EMS In Ontario Today

Until 1998, ambulance service in Ontario was the responsibility of the provincial Ministry of Health and Long Term Care, through its Emergency Health Services Branch. The Branch set standards, provided all ambulances and equipment, controlled dispatch centres and base hospital programs, and fully funded a network of 175 public (hospital and municipal), private, and Ministry of Health operated ambulance services.

Beginning January 1, 1998, the province commenced the process of transferring responsibility for land ambulance operations to upper tier municipalities and designated delivery agents.

The provision of ambulance service across Ontario is now a joint responsibility of approximately 50 Upper Tier Municipalities (Regions, Counties, selected cities, and designated Service Delivery Boards in Northern Ontario) and the Ministry of Health. The Ministry continues to set standards, fully funds air ambulance, dispatch and base hospital programs, and through an approved funding template, provides a maximum of 50% of required land ambulance service funding. During the 2001/2002 fiscal year, the provincial government contribution to ambulance funding was $368.6 million.

The balance of funding and actual delivery of ambulance service locally is the responsibility of the municipalities and designated delivery agents. This responsibility includes:

establishing governance mechanisms and the organizational structure that will manage the local ambulance system;
developing short and long-term plans for meeting the needs of the municipality;
determining whether to deliver the services directly or in a contracted relationship with a third party, and if so, managing contracts with these parties;
ensuring the supply of vehicles, equipment, services and information necessary for the proper provision of ambulance services;
ensuring the training and supervision of staff, maintenance of vehicles and equipment, the provision of a quality assurance program; and
ensuring that service levels and quality are maintained, as is compliance with the legislated land ambulance service standards.

Each municipality is required to maintain ambulance service that remains Accessible, Integrated, Seamless, Accountable and Responsive. Ontario's 72 certified land ambulance services, currently respond to some 1.5 million requests for service annually.