frontenac hereafter, “the Employer”.
- Establishment This amended plan applies to all non-union employees of the County of Frontenac.
- Job Classes Covered by this Plan The non-union female job classes are: Female Positions Administrative Assistant (ETS) Administrative Clerk (ETS) Administrator (Fairmount Home) Assistant Director of Resident Care (Fairmount Home) Communications Officer Deputy Treasurer Senior Financial Analyst Director of Resident Care (Fairmount Home) Executive Assistant Executive Assistant (ETS) Executive Assistant (Fairmount Home) Community Development Officer Human Resources Generalist Human Resources Generalist – Attendance Management Specialist Manager of Economic Development Manager of Legislative Services/Clerk Occupational Health Nurse Performance Standards Assistant
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AGENDA ITEM #b)
The male non-union job classes are as follows: Male Positions Deputy Chief - Operations Chief Paramedic/Director Director of Planning and Economic Development Logistics Clerk Manager of Information Services Marine Supervisor Operations Supervisor/Superintendent Supervisor, Performance Standards Manager of Continuous Improvement The gender neutral non-union job class is as follows: Gender Neutral Positions Deputy Chief of Performance Standards Director of Corporate Services/Treasurer Manager of Human Resources Manager of Community Planning 4. Male Comparator Job Classes The male comparator job classes include all of the above non-union male classes. 5. Method of Comparison The method of comparison used was a point factor job evaluation system. The application of this method resulted in a point value being assigned to each job class. The point of intersection of the total point value and the maximum hourly rate for each of the jobs was used to develop a male wage line for the purposes of establishing pay equity target rates for female jobs. Job classes of equal or comparable value were determined by dividing the system into point bands, 50 points wide.
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AGENDA ITEM #b)
The point-factor job evaluation system used is summarized below: Factor
Sub-factor Name
Subfactor Weight
Factor Weight 35.0%
SKILL
- Education
- Experience
- Communication Skills
- Decision Making/Problem Solving
10.0% 10.0% 7.5% 7.5% 37.5%
RESPONSIBILITY 5. Impact of Decisions
7.5%
- Financial Responsibility
- Supervision/Leadership
- Responsibility for the Physical Health and Safety of Clients, Co-workers and the General Public
- Responsibility for the Delivery of Services to the General Public
10.0% 10.0% 5.0% 5.0%
20.0%
EFFORT 10. Multiple Demands and Priorities 11. Mental/Sensory Effort 12a. Physical Effort
7.5% 7.5% 5.0%
WORKING CONDITIONS
7.5% 13. Work Environment/Hazards
100%
TOTAL
5
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7.5%
AGENDA ITEM #b)
- Results of Comparisons The result of the application of the job evaluation system to the female jobs and representative male jobs is shown below. JOB CLASS
TOTAL POINTS
GENDER
Administrative Assistant (ETS) Administrative Clerk Logistics Clerk Executive Assistant Executive Assistant (Fairmount Home) Executive Assistant (ETS) Performance Standards Assistant Human Resources Generalist Human Resources Generalist – Attendance Management Specialist Marine Supervisor Community Development Officer Communications Officer
290 355 385 419
Female Female Male Female
419 419 419 455
Female Female Female Female
455 486 488 494
Business Analyst Senior Financial Analyst
544 535
Female Male Female Female Gender Neutral Female
Manager of Economic Development
600
Female
Occupational Health Nurse Supervisor, Performance Standards Operations Supervisor Assistant Director of Resident Care (Fairmount Home)
606 625 627
Female Male Male
653
Female
Manager of Legislative Services/Clerk
657
Female
Manager of Continuous Improvement Manager of Information Services
660 664
Male Male
Deputy Treasurer
664
Manager of Community Planning
695
Female Gender Neutral
6
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JOB-TO-JOB MALE COMPARATOR OR PROPORTIONAL VALUE Proportional Value Proportional Value Proportional Value Proportional Value Proportional Value Logistics Clerk Marine Supervisor Marine Supervisor Marine Supervisor Marine Supervisor
Proportional Value Supervisor, Performance Standards Supervisor, Performance Standards
Manager of Information Services Manager of Information Services
Operations Supervisor
AGENDA ITEM #b)
Gender Neutral
Human Resources Manager Director of Resident Care (Fairmount Home) Deputy Chief of Performance Standards Deputy Chief - Operations Director of Planning and Economic Development Director of Corporate Services/Treasurer
714
800
Male Gender Neutral
Administrator (Fairmount Home) Chief Paramedic/Director
808 808
Female Male
715 716 716 783
Female Gender Neutral Male
Deputy Chief Operations
Chief Paramedic/Director
- Method of Determining Adjustment and Value of Job Classes Male comparator jobs were identified for the following female job classes: Administrator (Fairmount Home) Director of Resident Care (Fairmount Home) Deputy Treasurer Assistant Director of Resident Care (Fairmount Home) Manager of Legislative Services/Clerk Manager of Economic Development Occupational Health Nurse Communications Officer The proportional value method for achieving pay equity was used for the following female job classes: Senior Financial Analyst Performance Standards Assistant Executive Assistant Executive Assistant, ETS Executive Assistant, FMT Administrative Assistant (ETS) The method of determining adjustment involved placing the female job classes on the male wage line (developed by the input of job rates and job values of the nine representative male job classes) using the method of regression analysis. Any female job class paid below the predicted job rate (rate falling below the intersection point on the male wage line) requires a pay equity adjustment to the predicted job rate. Any female job class that is paid at or above the predicted job rate does not need a pay equity adjustment, since pay equity has already been achieved.
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AGENDA ITEM #b)
- Pay Equity Adjustments Required All of the identified female job classes are pay equity compliant as per the January 1, 2020 calculation with the compensation of each female job class is at least as high as that of its male comparator, or the target rate as determined by the male wage line.
Differences No positions under this amended plan were excluded under section 8 (3) of the Pay Equity Act.
- Implementation The amended pay equity plan will be implemented as of January 1, 2020. The pay equity plan will be reviewed on an annual basis beginning January 1, 2020 to ensure maintenance of this amended pay equity plan through monitoring of changes to job content and compensation.
- Further Information As of the posting date, March 20, 2020, employees have 90 days to raise concerns about the plan to the attention of Kelly Pender. Following this 90-day period, the County of Frontenac has 7 days to re-post a revised plan or post a notice saying there will be no revisions.
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AGENDA ITEM #b)
After this, any employee has 30 days to bring an objection to the Pay Equity Commission. If no objection is received by the Pay Equity Commission by the end of this 90-7-30 day appeal period, this plan is deemed approved and will be implemented. For further information regarding this amended pay equity plan, please contact: Kelly Pender Chief Administrative Officer County of Frontenac 2069 Battersea Road Glenburnie ON K0H 1S0 Phone: 613 548-9400 Ext 300 Email: kpender@frontenaccounty.ca
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AGENDA ITEM #c)
Report 2020-033 Council Information Report To:
Warden and Council
From:
Kelly Pender, Chief Administrative Officer
Prepared by:
Gale Chevalier, Chief of Paramedic Services/Director Emergency and Transportation Services
Date of meeting:
March 18, 2020
Re:
Frontenac Paramedics—Ambulance Service Review Final Report
Recommendation This report is for information purposes only. Background The Ambulance Act requires that all Paramedic Services in the Province Ontario pass a Ministry of Health Service Review every three years in order to confirm the provider meets legislated certification standards. Frontenac Paramedic’s (FP) previous certificate expired September 25, 2019. A Ministry Review was conducted June 4 and 5, 2019 and a draft report issued on September 16, 2019 indicated that FP had met the Ministry standard and a new certificate was issued, valid until September 25, 2022. A follow-up visit was conducted on December 10, 2019 to ensure FP was addressing any issues identified in the Draft Report. On February 18, 2020 FP received the Final Report (attached).
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AGENDA ITEM #c)
Comment The Ambulance Service Review focuses on three main areas
Patient Care
Quality Assurance
Administration
To meet certification standards, a Service Provider must meet two thresholds:
- 90%+ for Patient Care (which represents 70% of the overall inspection)
- 90%+ overall score (Patient care 70%, Quality Assurance 20%, Administration 10%) Inspection Methodologies include:
Interviews
Documentation Review
Ride-outs
Observation and Examination
Frontenac Paramedics received nine Observations and fourteen Commendations. Frontenac Paramedics were commended on:
Preparation for the certification inspection
Quality Assurance/CQI o 97.7% of ACRs reviewed demonstrated patient care was provided in accordance with Patient Care Standards o 100% of FP staff were noted to carry the service-specific ID card o Preventative maintenance programs met manufacturer’s specifications 93.1% of the time o 99.8% of HIR files met requirements o 99.2% of ACR data points captured
Information Report to Council Emergency and Transportation Services - Ambulance Service Review Final Report March 18, 2020
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Page 2 of 4
AGENDA ITEM #c)
Training o 100% of files reviewed demonstrated the components of patient care equipment knowledge and skills are demonstrated and tested.
Vehicles o 99.9% of equipment and supply requirements met o 100% of patient care and accessory equipment was maintained in working order and equipment and vehicles cleaned o 100% of vehicles and equipment observed demonstrated expired devices and material were identified and removed from use o 100% of bases and vehicles observed demonstrated the safe disposal of biomedical sharps o 100% of vehicles inspected met Ontario Provincial Land Ambulance and Emergency Response Vehicle Standards o Preventative Maintenance programs followed 100% of the time
Observations noted were:
75% of ride-out observations demonstrated patient care met Patient Care Standards
Patient care and accessory equipment and supplies were not always secured in vehicles as per the standards
Should straps were not always used on patient while vehicle in motion
Ambulances reviewed captured 99.9% of equipment and supply requirements from the Equipment Standards
Preventative maintenance programs for medical equipment met manufacturer’s specifications 93.1% of the time
Fire extinguishers from four vehicles were missing annual inspection certificates
99.8% of HRI files met requirements
Mandatory fields on ACR not always completed
Service did not always have sufficient staff at each level of qualification to meet deployment plan+
Information Report to Council Emergency and Transportation Services - Ambulance Service Review Final Report March 18, 2020
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Page 3 of 4
AGENDA ITEM #c)
Strategic Priority Implications Other Important and Continuing County Priorities: Continually improve customer and financial services Financial Implications None at this time Organizations, Departments and Individuals Consulted and/or Affected N/A
Information Report to Council Emergency and Transportation Services - Ambulance Service Review Final Report March 18, 2020
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AGENDA ITEM #c)
Ministry of Health
Ambulance Service Review Final Report Frontenac Paramedic Services December 10, 2019
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AGENDA ITEM #c)
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AGENDA ITEM #c)
Ministry of Health
Ministère de la Santé
Emergency Health Regulatory and Accountability Branch
Direction de la réglementation et de la responsabilisation des services de santé d’urgence
590 Rossland Rd. E. Whitby ON L1N 9G5 Tel.: 905-665-8086
590 rue Rossland E. Whitby ON L1N 9G5 Tél.: 905-665-8086
February 18, 2020 Ms. Gale Chevalier Chief of Paramedic Services County of Frontenac 2069 Battersea Road Glenburnie ON K0H 1S0 Dear Ms. Chevalier: Congratulations on successfully meeting the legislated requirements for certification as a land ambulance operator in the Province of Ontario. The Ambulance Service Review Follow Up conducted on December 10, 2019 found that Frontenac Paramedic Services continues ongoing improvement towards ensuring delivery of high-quality ambulance service. Frontenac Paramedic Services is to be commended for its efforts in the following areas: • • • •
Preparation for the certification inspection Quality Assurance/CQI Training Vehicles
The Review found that Frontenac Paramedic Services meets the review certification criteria and the legislated requirements. Accordingly, Frontenac Paramedic Services will be issued a renewed Certificate to operate an ambulance service Frontenac Paramedic Services. Once again, congratulations to you and your team. Sincerely,
Cindy Widawski Manager (A) Inspections and Certifications Cc:
Mr. Kelly Pender, CAO, County of Frontenac Mr. Steven Haddad, Director, EHRAB Mr. Stuart Mooney, Director, EHPMDB Mr. Michael Bay, Senior Manager, EHRAB Mr. Chris Baillie, Field Manager, EHPMDB
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AGENDA ITEM #c)
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Table of Contents Introduction ………………………………………………………………………………………………………………….. 7 Summation ………………………………………………………………………………………………………………….. 11 Patient Care ACR Review – ALS/BLS Standards ………………………………………………………………………… 13 Paramedic Ride-Outs ……………………………………………………………………………………………… 14 Training ……………………………………………………………………………………………………………….. 15 ID Cards……………………………………………………………………………………………………………….. 16 Communicable Disease Management ………………………………………………………………………. 16 Vehicle – Equipment Restraints ………………………………………………………………………………. 17 Communication – Communication Service Direction ………………………………………………… 18 Patient Care Equipment and Supplies ………………………………………………………………………. 19 Medications ………………………………………………………………………………………………………….. 20 Patient Care Devices and Conveyance Equipment Maintenance ………………………………….. 21 Vehicle – Staffing ………………………………………………………………………………………………….. 22 Vehicle – Maintenance/Inspection …………………………………………………………………………… 23 Quality Assurance Quality Assurance/CQI ………………………………………………………………………………………….. 29 Employee Qualifications ………………………………………………………………………………………… 30 ACR – IR Documentation ………………………………………………………………………………………. 31 Administrative Response Time Performance Plan ……………………………………………………………………………. 37 Service Provider Deployment Plan ………………………………………………………………………….. 38 Ambulance Service ID Card Program ………………………………………………………………………. 39 Base Hospital Agreement ……………………………………………………………………………………….. 40 Policy and Procedure ……………………………………………………………………………………………… 40 Insurance………………………………………………………………………………………………………………. 42 Appendices Appendix A – HRI Omissions Table………………………………………………………………………… 44 Appendix B – Ambulance Call Report Omissions Tables …………………………………………… 44 Appendix C – Paramedic Ride-Out Observation Tables ……………………………………………… 46 Appendix D – Vehicle, Equipment & Supplies Omissions Table…………………………………. 47 Appendix E – Patient Care Devices Maintenance Tables ……………………………………………. 47 Appendix F – Conveyance Equipment Maintenance Tables ……………………………………….. 50 Appendix G – Abbreviations …………………………………………………………………………………… 53
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Introduction The Ambulance Act (the Act) stipulates that no person shall operate an ambulance service unless the person holds a certificate issued by the certifying authority. The Act further stipulates that a person shall be issued a certificate by the certifying authority only if the person has successfully completed the certification process; the ministry conducts an Ambulance Service Review prior to the expiration of an existing certificate to confirm that the provider meets legislated certification standards. Legislated standards include:
Advanced Life Support Patient Care Standards Ambulance Service Communicable Disease Standards Basic Life Support Patient Care Standards Land Ambulance Certification Standards Ontario Ambulance Documentation Standards Ontario Provincial Land Ambulance & Emergency Response Vehicle Standards Patient Care & Transportation Standards Provincial Equipment Standards for Ontario Ambulance Services
In Ontario, the Patient Care Standards legislated under the Ambulance Act are designed to ensure that the highest levels of safety are in place for every patient being treated/transported by paramedics and are issued by the Ministry of Health with input from:
Ontario physicians specializing in Emergency Medicine Ontario Association of Paramedic Chiefs Ontario Base Hospital Advisory Group Provincial Medical Advisory Committee
The Ambulance Service Review focuses upon three main areas which are represented in this report:
Patient Care Quality Assurance Administration
Subsections within each area provide the legislative requirements, inspection methodologies, followed by the Review Team observations. Ambulance Service Review Overview Certification Process: Ambulance Service Providers undergo an Ambulance Service Review every three years - the certification of a service is not extendable under the Act. Service Providers due for review will be given advance notice, typically 90 days, before the onsite review occurs. This notification includes the Team Checklist Self-Assessment and Resource Tool which is provided to assist a service in preparing for the on-site review.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
A Service Provider will also be sent a letter to confirm the date and time of the review, typically, 30 days prior to the on-site visit. Services requiring a Supplemental Visit will be given advance notice prior to the date of the Supplemental Visit, typically 30 days. When a service meets certification standards, it is issued a three-year certificate to operate an ambulance service. When an ambulance service operator does not initially meet certification standards, the ministry conducts a Service Review Supplemental Visit to re-evaluate the service’s success in meeting certification standards. The diagram below graphically represents the certification process. Meets certification criteria
Ambulance Service Review
Did not meet certification criteria
Follow Up Inspection
Issue Certificate
Meets certification criteria
Service Review Supplemental Visit Did not meet certification criteria
Once the three year certificate is issued, unannounced inspections are conducted to monitor continued compliance.
