Ambulance costs could go critical if ER closes in Rainy River

By Heather Latter
Fort Frances Times

Given the shortage of doctors across the district, including in Rainy River where the lone full-time physician, Dr. Dave Singleton, plans to resign in June, 2013, the future of the Rainy River Health Centre’s emergency room remains uncertain.
Should it close, land ambulance costs will increase in an effort to bring all those seeking emergency medical care in the west end of the district to Fort Frances, noted Dan McCormick, manager of Health Services for the Rainy River District Social Services Administration Board.
Speaking to municipal leaders at the Rainy River District Municipal Association’s 21st-annual general meeting recently in La Vallee, McCormick talked about balanced emergency coverage and the plans that are in place for a potential ER closure.
“Balanced emergency coverage is ensuring emergency resources are readily available in a manner to reduce response time and ensure district coverage,” he explained, noting this means having the appropriate number of vehicles and staff levels.
He said meeting ministry standards and the local response time plan means reaching the patient in six-eight minutes.
“With a geographic area of over 15,000 square km, it is very difficult to serve,” McCormick admitted.
It will be even more difficult if the emergency room in Rainy River closes, whether it’s short-term or long-term.
It will affect the balanced emergency coverage, extending time with the patient to 1.5-2.5 hours, and extending the EMS time out of area to three hours minimum, he noted.
“Currently 450 calls out of area are served by Rainy River ambulance station,” said McCormick, adding there are another 200 additional walk-in emergency patients.
“That’s 650 transports, which will take the ambulance out of that area for a minimum of five hours,” he remarked.
“What does that do to our resources?”
He added this will increase the workload at La Verendrye Hospital in Fort Frances, and may result in treatment delays for others or a delay in transfer of care from the ambulance.
McCormick said a potential short-term closure possibly could be covered by existing resources, using a “staging” option or call in.
“‘Staging’ uses existing staff and places the vehicle in a central area to address the call,” he explained, though adding there is a bit more wear and tear on the vehicle and it uses more fuel.
But that is minimal compared to staffing, which has high costs and overtime rates to consider.
Staging, for example, means that if the Rainy River ambulance is called to take a patient to Fort Frances, the vehicle in Emo might be re-stationed in Stratton and the Fort Frances ambulance might be moved to Alberton so they are in a more central location.
Currently there is one ambulance staffed around the clock in Rainy River, Emo, Fort Frances, and Atikokan, with an additional ambulance in Fort Frances staffed Monday-Friday, excluding holidays.
In the case of a long-term closure of the ER in Rainy River, McCormick said staffing of the second ambulance in Fort Frances would be increased to 24/7.
But the approximate cost of a staffing increase would be $640,000, with the municipalities paying 35 percent of that, equalling a $242,000 annual cost, assuming the Ministry of Health provides funds through the Land Ambulance Grant.
McCormick said the ministry may not pay for the first year of implementation, but would lobby that the savings from the Institutions Branch be transferred to ambulance.
They would continue to use a full staging deployment to ensure balanced emergency coverage.
Meanwhile, municipal leaders passed a resolution Saturday supporting the efforts of the Northwestern Ontario Municipal Association (NOMA) to rectify this doctor recruitment and retention problem in Northwestern Ontario.
Rainy River Coun. Gordon Armstrong, who also sits on the NOMA board, noted they want to meet with the minister of health in order to bring the local doctor situation to the forefront.
They are hoping to set up a meeting during the Ontario Good Roads Association (OGRA) meeting in Toronto at the end of February.