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Sue Corke Emergency Medical Services Tel: (416) 397--9240
Deputy City Manager 4330 Dufferin Street Fax: (416) 392-2115
Cluster A Downsview, ON email@example.com
2011 BUDGET BRIEFING NOTE
Toronto Emergency Medical Services – Overtime
At the January 11, 2011, meeting of Budget Committee Toronto EMS was requested to provide a
Briefing Note for the Budget Committee wrap-up meeting of January 24 and 25 on a review to
convert the overtime positions to standard-time positions.
As a division that provides emergency service 24/7, 365 days per year, there are several factors
that have led to increasing EMS overtime expenditures. Unfortunately, however, there is no
accurate way to convert total overtime hours into additional staff for the purposes of eliminating
Although trends and call demand can be tracked historically and forecasted with some degree of
predictability, it is not an exact science because most of the “work” is, by its nature, unplanned.
EMS service-levels are based on those historical data/trends and EMS staffs according to daily
minimum car counts, or the number of ambulances required for a given period of time. When car
counts for upcoming shifts cannot be met with regularly scheduled staff (because of weather,
special events, training, employee illness/injury, etc.), service levels are maintained with
In addition, unlike a plant or factory, paramedics must complete the “work” of caring for the
patient being transported to the hospital, even if that work passes over the normal end time of
Following are some of the factors that continue to cause overtime:
Increased emergency patient volumes with only a marginal increase in paramedic positions
since 2002 – too few staff to support increased emergency patients while maintaining
response time standards.
Hospital off-load delay caused by a shortage of hospital emergency room resources.
Unanticipated increases in demand outside of Toronto EMS’s control that require additional
ambulances within a short timeframe, such as environmental emergencies caused by
extended heat or cold alerts, contingency response (e.g. influenza), major incidents requiring
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Collective agreement and legislative requirements – e.g., the requirement to provide meal
breaks during a 12-hour shift and the requirement to pay overtime when meal breaks are
missed or late and a second obligation when an employee’s shift extends past 12 hours. The
requirement to pay overtime when a call continues beyond the end of a paramedic’s
scheduled shift, incurring other premiums.
Special Events – the City supports many key community events and international visits
requiring EMS coverage in addition to normal operations and requires backfilling with
overtime – e.g., CNE, Pride, Caribana, Toronto Indy, etc. Special events also attract large
numbers of attendees and increase congestion on transportation routes in the City and
contribute to increased “time on task” for ambulance calls in general.
It is the opinion of the Chief of EMS that the conversion of overtime expenditures to the
standard, operations budget will not result in a straight dollar-to-dollar translation of overtime to
regular time with savings. Most of the factors and conditions that contribute to paramedic
overtime will still be present. These factors include a continual understaffing of paramedics to
respond to increased emergency patient volumes, along with the unplanned nature of the work
and the inability to hand off patients or defer work.
Alan Craig, Deputy Chief
Further information: As above
Date: January 17, 2011