With every Service Review, an exit meeting is conducted with the Service Provider. Continued consultation/assistance and a draft report are provided to assist the Service Provider. To meet certification standards, a Service Provider must meet two thresholds:
- 90%+ for Patient Care (which represents 70% of the overall inspection) AND
- 90%+ overall score (Patient Care 70%, Quality Assurance 20%, Administration 10%) Review Team: Each Review Team will be comprised of persons experienced in management, operational and patient care delivery aspects of providing ambulance service. Team members are selected for their experience and are trained by Emergency Health Regulatory and Accountability Branch as quality surveyors. Composition of each Review Team is specific to the size and type of service being reviewed.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Currently the Review Team is comprised of service representation from approximately 70 percent of Ontario Paramedic Services. The on-site team will include one Ministry Team Leader, Service Chiefs, Deputy Chiefs, Commanders, Deputy Commanders, Superintendents, Primary, Advanced and Critical Care Paramedics, all of whom are considered seasoned subject experts in their field, working together to ensure excellence in ambulance services to all Ontarians. Upon completion of the on-site review, a report is provided to the Service Provider in draft. The Service Provider is provided opportunity to respond to the draft report. The response process is an opportunity for the Service Provider to identify potential inaccuracies and provide response in addressing any noted observations. Once the Service Provider’s response has been received, the ministry will coordinate with the Service Provider a suitable time for a Follow Up Inspection. A Follow Up Inspection is conducted to ensure the noted observations have been addressed by the Service Provider. A final report, culminating the initial Review Team observations, response from the Service Provider (to the draft report) and any follow up observations, is then provided to the Service Provider. Upon successful completion of the Review process, a renewed Certificate is issued for a further three years. Inspection Types: In addition to the Ambulance Service Review inspection, three other types of inspections are conducted: Service Review Supplemental Visit Inspection conducted when a service has been found not to meet certification standards during an Ambulance Service Review. Follow Up Inspection Inspection conducted after a service has been found to meet certification standards, to confirm actions planned by a service to address observations of the Ambulance Service Review process, have been completed. Unannounced Inspection Inspection undertaken without prior notice, conducted throughout the three year certificate period. Inspection Methodologies: The Ambulance Service Review Team will utilize a number of activities and processes to evaluate the success of a Service Provider in meeting the requirements of the legislation and standards. The team may utilize some or all of the following methods: •
Interviews: Interviews with the Service Provider and other service staff will be conducted. Also, interviews may be held with receiving hospital emergency unit staff, Base Hospital staff, Ambulance Dispatch staff and staff of the municipality or delivery agent where appropriate.
•
Documentation Review: Files pertinent to the delivery of ambulance service will be reviewed including: staff qualifications, policies & procedures, Incident Reports, Ambulance Call Reports, vehicle and equipment maintenance records, staff training records and other relevant standards related documents. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 9 of 54
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
•
Ride-Outs: In order to provide the broadest possible assessment of the patient care provided by a service, team members will conduct ride-outs with paramedics on every priority call and Canadian Triage Acuity Scale category call opportunity that presents. Observations will be recorded and combined with the documented patient care information provided by the crews as well as any feedback from the receiving hospitals. This information is utilized to evaluate that the provision of patient care is consistent with the patient care standards.
•
Observation and Examination: To accurately determine compliance with the legislation and standards the Review Team will conduct various examinations of service vehicles, equipment, supplies and documents. For example, the team will ensure ambulances and ERVs are constructed and equipped in accordance with the standards.
•
Exit Interview: Upon completion of the Ambulance Service Review site visit, the Team Leader and designated team members will meet with the Service Provider to provide a brief verbal overview of the observations from the Review site visit. This meeting will provide an opportunity for the Service Provider to be informed of any areas that require prompt attention. The meeting will also serve to provide the Service Provider an early indication of their success in meeting the requirements of the Ambulance Service Review.
•
Reports: Following the Ambulance Service Review site visit, the Review Team Leader will prepare and submit a written summary to the ministry. The on-site observations will determine if a Service Provider has met the requirements of the legislation and standards. The written report in draft will then be forwarded to the Service Provider for comment and for the preparation of an action plan to address any observations noted within the report. The draft report forwarded to the Service Provider will indicate that their service has: Satisfied the Requirements: o The Service has met the requirements of the Review. o A report in draft has been provided indicating the Service Provider has been successful in meeting the requirements to be certified as a land ambulance operator in the Province of Ontario. o Response to Draft Report from Service Provider. o Follow Up Inspection completed. o Final Report transmitted. o A renewed 3 year certificate is provided. Not Satisfied the Requirements: o The Service has not met the requirements of the Review. o To assist the Service Provider, the Review Draft Report will include observations on how the service can meet the Review requirements. o Continued collaboration and consultation are available to assist a Service Provider. o Review Team resources are available to assist a Service Provider if required or requested in preparing for the Supplemental Visit. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 10 of 54
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Summation Frontenac Paramedic Services operates from seven stations, excluding headquarters and provides primary and advanced paramedic patient care. The Service responded to approximately 28,164 calls in 2018. At the time of the Ambulance Service Review, the Service had eleven front line ambulances, four mechanical spares, and five command vehicles. The Service provides ambulance service to the residents of Kingston, Glenburnie, Parham, Wolfe Island, Sydenham, and Clarendon, as well as the surrounding areas. Headquarters is located at 2069 Battersea Road, Glenburnie. Frontenac Paramedic Services is dispatched by Kingston CACC and has a Base Hospital relationship with the Regional Paramedic Program for Eastern Ontario. This Service has been in operation since January 1, 2004. The certificate for Frontenac Paramedic Services expires on September 25, 2019. As required to renew their certificate, Frontenac Paramedic Services participated in an Ambulance Service Review by the Ambulance Service Review Team on June 4-5, 2019. The Ambulance Service Review found that Frontenac Paramedic Services has met the requirements of the Land Ambulance Certification Standards. The Review Team for Frontenac Paramedic Services was comprised of: Ministry Reps.: o One Team Leader and o One Fleet Services Officer. Management Reps. from: o The County of Dufferin and o The City of Toronto. Paramedic Reps. from: o The County of Simcoe, o The District of Muskoka, o The City/County of Peterborough, and o The City of Toronto. The Service is to be commended for making staff available during the course of the Review and the Review Team would like to thank Frontenac Paramedic Services staff for their assistance throughout the Review. In view of accommodating the requirements for the administration of an ambulance service, it was recommended that a renewed certificate be issued to Frontenac Paramedic Services for a further three years.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Patient Care Subsections: o ACR Review – ALS/BLS Patient Care Standards, o Paramedic Ride-Outs, o Training, o ID Cards, o Communicable Disease Management, o Vehicle – Equipment Restraints, o Communication – Communication Service Direction, o Patient Care Equipment and Supplies, o Medications, o Patient Care Devices and Conveyance Equipment Maintenance, o Vehicle – Staffing, and o Vehicle – Maintenance/Inspection.
ACR Review – ALS/BLS Standards Legislated Requirement: ACR documentation of patient care delivered by paramedics is one avenue used to confirm that ALS/BLS Patient Care Standards are properly performed and that the appropriate CTAS level was assigned according to patient condition. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards (a) states, as a condition of employment, each employee and volunteer in the applicant/operator’s service, who is required to provide patient care, will provide such patient care in accordance with the standards set out in the Basic Life Support Patient Care Standards and where applicable, the Advanced Life Support Patient Care Standards published by the ministry as those documents may be amended from time to time. Inspection Methodologies: The Review Team obtained and reviewed reports and records, such as Ambulance Call Reports (ACRs), Incident Reports (IRs), conducted eight ride-outs at six stations on every priority call and Canadian Triage Acuity Scale level call opportunity presented and conducted interviews with Frontenac Paramedic Services personnel. Observations: 97.7% of the ACRs reviewed demonstrated patient care was provided in accordance with the ALS/BLS Patient Care Standards. The Service Provider is commended for this review observation. Of the three hundred and six Ambulance Call Reports reviewed by the Review Team, the following seven or 2.3% demonstrate that documentation to confirm adherence to the ALS/BLS Patient Care Standards was not completed (based upon documentation only). (Observation: 1) Call Number 942001727910 942001729809 942001736361 942001743782
Patient Issue 61 y/o male, VSA patient. 59 y/o female, VSA patient. 61 y/o female, VSA patient. 41 y/o female, VSA patient.
Review Observations ETCO2, vital signs not documented. ETT airway, ETCO2 not documented. Supraglottic airway, ETCO2 not documented. Non shockable rhythm; manual defib delivered.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Call Number 942001743675 942001732083 942001741998
Patient Issue 65 y/o male, palpations – SVT. 21 y/o female, transfer. 21 y/o male, MVC - head, blunt trauma.
Review Observations Valsalva maneuver not documented prior to drug treatment. No vital signs documented. No pupil assessment documented.
The Review Team noted the Service Provider’s ACR audit process is designed to monitor paramedic compliance with the ALS/BLS Patient Care Standards. The Service Provider audited each paramedic’s ACRs to determine if patient care provided was appropriate and consistent with ALS/BLS standards. The Service Provider’s QA/CQI of ACRs includes: o o o o
Recommendations to staff for appropriateness and consistency with ALS/BLS standards. Recommendations resulting from an ACR audit are addressed to mitigate reoccurrence. The Service Provider works with Base Hospital to review and investigate calls. Recommendations resulting from Service Provider/Base Hospital review are addressed to mitigate reoccurrence.
Paramedic Ride-Outs Legislated Requirement: The diagnostic modalities employed by paramedics are spelled out in standards of practice or practice guidelines set out in the BLS Patient Care Standards, the ALS Patient Care Standards and Base Hospital Medical Directives. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards (a) states, as a condition of employment, each employee and volunteer in the applicant/operator’s service, who is required to provide patient care, will provide such patient care in accordance with the standards set out in the Basic Life Support Patient Care Standards and where applicable, the Advanced Life Support Patient Care Standards published by the ministry. Inspection Methodologies: The Review Team, consisting of two Primary Care Paramedics and one Critical Care Paramedic, conducted ride-outs for direct observation of the provision of patient care. Ride-outs were conducted with Frontenac Paramedic Services paramedics at six stations during the on-site review. Observations: 75% of ride-out observations demonstrated patient care provided met the ALS/BLS Patient Care Standards (Call #942001775261 - patient with severe lethargy, SOB, dizziness and chest pain; 20 minutes to auscultate chest and obtain a temperature, no 12 lead completed. Call #942001775349 - patient with productive cough and SOB; salbutamol not considered). During the review, paramedic reviewers completed eight ride-outs, as observers. Of the eight calls observed, all were patient carried calls. Of the patient carried calls, two calls were priority 4; and six calls were priority 3. Patient care observed during ride-outs was described as professional, courteous and compassionate. (Observation: 1) A priority 4 call is a threat to life and or limb, priority 3 is an emergency call of serious illness or injury, and should be performed without delay, priority 2 is a routine call that must be completed at a specific time, priority 1 is a routine call that may be delayed without detriment to the patient. Non patient carried calls depict a patient was not transported. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 14 of 54
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Some examples of the ride-out observations are attached as Appendix C on page 45.
