Tuesday, September 29, 2020

'It's not broken': Calgary City council votes to oppose consolidation of ambulance dispatch

Madeline Smith CALGARY HERALD/POSTMEDIA
© Provided by Calgary Herald Calgary Mayor Naheed Nenshi (L) and Minister of Health Tyler Shandro (R). Alberta Health Services is planning to consolidate EMS Dispatch. Calgary is one of four municipalities that has yet to be consolidated. Calgary city council is opposing the plan.

City council took an official stand Monday against a bid to centralize Calgary’s ambulance dispatch under Alberta Health Services.


The latest move in the dispute between the provincial government and the municipalities that still control local EMS dispatch comes after Mayor Naheed Nenshi joined three other mayors in Edmonton last week to make the case directly to Health Minister Tyler Shandro against consolidation.

Calgary council held a special meeting Monday to hear from a series of officials and experts about how the city’s 911 and emergency dispatch system works. Calgary Community Standards director Richard Hinse and Calgary fire Chief Steve Dongworth both said the current model, where dispatchers for police, fire and EMS work in the same room, shouldn’t be changed.

Council voted nearly unanimously to oppose moving Calgary’s EMS dispatch and to ask Shandro to overturn the decision. Coun. Sean Chu and Joe Magliocca voted against the statement because they said AHS and the province hadn’t been given a chance to explain the “other side” of the issue.


According to city data, Calgary 911 deals with 15,000 calls per year that require all three types of first responders at the scene.

“Calgarians have already had the gold standard for 15 years of this model based on 911,” Hinse said. “It’s not broken. Why would you fix it?”

Red Deer, Lethbridge and the Regional Municipality of Wood Buffalo are the other places in Alberta where ambulance dispatch is still done locally. Starting in 2009, across the rest of the province, AHS dispatches EMS from three centres in Edmonton, Calgary and Peace River.

Mayor Naheed Nenshi said if he believed that the change would improve patient outcomes or save a significant amount of money, that could convince him to hand over EMS dispatch.

“I don’t believe either of those things,” he said, adding he questions why the city is having this conversation again.

'He has to stand down': Calgary council vows to fight Shandro on EMS dispatch consolidation

AHS has tried several times over the last decade to consolidate the remaining municipally run EMS dispatch work, but health ministers across several governments have rejected it.

“I have yet to see any evidence that patient outcomes will improve or money will be saved,” Nenshi said.

In an interview with Postmedia last week, Alberta’s chief paramedic Darren Sandbeck said the move is about finishing the work AHS started in 2009 and creating a “truly integrated” EMS dispatch system.

“When we started this journey there was 37 EMS dispatch centres in Alberta. Those 37 dispatch centres were not connected in any way, shape or form and had no understanding of what resources were available,” he said.

“Emergency services, first response groups always want to have direct co-ordination over their resources. … We want to have the same thing. We want to have direct co-ordination with our staff, within our system of all of our EMS resources across the province.”
© Gavin Young/Postmedia Network Alberta Health Service’s chief paramedic Darren Sandbeck was photographed in Calgary on Tuesday May 30, 2017.

If consolidation goes ahead, EMS dispatch would move over to AHS in January. There are currently 45 ambulance dispatchers that work for the city, and they’d be replaced with 25 positions at AHS.

After meeting with Nenshi and the mayors of the other affected communities last week, Shandro said he would review their information.

And on Monday, he said if there’s evidence that shows emergency response times would “somehow be adversely affected” then he’d be against the change.

“But that’s quite frankly not the evidence I’ve seen right now from AHS.”
How Calgary 911 works

When a Calgarian dials 911, a municipal employee answers the call — and that would still be the case even if consolidation goes ahead.

But the process of sending out emergency services would look different. Currently, depending on whether the caller says they need police, fire or ambulance, they’re transferred to a municipal dispatcher who’s responsible for sending that service to the scene.

But if AHS takes over EMS dispatch, a call for an ambulance would be transferred to the AHS dispatch centre, while police and fire dispatch are in a different building.

Hinse said splitting emergency dispatchers into different workplaces means they won’t be able to communicate directly, and that opens them up to errors.

