Councillor W. Byrne, sitting as Chair of the Committee, indicated that Councillor A. Munter is absent due to illness and has requested this matter be deferred to the next meeting.

DEFERRED

- Medical Officer of Health’s report dated 1 Feb 99

CARRIED

3. RESPONSE TO CSC INQUIRY NO. 1(99):ADVANCED LIFE SUPPORT PARAMEDICS

- Medical Officer of Health/Director, Land Ambulance Health Services
joint report dated 5 Feb 99

Robert Davidson, indicated he is a Paramedic 1 Ambulance Officer, who has worked in Ottawa for 20 years. He spoke in support of the recommendations contained in the staff report with respect to filling the Paramedic 2 positions (Advanced Life Support Paramedic), however he pointed out the recommendations do not address the fact that ambulance service is not yet a regional service. He stressed the great need for Paramedic 2’s in the core, noting there are at least five Paramedic 2’s missing due to long term injury or disability.

Mr. Davidson cautioned that under the new process for the Advanced Life Support course (the one in April which is funded or the following one for which funding is not secured), all the spots could be filled by people outside the core and from outside of the Region (e.g. Prescott). He said Ottawa-Carleton Regional Ambulance Service (OCRAS) has a double complement of employees to fill its positions, full time staff who have the benefit of being able to take the course and unclassified staff who have been lobbying to be involved since the program began. As a result of regional staff involvement and the recommendations contained in the report, unclassified staff (part-timers) at OCRAS now have the opportunity to compete for the next program once the full-timers are fully exhausted. However it is possible that none of the six positions in the next course be from the core area. He noted the full time compliment at OCRAS is for the most part exhausted. In the other large service, Rural Metro Nepean, most of the vehicles are staffed with two Advanced Life Support Paramedics; only one position has not been fully trained.

Mr. Davidson said he realized that, until regionalization of the ambulance service is complete, the need for Paramedic 2’s in the downtown core will not be addressed. However, he expressed the hope that, until that time, the unclassified staff at OCRAS who have proven they are qualified and willing, could fill the open spots if there are no full-time people available.

In reply to a question from Councillor Doucet, Joanne Yelle-Weatherall, Director, Land Ambulance Health Services, indicated it is too late to negotiate specific changes for the upcoming course, given that those described in the report took months to negotiate with the Minister of Health. She explained this is an extremely complex issue, complicated by the fact there are six ambulance service providers in the Region. She said she had originally been advised by the Ministry of Health (MOH) that the issue was subject to negotiations with the Ontario Public Service Employees Union (OPSEU). She has since been informed that OPSEU is flexible on this issue. Ms. Yelle-Weatherall added that, provided the Ministry of Health (MOH) gives the Region control of dispatch and provides adequate funding, the Region can then get on with improving the ambulance service.

Councillor Holmes sought clarification on whether or not the MOH and the base hospital have a policy on geographic dispersal of persons qualifying for the Advanced Life Support Paramedic positions. Ms. Yelle-Weatherall replied that the base hospital is not in agreement with the MOH dispatch "closest to" policy, given that the hospital’s position is strictly "patient care". The MOH’s position is that it has six service providers and an agreement with the Union about numbers, as per a 1991 agreement resulting from the Ontario Pre-Hospital Advanced Life Support (OPALS) study. Regional staff’s position is that the six service provider lines will be invisible in less than a year and it would be in the best interest of the residents of Ottawa-Carleton to get the best qualified candidate, regardless of which service they work for.

Ms. Yelle-Weatherall expressed the view that Mr. Davidson’s point about not having enough paramedics in the core was correct. Regrettably regional staff have little information from the MOH and hence the difficulty of commenting on this issue. She advised a report would be coming forward as a result of a request from OCRAS for additional funds in advance of the year 2000.

In response to a question from Councillor Holmes, Ms. Yelle-Weatherall indicated there are 56 Paramedic 2s in the Region. She added the intent is to have one Advanced Life Support Paramedic per ambulance in the new system. It will, however, take time to train more Paramedic 2s.

In response to further questions from Committee members, Ms. Yelle-Weatherall advised that the Region must continue lobbying the Province for additional funds and for control of dispatch. She pointed out that the current level of service cost 30% to 40% more than the $12.5 million the Province allotted. If the Province does not give the Region dispatch, it is saying to the regional taxpayers that their property taxes will pay for the ambulances, paramedics, supplies and equipment and the Province will control where the ambulances go, and what they do.

Mr. Davidson requested that, if unclassified or part-time staff are to be the subject of future negotiations, they be allowed to provide their input through their Union.

Chair Byrne thanked the Mr. Davidson for his comments and she commended staff for their commitment and hard work on this issue.