Training Legislated Requirement: Training and Continued Medical Education ensure paramedic competencies and abilities in the provision of patient care. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards (k) states, all reasonable measures are taken to ensure that each emergency medical attendant and paramedic employed in the applicant/operator’s land ambulance service maintain competence in the use of the patient care, accessory and communications equipment required for the proper provision of service in accordance with the Basic Life Support and Advanced Life Support Patient Care Standards. Further, the Child in Need of Protection Standard, Training Bulletin Number 116 and the Basic Life Support Patient Care Standards v 3.1, Section 1, General Standard of Care, Child in Need of Protection Standard provides general directives to be followed by paramedics when dealing with suspected child abuse, including the Duty to Report. Paramedics must be informed of, and become familiar with, revisions to this standard, that came into force on June 1, 2015. Inspection Methodologies: The Review Team reviewed reports and records relevant to staff training and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider ensured paramedics have access to: o o o o o o
Current user guides, Training bulletins, Videos and mandatory learning materials, A medium for the review of training materials, Base Hospital training, and Base Hospital Policies and Protocols.
The Service Provider has processes in place to ensure paramedic knowledge and skills are maintained, which includes: o o o o
Annual evaluation demonstrating compliance with the current legislation and standards. Evaluation results communicated to staff. New staff members undergo an evaluation of their patient care skills. A remedial training program for staff who demonstrated deficiencies in the use of patient care equipment. o Training for new, updated and additional equipment. o Training on changes/updates to standards and/or legislation. Documentation demonstrates the Training Bulletin Number 116 - Child in Need of Protection Standard had been provided to all staff.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
All paramedics employed by the Service Provider are included in the QA/CQI Program. From the fifteen paramedic files reviewed by the Review Team, 100% demonstrated the components of patient care equipment knowledge and skills are demonstrated and tested. The Service Provider is commended for this review observation. Documentation demonstrated the Service Provider works with the Base Hospital to: o o o o o
Ensure staff regularly demonstrates proficiency in patient care skills. Provide remedial training to employees whose patient care skills are considered deficient. Ensure identified staff attended and successfully completed remedial training. Ensure staff regularly demonstrates proficiency in performing Controlled Acts. Provide remedial training for employees whose certification has been suspended or revoked. o Ensure identified staff attended and successfully completed remedial training for Controlled Acts. o Ensure Base Hospital certification is on file.
ID Cards Legislated Requirement: Ministry issued ID Cards are required to be carried by the paramedic while on duty during the provision of patient care. Paramedic ID Cards with the Service Specific Number permit a means for the paramedic to log onto the ambulance dispatch environment; provides a recognizable identifier to the general public and law enforcement; and further provides a paramedic required ID for access to secure areas such as correctional facilities and airports. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards (g.1) states, each emergency medical attendant and paramedic employed by the applicant/operator in his or her ambulance service is assigned a unique identification number issued by the Director. (g.2) The unique identification number referenced in clause (g.1) shall appear on a photo identification card that conforms to Schedule 1 of this standard, and the photo identification card shall be on the person of the emergency medical attendant or paramedic while on-duty. Inspection Methodologies: The Review Team observed twenty-nine Frontenac Paramedic Services personnel for compliance respecting ID Cards. Observations: 100% of Frontenac Paramedic Services paramedic staff observed during patient care ride-outs and at stations, were noted to carry the service specific identification card exhibiting the ministry unique identification number on their person while on duty. The Service Provider is commended for this review observation.
Communicable Disease Management Legislated Requirement: The Service Provider, management team and staff, have an obligation to ensure infection control and occupational health and safety measures are in place to prevent transmission of an infectious disease.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
The Patient Care and Transportation Standards, Patient Transport, section 2, subsection (b) states in part, each operator shall ensure that appropriate measure(s) are employed by staff to protect themselves and patients from transmission of communicable disease between employees and patients, and (c) each EMA, paramedic and ambulance student takes appropriate infection control and occupational health and safety measures to prevent transmission of all infectious agents to and from themselves and does not knowingly expose himself or herself or his or her patients to any communicable disease in the course of work, without taking the precautions set out in this standard. Inspection Methodologies: The Review Team conducted ride-outs at six stations for direct observation of the provision of patient care. The Review Team also reviewed reports and records relevant to Service Communicable Disease Management and conducted interviews with Frontenac Paramedic Services personnel. Observations: 100% of service paramedics observed, washed their hands as soon after a call as was practical, in accordance with the Patient Care and Transportation Standards (PCTS) and service policy. Paramedics used an alcohol-based hand cleaner when unable to wash their hands after a call. Paramedics followed all other elements of PCTS and Communicable Disease Management. There was documentation indicating the Service Provider monitors and enforces Communicable Disease Management. There was documentation demonstrating the Service Provider has identified a person who is designated to implement Section B, Communicable Disease Management of the PCTS, for the service.
Vehicle - Equipment Restraints Legislated Requirement: Staff, passengers, patients and equipment must be secured within the vehicle while the vehicle is in motion to ensure that in an unforeseen circumstance, unsecured equipment, supplies and/or persons do not become projectiles. The PCTS, Patient Transport subsection (c) states, each EMA and Paramedic shall ensure that each item of equipment transported in an ambulance or ERV is properly restrained in the ambulance or ERV, (g) each person transported in an ambulance or ERV is properly restrained in the ambulance or ERV. Inspection Methodologies: The Review Team conducted ride-outs for direct observation of patient care and the securing of equipment and supplies. A total of seventeen vehicles were inspected for the securing of equipment and supplies. The Review Team also reviewed reports/records relevant to service vehicles and equipment and conducted interviews with Frontenac Paramedic Services personnel. Observations: Patient care and accessory equipment and supplies were not always secured in the vehicles as per the PCTS (multiple loose items in the front of all vehicles inspected; call #942001775210 – paramedic working on an unsecured computer while vehicle in motion; call #942001775209 – large response bag unrestrained in vehicle 4122). Paramedics and passengers were not always secured while the vehicle was in motion (call #942001775210 – paramedic not wearing seat belt while vehicle in motion and not rendering patient care requiring the paramedic to be out of the seatbelt). (Observation: 2)
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
During transport, patients were not always secured to the stretcher (call #942001775261 – no shoulder straps on patient while vehicle in motion) however the stretcher was secured in the vehicle. (Observation: 3)
Communication - Communication Service Direction Legislated Requirement: To ensure continuity of operations and response by appropriate service resources, the Service Provider and staff must provide the Ambulance Dispatch Centre their deployment plan, care provider levels of training (Primary/Advanced Care), vehicle availability, resource-call contingencies, tier response agreement and follow the direction of the Ambulance Dispatch Centre at all times. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards states in part, no employee of the applicant/operator’s land ambulance service shall refuse or disregard the direction of a Communications Officer in regard to any request for ambulance service. The Communication Service that normally directs the movement of the ambulances and ERVs will be kept informed at all times as to the availability and location of each employee, ambulance or emergency response vehicle. The standard also states in part, that each paramedics employed in the applicant/operator’s land ambulance service maintain competence in the use of the patient care, accessory and communications equipment required for the proper provision of service. The Basic Life Support Patient Care Standards, Patient Transport Standard states in part, the Paramedic shall make a decision regarding the appropriate receiving health care facility and initiate transport of the patient as confirmed or directed by an Ambulance Communications Officer (ACO). If confirmation or direction cannot be obtained by an ACO, the paramedic must transport to the closest or most appropriate hospital capable of providing the medical care required by the patient. Inspection Methodologies: The Review Team conducted ride-outs for direct observation of patient care and radio interaction with their Communication Service. The Review Team also reviewed reports and records relevant to service policy, service equipment (radios), staffing, QA/CQI, and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider and staff accept ambulance calls as assigned by the Communication Service and followed the direction from the Communications Officer, according to the Service Provider’s Deployment Plan. As part of the Service Provider’s deployment strategies to ensure continuity of operations, the Service notified the Communication Service: o Of each ambulance or emergency response vehicle’s availability and location. o Whenever an ambulance or ERV was removed from service. o Whenever an ambulance or ERV was returned to service. There was documentation demonstrating there is clear direction to paramedic staff regarding transport of a patient when directed by the Communication Service, i.e. hospital availability. There was also documentation demonstrating clear direction to paramedic staff regarding transport of a patient when not directed to a destination by the Communication Service. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 18 of 54
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Paramedics ensured patients are transported to a facility as directed by the Communication Service or to the most appropriate facility when not directed by the Communication Service. Staff demonstrated proficiency using communication equipment.
Patient Care Equipment and Supplies Legislated Requirements: The Patient Care Standards have been developed with the assistance and input of Ontario physicians specializing in Emergency Medicine, input from the Ontario Association of Paramedic Chiefs (OAPC), the Ontario Base Hospital Advisory Group and the Provincial Medical Advisory Committee (PMAC). To ensure patient care meets the legislated standards, equipment and supplies utilized by paramedics must meet and be maintained to the standards. The Provincial Equipment Standards for Ontario Ambulance Services specify the minimum quantities of each piece of equipment that are required to be carried on a land ambulance or emergency response vehicle. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards states in part, each vehicle used as an ambulance or ERV in the applicant/operator’s service shall contain as a minimum the accessory and patient care equipment set out in the document titled “Provincial Equipment Standards for Ontario Ambulance Services,” published by the ministry as may be amended from time to time. Further, each land ambulance or ERV used in the applicant/operator’s service and the patient care and accessory equipment contained therein shall be maintained in a safe operating condition, in a clean and sanitary condition, and in proper working order. Inspection Methodologies: The Review Team inspected a total of seven vehicles at six base locations for equipment and supply compliance per the equipment and certification standards. The Review Team also reviewed reports and records relevant to service policy, vehicles, equipment and supplies, and conducted interviews with Frontenac Paramedic Services personnel. Observations: Seven ambulances were inspected, and we noted the following: Ambulances: o From the seven ambulances reviewed by the Review Team, the Service Provider captured 2,811 of 2,812 equipment and supply requirements from the Provincial Equipment Standards for Ontario Ambulance Services, or 99.9%. The Service Provider is commended for this review observation. (Observation: 4) The Service Provider has a policy regarding cleaning and sanitization of equipment and the patient care compartment. There were cleaning supplies accessible to staff to clean the equipment and patient care compartment. The Service Provider monitored and enforced the cleaning and sanitization policy. 100% of the patient care and accessory equipment observed was clean and sanitary. 100% of the patient care and accessory equipment observed was maintained in working order. It was also noted that staff cleaned the patient care and accessory equipment prior to re-use and cleaned the patient care compartment after an ambulance call. The Service Provider is commended for this review observation. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 19 of 54
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
The patient care equipment observed was stored in a manner that is consistent with manufacturer’s direction and according to service policy. Further, 100% of the patient care equipment provided for use met the Provincial Equipment Standards for Ontario Ambulance Services. The Service Provider had a quantity of supplies and equipment on hand to maintain the level of ambulance service to meet continuity of service requirements. There were an adequate number of replacement oxygen cylinders accessible to staff to meet continuity of service requirements. The Service Provider identified patient care and accessory equipment in need of repair, removed it from service and responded to identified deficiencies/concerns. There was documentation demonstrating that patient care equipment repairs had been completed and the Service Provider maintains repair receipts for the life of each piece of equipment. 100% of the vehicles and equipment observed demonstrated that expired devices and patient care materials were identified and removed from use. The Service Provider is commended for this review observation. The Review Team noted while on site, vehicles were stocked as soon as possible after a call and were re-stocked with supplies, according to the equipment standard. Examples of the equipment and/or supply observations are noted in the table attached as Appendix D on page 46.
Medications Legislated Requirements: To ensure patient care provided by paramedics meets the legislated standards, the equipment, supplies and medications utilized must meet and be maintained to the standards. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards states in part, a valid agreement is in effect between the applicant/operator and the designated Base Hospital Program, for each area in which the applicant/operator proposes to provide land ambulance service, for the delegation of Controlled Acts by paramedics employed by the applicant/operator. Further, each vehicle used as an ambulance or ERV in the applicant/operator’s service shall contain as a minimum the accessory and patient care equipment set out in the document titled “Provincial Equipment Standards for Ontario Ambulance Services”. Also, each land ambulance or ERV used in the applicant/operator’s service and the patient care and accessory equipment contained therein shall be maintained in a safe operating condition, in a clean and sanitary condition, and in proper working order. Inspection Methodologies: The Review Team inspected a total of seven vehicles at six base locations for securing/storing of medications, vehicle stocking and supply compliance per the equipment and certification standards. Further, the Review Team conducted ride-outs for direct observation of patient care/medication interventions and securing/storing of medications.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
The Review Team also reviewed reports and records relevant to service policy, vehicles, equipment and supplies, and conducted interviews with Frontenac Paramedic Services personnel. Observations: 100% of the medications observed were stored in a manner consistent with manufacturer’s requirements and secured from unauthorized access. 100% of the controlled medications observed were secured according to service policy. The Service Provider is commended for this review observation. Staff followed the policy respecting the disposal of expired medications. 100% of the bases and vehicles observed demonstrated the Service Provider ensured the safe disposal of biomedical sharps in an appropriate sharp’s container.