“For a purely medical emergency — a broken leg, a slip, a fall — an AHS dispatch centre may work well,” he said. “The problem is that emergencies are messy.”


In Calgary’s 911 call centre, police, fire and EMS dispatchers are intentionally seated adjacent to each other, and Hinse said there are times when dispatchers simply “twist and shout” to their colleagues that they need additional first responders on their call.

Alerting Calgary fire to calls is one of the city’s main concerns. Firefighters are currently first on the scene of a medical emergency slightly more than half the time, and they can offer medical help before the ambulance arrives. But that requires co-ordination between ambulance and fire dispatchers to make sure resources are sent out as soon as possible.

Chief paramedic Sandbeck maintains that emergency response times won’t be affected, and firefighters will continue to be first on the scene for the same percentage of calls.

Calgary ambulance dispatchers started using an AHS computer-aided dispatch (CAD) system to handle calls in 2017, and Sandbeck said that means the only thing that changes under consolidation is the dispatcher’s employer and location.

“There’s CAD to CAD interface, which means our dispatch software immediately talks to fire dispatch software and alerts them that we need them for a response,” he said.

“If the call triggers up as unconscious and not breathing, that will automatically send a notification to the fire dispatcher that we need a medical first response.”
© Gavin Young Calgary Fire Chief Steve Dongworth speaks at a media press conference on Wednesday, June 3, 2020.

But Calgary fire Chief Dongworth told council Monday the AHS CAD system added extra steps that actually set firefighter response times back by 49 seconds, on average, since 2017.

And Hinse said waiting for call takers in another building to let fire dispatch know whether they’re needed is a waste of precious seconds when firefighters could be pre-alerted that they’re needed. And in the meantime, the caller has to wait to be transferred to the AHS centre.


Replying to @meksmith
Nenshi says he doesn't like the implication that city staff telling #yyccc their professional opinion "is just one side of the story."
Nenshi: "This is not a matter of council mediating between both sides," says calling city staff "just one side" is "troubling" to him. #yyccc



Replying to @meksmith
Hinse: "If AHS consolidates EMS dispatch, they will do a great job at dispatching ambulances. The problem is emergencies are messy," and they often require multiple first responders. #yyccc
This is an example about how emergency dispatchers are sitting together in Calgary's call centre. Hinse says the CAD system that AHS uses to transfer calls with the push of a button sometimes doesn't work, and communication is crucial. #yyccc
Image

Foothills County opposition

Foothills County Reeve Suzanne Oel also told council about her community’s experience with consolidated dispatch.

AHS took over EMS dispatch across most of southern Alberta in 2009, and Foothills has been advocating to take it back for years, citing particular problems with dispatching firefighters for medical first response.

“Because of the logistics of transferring the call back and forth, the total time to dispatch a medical fire response averages about five minutes now, or three times longer than before,” Oel said.

Sandbeck said a CAD to CAD interface was put in place between EMS and fire dispatch over the summer to address concerns from Foothills.

Coun. Jyoti Gondek said she was dismayed to see the province consider changing Calgary’s emergency dispatch system without adequate data.

“I’m really at a loss of understanding how we’re going to build a relationship or collaborate with a government that continually degrades, defunds and dismisses anything that municipalities have to say. This is a perfect example.”

Council also voted to ask for representatives from AHS to meet with them as soon as possible.

“This is the beginning,” Coun. Diane Colley-Urquhart said. “And we’ve got several months ahead of us where we’re going to stay the course and fight a good fight on behalf of Calgarians.”

masmith@postmedia.com

Twitter: @meksmith




East Asia poverty could rise for first time in 20 years due to the pandemic, World Bank says


Yen Nee Lee

The number of people living in poverty in developing East Asian and Pacific countries could increase for the first time in 20 years, a World Bank forecast showed on Monday. 

The bank said as many as 38 million more people could fall below below the poverty line this year, including 33 million who would have escaped poverty if the Covid-19 shock didn't happen.

World Bank defined the poverty line as income of $5.50 a day.

© Provided by CNBC People gather at one of slums in Jakarta, Indonesia in the midst of the Covid-19 pandemic.