RECEIVED

Joanne Yelle-Weatherall, Director, Land Ambulance Health Services, provided an update on the issues of dispatch, other upper tier municipalities in Ontario, public consultation and the "next steps". With respect to dispatch, Ms. Yelle-Weatherall indicated she had not received an answer from the Province. The Ministry of Health (MOH) had agreed to provide the Region with an answer on 31 January 1999, however, when the Medical Officer of Health inquired, he was advised it would be another two weeks. The MOH also missed the 12 February deadline and it is not known when an answer is forthcoming. Ms. Yelle-Weatherall explained this means the Region will be unable to implement a performance-based system on 1 January 2000.

On the issue of the other upper tier municipalities, Ms. Yelle-Weatherall advised the Region of Niagara, Brant County, Northumbeland County and Muskoka are in the process of preparing Request for Proposals (RFP) for a level of effort system. She pointed out that Northumberland County had rescinded on a Motion it passed in the Fall of 1998 not to pay the bill and are proceeding with the RFP. Durham Region is recommending an internal department be set up and Peel Region has plans to call for a RFP for a quasi-performance based system for ambulance service only, without dispatch.

On the matter of public consultation, Ms. Yelle-Weatherall advised she will present a report on response time at the first meeting in April. She emphasized the importance of establishing the level of response time wanted by the Region. She indicated she had met with the Land Ambulance Health Services Consultation Committee (made up of the Community stakeholders) and response times were discussed at length. As well, Ms. Yelle-Weatherall advised she had another meeting with the Fire Chiefs and that the talks were proceeding well. She said much was learned about the Region’s rural communities and the importance of partnership with fire services in these areas.

Speaking to the "next steps", Ms. Yelle-Weatherall advised she was preparing a report to address contingency plans should the Region not get dispatch. She stressed the importance of continuing to lobby to get dispatch and additional funding. As well, Ms. Yelle-Weatherall advised she is preparing a report requesting direction from the Committee and Council on how to proceed next.

Councillor McGoldrick-Larsen asked if staff had considered holding a public forum where the public would receive presentations and provide their input, as opposed to receiving these just from the Coordinating Committee. Ms. Yelle-Weatherall advised this was considered, but with only two staff persons working on land ambulance services, it would be difficult to organize a forum. Councillor McGoldrick-Larsen said she thought a public forum would raise public awareness of the challenge the Region is facing and assist in getting the public on side to lobby the Province for dispatch and additional funding.

Replying to a question from Councillor Kreling, Ms. Yelle-Weatherall indicated that the uncertainty about introducing a performance-based system in January 2000 is directly related to the uncertainty about the Region being given responsibility for the dispatch function. She added that the provider must have control of dispatch to control the quality and the cost from the incoming call to the delivery of service. She added, in response to further questions from Councillor Kreling, that the March 4 report will address whether or not the Region has received an answer on dispatch and will present options for this eventuality.

That the Community Services Committee receive this report for information.

RECEIVED

4. REQUEST FOR CAPITAL FUNDING: EARLY BEGINNINGS

- Social Services Commissioner’s report dated 5 Feb 99

Dick Stewart, Commissioner, Social Services Department and Suzanne Gagnon, Assistant Director, Child Care Division, appeared before the Committee. Mr. Stewart summarized the report, noting that the recommendation before the Committee is in accordance with the current Child Care Capital policy and will sustain the number of child care spaces in the Region’s inventory without creating new spaces.

Councillor Loney asked if staff had been aware that there would be additional costs for moving when the original grant was provided to the centre. Mr. Stewart replied staff in the Child Care Division were not aware of this but he could not say whether other parts of the Corporation were aware of it. He stated it is clear the child care program would have known what the location for the new long term care facility would be otherwise they would not have come forth with a Capital request based on a proposal.

Responding to questions from Councillor McGoldrick-Larsen, Mr. Stewart advised it is normal practice to deal with the contribution to the Capital fund (i.e. this year it is $1.5 million) as part of the budget process. However, requests for specific funds from the Reserve fund typically come forward throughout the year. He said there have not been an overwhelming number of requests in the past and the Department is usually able to advise Council about the priority of the requests.

With respect to the number of requests anticipated in the near future, Mr. Stewart referred to page 14 of the Agenda, "Anticipated Requests For Capital Funding" which discusses briefly activities such as school closures and potential new school construction. The Commissioner went on to say staff have made a recommendation to approve this request for two reasons: the project is ready to go and the child care centre must be moved to facilitate the construction of the new long term care facility (a project already approved). Secondly, the amount requested is $135,000 and while this is not an insignificant amount, it is not a great amount relative to the overall need within Child Care Capital. Mr. Stewart advised staff will bring forward a more detailed report on other capital requests anticipated for 1999., adding staff anticipate a considerable amount of activity in this area over the next two years.