Patient Care Devices and Conveyance Equipment Maintenance Legislated Requirements: To ensure patient care provided by paramedics meets the legislated standards, the equipment, supplies and medications utilized must meet and be maintained to the standards. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards states in part, o Each vehicle used as an ambulance or ERV in the applicant/operator’s service shall contain as a minimum the accessory and patient care equipment set out in the document titled “Provincial Equipment Standards for Ontario Ambulance Services”, published by the ministry as may be amended from time to time. o Each land ambulance or ERV used in the applicant/operator’s service and the patient care and accessory equipment contained therein shall be maintained in a safe operating condition, in a clean and sanitary condition, and in proper working order. Inspection Methodologies: The Review Team inspected patient care devices and conveyance equipment preventative maintenance records. The Review Team also reviewed reports and records relevant to service policy, equipment maintenance and conducted interviews with Frontenac Paramedic Services personnel. Observations: All patient care devices requiring regular inspection and/or calibration e.g. oxygen delivery systems, suction equipment, and defibrillator were included within the Service Provider’s Preventative Maintenance program. Service oxygen testing equipment had been calibrated according to the manufacturer’s specifications. Based on data available from Service files, of the one hundred and twenty-two patient care devices inspected, the preventive maintenance program met the manufacturer’s specification 93.1% of the time. The Service Provider is commended for this review observation. (Observation: 5) Some examples of the patient care devices preventative maintenance review are attached as Appendix E on page 46.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
The Service Provider’s Preventative Maintenance program also included all patient carrying equipment. The preventative maintenance schedule was based on a quarterly basis. Of the sixtyeight patient carrying equipment preventative maintenance files reviewed, 88.7% met the manufacturer’s specification. (Observation: 5) Some examples of the patient carrying equipment preventative maintenance review are attached as Appendix F on page 49.
Vehicle - Staffing Legislated Requirements: The Municipality/DDA is obligated to ensure provision of service to meet community needs. Further, the Service Provider must ensure each vehicle designated as a PCP, ACP or CCP response vehicle, must be staffed accordingly to meet their service commitment/deployment plan. Subsection 6 (1) (b) of the Ambulance Act (the Act) states in part that every upper tier municipality (UTM) shall be responsible for ensuring the proper provision of land ambulance service in the municipality in accordance with the needs of persons in the municipality. The Patient Care and Transportation Standards, Patient Care section (A) states in part, each operator and each emergency medical attendant (“EMA”) and paramedic employed or engaged as a volunteer by the operator, shall ensure that: (a) Each emergency response vehicle (“ERV”) responding to a request for service is staffed with at least one person who is qualified as an EMA or paramedic under the regulations. (b) Each ambulance responding to a request for service is staffed with at least one primary care paramedic and one EMA qualified under the regulations. (c) Each ambulance that is designated by an ambulance service operator as an advanced care paramedic ambulance is staffed with at least one advanced care paramedic and one primary care paramedic when responding to a request for service or while transporting a patient. Inspection Methodologies: The Review Team conducted ride-outs for direct observation of patient care provider configurations/service deployment strategies. A total of seven vehicles at six base locations were inspected for compliance per the Patient Care and Transportation Standards. The Review Team also reviewed reports and records relevant to service policy, staffing deployment and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider meets their service commitment/deployment plan to ensure provision of service to meet community needs. The Service Provider has access to spare vehicles to maintain service. Incidents where a replacement vehicle was unavailable are documented. Each ERV responding to a request for service is staffed with at least one person qualified as a PCP under the regulation. Each ambulance responding for a request for service is staffed with at least one PCP and one EMA qualified as per the regulation. Each ambulance designated by the Service as an ACP ambulance is staffed with at least one ACP and one PCP when responding to a request for service or while transporting a patient.
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Vehicle - Maintenance/Inspection Legislated Requirements: The Municipality/DDA is obligated to ensure provision of service meets community needs. To meet community needs, the Service Provider must ensure each vehicle is equipped according to the equipment standards, each vehicle meets the vehicle standards and that equipment, supplies and vehicles are maintained according to manufacturer’s specifications. Subsection III Operational Certification Criteria of the Land Ambulance Certification Standards states in part, only ambulances and emergency response vehicles that comply with the applicable version at time of manufacture of “Ontario Provincial Land Ambulance and Emergency Response Vehicle Standards”, published by the ministry as may be amended from time to time, are or will be used in the applicant/operator’s ambulance service. o Each land ambulance and ERV used in the applicant/operator’s service and the patient care and accessory equipment contained therein shall be maintained in a safe operating condition, in a clean and sanitary condition, and in proper working order. Inspection Methodologies: The Review Team inspected vehicles for compliance to the Ontario Provincial Land Ambulance and Emergency Response Vehicle Standard. Also, vehicle preventative maintenance files and vehicles were reviewed for compliance to the LACS. A total of ten vehicles at five base locations were inspected for compliance to the Ontario Provincial Land Ambulance and Emergency Response Vehicle Standard. In addition, a total of seven vehicles at six base locations were inspected by Review Team paramedics for compliance to the LACS. The Review Team also reviewed reports and records relevant to service policy, vehicle maintenance and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider had a complete certificate package from each ambulance manufacturer/conversion vendor certifying each ambulance used in the provision of service meets the standard. There was documentation on file confirming certification of ERVs (self certification or manufacturer’s certification). There was documentation confirming additions/ modifications completed after the original conversion continue to meet the manufacturer’s specifications and related legislation. Of the ten vehicles inspected, all vehicles met the Ontario Provincial Land Ambulance and Emergency Response Vehicle Standards, or 100%. The Service Provider is commended for this review observation. The Service Provider’s Vehicle Preventative Maintenance program is based on 8,000 kms between services. Each vehicle is included within the Service Provider’s Vehicle PM program. A review of ten vehicle PM files demonstrated the Service Provider’s Vehicle Preventative Maintenance met the Service Provider’s schedule/Original Equipment Manufacturer’s schedule 100% of the time. The Service Provider is commended for this review observation. Maintenance and repair records are maintained by the Service Provider for the life of the vehicle. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 23 of 54
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
The Service Provider provides the Communication Service access to radios and communication equipment upon request. The Service Provider ensured that communication equipment remains operational at all times and works co-operatively with the Communication Service to ensure communication equipment repairs are completed when and as required. Seven ambulance vehicles were inspected by paramedic reviewers. There was documentation indicating the Service Provider used only vehicle identification numbers assigned by the Director, EHRAB. Each vehicle’s identification was displayed on the front and rear of the vehicle as required. The Service Provider has a policy that states staff will use only the designated radio call identifier when using ministry telecommunication devices. During the inspection of vehicles, it was noted: o o o o o o o o o o o o o o o
Each vehicle had a minimum annual safety check as per related legislation. Each vehicle had an up-to-date Ministry of Transport annual sticker affixed. Each vehicle was maintained mechanically and in proper working order. Staff completed a checklist ensuring safety features were functional. Paramedics could comment regarding vehicle deficiencies or safety concerns. Staff checked each vehicle at least once per day or shift. The Service Provider audits checklists for completeness, accuracy and vehicle deficiencies or safety concerns. Safety concerns raised by staff were resolved. Repairs or replacement items were completed in a timely manner. Ambulances, ERVs and ESUs were stored in a protected environment from heat or cold to protect medications. At the time of inspection, safety concerns were noted by the reviewer (vehicles 4181, 4525, 4120, 4132; fire extinguishers missing annual inspections). (Observation: 6) Each vehicle follows the deep clean program. Patient care compartment of vehicles was maintained in a clean and sanitary condition at the time of the review. Supplies were accessible to clean the vehicles. There was required clean storage space available for supplies.
Examples of the vehicle observations are noted in the table attached as Appendix D on page 46. Observation: 1
Service Provider Response This observation reads that “97.7% of the ACRs reviewed demonstrated patient care was provided in accordance with the ALS/BLS Patient Care Standards”. Thank you for this positive review finding. This observation goes on to say “of the three hundred and six Ambulance Call Reports reviewed by the Review Team, the following seven or 2.3% demonstrated that documentation to confirm adherence to the ALS/BLS Patient Care Standards were not completed…” We have reviewed Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 24 of 54
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these calls and have completed an Ambulance Call Evaluation, where one was not previously completed, and have provided feedback to crews. We will continue to emphasize the need for good documentation at CME, during observations, and through normal and ongoing chart audits. This observation reads “75% of ride-out observations demonstrated patient care provided met the ALS/BLS Patient Care Standards”. It goes on to identify two calls where reviewers had concerns. One of which was identified during the exit meeting on June 5, 2019. Call # 942001775261 – Comments made in regards to this call were that “patient with severe lethargy, SOB, dizziness and chest pain; 20 minutes to auscultate chest and obtain a temperature, no 12 lead completed”. I have reviewed the ACR from this call. It does not appear That this patient had any chest pain. Paramedics describe a patient that had previously been assessed by another crew for palpitations; however, at the time of their assessment the patient was only complaining of some mild SOB on exertion and some dizziness when walking. I agree that in best practice a 12-Lead should be obtained; however, I am hesitant to call that a violation of ALS or BLS standards. In regards to the auscultation of the chest and obtaining a temperature 20 minutes into the call, I acknowledge those finding. My only comment; however, is that there may have been competing priorities in patient care that allowed for postponing these assessments. Call # 942001775349 – Comments made in regards to this call were that “patient with productive cough and SOB; salbutamol not considered”. I would like it noted that this was not brought to our attention in the exit presentation. In reviewing the Ambulance Call Report, I note that this patient was an 85 year old female who presented with a 6 day history of a productive cough with yellow phlegm and associated dyspnea that has been increasing in severity over that time. On physical exam it is noted that the patient had good air entry with some upper airway congestion. Vital signs of note include the initial room air SPO2 of 96%. Although it is not specifically noted in the ACR, I would argue that this patient had symptoms consistent with pneumonia and Ventolin is not the appropriate treatment for this particular patient.
Inspector’s Findings Frontenac Paramedic Services strives towards excellence in the provision of Advanced Life Support and Basic Life Support Patient Care Standards and is cognizant of the need for follow up with staff when patient care deficiencies are identified. As part of the Service’s QA Program, the calls found to be deficient during the Service Review were reviewed by the Service. The Service Provider has an audit process in place to ensure that Ambulance Call Reports (ACRs) reflect the patient care provided. The Service Provider continues to monitor and review ACRs for quality of patient care in order to avoid a recurrence of similar future findings. Concerns are addressed with staff via memos, and ALS/BLS Patient Care Standards will be reviewed at this year’s Continuous Medical Education (CME) training session to ensure the changes and education have been introduced to staff. Frontenac Paramedic Services maintains the highest expectations respecting patient care and meeting the ALS/BLS Patient Care Standards. Frontenac Paramedic Services are committed to compliance in this area.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Observation: 2
Service Provider Response We acknowledge your observations in regard to equipment and supplies not always being secured. We have, and will continue to, reminded all staff that equipment and personnel need to be secured while the ambulance is in motion.
Inspector’s Findings Frontenac Paramedic Services documentation demonstrates there is a long standing policy with respect to securing equipment. The Service Provider has sent a memo to all staff via email to remind them to ensure that all equipment is properly secured in the patient compartment and front of all ambulances and ERVs. In addition, the paramedics involved have been personally reminded to secure all equipment. Frontenac Paramedic Services is working towards compliance in this area. Observation: 3
Service Provider Response We acknowledge your observation regarding a patient being transported on a stretcher without the use of shoulder straps. We continue to message this out to staff and address the issue individually when it is observed. We will continue to monitor compliance in this area.
Inspector’s Findings Frontenac Paramedic Services maintains the highest expectations respecting patient, public and provider safety. Documentation demonstrates there is a long standing policy with respect to proper securing of patients. The Service Provider has conducted a coaching session with the paramedics involved and reminded them of the Service’s policy respecting the proper securing of all equipment and passengers transported in an Ambulance or ERV. A Service wide email reminder was also sent out as a reminder to always properly restrain all patients. Frontenac Paramedic Services are working towards compliance in this area. Observation: 4
Service Provider Response The review team was able to audit seven ambulances and captured 2,811 of 2,812 (99.9%) equipment and supply requirements. We thank you for your commendation and we will continue to strive for these high standards.
Inspector’s Findings Frontenac Paramedic Services understands the importance of ensuring that each vehicle is equipped according to the Provincial Equipment Standards for Ontario Ambulance Services.
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Frontenac Paramedic Services replaced the paper ACRs within the vehicle that was missing them post Service Review. Staff were reminded to always ensure that there are paper ACRs accessible in the ambulances. Frontenac Paramedic Services are striving towards compliance in this area. Observation: 5
Service Provider Response The Review Team found that of the 122 patient care devices inspected, the preventative maintenance program met the manufacturer’s specifications 93.1% of the time. The Review Team also found that 88.7% of patient carrying equipment met the manufacturer’s specification for preventative maintenance. In reviewing the findings, we note that the majority of missing maintenance information is on equipment that is routinely moved from vehicle to vehicle. This movement can cause these pieces of equipment to miss normal preventative maintenance cycles when their originally assigned vehicle comes in for maintenance. Our logistics team has been using an electronic asset tracking software that will be able to catch and better monitor the scheduled maintenance cycles of patient care devices and conveyance equipment. This software was not fully in use during the review period; hence, a few gaps still remained. We continue to improve in tracking equipment and maintenance cycles. Processes have been improved and continue to develop. These improvements will ensure better tracking on maintenance requirements for equipment.
Inspector’s Findings Frontenac Paramedic Services understands the importance of ensuring that all patient care devices and equipment are tested and inspected according to the manufacturer’s specifications respecting preventative maintenance. Frontenac Paramedic Services continues to improve the documentation and record keeping system for their patient care, accessory and conveyance equipment. Frontenac Paramedic Services noted that they have introduced an electronic asset planner program for tracking equipment that is coming up for service. With this new electronic system in place, Frontenac Paramedic Services is confident the in-house tracking of equipment and preventative maintenance will ensure future compliance. Frontenac Paramedic Services is committed to compliance in this area. Observation: 6
Service Provider Response The review team found that four ambulances were carrying fire extinguishers that were missing their annual inspections. This work has been contracted to an outside agency. We are working with this agency to improve their process and ability to inspect all fire extinguishers annually. We will continue to monitor and improve this finding.