SINGAPORE — The number of people living in poverty in developing East Asian and Pacific countries could increase for the first time in 20 years, as the coronavirus pandemic erased much of this year's economic growth, a World Bank forecast showed on Monday.

The bank defined the poverty line as income of $5.50 a day. It said as many as 38 million more people could fall below that income level this year, including 33 million who would have escaped poverty if not for the Covid-19 shock.

That World Bank forecast was published in an economic update for the region, which includes China, Southeast Asian countries and the Pacific Islands, such as Fiji and Samoa. The report doesn't include India and other South Asian countries.

The report adds to an expanding body of research on how the pandemic is disproportionately hurting the poor. In July, the United Nations projected that 8.8% of the world's population will live in extreme poverty this year, an increase of 8.2% in 2019. Extreme poverty is defined as income below $1.90 a day.

"Scars" left behind by the Covid-19 crisis could last for many years, said the World Bank.

"Sickness, food insecurity, job losses, and school closures could lead to health and learning losses that could last a lifetime. The poor will be disproportionately disempowered because of worse access to hospitals, schools, jobs, and finance," it said in the report.

But greater adoption of technology as a result of the pandemic could help the poor better access opportunities and public services, the bank added.

"For these benefits to arise, these technologies must be broadly available."
Weakest economic growth since 1967

The poverty forecast for developing countries in East Asia and the Pacific comes as the region is expected to grow just 0.9% this year — the weakest growth rate since 1967, according to the World Bank.

"COVID-19 has delivered a triple shock to the developing East Asia and Pacific (EAP) region: the pandemic itself, the economic impact of containment measures, and reverberations from the global recession brought on by the crisis," it explained.


China, the world's second-largest economy, is expected to grow by 2% this year — one of the only three countries in the grouping expected to register growth this year, the bank said.

But economic growth in the region is forecast to jump by 7.4% next year, with China projected to register the largest expansion of 7.9%, the report showed.

"Prospects for the region are brighter in 2021," said the World Bank. "However, output is projected to remain well below pre-pandemic projections for the next two years."
#FIREWILBURROSS

US official: 2020 census to end Oct. 5 despite court order

© Provided by The Canadian Press

ORLANDO, Fla. — U.S. Secretary of Commerce Wilbur Ross says the 2020 census will end Oct. 5, despite a federal judge's ruling last week allowing the head count of every U.S. resident to continue through the end of October, according to a tweet posted by the Census Bureau on Monday.

The tweet said the ability for people to self-respond to the census questionnaire and the door-knocking phase when census takers go to homes that haven't yet responded are targeted to end Oct. 5.

The announcement came as a virtual hearing was being held in San Jose, California, as a follow-up to U.S. District Judge Lucy Koh's preliminary injunction. The injunction issued last week suspended the Census Bureau's deadline for ending the head count on Sept. 30, which automatically reverted back to an older Census Bureau plan in which the timeline for ending field operations was Oct. 31.

The new Oct. 5 deadline doesn't necessarily violate the judge's order because the injunction just suspended the Sept. 30 deadline for field operations, as well as a Dec. 31 deadline the Census Bureau has for turning in figures used for determining how many congressional seats each state gets in a process known as apportionment. The census also is used to determine how to distribute $1.5 trillion in federal spending annually.

Koh asked federal government attorneys during Monday's hearing to provide documents on how the new decision to end the head count on Oct. 5 was made. When a federal government lawyer suggested that the decision-making was a moving target without any records, the judge asked, “A one sentence tweet? Are you saying that is enough reason to establish decision-making? A one sentence tweet?"

Given the judge's preliminary injunction and a temporary restraining order she had previously issued prohibiting the Census Bureau from winding down 2020 census operations, the decision was made that the Sept. 30 deadline was no longer viable, said August Flentje, special counsel to the assistant U.S. Attorney General.

“It's day to day adjustments and assessments," Flentje said.

Koh said in her ruling last Thursday that the shortened schedule ordered by President Donald Trump’s administration likely would produce inaccurate results that would last a decade. She sided with civil rights groups and local governments that had sued the U.S. Census Bureau and the U.S. Department of Commerce, which oversees the statistical agency, arguing that minorities and others in hard-to-count communities would be missed if the counting ends this month.