Councillor McGoldrick-Larsen asked about the geographic area this centre draws from. Ms. Gagnon advised she did not have this information readily available, but agreed to provide this to the Councillor. The Councillor pointed out that children often have to travel outside their communities to receive child care services and have to make yet another adjustment when they start attending school. She explained she wanted to get an idea about how this would affect the dollars that are proposed to be spent.

Councillor Davis noted that, since she has been on Council, potential school closures has been an issue. She pointed out that the uncertainty about when schools will close makes it difficult for agencies to do any planning. In the case of this centre, construction of the long term care facility is slated to begin in March, therefore it was known that the centre had to be relocated.

Councillor Beamish stated if the Region is going to have a more proactive program and put funds into the Child Care Capital Reserve Fund, it would be prudent to have a long term and strategic plan regarding how these funds will be spent.

Commissioner Stewart recalled that the Department was given a direction to collaborate with the Child Care Council and le Regroupement des services de garde de langue française d’Ottawa-Carleton, to develop a long term strategic plan for child care, not only from the point of view of Capital investment but also for broader planning purposes. This plan is well underway and a notice has been sent to all members of Council indicating that a firm has been engaged to poll for child care needs among families in the Region. In addition, staff have almost completed a survey of all the child care infrastructure which currently exists in the community. This will assist in ascertaining what activity will be required in the short, intermediate and longer term to maintain the infrastructure.

Commissioner Stewart pointed out all this has been made necessary by the abdication of the Province of its responsibility for capital funding, whether for maintenance or construction purposes. He went on to say that even contributing $1.5 million per year to the Child Care Capital Reserve Fund will make it hard to move forward. At this time last year, the Department did not foresee that school closures would become an issue and would bring about peak demand from the Capital fund for the next two or three years. Mr. Stewart pointed out that, subject to Council approval on the 24^th of February, the Capital Reserve Fund for Child Care will have approximately $2.9 million in uncommitted funds, however his amount will not go very far to meet emerging needs.

Councillor McGoldrick-Larsen asked to be provided with a list (from a statistical perspective) of the number of child care spaces available per capita inside and outside the Greenbelt. Councillor Holmes asked if, in the same report, a history could be provided with respect to the number of years the cities outside the Greenbelt refused have anything to do with child care while cities inside the Greenbelt worked at creating child care spaces.

Committee Chair Byrne pointed out the Centre is only requesting funding for 50% of the total renovation costs; the Region’s policy provides for 50 to 80% assistance. This child care facility is being closed due to circumstances similar to that of a school closure however, in this instance they have another location in which to locate the spaces. She asked what steps the Department would take to relocate facilities in the schools recommended for closure.

Mr. Stewart said that, in discussion with the School Boards, the Department’s first priority has been (if the schools close) whether or not the Region will be able to negotiate space in the receiving school. In large part, the Boards have as yet been unable to answer this question. In the advent of a negative response, staff will look at nearby schools with available space to maintain child care within a school setting. Another possibility is to examine whether there can be trading of resources between Boards or school sites. Mr. Stewart referred to p. 14 of the Agenda, and he explained that the figure quoted, i.e., $7.25 million to replicate the 483 spaces is simply an arithmetic calculation of new construction at $150 per square foot for 490 spaces (without land costs). He assured the Committee the spaces will not be lost: if all other options are exhausted, the Department will look at current school sites or other sites that could be expanded to accommodate the subsidized spaces. The assets of current programs, for example wage subsidies, will need to be maintained in the system. Commissioner Stewart indicated both Ms. Gagnon and Gayle Preston, Director, Child Care Division, have advised that the Division will be involved in this work for the next 12 to 18 months, and that a full-time person and resources will need to be dedicated to this project.

The Acting Chair, W. Byrne, pointed out the request meets the Region’s criteria and she urged the Committee to support the recommendation.

That Community Services Committee recommend Council approve a capital grant to Early Beginnings Multicultural Child Development Centre comprising 50% of the total renovation costs up to $135,000.

CARRIED

Moved by D. Holmes

REGIONAL HOUSING AUTHORITY PRIORITY PLACEMENT

POTENTIAL FOR THE REGION TO PURCHASE SCHOOL PROPERTIES

Councillor A. Loney said he has asked the Social Services Commissioner and the Legal Department to look into whether or not the Region or an area municipality can purchase schools that are closed for a nominal fee of $1 or whether the facilities would have to be purchased for full market value. He has also requested that a copy of the response be circulated to all Committee members.

The Councillor clarified he was not suggesting the Region purchase every school proposed for closure, however the Department will need to assist the child care agencies that will be displaced and knowing the parameters on the possibility of purchase would be important. Councillor Loney cited the example of a group of artists who are currently renting a school and paying approximately $45,000 in rent plus the costs of maintaining the premises. He suggested that, should the Region end up buying a school for child care purposes, other spaces within the building could be rented to groups similar to the once cited.