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Inspector’s Findings Frontenac Paramedic Services understands the importance of ensuring that all safety equipment is tested and inspected according to the manufacturer’s specifications respecting preventative maintenance. Frontenac Paramedic Services contracts an outside agency to complete annual fire extinguisher inspections. As the outside agency is only in for one day to complete the inspections, some ambulances may be out on calls or not at base, therefore missing the inspection. The Service Provider is working on a system to try to alleviate this issue. Frontenac Paramedic Services are working towards compliance in this area.
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Quality Assurance Subsections: o Quality Assurance/CQI, o Employee Qualifications, and o ACR and IR Documentation.
Quality Assurance/CQI Legislated Requirements: A Service Provider’s QA/CQI Program provides a Service Provider continued oversight in their quality of patient care and provision of service delivered to the public. o Subsection 6 (1) (b) of the Ambulance Act (the Act) states in part that every upper tier municipality (UTM) shall be responsible for ensuring the proper provision of land ambulance service in the municipality in accordance with the needs of persons in the municipality. o Subsection 3 (1) of Ontario Regulation 257/00 made under the Act requires that the operator of an ambulance service meets the requirements of the Land Ambulance Certification Standards. o Section III Operational Certification Criteria of the Land Ambulance Certification Standards subsection (r) states in part, incident reports, ambulance call reports and collision reports are made in accordance with “Ontario Ambulance Documentation Standards”, published by the Ministry of Health as may be amended from time to time, respecting each incident, complaint, investigation, and collision relating to the applicant/operator’s service, employees, agents and to each patient served. o The Ontario Ambulance Documentation Standards, Part IV – Patient & Patient Care Documentation Requirements stipulate ACR documental requirements. Inspection Methodologies: The Review Team reviewed reports and records relevant to service policy, QA/CQI initiatives and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider has a Quality Assurance program in place. The Service Provider’s Quality Assurance program included: o o o o o
Ambulance Call Report audits, Service form completion audits, Incident Report audits, In Service CME, and Base Hospital Certification.
The Service Provider responds to recommendations made by quality assurance programs to ensure optimal provision of service.
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As part of the QA/CQI Program, the Service Provider investigates and responds to patient care and service delivery complaints. The Service Provider addresses recommendations resulting from an investigation to mitigate reoccurrence.
Employee Qualifications Legislated Requirements: In Ontario, to work as a Paramedic, an individual must meet the qualification requirements delineated by Ontario Regulation 257/00. There are three levels of paramedic practice in Ontario with each level building on the competencies and skills of the prior level and assuming its scope of practice. Section III Operational Certification Criteria of the Land Ambulance Certification Standards states in part, a personnel record is maintained for each emergency medical attendant and paramedic employed by the applicant/operator. The record shall include evidence of qualification as described in Part III of the regulation. The Ambulance Service Communicable Disease Standards stipulates the immunization requirements for employment in Ontario. The Patient Care and Transportation Standards delineate influenza immunization and reporting requirements. Inspection Methodologies: The Review Team, consisting of one Management Review Team representative, undertook a review of forty-one Primary Care Paramedic and ten Advanced Care Paramedic HRI files. The Review Team also reviewed reports and records relevant to service policy, QA/CQI employment initiatives and conducted interviews with Frontenac Paramedic Services personnel. Observations: Frontenac Paramedic Services maintains a mechanism to help ensure each employee record includes documentation that demonstrates each employee meets the minimum employment standards according to legislation. From the fifty-one HRI files reviewed by the Review Team, the Service Provider captured 1,394 of 1,397 possible qualification requirements, or 99.8%. The Service Provider is commended for this review observation. (Observation: 7) Further, there was documentation demonstrating each type of paramedic is authorized by a medical director to perform the controlled acts set out in O. Reg. 257/00 Part III s.8. Frontenac Paramedic Services employs thirty-four paramedics reported to be Advanced Care Paramedics. Of the ten ACP files reviewed by the Review Team, 100% contained the required MOHLTC ACP certification. The Service Provider is commended for this review observation. Examples of the observations are itemized in detail and attached as Appendix A on page 43. As of December 14, 2018, EMAs and paramedics must: (a) provide a valid certificate signed by a physician or delegate that states that he or she has been vaccinated against influenza, or that such vaccination is medically contraindicated; or
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(b) provide a written statement that he or she has taken the educational review and has not been, and does not intend to be, vaccinated against influenza. From the fifty-one HRI files reviewed by the Review Team, the Service Provider captured 100% Influenza Immunization status requirements no later than directed by EHRAB. Each operator shall, no later than January 19, 2019, report to the local Senior Field Manager of the Emergency Health Program Management & Delivery Branch, the following: a) the total number of active paramedics employed by the operator; b) the number of paramedics that have provided a valid certificate signed by a physician or delegate that states that he or she has been vaccinated against influenza; c) the number of paramedics that have provided a valid certificate signed by a physician or delegate that states that vaccination is medically contraindicated; d) the number of paramedics that signed the written statement that he or she has taken the annual educational review and has not been, and does not intend to be, immunized against influenza. The Service Provider reported to the Field Office the Influenza Immunization status of each employee no later than directed by EHRAB each year.
ACR – IR Documentation Legislative Requirement: ACRs document the patient care delivered by paramedics and are used to confirm that ALS/BLS Patient Care Standards are properly performed. The ACR forms part of the patient record and must be completed according to the Ontario Ambulance Documentation Standards. The Land Ambulance Certification Standards subsection (r) states in part, incident reports, ambulance call reports and collision reports are made in accordance with “Ontario Ambulance Documentation Standards”, published by the Ministry of Health as may be amended from time to time, respecting each incident, complaint, investigation, and collision relating to the applicant/operator’s service, employees, agents and to each patient served. The Ontario Ambulance Documentation Standards, Part IV – Patient & Patient Care Documentation Requirements stipulates ACR documental and distribution requirements. Inspection Methodologies: The Review Team, consisting of one Primary Care Paramedic and one Advanced Care Paramedic undertook a review of three hundred and six ACRs (all priority and CTAS level calls). The Review Team also reviewed reports and records relevant to service policy, QA/CQI initiatives and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider audits ACRs to determine if they are completed as per the Ontario Ambulance Documentation Standards. As a result of their audit, the Service Provider makes recommendations to staff respecting compliance with the OADS. Further, the Service Provider addresses recommendations to mitigate reoccurrence. There was documentation demonstrating staff review the ACR Completion Manual and OADS as part of the Service Provider’s QA/CQI Program. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 31 of 54
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As part of their responsibility, the Service Provider identifies the number of outstanding Ambulance Call Reports. The Service Provider ensured such reports were completed as required under the Documentation Standards. There was documentation demonstrating the Service Provider works with their Base Hospital to audit Ambulance Call Reports. Audits completed by the Base Hospital and the Service Provider are compared for discrepancies. Audit discrepancies are investigated and resolved. During the review, a random sample of ACRs were reviewed. The review of ACRs was not only to determine compliance with patient care standards, as was addressed earlier, but to also determine if documentation meets the Ontario Ambulance Documentation Standards. Two hundred and fifty-six were patient carried calls covering all priority and CTAS level patient transports, fifty were non patient carried calls. From the three hundred and six ACRs reviewed by the Review Team, the Service Provider captured 32,263 of 32,524 possible data points, or 99.2% of the Ambulance Call Report information requirements. The Service Provider is commended for this review observation. (Observation: 8) Patient Carried Calls Mandatory fields were not always completed on patient carried calls according to the Ontario Ambulance Documentation Standards. Forms were legible and easy to read. Examples of the Ambulance Call Report observations are attached as Appendix B on page 43. (Observation: 8) Non Patient Carried/Patient Refusal Calls Mandatory fields were not always completed on non patient carried and patient refusal calls according to the Ontario Ambulance Documentation Standards. Forms were legible and easy to read. Examples of the Ambulance Call Report observations are attached as Appendix B on page 43. (Observation: 8) It was noted that Ambulance Call Reports were distributed according to the Ambulance Act, Regulations and Ontario Ambulance Documentation Standards. It was also noted that completed Ambulance Call Reports were secured from unauthorized access. The Service Provider maintains Ambulance Call Reports on file for a period of not less than five years. As part of their QA/CQI process, the Service Provider audits Ambulance Call Reports to determine if an Incident Report was to have been completed. The Service Provider audits Incident Reports for completeness and accuracy. Documentation demonstrated the Service Provider makes recommendations to staff after auditing Incident Reports regarding completeness and/or accuracy. Recommendations are addressed to mitigate reoccurrence. It was noted that Incident Reports were secured from unauthorized access and are maintained on file for a period of not less than five years. Completed Incident Reports are transmitted to the Field Office according to legislation.
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Observation: 7
Service Provider Response Review finding indicate that Frontenac Paramedics captured 1,394 possible qualification requirements out of 1,397, or 99.8%. There were three documentation issues noted during the review: Employee # 13279 was noted to be missing a current CPR certificate. This was not brought to our attention during the review. I have subsequently reviewed this employee’s file and find there to be no issue with his certificates. The most current CPR certificate was issued on April 23, 2019 and was place in the employee’s file on May 30, 2019. This was time stamped when we uploaded this qualification to our electronic employee records software. I am happy to provide you with all this documentation upon your request for further inspection. Employee # 66797 was noted to be “missing Tetanus/Diphtheria”. This paramedic had his last booster on April 27, 2018 and was properly documented on his immunization record and his employee file was updated as well. During the review, it is my understanding that the Review Team took issue with his immunization record not being signed by a physician. It is our opinion that this is not reasonable for the Ministry of Health to have this as an expectation. Immunizations and subsequent boosters, like Tetanus/Diphtheria, are administered by registered nurses and signed off as such. Patients do not necessarily see a physician for this. It is unreasonable to expect that. I would kindly ask that the Ministry of Health be a leader in insuring that patients see the right practitioners for the right reasons and as such, accept that this paramedic’s employee file and immunizations are up to standard. Employee # 18521 was noted to be “missing Tetanus/Diphtheria”. This employees immunizations are up to date; however, we do acknowledge the Review Teams finding in regards to the documentation of their Table 1 – Part A. In this case their physician had signed and dated form on April 1, 2015; however, the Tetanus/Diphtheria booster was given on July 20, 2015 without a physician resigning the form. We have asked this employee to have their physician resign form as required.
Inspector’s Findings Frontenac Paramedic Services have obtained the proper CPR certification documentation for paramedic 13279 to ensure compliance. Employees 66797 and 18521 have immunization records showing Tetanus/Diphtheria vaccination on file but without a physician signature. Newly hired staff are required to have obtain a physician signature on their immunization records. In addition, the Service Provider is also working to obtain a physician’s signature on the remaining paramedic’s records. Frontenac Paramedic Services are working towards compliance in this area. Observation: 8
Service Provider Response The Review Team found that of the 306 ACRs reviewed 32,263 of 32,524, or 99.2%, of data points were captured on the ACR. Thank you for your commendation on this finding. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 33 of 54
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On patient carried calls, the Review Team found that mandatory fields were not always completed. We acknowledge this finding and have reviewed and completed Ambulance Call Evaluations (ACEs) for all calls listed in “Appendix B ACR Omissions Tables: Patient Carried Calls Code 4 & 3”. Staff were also provided feedback based on those ACEs. We are also undertaking a review of our closed call rules to help with the completion of mandatory fields. Further messaging will also be sent out to staff and documentation standards are reviewed during continuing medical education (CME) days. We will continue to monitor, complete ACEs, and provide feedback and coaching to staff where needed. In regards to the Review Team’s findings that mandatory fields are not always completed on non-patient/patient refusal calls, we acknowledge this finding. We have completed ACEs on all calls listed in table “Non Patient Carried/Patient Refusal Calls” and have provided staff feedback based on those ACEs. We have increased the number of non-patient transport calls that are being audited and are working with our local base hospital on a standardized template for auditing patient refusal calls.
Inspector’s Findings Frontenac Paramedic Services are cognizant of the need for follow up with staff when documentation completion deficiencies are noted. The Service is dedicated to proficiency in the documentation of Ambulance Call Reports, Incident Reports and Collision Reports. The Service Provider utilizes iMedic, an electronic system to track and evaluate eACRs Mandatory fields within the electronic program are also used to ensure that all fields are completed accurately and according to the standards. Any persistent areas of non compliance identified during ongoing eACR audits, will be incorporated into the Service’s continuous medical training sessions. This will remain an ongoing monitoring matter for all management personnel performing quality assurance activities.
Follow Up Ambulance Call Report Review A review of twenty ACRs was conducted during the follow-up inspection with Frontenac Paramedic Services. A random sample of eACRs was reviewed for priority codes and Canadian Triage Acuity Scale (CTAS) levels. The Service is reminded that the Ambulance Call Report shall be completed according to the requirements set out in the Ambulance Call Report Completion Manual, as required by the Basic Life Support Patient Care Standards. Ambulance Call Reports reviewed were completed according to the Ontario Ambulance Documentation Standards, as demonstrated in the tables below:
Patient Carried Calls Not to ALS/BLS Standard Call Number
Patient Issue
Review Findings
No issues.
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Patient Carried Calls Code 3 & 4 Call Number 1835286 1836992 1837002 1836133 1834100 1827688 1786435 1834903 1817570 1821195
No issues. No issues. No issues. No issues. No issues. No issues. No issues. No issues. No issues. No issues.
Documentation Issue
Driver # 15610 18520 13905 23607 15758 17362 18212 13161 39434 22489
1822009 1833475
No issues. No issues.
50746 15725
1835160 1836477
No issues. No issues.
95529 15758
Attendant # 19289 22490 21804 22980 19576 18212 17362 28934 28934 / 13161 15433 /22921 / 23871 19289 15036/ 10311 / 10571 12904 23871
Documentation Issue
Driver # 14321 25075
Attendant # 15036 23607
Documentation Issue
Driver # 23784
Attendant # 18528
Driver # 15725 19576 12930 18534
Attendant # 14321 15758 15756 18605
Patient Carried Calls Code 1 & 2 Call Number 1799254 1778515
No issues. No issues.
