Community Paramedicine Program Update and Pilot Service Navigator Extension - Issue Report

Report To:                           Manitoulin-Sudbury District Services Board

From:                                      Robert Smith, Chief of Paramedic Services

Date:                                       February 19, 2026

Re:                                            Community Paramedicine Program Update and Pilot Service Navigator Extension - Issue Report

Strategic Plan Goal:     1. Expand Service Delivery
Objective:                            1.2. Integrate paramedic services with other services to enhance coordination, improve system navigation, and deliver more connected person-                                                                      centered care

Executive Summary

Over the last decade, Paramedic Services have been engaged with a variety of funding agents to allow the development and evolution of a robust Community Paramedicine (CP) Program. Over the last 4 years, there have been significant provincial investments that have permitted program expansion and design success that allowed delivery of community-based patient care and reduced dependance on hospital admissions/Emergency Department visits. The CP Program operates without any direct municipal funding. In early 2024, a collaborative pilot program was initiated to utilize an Espanola Regional Hospital staff member as part of the CP team. This position introduced wraparound services to community members serviced by the CP Program. This proof-of-concept project has demonstrated success for partner agencies, residents and communities and staff propose its extension through March 31, 2027.

Background

Upper Tier Municipalities and Direct Delivery Agencies, including Manitoulin-Sudbury DSB, have been responsible for the provision of Paramedic Services since 2001, following the provincial download of this land ambulance services. This service has continued to evolve as overall health care consumption increased. Social determinants of health that specifically impact on less urban centres and the again population growth have driven Paramedic Services call volumes. These factors have, in turn, resulted in increased Emergency Department visits, hospital admissions and a rise in institutional care requirements. In an effort to mitigate causal factors and improve independence of an aging population, the Ontario Seniors Strategy was developed in 2012. This program included the development of Community Paramedicine as a measure to increase patient independence and help offset growing 9-1-1 medical calls, ED visits and hospital admissions. CP programs have advanced significantly since then. In 2021, the Ministry of Long-Term Care invested in CP programs to delay admissions into Long Term Care (LTC) residences. This funding, combined with the Ontario Health (OH) funding allowed for Manitoulin-Sudbury DSB Paramedic Services to expand the CP program to a total of 8 Full time Paramedics. Unfortunately, the funding sources had not made CP dollars permanent. In 2024, Ontario Health (OH) made their funding permanent. This was followed by Ministry of Long-Term Care (MLTC) in 2025.

The Manitoulin-Sudbury DSB CP program identified the geography of the districts as a significant barrier to efficient program delivery. In late 2024, staff were deployed from Mindemoya PS station to capture Manitoulin Island patients, and from Noelville PS station to capture patients across French River, Killarney, St. Charles and Markstay-Warren. This change increased functional deployment by 17-20% in each of those two areas. In future, the need for enhanced staffing will be required.

Paramedic Services CP program continued growing, but staff identified challenges in the delivery of holistic health care, specifically around accessing resources for their patients. To identify possible service opportunities, a proposal was submitted to OH to provide service navigation to rostered patients, something that was thought would improve the overall wellness of the patient population and result in greater independence.

A pilot project was developed in collaboration with Espanola Regional Hospital (ERH), where a Service Navigator, as an ERH employee, was recruited to join the CP team, focusing on assistance to patients for access to wrap-around services. The Service Navigator was onboarded in late June 2024.

In fall of 2025, Manitoulin-Sudbury DSB received temporary funding from the local Ontario Health Team to expand the Service Navigator. This work is underway in LaCloche onto Manitoulin Island. This temporary position was recruited through Integrated Human Services and operational in late fall, 2025.

Current Trending of CP/Service Navigator Program

Paramedic Services’ CP program is fully staffed with 8 Paramedics, a Service Navigator, and the Commander of Community Paramedicine. The program has proven to be successful with growth of rostered patients and greater engagement with allied agencies.

