AHS understands there may be situations, for a variety of reasons, where an agency is not available to respond and assist EMS. One of the principles of the MFR Program is that MFR event response is voluntary and provided so long as the agency has the capacity to do so.

There is a long history of Medical First Response (MFR) activity across the province. MFRs make valuable contributions to patient care and in the past, there were many inconsistencies with how care was provided across the province. The MFR Program builds on the positive experiences and provides supports for the medical first response providers to ensure safe care is provided to patients. The Alberta MFR Program has created guidelines to formalize the types of medical first response that are provided in communities across the province. Municipalities and agencies can determine if they want to participate depending on community interest, resources, capacity and ability to respond to calls.

Agencies can choose to withdraw their enrollment with Alberta MFR if they no longer wish to provide this assistance. Agencies that wish to respond to medical emergencies in their service area are required to remain enrolled with the Alberta MFR Program.

AHS offers assistance with training, support and medical supplies. There is also a limited amount of funding available each year to help offset some of the direct costs of MFR activity.

During the enrollment process, the MFR Agency clearly outlines the types of events that they would like to respond to. The list can be reviewed at any time and changed given the interests and resources of the community and the agency. There is no minimum number of events or certain types of events that groups must respond to in order to enroll. The program includes increased ability to monitor and track medical first responder utilization, and for AHS to accurately report back to stakeholders.

AHS is responsible for ensuring that Albertans receive the care they need in a timely manner. The MFR program helps agencies provide a consistent level of care to patients no matter where they are in the province. AHS works with participating agencies to provide medical direction so that safe care is being provided. Agencies participating in the program also get access to AHS-funded training opportunities, equipment supports, online patient care reporting and training portal, as well as provincially standardized processes.

No. While a number of AHS EMS employees volunteer with their local fire service and many agencies do employ AHS EMS staff, MFR agencies will continue to be operated by the same local municipality as they are today, independent of AHS.

AHS is participating in the Alberta First Responders Radio Communications System (AFRRCS). Communication between public safety agencies, such as EMS, police, fire departments and other first responders who are responding to the same event occurs in a number of ways. Currently, EMS uses a radio network to verbally provide information to the other agency or computer connections to send the same information as is transmitted to the ambulance crew.

Organizations should consult with their municipality's legal service and insurance provider for a full understanding of their legal protection. The information here is provided for information purposes only and is not to be considered legal advice.

The information points below were created upon consultation with Alberta's Office of the Fire Commissioner (March 10, 2015):

• Two layers of protection exist for municipal officers, agencies and responders: the Municipal Government Act Sec 535 (pt 1 and 2), as well as each municipality's Insurance Policy.
• The Municipal Government Act specifies when fulfilling duties at the direction of the municipality all employees are indemnified.

It must be emphasized that MFR Program enrollment does not provide specific legal protection, but strengthens provision of service by supporting standards, diligence and quality assurance.

The Emergency Medical Aid Act is not applied to MFR responders when they are on-duty since they are employed by the municipality, regardless of staffing model, volunteer, paid-on-call or full time.

An MFR practitioner is only obligated to travel with the EMS unit to the hospital or intercept with an ALS unit in the case where the treatments/interventions performed by the MFR practitioner exceed the scope of practice of the EMS crew on scene. For example, if an RN or Advanced Care Paramedic initiate ALS care and it is a BLS EMS crew on scene, they will have to stay with the patient to continue care, or the BLS crew can request an ALS intercept. If the MFR practitioner is providing basic care such as monitoring vitals and providing oxygen, there is no requirement for them to travel with the patient.

The AFRRCS team has published a series of documents as part of their AFRRCS Agency Handbook located at http://open.alberta.ca/publications/afrrcs-agency-handbook.  In particular, one of the documents is titled the "Migration Application Package.pdf" and walks each agency through the process of getting onto AFRRCS. This process must be followed whether you are buying a single radio or replacing your entire operational inventory. As part of the first step, an AFRRCS transformation consultant will be assigned to the agency to assist them in completing the necessary steps.  For further AFRRCS questions, please contact the AFRRCS team at afrrcs.Consultant@gov.ab.ca or call them at 780-643-1695.

Yes, after a conversation with and under the direction of the on-scene EMS crew.  EMS must support the need to utilize the MFR at the higher scope and follow the "Healthcare Professional On Scene" Medical Control Protocol.

No. The level of service is the maximum level of service that you will respond with and there is no requirement to always have that skill level respond if there are not enough available resources. However, the minimum training level of responders must be Standard First Aid with CPR and AED.

In cooperation with Alberta Health and the Alberta College of Paramedics, we have developed a level of service comparison chart to assist agencies with choosing a level of service. You can click this link to view the MFR Level of Service Comparison Chart.

MFR members who are employed or volunteer as an RN should be knowledgeable, competent, and skilled to practice in the out of hospital setting. They should practice within their job/volunteer description and responsibilities which may include the performance of any restricted activities. If RNs have questions about what they are being asked to do or are unsure that the practice is within their scope of practice in this specific situation they can call CARNA. There are several documents on the  CARNA’s website that help guide practice including the Scope of Practice and the Restricted Activities Standards.

RNs should also ensure they have adequate professional liability protection through the Canadian Nurses Protective Society. 

AHS will work with partner agencies to determine if improvements or upgrades are needed to ensure the agency is able to operate within the program's guidelines. AHS will assist agencies to help them meet the requirements.

No. The level of care offered by an MFR agency is determined by local communities. The program has established a minimum training requirement of Standard First Aid with CPR and AED, which does not require enrolment with the Alberta College of Paramedics.

MFR agencies are incredibly diverse throughout the province and impacted by many different factors. Decisions about the operation of MFR agencies will continue to be made at the local level collaboratively between the municipality, the local agency, and AHS EMS.

The MFR Agency is ultimately responsible for the medical training and equipment for their staff. AHS provides some support for agencies including training and equipment funds, first aid instructor development, online training resources, access to medical supplies and access to certain EMS continuing education opportunities.