Non Patient Carried Calls Call Number 1838733
No issues.
Patient Refusal of Service Section Call Number 1828474 1831968 1834384 1816419
Documentation Issue No issues. No issues. No issues. No issues.
The Service Provider is committed to the proper completion of all eACRs and will continue to audit eACRs to ensure documentation and patient care meets the standards. Frontenac Paramedic Services are committed to compliance in this area.
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Administrative Subsections: o Response Time Performance Plan, o Service Provider Deployment Plan, o Ambulance Service Identification Cards, o Base Hospital Agreement, o Policy and Procedures, and o Insurance.
Response Time Performance Plan Legislated Requirement: A Service Provider is required to establish a Response Time Performance Plan, to monitor, enforce and where necessary, update their plan as required to ensure patients categorized as the most critical, receive response and assistance in the times established within their plan. Part VIII of Ontario Regulation 257/00 made under the Act states in part, that every upper-tier municipality and delivery agent responsible under the Act for ensuring the proper provision of land ambulance services shall establish, for land ambulance service operators selected by the upper-tier municipality or delivery agent in accordance with the Act, a performance plan respecting response times. An upper-tier municipality or delivery agent shall ensure that the plan established under that subsection sets response time targets for responses to notices respecting patients categorized as Canadian Triage Acuity Scale (CTAS) 1, 2, 3, 4 and 5, and that such targets are set for each land ambulance service operator selected by the upper-tier municipality or delivery agent in accordance with the Act. An upper-tier municipality or delivery agent shall ensure that throughout the year the plan established under that subsection is continuously maintained, enforced and evaluated and where necessary, updated whether in whole or in part. An upper-tier municipality or delivery agent shall provide the Director with a copy of the plan established under that subsection no later than October 31st in each year, and a copy of any plan updated, whether in whole or in part, no later than one month after the plan has been updated. An upper-tier municipality or delivery agent shall provide the Director with the percentages for the preceding calendar year, required under Part VIII of Ontario Regulation 257/00, section 23, subsection 7(1), (2), (3), no later than March 31st of each year. Inspection Methodologies: The Review Team reviewed reports and records relevant to Service Response Performance and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider has an established Service Response Time Performance Plan with response time targets for responses to notices respecting patients categorized as Canadian Triage Acuity Scale (CTAS) 1, 2, 3, 4 and 5.
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The Service Provider provides the Director of EHRAB with a copy of the Response Time Performance Plan no later than October 31st of each year. The Service Provider produced a report to demonstrate they meet their Response Time Performance Plan. Documentation demonstrates the Service Provider, throughout the year, continuously maintains, enforces, evaluates and where necessary, updates their Response Time Performance Plan. There was also documentation demonstrating the Service Provider investigates those instances where their Service Response Time Performance Plan had not been met. Further, documentation demonstrates that recommendations resulting from investigations as to why the Response Time Performance Plan had not been met are addressed to mitigate reoccurrence. The Service Provider reviewed and updated their Response Time Performance Plan by October 1st of each year. Updates are provided to the Director no later than one month after the plan was updated. There was also documentation to demonstrate that by March 31st of each year the Service Provider reported to the Director the following for the preceding calendar year: o The percentage of times that a person equipped to provide defibrillation arrived on-scene for sudden cardiac arrest patients, within six minutes. o The percentage of times the ambulance crew arrived on-scene for sudden cardiac arrest or other CTAS 1 patients, within eight minutes. o The percentage of times the ambulance crew arrived on-scene for patients categorized as CTAS 2, 3, 4 and 5, within the response time targets set by the UTM or Service Provider.
Service Provider Deployment Plan Legislated Requirement: A Service Provider’s Deployment Plan and strategies provide the Service Provider oversight to ensure in part, the continuity of operations and provision of service meets community needs. Subsection 6 (1) (b) of the Ambulance Act (the Act) states in part that every upper tier municipality (UTM) shall be responsible for ensuring the proper provision of land ambulance service in the municipality in accordance with the needs of persons in the municipality. Section III Operational Certification Criteria of the Land Ambulance Certification Standards subsection (i.1) states in part, the communication service that normally directs the movement of the ambulances and emergency response vehicles in the applicant/operator’s service, will be kept informed by the employees of the applicant/operator at all times as to the availability and location of each employee, ambulance or emergency response vehicle. Inspection Methodologies: The Review Team reviewed reports and records relevant to service/staffing deployment and conducted interviews with Frontenac Paramedic Services personnel.
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Observations: The Service Provider has provided a copy of their deployment plan to the Field Office. Documentation demonstrates the service did not always have sufficient staff at each level of qualification to meet their deployment plan (2018 reported equivalent of 355 ½ days down-staffed, since then 21 paramedics have been hired). (Observation: 9) To ensure continuity of operations, the Service Provider does notify the Communication Service of any changes to their staffing pattern. The Service Provider notifies the Communication Service before implementing or revising policies or procedures that may affect the dispatching/deployment of ambulances or ERVs.
Ambulance Service ID Card Program Legislated Requirements: A paramedic in Ontario is required to obtain a ministry issued, service specific ID card prior to the provision of patient care. The ID card must be carried on their person at all times while performing patient care duties. The ID card process ensures the paramedic meets qualification requirements and provides the paramedic an ability to log onto the ambulance dispatch environment. The ID card is a provincially accepted ID for access to restricted areas otherwise not available to the general public and must be returned to the ministry upon employment separation. Section III Operational Certification Criteria of the Land Ambulance Certification Standards subsection (g) states in part, each emergency medical attendant and paramedic employed by the applicant/operator in his or her ambulance service is assigned a unique identification number issued by the Director. The unique identification number shall appear on a photo identification card and the photo identification card shall be on the person of the paramedic while on-duty. Section III also states in part, ambulance service identification cards are and remain the property of the Ministry of Health (the ministry). Upon release from employment, the identification card must be surrendered to the employer and returned to the ministry. Ambulance Service Identification Card Program, Operating Protocols and Processes stipulates, the ministry is to be notified of an employee’s release by way of either email or facsimile so that the Human Resources Inventory database may be updated. Inspection Methodologies: The Review Team reviewed reports and records relevant to the service staffing deployment/ID Cards (service and ministry documentation) and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider has provided their baseline employee record information to the ministry. Documentation demonstrates the Service Provider notifies the ministry of each instance of employee hiring and separation. It was noted that newly hired paramedics commence patient care activities only after receipt of their service specific identification number and card. Accordingly, we did not note any occasions when a newly hired paramedic logged onto the communication environment with either a fictitious number or a number assigned to another person.
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The ministry is notified in each instance an identification card is lost. The Service Provider recovered the paramedic’s service specific identification card and returned it to the ministry on each occasion of employment being terminated.
Base Hospital Agreement Legislated Requirement: Each Service Provider must have an Agreement in place with their regional Base Hospital for medical oversight. Each Base Hospital has a framework within which its medical director provides guidance and medical advice, quality assurance, advanced care skills training, certification of paramedics and the delegation of Controlled Acts. Base Hospital Policies and Medical Directives are established specifically to enable delegation to paramedics in accordance with legislated requirements, regulations, standards, College of Physician and Surgeons of Ontario (CPSO) and provincial guidelines. The Base Hospital Program has been providing pre-hospital medical oversight for over thirty years. Section III Operational Certification Criteria of the Land Ambulance Certification Standards subsection (l) states in part, a valid agreement is in effect between the applicant/operator and the designated Base Hospital Program, for each area in which the applicant/operator proposes to provide land ambulance service, for the delegation of Controlled Acts by paramedics employed by the applicant/operator. Inspection Methodologies: The Review Team reviewed reports and records relevant to Service QA/CQI/Base Hospital initiatives and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider has a written performance agreement with the Base Hospital that includes: o o o
Providing medical direction and training to all paramedics. Monitoring quality of patient care given by those paramedics. Delegation of controlled medical acts to paramedics.
Policy and Procedure Legislated Requirement: A Service Provider has in place, policies and procedures which impact directly or indirectly on patient care. Policies and procedures are monitored and enforced to ensure compliance with standards and legislation. o The Ambulance Act (the Act) states in part that every upper tier municipality (UTM) shall be responsible for ensuring the proper provision of land ambulance service in the municipality in accordance with the needs of persons in the municipality. o No person smokes any cigar, cigarette, tobacco or other substance while in an ambulance or emergency response vehicle.
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o No paramedic, while on duty, takes or consumes any liquor within the meaning of the Liquor Control Act, or any drug which could impair his or her ability to function as an paramedic: or reports for duty while under the influence of any liquor within the meaning of the Liquor Control Act, or any drug which impairs his or her ability to function as an paramedic: or responds to a request for ambulance service while apparently under the influence of liquor or drugs or is apparently suffering the effects of liquor or drugs. o The Ambulance Service Communicable Disease Standards states in part, each operator shall ensure that: employees are aware of current communicable disease risks and follow all aspects of the ASCDS. o The Ambulance Act, Part III Discharge of Responsibilities states in part, an upper-tier municipality shall ensure the supply of vehicles, equipment, services, information and any other thing necessary for the proper provision of land ambulance services in the municipality in accordance with this Act and the regulations. o The Act further states the requirements respecting the disclosure of personal health information and personal health information has the same meaning as in the Personal Health Information Protection Act, 2004. o Part VI of Ontario Regulation 257/00 made under the Act states in part, the operator of an ambulance service shall ensure that the remains of a dead person are not transported by ambulance unless, the remains are in a public place and it is in the public interest that the remains be removed; arrangements are made to ensure that an alternative ambulance is readily available for ambulance services during the time that the remains are being transported; and no patient is transported in the ambulance at the same time as the remains are transported. o An ambulance may be used to transport the remains of a dead person for the purpose of tissue transplantation on the order of a physician if a physician at the hospital where the tissue is being delivered acknowledges the order. Inspection Methodologies: The Review Team reviewed reports and records relevant to Service Policies and Procedures, Service QA/CQI initiatives and conducted interviews with Frontenac Paramedic Services personnel. Observations: The Service Provider has a Policy and Procedure document accessible to staff. New and updated Policies and Procedures are communicated to staff. The Service Provider monitors and enforces Policies and Procedures to ensure optimal provision of service. The Service Provider had policies covering the following areas: o o o o
Prohibiting staff from responding to calls under the influence of alcohol or drugs. Prohibiting staff from reporting to work under the influence of alcohol or drugs. Prohibiting staff from consuming alcohol or drugs while at work. Prohibiting any person from smoking any cigar, cigarette, tobacco or other substance while in an ambulance service vehicle. o Regarding transport of a person’s remains as per legislation. o Regarding the disposal of bio-medical materials/waste. o That students are to be free from communicable diseases. Ambulance Service Review – Final Report – Frontenac Paramedic Services December 10, 2019 Page 41 of 54
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o That students are to be immunized. o Requirements for students/observers are monitored and enforced. o Staff will immediately notify the Communication Service in the case of any accident involving an ambulance or ERV. o Outlining the legislative parameters of sharing and disclosure of personal health information. o Governing the protection of personal information of patients. o Directing staff in the release of confidential information to allied agencies. o Directing staff in the release of confidential information to the public. o Regarding cleaning and disinfection of patient care equipment. There was documentation to demonstrate Service Policies relating to drugs, alcohol and tobacco are complied with. There was further documentation to demonstrate Service Policies relating to the release of confidential information are complied with. The Service Provider ensured the continuity of operations.
Insurance Legislative Requirement: To mitigate risk and exposure to paramedics, staff and their management team, Service Providers must have appropriate insurance coverage as outlined in Regulation 257/00. Part VI of Ontario Regulation 257/00 made under the Act states in part, if the operator of a land ambulance service that is an applicable enterprise uses or permits the use of a land ambulance or emergency response vehicle that is not owned by the Province of Ontario, the operator shall obtain and maintain in good standing a contract of automobile insurance under Part VI of the Insurance Act in respect of the vehicle, under which, the operator and every driver are insured and delineates all insurance requirements. Inspection Methodologies: The Review Team reviewed reports and records relevant to Service insurance policy coverage and conducted interviews with Frontenac Paramedic Services personnel. Observations: It was noted the Service Provider’s insurance policy was current and valid. Further, the insurance coverage was at least equal to that outlined in legislation. The insurance policy includes and covers: o o o o
Each ambulance, ERV and ESU, The Service Provider and every driver, An amount equal to at least $5,000,000, in respect of any one incident, Liability for loss of or damage to, resulting from bodily injury to or the death of any passenger carried, getting into or alighting from the ambulance or ERV, o Liability for loss of or damage to, the property of a passenger carried in an ambulance or ERV, and o Liability while the ambulance is used for carrying passengers for compensation or hire.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Observation: 9
Service Provider Response The Review Team found that “the service did not always have sufficient staff at each level of qualification to meet their deployment plan (2018 reported equivalent of 355 ½ days downstaffed, since then 21 paramedics have been hired)”. We acknowledge that Frontenac Paramedics had difficulties meeting staffing requirements during 2018. We started a hiring process in September of 2018 and have subsequently hired 21 paramedics. The characterization of being down-staffed the “equivalent of 355 ½ days in 2018 is not accurate. That depiction implies we were down-staffed almost every day in 2018. We were not. There were a number of days in the summer were down-staffed; however, it was not 355 ½ days. The total number of hours paramedics should have been on the road in 2018 were 163,520. Of the 163,520 hours we were down-staffed 1,975.25 hours. I would ask that you revise observation 9 to better reflect the occurrences of down-staffing.