Attorneys for the federal government said they were appealing the decision. During hearings, federal government attorneys argued that the head count needed to end Sept. 30 in order to meet a Dec. 31 deadline for handing in figures used for apportionment.

Monday's statement was noteworthy in that it was solely attributed to the commerce secretary, while previous announcements about census schedule changes had been made either by Census Bureau director Steven Dillingham or both men jointly.

“It is time that the Trump Administration stopped working to politicize and jeopardize the 2020 Census," said U.S. Rep. Carolyn Maloney, a Democrat from New York, who chairs the House Committee on Oversight and Reform, which has oversight over the Census Bureau.

The decision by the Commerce Department came as census takers across the U.S. told The Associated Press that they were being pressured to meet the Sept. 30 deadline, even after Koh issued her injunction.

In upstate New York, a census supervisor told her census takers Friday that the Buffalo office was operating with Sept. 30 as the end date, according to a text obtained by AP. “5 days left (no matter what the court status),” the text said.

In northern California, a manager told supervisors working under him on Sunday, “We’re in the home stretch with only 3 days left,” according to an email obtained by AP.

In that same region, a different manager told the census supervisors working underneath her Monday that they needed to complete 99% of households in the the Santa Rosa region by Wednesday, including 12,000 households yet to be counted in Mendocino County. In the conference call, area manager Nicole Terrazas pleaded with her supervisors to ask their census takers to head to Mendocino County, even though that part of California is under threat of wildfires.

“We need as much help as we can get. We only have three days to do it,” said Terrazas on a call that an AP reporter listened in on.

When a census supervisor asked why they were being pressured with the Sept. 30 deadline when Koh’s preliminary injunction prohibits the count from ending at the end of this month, Terrazas called the judge’s order “something completely different.”

Other census takers and supervisors, including one from Texas, have sent emails to Koh’s court, saying that field operations in their areas are slated to shut down Sept. 30.

In response to the pandemic, the Census Bureau last April pushed back the deadline for ending the 2020 census from the end of July to the end of October. The bureau also asked Congress to let it turn in numbers used for apportionment from the end of December to the end of April.

The deadline extension passed the Democratic-controlled House but it stalled in the Republican-controlled Senate after President Donald Trump issued a memorandum seeking to exclude people in the country illegally from being used in the apportionment count. A panel of three judges in New York said earlier this month that the memorandum was unlawful.

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Follow Mike Schneider on Twitter at https://twitter.com/MikeSchneiderAP

Mike Schneider, The Associated Press




A boy sent his Baby Yoda doll to Oregon firefighters. Now they take it on their calls


By Marika Gerken, CNN

© Courtesy Tyler Eubanks

When 5-year-old Carver learned about the wildfires ravaging his home state of Oregon, he told his grandmother Sasha Tinning he wanted to do something to help the heroes on the front lines.

So, when Tinning heard about a local donation drive for firefighters in Molalla and Colton, Oregon, she took Carver shopping to buy groceries and other items they thought the firefighters might need.

While at the store, Carver's eyes fixed on something in the toy aisle -- a Baby Yoda doll.

For those not familiar with "The Force," Baby Yoda -- or "The Child" -- is a character from the Star Wars Disney+ original series "The Mandalorian." He is an infant member of the same alien species as Yoda. The character took over the internet last year with its big ears and adorable doe eyes.

Carver had a feeling the firefighters would need the doll more than he did, so he sent it off in a care package along with a note.

"Thank you, firefighters," he wrote. "Here is a friend for you, in case you get lonely <3 Love, Carver."

A couple of days later, Tyler Eubanks, who runs the donation drive, told Tinning how much all the firefighters loved Baby Yoda.

"These firefighters are putting their lives on the line," Tinning told CNN. "To have a little bit of sunshine during such a dark time, I think that's really special for them. He (Baby Yoda) is also just cute as the dickens."

The firefighters now bring Baby Yoda with them everywhere and even document his travels in a Facebook group -- with more than 20,000 followers -- so that Carver and others can see how much Baby Yoda has helped them along the way.

"These firefighters are away from their children, their loved ones. This is a little pal that brings a bit of normalcy to a crazy time," the proud grandmother said.

May the force be with you, Carver.