Ontario Expanding Innovative Models of Care

Published on May 12, 2021

Ontario Expanding Innovative Models to Deliver Better, Connected Care

9-1-1 Models of Care Will Provide the Right Care in the Right Place and Protect Hospital Capacity

NEWS                                                          May 7, 2021

NORTHUMBERLAND — The Ontario government is launching new 9-1-1 models of care to now cover 33 municipalities across the province. These new models of care will ensure paramedics have more options to provide safe and appropriate treatment for patients while helping to protect hospital capacity as the province continues to respond to the third wave of COVID-19.

Details on the Central East Ontario model of care were provided today by David Piccini, MPP Northumberland-Peterborough South, Dave Smith, Peterborough-Kawartha Member of Provincial Parliament; Lorne Coe, MPP Whitby, Lindsey Park, MPP Durham, the Peterborough County/City Paramedics Chief, Randy Mellow, and the Northumberland County Paramedic Service Chief, Susan Brown.  The Central East region pilot project includes Kawartha Lakes, Region of Durham, Haliburton County, Northumberland County and Peterborough County/City.

Currently, paramedics are required to bring 9-1-1 patients to overcrowded hospital emergency departments, even when there are other appropriate care and treatment options available in the community. Under the innovative patient care model pilots, eligible palliative care patients and those experiencing mental health and addictions challenges can receive appropriate care by the paramedic directly or in the community as appropriate. The patient will remain in ultimate control of the care they receive and can at any time request to be taken to the emergency department.

“These new models of care will enable our paramedics to support our most vulnerable patients in the most appropriate setting, while avoiding unnecessary emergency department visits. Our Northumberland Paramedics do remarkable work, and this pilot will allow them to expand their scope of practice and deliver enhanced palliative care services in our communities.” - David Piccini, Member of Provincial Parliament for Northumberland-Peterborough South

The Central East region 9-1-1 model of care pilot will be using the Treat and Refer Model for Palliative Care Patients. Palliative care patients calling 9-1-1 will have the option to be treated on-scene for pain and symptom management, including pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Following treatment on-scene, patients have the option for paramedics to coordinate the patient’s follow-up care directly with the patient’s primary palliative care provider or with a local hospice for further treatment and wrap-around care.

Paramedics are trained to administer a range of medications to address the above symptoms:

  • Morphine
  • Hydromorphone
  • Salbutamol
  • Haloperidol
  • Midazolam
  • Ondansetron
  • Dimenhydrinate
  • Glycopyrrolate
  • Atropine

“We applaud the province for engaging paramedic services to identify innovative opportunities to end hallway medicine, and for building flexibility into the process to allow for locally-developed solutions that meet unique local needs. This initiative will enhance delivery of palliative care services in Northumberland and neighbouring communities, adding further value to a model of care focused on respectful, compassionate, end-of-life treatment. This is a natural extension of the important services provided by our paramedics, who are focused on delivering industry-leading pre-hospital care for Northumberland residents in collaboration with local health and community care partners.” - Bob Crate, Warden, Northumberland County

“The Treat and Refer Palliative Care Pilot leverages the skills and training of our paramedics to deliver enhanced health care services to the community. Northumberland Paramedics strive to be leaders in collaborative, innovative models of care, including introduction of a Community Paramedicine program in 2020 together with Ontario Health Team of Northumberland partners. By enabling in-home care and symptom relief supports for palliative patients, the pilot announced today is another opportunity to improve patient and caregiver experience with the health care system while decreasing pressure on our local hospitals. We are proud to be working with neighbouring paramedic services as well as local health and community care providers to make this service accessible in Northumberland and throughout the region.” - Susan Brown, Chief, Northumberland Paramedics

Each pilot project will be in place for one year, after which it will be evaluated to assess outcomes, identify where program adjustments may be needed, and how to implement new models of care throughout the province.


  • Under the Treat and Refer model, specially trained paramedics treat palliative care patients on-site in their home, which can include administering medication for pain or dyspnea, hallucinations or agitation, terminal congested breathing, and nausea or vomiting. Once the patient has been treated, paramedics would directly coordinate follow-up care with a local hospice or the patient’s primary palliative care team to provide longer-term treatment options. This model is currently only available for palliative care patients in select regions.

  • Patient eligibility criteria varies from model-to-model. Paramedics responding to 9-1-1 calls for select palliative care patients and mental health and addictions patients will conduct an assessment on-scene for eligibility to participate in new models of care. If patients are not registered, paramedics would ask the patients on-scene if they would like to be registered with their local centres in order to be eligible for the next time they dial 9-1-1.

  • The majority of the new models for palliative care patients being piloted are based on the “Ontario Palliative Care Network’s Competency Framework for Paramedics” which is designed to equip paramedics with the skills and knowledge to respond to palliative care needs. The model is federally supported by the Canadian Partnership Against Cancer and the Centre for Healthcare Improvement.

  • Where pilots were submitted by a region of municipalities as a group or as an individual municipality, the paramedic services for each municipality are responsible for the implementation of this model within their municipal boundaries.



Paige Wiggans, Executive Assistant

Office of MPP David Piccini
[email protected]