In the LaCloche area, CP staff are starting to collaborate closely with the local family health teams, while in Sudbury East, the CP team is collaborating with Univi Health, and on Manitoulin Island, the CP team is starting to collaborate with multiple family health teams. The last of the relationships includes work to assist with mitigation from impact due to the FHT facility loss in Mindemoya. Community Paramedics continue to demonstrate their capacity to be the Swiss Army Knife of health care, something first reported by the CEO of Ontario Health.

The deployment design now utilizes a dynamic staffing profile where the number of staff working mirrors community needs. This design is limited based on the total staffing profile, with 5 staff on peak days. The design ensures that program efficiency is achieved.

The following spreadsheet captures data pertaining to rostering of new clients, discharging of patients who no longer require CP care, and specific Service Navigator activities. These data points are tracked and reported to Ontario Health and the Ministry of Long-Term Care by quarter.

Community Paramedicine Patient Rostering and Discharge

Service Navigator Patient Engagement and Primary Care Connection

Paramedic Services, in partnership with provincial partners, has continued investment in the CP program, in a manner intended to meet evolving needs of patients, communities and the health care system. In spring of 2025, three (3) CPs were enrolled into the Community Paramedicine Certification program delivered by Saskatchewan Polytechnic Institute. Two more were enrolled in late 2025. The remaining three (3) paramedics will be enrolled in the fall of 2026. All CP personnel are also certified to perform specialized skills including phlebotomy, something that has proven extremely effective for homebound and at-risk patients. This skill reduces workload at hospitals and community lab locations. The CP program has also purchased a portable ultrasound device and will be deploying this equipment as part of the diagnostic program. Provision of community ultrasound diagnostics will ensure at risk patients avoid travel for these procedures.

Strategies to Evolve Program

Paramedic Services has submitted multiple Community Paramedic expansion business cases to Ontario Health and the Ontario Health Team. These have included expansion proposals to address system gaps in Sudbury East and the Highway 101 corridor. To date, no proposals for these areas of operation have been endorsed or funded by the province. Staff will continue to advocate for program expansion into these areas as well as to increase the CP footprint on Manitoulin Island. Staff have also engaged with Federal partners to explore CP expansion into Indigenous communities, something that staff have found to be necessary. To date, these preliminary discussions appear to be of interest but have not developed in a fulsome manner.

Since the inception of the CP program, one of the success metrics has included the tracking of 9-1-1 calls by CP rostered patients, who are significant consumers of health care. Of the current 354 rostered clients, 65 calls have been made to 9-1-1. Staff continue to collaborate with the patient records vendor to closely track the trending of rostered patients’ use of the 9-1-1 system. Additionally, staff are tracking data to confirm that these residents maintained low use of the 9-1-1 system once discharged from the CP program.

Financial Impact

Funding of the Community Paramedic program is received through multiple provincial sources, including Ontario Health, the Ministry of Long-Term Care Services and the Sudbury Espanola Manitoulin Elliot Lake Ontario Health Care Team (SEMEL). The current model for funding the CP program has no municipal contributions. Any program expansion submissions have been submitted for full provincial funding. Paramedic Services will manage the proposed one-year Service Navigator extension within the existing funding envelope and without impact on the municipal tax levy.

Conclusion

The evolution of Manitoulin-Sudbury DSB Paramedic Services Community Paramedic Program, including the pilot project that has involved a Service Navigator, has yielded some significant successes for patients across Manitoulin and Sudbury Districts. Staff will continue to advocate for expansion of the Community paramedicine program as a measure to reduce hospitalizations, reduce ED visits and reduce 9-1-1 calls. The introduction of the pilot Service Navigator collaboration has helped advance the program mandate and staff expect to find further patient and health system benefits with the one-year extension of this position.

Recommendation

Manitoulin Sudbury District Service Board accept the recommendation put forth by Paramedic Services to extend the pilot Community Paramedicine Service Navigator position for an additional year, within the existing funding envelope as set out in the accompanying resolution.