May 2026

Ambulance Service in St. Albert

The City has recently been placed in a difficult situation with respect to the provision of ambulance service. I’ve put the following together to try to explain as best I can and this represents my understanding of the decision before us. It is a complex and nuanced discussion and I’ve done my best to break it down from my perspective. More will be known once Council gets the full report including costing and potential recommendations from our administration later this week.

I think it is important to understand a bit of the background before I get into the options that are now before Council. Until 2009, municipalities were largely responsible for the provision of ambulance services. In St. Albert, that took the form of an integrated fire and ambulance service. For decades St. Albert had among the highest quality patient care in the province with cross trained paramedic-firefighters and advanced life support ambulances. This is still true today. As healthcare is a provincial responsibility, municipalities lobbied for the province to assume the costs associated with the ambulance service, something they finally agreed to in 2009. At that time, some municipalities chose to get out of the ambulance business altogether, turning everything over to Alberta Health Services, while other municipalities like St. Albert, chose to continue to operate their integrated service and contract to AHS (technically EHS).

In addition to the history, I should also lay out some facts that will help inform the decision before council:

• Currently, St. Albert’s ambulances are staffed with Advanced Care Paramedics and we provide Advanced Life Support (ALS) service.

• Currently 40% of all St. Albert ambulance calls are outside of St. Albert. Ambulance dispatch is operated through a regional dispatch and St. Albert has no authority over where our ambulances respond.

• As an integrated service with cross-trained staff, we currently have paramedics that are able to respond on firetrucks and often arrive before the ambulance

• Currently, AHS is having difficulty around the province maintaining ALS level service - staffing ambulances instead with Primary Care Paramedics or sometimes even Emergency Medical Responders and offering basic life support (BLS) service. This has led to a degradation of care in many municipalities.

• Our current contract for service is set to expire this September. As the St. Albert Gazette has reported, the province has identified a maximum they are willing to pay to continue to contract our integrated service. Anything above that would be subsidized by the St. Albert taxpayer.

As best as I can tell, there are three different options before council.

Option A - renew Contract with EHS: Under this option, we would renew our contract and maintain our integrated service and our ALS ambulances. We would continue to have cross-trained staff on both and continue to operate as we are now. This would come at an increased cost to the City and in effect St. Albert taxpayers would be funding what is a provincial responsibility. Despite this cost to St. Albert residents, our ambulances would continue to be used in other communities, often being backfilled by non-St. Albert ambulances. These ambulances may be ALS, but are often BLS. We would still have paramedic firefighters able to respond and we would still benefit from having ALS ambulances responding to our residents calls the majority of the time.

Option B - cease providing ambulance services but backfill with something known as Fire Medical Response (FMR): This is similar to what Strathcona is currently operating as ‘Community Response Units.’ The City of St. Albert could exit the provision of ambulance service and let the province take it over. St. Albert could then ‘backstop’ the provincial ambulances by continuing to hire paramedics and staffing firetrucks or other community response units with paramedics who can respond when the province is unable to provide an ALS response. Based on experiences in other communities as well as in our own, it is unlikely that the province would be able to maintain the same level of service that we currently enjoy. Evidence suggests that they have a harder time staffing them with paramedics and that we could see a degradation of service here in St. Albert. We could still respond to medical emergencies with fire personnel however this would come at a cost. There is a cost for staffing paramedics, a cost for additional vehicles or wear and tear on firetrucks etc among a whole host of other considerations.

Option C - EHS becomes fully responsible for emergency medical service: Under this option, the province would assume control of ambulance service, and St. Albert would cease to employ paramedics and simply become a fire service only. This would be the cheapest option for the City and would make the province solely responsible for emergency ambulance care. It would put emergency response squarely in their court. As stated above however, the experience across the province suggests that this would result in a decrease in patient care for St. Albertans.

As I see it, these are roughly the three options. There may be other permutations and combinations, and of course there is a lot of nuance and context that I can’t even begin to capture in what is already a lengthy post, but my purpose here was to try to present Council’s decision in a digestible way for residents.

As for my opinion, I am not at all interested in a degradation of patient care for St. Albert residents. Regardless of who is paying, I want to do everything I can to ensure an advanced care paramedic shows up at your door when you need one. That is my first and most important consideration and that will help guide my decision making on the matter and Council will be getting more information in advance of our May 19th decision. Suffice it to say it will be a tough one.

In a perfect world the province would pay 100% of the cost and simultaneously be able to guarantee advanced life support ambulances but it doesn’t look like that is an option at this time.