Inspector’s Findings During the follow-up visit, a review of the Service Provider Deployment Plan was undertaken. The Service is currently looking at ways to enhance their staffing levels to meet the staffing benchmark. Frontenac Paramedic Services’ have undertaken a review of their plan and hired more paramedics in September of 2018, and another hiring process begins in January 2020. The Service Provider hopes this will eliminate down staffed hours in the future. Frontenac Paramedic Services are committed to compliance in this area.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Appendix A HRI Omissions Table Employee # 13279 66797 18521
Documentation Issue • Missing current valid, annual CPR certificate. • Missing Tetanus/Diphtheria. • Missing Tetanus/Diphtheria.
Appendix B ACR Omissions Tables; Patient Carried Calls Code 4 & 3 Call Number 942001721449
• Date of Occurrence.
Documentation Issue
Driver # 50754
Attendant # 22920
942001721577
• Date of Occurrence.
15724
13280
942001732083
• Date of Occurrence.
12172
11608
• Time of Occurrence. • Time of Occurrence. • Time of Occurrence. • Pulse Rate.
• Resp. Rate. • B/P.
• Temp. • SpO2.
• EtCO2. • GCS.
• Pupils.
• Pain Scale.
942001734185 942001723071
• Pupils. • Time of Occurrence.
10311 12930
15725 22893
942001743782
• Pulse Rate.
12429
50754
70084
46863
• Chief Complaint. • Resp. Rate.
• Reading/Code. • SpO2.
• EtCO2. • GCS.
• Pupils.
• Pain Scale.
942001749532
• Date of Birth. • Deceased.
• Physician/BHP Name. • Date.
• Time.
• Warning Systems - to destination.
942001725298
• Date of Occurrence.
24601
18211
942001725317
• Date of Occurrence.
18212
17362
942001748252
• Date of Occurrence.
19288
22963
13161
28934
• Time of Occurrence. • Time of Occurrence. • Time of Occurrence. • Pain Scale.
942001726027
• Date of Occurrence.
• Time of Occurrence.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Call Number 942001726196 942001727231 942001727248
Documentation Issue • Date of Occurrence.
• Time of Occurrence. • Date of Occurrence. • Date of Occurrence.
• Time of Occurrence.
Driver # 18520
Attendant # 15411
22893 62687
22892 12405
• Treatment Prior to Arrival.
942001727910 942001728612
• EtCO2. • Date of Occurrence.
22489 18520
19754 15411
942001729919
• Date of Occurrence.
10631
19986
942001731383
• Date of Occurrence.
14321
20913
942001728891
• Sex.
10571
10311
19289
18522
Driver #
Attendant #
Driver # 24601 19290 18534 15756 11171 19289 19754 18211 18605 10311 12991 95529 62734 19290 14322 15725 15151 18534
Attendant # 18211 15433 15724 12930 50746 18522 22489 13279 24461 10571 12675 20271 63410 15433 15724 66797 63410 23913
• Time of Occurrence. • Time of Occurrence. • Time of Occurrence. • Date of Occurrence.
• Time of Occurrence. • Chief Complaint.
942001729809
• Health Insurance Number. • Version. • EtCO2.
Patient Carried Calls Code 2 & 1 Call Number
Documentation Issue No documented issues.
Non Patient Carried/Patient Refusal Calls Call Number 942001721234 942001723846 942001724500 942001728577 942001728756 942001729975 942001730207 942001730719 942001732650 942001734305 942001734440 942001735089 942001738407 942001738446 942001739794 942001740160 942001741181 942001741840
Documentation Issue • Date of Occurrence. • Date of Occurrence. • Date of Occurrence. • Date of Occurrence. • Non Paramedic Witness Name. • Non Paramedic Witness Name. • Non Paramedic Witness Name. • Non Paramedic Witness Name. • Time of Occurrence. • Date of Occurrence. • Non Paramedic Witness Name. • Date of Occurrence. • Non Paramedic Witness Name. • Date of Occurrence. • Date of Occurrence. • Non Paramedic Witness Name. • Non Paramedic Witness Name. • Non Paramedic Witness Name.
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Appendix C Paramedic Ride-Out Observation Tables Call Observation Summary 942001775209 VEHICLE NO.: CALL NO.: 19754 MEDIC # 2 MEDIC #1 Call Sequence Pre-Call Performed to Standard Communications Performed to Standard Primary Assessment Performed to Standard Patient Management Performed to Standard Patient Refusal Performed to Standard Patient Transport Performed to Standard Transfer of Care Performed to Standard General Duties Performed to Standard Post Call Duties Performed to Standard Call Completed to ALS/BLS Standards
4122 13161
PRIORITY CALL TYPE: Y
OUT: 3 IN: 3 Medical P N NA
Call Observation Summary 942001775305 VEHICLE NO.: CALL NO.: 13161 MEDIC # 2 MEDIC #1 Call Sequence Pre-Call Performed to Standard Communications Performed to Standard Primary Assessment Performed to Standard Patient Management Performed to Standard Patient Refusal Performed to Standard Patient Transport Performed to Standard Transfer of Care Performed to Standard General Duties Performed to Standard Post Call Duties Performed to Standard Call Completed to ALS/BLS Standards
4122 19754
PRIORITY CALL TYPE: Y
OUT: 4 IN: 3 Medical P N NA
Call Observation Summary 942001775349 VEHICLE NO.: CALL NO.: 66797 MEDIC # 2 MEDIC #1 Call Sequence Pre-Call Performed to Standard Communications Performed to Standard Primary Assessment Performed to Standard Patient Management Performed to Standard Patient Refusal Performed to Standard Patient Transport Performed to Standard Transfer of Care Performed to Standard General Duties Performed to Standard Post Call Duties Performed to Standard Call Completed to ALS/BLS Standards
4126 91685
PRIORITY CALL TYPE: Y
OUT: 4 IN: 3 Medical P N NA
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Call Observation Summary 942001775606 VEHICLE NO.: CALL NO.: 66797 MEDIC # 2 MEDIC #1 Call Sequence Pre-Call Performed to Standard Communications Performed to Standard Primary Assessment Performed to Standard Patient Management Performed to Standard Patient Refusal Performed to Standard Patient Transport Performed to Standard Transfer of Care Performed to Standard General Duties Performed to Standard Post Call Duties Performed to Standard Call Completed to ALS/BLS Standards
4126 91685
PRIORITY CALL TYPE: Y
OUT: 4 IN: 3 Medical P N NA
Appendix D Vehicle, Equipment and Supplies Omissions Table Vehicle No.
Review Findings
Vehicle No.
Review Findings
4131
Safe Mechanical Condition • Missing supply of ACRs (paper) in the vehicle.
4181
Safe Mechanical Condition • Missing front fire extinguisher annually.
4120
Safe Mechanical Condition • Missing front fire extinguisher annually. • Missing rear fire extinguisher annually. Safe Mechanical Condition • Missing front fire extinguisher annually.
4525
Safe Mechanical Condition • Missing front fire extinguisher annually. • Missing rear fire extinguisher annually.
4132
Appendix E Patient Care Devices Maintenance Table Device Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection
Patient Care Devices Testing Last Inspection Serial Number Date 47357520 15-04-2019 47359933 11-04-2019 47359939 12-04-2019 47360145 09-04-2019 47360215 09-04-2019 47360408 12-04-2019 47360631 09-04-2019 47362588 09-04-2019 47362777 12-04-2019 47363199 09-04-2019 47363669 11-04-2019 47363837 11-04-2019 47364041 11-04-2019
Previous Inspection Date 20-06-2018 19-06-2018 19-06-2018 19-06-2018 21-06-2018 19-06-2018 19-06-2018 22-06-2018 21-06-2018 21-06-2018 20-06-2018 21-06-2018 21-06-2018
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Previous Inspection Date New New New New New New New New New New New New New
AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Device Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection Defibrillator – Annual Inspection
Device Oxygen Calibration Machine
Device Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator Wall Mount Oxygen Regulator
Patient Care Devices Testing Last Inspection Serial Number Date 47367295 09-04-2019 47367335 12-04-2019 47367340 12-04-2019 47367515 09-04-2019 47367515 09-04-2018 47367625 09-04-2019 47367987 11-04-2019 41423208 09-04-2019 41423133 11-04-2019
Previous Inspection Date 21-06-2018 21-06-2018 21-06-2018 21-06-2019 21-06-2018 21-06-2018 21-06-2018 09-10-2018 09-10-2018
Previous Inspection Date New New New New New New New 27-12-2017 27-12-2017
Patient Care Devices Testing Last Inspection Serial Number Date TC02 07-05-2019
Previous Inspection Date 02-05-2018
Previous Inspection Date 03-08-2017
Patient Care Devices Testing Last Inspection Serial Number Date 552008 06-03-2019 612240 19-03-2019 612241 21-03-2019 612242 19-03-2019 612243 21-03-2019 612244 21-03-2019 620925 19-03-2019 620926 14-03-2019 620927 21-03-2019 644424 11-03-2019 656290 21-03-2019 656294 05-03-2019 656295 21-03-2019 656297 21-03-2019 656298 07-03-2019 660973 21-03-2019 660970 21-03-2019 660970 21-03-2019 656299 21-03-2019 660969 01-03-2019 612255 13-03-2019
Previous Inspection Date 25-09-2018 05-09-2018 05-09-2018 21-09-2018 21-09-2018 05-09-2018 21-09-2018 11-09-2018 05-09-2018 18-09-2018 05-09-2018 21-09-2018 05-09-2018 Missing 14-09-2018 05-09-2018 05-09-2018 05-09-2018 05-09-2018 05-09-2018 Missing
Previous Inspection Date 22-03-2018 02-03-2018 02-03-2018 28-03-2018 02-03-2018 02-03-2018 28-03-2018 28-03-2018 02-03-2018 14-03-2018 02-03-2018 23-03-2018 02-03-2018 23-03-2018 21-03-2018 02-03-2018 02-03-2018 02-03-2018 02-03-2018 02-03-2018 28-03-2018
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Device Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator Portable Oxygen Kit Regulator
Device Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator Main Tank Regulator
Patient Care Devices Testing Last Inspection Serial Number Date 592784 01-03-2019 592786 12-03-2019 606973 13-03-2019 592785 18-03-2019 592786 12-03-2019 612246 06-03-2019 612247 07-03-2019 612248 07-03-2019 612254 01-03-2019 612254 01-03-2019 612255 13-03-2019 621427 Missing 621428 05-03-2019 621431 19-03-2019 626455 12-03-2019 626456 29-03-2019 626457 26-03-2019 626458 Missing 626460 29-03-2019 644365 13-03-2019 644368 20-03-2019 644370 26-03-2019 644371 12-03-2019 656281 21-03-2019 656282 21-03-2019 565286 12-03-2019
Previous Inspection Date Missing 25-09-2018 New 06-09-2018 25-09-2018 25-09-2018 05-09-2018 05-09-2018 12-09-2018 12-09-2018 Missing Missing 05-09-2018 21-09-2018 11-09-2018 27-09-2018 05-09-2018 Missing 26-09-2018 19-09-2018 05-09-2018 27-09-2018 05-03-2018 05-09-2018 07-09-2018 12-09-2018
Previous Inspection Date 21-03-2018 21-03-2018 N/A Missing 21-03-2018 22-03-2018 Missing Missing 22-03-2018 22-03-2018 28-03-2018 22-03-2018 Missing 28-03-2018 06-02-2018 Missing Missing 15-03-2018 28-03-2018 Missing 02-03-2018 Missing Missing Missing 21-03-2018 Missing
Patient Care Devices Testing Last Inspection Serial Number Date 609561 11-03-2019 610934 14-03-2019 620750 19-03-2019 620751 19-03-2019 620751 26-03-2019 638863 19-03-2019 638864 11-03-2019 638865 05-03-2019 638866 26-03-2019 638867 21-03-2019 655216 01-03-2019 655217 19-03-2019 665218 07-03-2019 665219 21-03-2019
Previous Inspection Date 07-09-2018 11-09-2018 05-09-2018 05-09-2018 05-09-2018 21-09-2018 05-09-2018 04-09-2018 05-09-2018 05-09-2018 12-09-2018 05-09-2018 14-09-2018 05-09-2018
Previous Inspection Date 21-03-2018 28-03-2018 Missing Missing 28-03-2018 28-03-2018 06-03-2018 27-03-2018 Missing 06-03-2018 21-03-2018 06-03-2018 21-03-2018 06-03-2018
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AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Device On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit On Board Vehicle Suction Unit
Device Battery Powered Portable Suction Battery Powered Portable Suction Battery Powered Portable Suction Battery Powered Portable Suction Battery Powered Portable Suction Battery Powered Portable Suction Battery Powered Portable Suction
Patient Care Devices Testing Last Inspection Serial Number Date 4120 01-03-2019 4121 01-03-2019 4122 01-03-2019 4123 01-03-2019 4124 01-03-2019 4125 01-03-2019 4126 01-03-2019 4129 01-03-2019 4131 01-03-2019 4132 01-03-2019 4176 01-03-2019 Patient Care Devices Testing Serial Last Inspection Number Date 120716A020 29-03-2019 5 130401A051 01-03-2019 9 150303A172 13-03-2019 150303A019 12-03-2019 9 170301A140 04-03-2019 3 150303A022 12-03-2019 2 170301A152 18-03-2019 3
Previous Inspection Date 11-09-2018 18-09-2018 12-09-2018 25-09-2018 06-09-2018 13-09-2018 14-09-2018 21-09-2018 18-09-2018 07-09-2018 04-09-2018
Previous Inspection Date 20-03-2018 22-03-2018 Missing 22-03-2018 13-03-2018 13-03-2018 21-03-2018 22-03-2018 14-03-2018 07-03-2018 27-03-2018
Previous Inspection Date 11-09-2018 12-09-2018 13-09-2018 04-09-2018 12-09-2018 18-09-2018 21-09-2018
Previous Inspection Date 28-03-2018 22-03-2018 23-03-2018 23-03-2018 08-03-2018 27-03-2018 New
Appendix F Conveyance Equipment Maintenance Summary Table Stretcher Type Power load devices Power load devices Power load devices Power load devices Power load devices Power load devices Power load devices Power load devices Power load devices Power load devices
Stretcher Type Stretchers Stretchers Stretchers
Conveyance Equipment Maintenance Last Inspection Previous Serial Number Date Inspection Date 160739050 11-03-2019 05-12-2018 160739051 18-03-2019 19-12-2018 160739052 12-03-2019 12-12-2018 160739053 13-03-2019 12-12-2018 160739054 01-03-2019 07-12-2018 160739055 18-10-2018 02-01-2019 160739056 13-03-2019 18-12-2018 160739057 28-03-2019 18-12-2018 160739060 06-03-2019 31-12-2018 160739063 28-03-2019 02-01-2019
Previous Inspection Date 17-10-2018 18-10-2018 18-10-2018 18-10-2018 18-10-2018 14-03-2019 18-10-2018 18-10-2018 18-10-2018 18-10-2018
