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Sparks fly as gulf between city and county approach to battling opioid crisis is revealed

"Why are we not trusting the professionals ... out there saving lives is beyond me,' said Coun. Sarah Valiquette-Thompson, who was 'frustrated' by debate
2018-06-06 Orillia City Centre

The Orillia Fire Department met some unexpected resistance from Mayor Steve Clarke and others Monday night at City Hall.

Fire Chief Ralph Dominelli and Assistant Fire Chief Brent Thomas made a presentation to council committee Monday night, bringing “good news” to the table: news of how their ground-breaking response to the opioid crisis has saved lives.

To ensure that continued, they were asking for approval to extend their “medical oversight agreement” with Dr. Michael Boucher. Surprisingly, however, tempers flared and sparks flew as the debate devolved into a dispute over protocols and politics.

Last summer, council voted to OK an agreement which, essentially, paved the way for Boucher to train firefighters to administer Naloxone and Epinephrine, Nitro Spray, Ventolin and Aspirin (ASA) to those in need. The program is in response to the opioid crisis and the spate of overdoses caused by the drug.

Thomas told councillors the agreement has been “a good news story.” He reported that after the agreement was approved by council on July 4, the Orillia Fire Department “went live” with the program on July 21, by which time 92% of staff were already trained.

Just a month later, firefighters used Naloxone for the first time and over the year, it was administered nine times. Basically, officials said, that equates to nine lives saved.

Thomas said firefighters have responded to 54 overdose calls since last July. “The increased training (through this program led) to better patient outcomes without delivering Naloxone (in some cases) which is a definite benefit to those suffering from opioid overdoses,” said Thomas, who noted firefighters responded to 1,681 medical calls in 2017.

The bottom line, said Thomas, is the program works, and thanks to training occurring while firefighters are on shift, it’s cost effective.

Despite all that, the mayor asked his colleagues to defer renewing the agreement for a few weeks so they could hear from County of Simcoe officials. He noted the county’s CAO had sent an email to council earlier Monday asking for an opportunity to make a presentation to council about their medical oversight program.

The mayor noted the county is in the midst of developing its own program; five Simcoe County fire departments are participating in a pilot project.

At the time city council approved the initial agreement with Boucher, the county indicated it was close to being ready to roll out its program. A year later, thas not yet occurred.

However, Thomas noted the county has formed a steering committee to ensure “the interests of all fire departments could be covered. I happen to be on the steering committee,” he said.

Thomas said the county’s program, as it stands, would not work as effectively for Orillia, whose call volume (2,500 calls per year) requires training to be done while firefighters are on shift. He said the county training regimen would cost about $80,000 in the first year and about $41,000 in subsequent years. 

“(Our) program works for us and our level of service is greater than the program offered by the county,” said Thomas. “We are not in favour of a reduction of the level of service.”

The mayor said he was frustrated the city and county could not work together on this.

“I gotta tell you, I am a little disappointed and perplexed that we’re in this situation (where) there seems to be disconnect between the two main players in this,” said Clarke. “I’m certainly not suggesting any reduction of any service.”

That prompted Dominelli to weigh in.

“I am a little puzzled when it’s said we haven’t been talking to the county’s paramedic services,” said Dominelli. “As the Assistant Chief said in his opening statements and it’s stated in the report, he sits on the steering committee that was created for this program.”

Dominelli said there have been three meetings of that group, which includes paramedic services, county staff and three fire chiefs and they’ve, to date, developed terms of reference.

“Discussions about training have been taking place,” stressed Dominelli. However, the contract with Boucher ends in July. “We are here recommending what’s best for the City of Orillia. Right now, (the county program) is not good for the City of Orillia and that’s our opinion.”

The fire chief said staff will “continue to work through the steering committee … but one program does not fit the entire county. (It) doesn’t meet the needs of Orillia.”

At that point, Clarke’s move to defer the decision was nixed. He then introduced an amendment to extend the deal by just one year instead of three, with a caveat that the city, within a year, try to work out a deal with the county to “align” protocols.

That infuriated Coun. Sarah Valiquette-Thompson.

“Our staff have found a system that works for the City of Orillia,” she said. “Why are we not trusting the professionals who are out there with hands-on experience, saving lives is beyond me. This is what sometimes really frustrates me about politicians getting involved.”

Clarke bristled at the comments.

“This isn’t about a lack of trust in our fire department (who) are doing one heck of a job,” said Clarke. “As far as politicians getting involved in this, I’m afraid this is absolutely our job and a difference of opinion is all that’s happening.”

He said his request was simply about listening to a “significant partner” and taking time to weigh all options.

Thomas, however, noted there is an “out clause” in the agreement with Dr. Boucher that would allow the city to walk away from the deal if it chose to do so. He also noted the city’s protocols are the same as the county’s and stressed communication is taking place.

In the end, council committee endorsed the fire department’s request to renew the agreement for three years. Decisions have to be ratified by council next Monday night.


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Dave Dawson

About the Author: Dave Dawson

Dave Dawson is community editor of OrilliaMatters.com
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