Conveyance Equipment Maintenance Last Inspection Previous Serial Number Date Inspection Date 160641204 02-04-2019 12-12-2018 160641206 20-03-2019 13-11-2018 160641207 28-03-2019 12-12-2018
Previous Inspection Date 18-10-2018 18-10-2018 10-10-2018
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Stretcher Type Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers Stretchers
Stretcher Type Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9 Stretchers – #9
Stretcher Type Stair Chairs – 59T Stair Chairs – 59T Stair Chairs – 59T Stair Chairs – 59T Stair Chairs – 59T Stair Chairs – 59T
Conveyance Equipment Maintenance Last Inspection Previous Serial Number Date Inspection Date 160641209 12-03-2019 31-12-2018 160641210 18-03-2019 19-12-2018 160641211 07-03-2019 18-12-2018 160641213 19-03-2019 12-12-2018 160641221 12-03-2019 12-12-2018 013615 07-03-2019 12-12-2018 013628 29-03-2019 20-12-2018 0141181 26-03-2019 02-01-2019 021055 26-03-2019 26-10-2018 032461 14-03-2019 Missing 078500 20-03-2019 17-10-2018 034275 18-03-2019 19-12-2018 034567 27-03-2019 07-12-2018 036553 20-03-2019 13-11-2018 036186 11-03-2019 31-12-2018
Previous Inspection Date 30-11-2018 18-10-2018 18-10-2018 18-10-2018 18-10-2018 18-10-2018 Missing 19-10-2018 14-09-2018 Missing Missing 17-10-2018 18-10-2018 17-10-2018 18-10-2018
Conveyance Equipment Maintenance Last Inspection Previous Serial Number Date Inspection Date 286510 18-03-2019 Missing FC 1001 20-03-2019 Missing FC 1614 27-03-2019 Missing FC 1704 26-03-2019 Missing FC 1898 05-03-2019 Missing FC 2051 26-03-2019 31-12-2018 FC 2661 06-03-2019 12-12-2018 FC 2696 04-03-2019 Missing FC 2697 11-03-2019 02-01-2019 FC 2797 28-03-2019 Missing I 32344 07-03-2019 Missing K 82487 26-03-2019 31-12-2018 L 19021 14-03-2019 Missing 286510 18-03-2019 Missing FC 1001 20-03-2019 Missing FC 1614 27-03-2019 Missing
Previous Inspection Date Missing Missing Missing Missing Missing 17-10-2018 18-10-2018 Missing 18-10-2018 Missing Missing 17-10-2018 Missing Missing Missing Missing
Conveyance Equipment Maintenance Last Inspection Previous Serial Number Date Inspection Date 06-016353 05-03-2019 01-12-2018 06-016354 01-03-2019 18-12-2018 06-016356 21-03-2019 31-12-2018 06-016916 12-03-2019 11-12-2018 08-069672 11-03-2019 07-12-2018 10N-150881 07-03-2019 18-12-2018
Previous Inspection Date 17-10-2018 Missing 17-10-2018 18-10-2018 18-10-2018 18-10-2018
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Stretcher Type Stair Chairs – 59T Stair Chairs – 59T Stair Chairs – 59T Stair Chairs – 59T Stair Chairs – 59T
Conveyance Equipment Maintenance Last Inspection Previous Serial Number Date Inspection Date 11N-208204 21-03-2019 31-12-2018 11N-208206 18-03-2019 19-12-2018 18N-388478 14-03-2019 01-12-2018 18N-390358 12-03-2019 12-12-2018 18N-388482 13-03-2019 18-12-2018
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Previous Inspection Date 17-10-2018 18-10-2018 01-09-2018 18-10-2018 18-10-2018
AGENDA ITEM #c) Emergency Health Regulatory and Accountability Branch – Ministry of Health
Appendix G Abbreviations Glossary of Abbreviations ACRONYM
MEANING
ACRONYM
ACP
Advanced Care Paramedic
EORR
ACR
Ambulance Call Report
ERV
MEANING Education, Operational Readiness and Regulations Emergency Response Vehicle
ACS
Ambulance Communications Service
ESU
Emergency Support Unit
ACO
Ambulance Communications Officer Advanced Emergency Medical Care Assistant Advanced Life Support Ambulance Service Communicable Disease Standards
HRI
Human Resources Inventory
IC
Inspections and Certifications
IR
AEMCA ALS
CCP
Critical Care Paramedic
OADS
CME
Continuing Medical Education
OBHAG
CO
Communications Officer
OEM
CPR
Cardiopulmonary Resuscitation
OPLA & ERVS
CPSO
College of Physician and Surgeons of Ontario
PCTS
CQI
Continuous Quality Improvement
PMAC
CTAS
Canadian Triage & Acuity Scale
QA
Incident Report Land Ambulance Implementation Steering Committee Land Ambulance Certification Standards Ministry of Health Ontario Association of Paramedic Chiefs Ontario Ambulance Documentation Standards Ontario Base Hospital Advisory Group Original Equipment Manufacturer Ontario Provincial Land Ambulance & Emergency Response Vehicle Standard Patient Care and Transportation Standards Provincial Medical Advisory Committee Quality Assurance
DDA
RTPP
Response Time Performance Plan
P&P
Policy and Procedure
PCP
Primary Care Paramedic
EMA
Direct Delivery Agent District Social Services Administration Board Emergency Health Program Management & Delivery Branch Emergency Health Regulatory and Accountability Branch Emergency Medical Attendant
EMCA
Emergency Medical Care Assistant
UTM
Upper Tier Municipality
EMS
Emergency Medical Service(s)
VIN
Vehicle Identification Number
ASCDS
LAISC
ASR
Ambulance Service Review
LACS
BLS
Basic Life Support Central Ambulance Communications Centre
MOH
CACC
DSSAB EHPMDB EHRAB
OAPC
PESFOAS RFO
Provincial Equipment Standards for Ontario Ambulance Services Regional Field Office EHPMDB
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AGENDA ITEM #c)
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AGENDA ITEM #a)
By-Law Number 2020-0013 of The Corporation of the County of Frontenac being a by-law to amend By-law No. 2018-0032 (Council Remuneration By-law) as it relates to Per Diems for attendance at conferences, training and workshops Whereas Sections 5 of the Municipal Act, 2001, as amended (hereinafter the Act) provides that a municipal power, including a municipality’s capacity, rights, powers and privileges, shall be exercised by its council by by-law, unless the municipality is specifically authorized to do otherwise; and, Whereas under the Municipal Act, 2001, Section 283 a municipality may pay any part of the remuneration and expenses of the members of any local board of the municipality and of the officers and employees of the local board; and, Whereas By-law No. 2018-0032, being a by-law to authorize the payment of remuneration to Members of Council and Non-Council Appointees to Statutory Boards and Committees was passed by Frontenac County Council on December 1, 2018; and, And Whereas the Corporation of County of Frontenac deems it expedient to amend Bylaw No. 2018-0032 as it relates to Per Diems for attendance at conferences, training and workshops; Now Therefore Be It Resolved That the Council for The Corporation of the County of Frontenac hereby enacts as follows: That by-law 2018-0032 be amended to add to Schedule A, section 1 a clause d) that being: d)
A per diem of $250 may be claimed by members of Council against their annual expense account when attending conferences, training and workshops.
That this by-law shall come into force and take effect on the date of final passing. Read a First and Second Time this 18th day of March, 2020. Read a Third Time, Signed, Sealed and Finally Passed this 18th day of March, 2020. The Corporation of the County of Frontenac
Frances Smith, Warden
Jannette Amini, Clerk
129 of 134 Remuneration By-law) as it relate… To amend By-law No.Page 2018-0032 (Council
AGENDA ITEM #b)
By-Law Number 2020-0014 of The Corporation of the County of Frontenac being a by-law to authorize the execution of an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”). Whereas Sections 5 of the Municipal Act, 2001, as amended (hereinafter the Act) provides that a municipal power, including a municipality’s capacity, rights, powers and privileges, shall be exercised by its council by by-law, unless the municipality is specifically authorized to do otherwise; and, Whereas the Eastern Ontario Leadership Committee submitted an application on December 6, 2019 to the Municipal Modernization Fund to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”); which requires each municipality to sign an agreement for the said funding; and, Whereas the County of Frontenac wishes to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a OneWindow Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”); Now Therefore Be It Resolved That the Council of the Corporation of the County of Frontenac enacts as follows: 1.
That the Warden and Clerk are hereby authorized to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”).
That this By-law shall come into force and take effect upon the date of final passing.
Page of 130 of 134 with Her Majesty the Queen in… To authorize the execution an Agreement
AGENDA ITEM #b)
Read a First and Second Time this 18th day of March, 2020. Read a Third Time, Signed, Sealed and Finally Passed this 18th day of March, 2020.
The Corporation of the County of Frontenac
Frances Smith, Warden
Jannette Amini Clerk
By-law 2020-0014 - to authorize the execution of an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to review the possible cost savings in creating a One-Window Permitting System for Freight Movement in the County of Frontenac, the United Counties of Leeds and Grenville, the County of Lanark, the United Counties of Prescott and Russell, United Counties of Stormont, Dundas and Glengarry, the City of Cornwall, and the Town of Smith Falls, (“the Municipalities”) March 18, 2020 Page 2 of 2
Page of 131 of 134 with Her Majesty the Queen in… To authorize the execution an Agreement
AGENDA ITEM #c)
By-Law Number 2020-0015 of The Corporation of the County of Frontenac being a by-law to authorize the execution of an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program Whereas Sections 5 of the Municipal Act, 2001, as amended (hereinafter the Act) provides that a municipal power, including a municipality’s capacity, rights, powers and privileges, shall be exercised by its council by by-law, unless the municipality is specifically authorized to do otherwise; and, Whereas the County of Frontenac wishes to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program; Now Therefore Be It Resolved That the Council of the Corporation of the County of Frontenac enacts as follows: 1.
That the Warden and Clerk are hereby authorized to enter into an Agreement with Her Majesty the Queen in right of Ontario as represented by the Minister of Municipal Affairs and Housing for the Municipal Modernization Program to complete a third party review of the Frontenac County Economic Development program.
That this By-law shall come into force and take effect upon the date of final passing.
Read a First and Second Time this 18th day of March, 2020. Read a Third Time, Signed, Sealed and Finally Passed this 18th day of March, 2020. The Corporation of the County of Frontenac
Frances Smith, Warden
Jannette Amini Clerk
Page of 132 of 134 with Her Majesty the Queen in… To authorize the execution an Agreement
AGENDA ITEM #d)
By-Law No. 2020-0016 of The Corporation of the County OF Frontenac being a by-law to confirm all actions and proceedings of County Council on March 18, 2020
Whereas Section 8 of the Municipal Act, S.O. 2001, c.25 and amendments thereto provides that a municipality has the capacity, rights, powers and privileges of a natural person for the purpose of exercising its authority under the Municipal Act or any other Act; and; Whereas Subsection 2 of Section 11 of the Municipal Act, S.O. 2001, c.25 and amendments thereto provides that a lower-tier municipality and an upper-tier municipality may pass by-laws respecting matters within the spheres of jurisdiction described in the Table to Subsection 2 subject to certain provisions, and; Whereas Section 5 of the Municipal Act, S.O. 2001, c. 25 and amendments thereto provides that a municipal power, including a municipality’s capacity, rights, powers and privileges under Section 8 shall be exercised by its council and by by-law unless the municipality is specifically authorized to do otherwise; and; Whereas the Council of the County of Frontenac deems it expedient to confirm its actions and proceedings; Now Therefore Be It Resolved That the Council of the Corporation of the County of Frontenac hereby enacts as follows:
- That all actions and proceedings of the Council of the County of Frontenac taken at its regular meeting held on March 18, 2020 be confirmed as actions for which the municipality has the capacity, rights, powers and privileges of a natural person.
- That all actions and proceedings of the Council of the County of Frontenac taken at its regular meeting held on March 18, 2020 be confirmed as being matters within the spheres of jurisdiction described in Subsection 2 of Section 11 of the Municipal Act, S.O. 2001, c.25 and amendments thereto.
- That all actions and proceedings of the Council of the Corporation of the County of Frontenac taken at its regular meeting held on March 18, 2020 except those taken by by-law and those required by by-law to be done by resolution are hereby sanctioned, ratified and confirmed as though set out within and forming part of this by-law.
133 of 134of County Council on March 18, 20… To confirm all actionsPage and proceedings
AGENDA ITEM #d)
- That this by-law shall come into force and take effect as of the final passing thereof. Read a First and Second Time this 18th day of March, 2020 Read a Third Time and Finally Passed, Signed and Sealed this 18th day of March, 2020.
The Corporation of the County Of Frontenac
Frances Smith, Warden
Jannette Amini, Clerk
By-Law No. 2020-0016 – To Confirm all Actions and Proceedings of County Council March 18, 2020
134 of 134of County Council on March 18, 20… To confirm all actionsPage and proceedings
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