Province Expanding Innovative Models to Deliver Better, Connected Care in

Published on May 07, 2021

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

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 Ottawa’s model of care were provided today by the Hon. Merrilee Fullerton, Minister of Long Term care, and Pierre Poirier, Chief of the Ottawa Paramedic Service.

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.

“The 9-1-1 model of care program will ensure those requiring medical assistance will get timely, appropriate care and it will help to reduce capacity pressure in our hospitals,” says Dr. Merrilee Fullerton, MPP for Kanata-Carleton and Minister of Long-Term Care.  “As we have seen with our local long-term care pilot programs, community paramedics are proving invaluable in the delivery of health care in Ottawa and throughout the Ottawa Valley. I would like to thank both Chief Michael Nolan and Chief Pierre Poirier for their leadership in establishing this new approach that better employs the knowledge and skills of our paramedicine practitioners.”

“The expanded 9-1-1 models of care is a common sense measure that will help ensure that patients receive the care they need without always having to go to a hospital,” said Jeremy Roberts, MPP for Ottawa West – Nepean, “Growing up with a younger brother who suffered from seizures, I’ve seen firsthand the incredible level of care that our paramedics provide. I have no doubt that, through this announcement, they will continue to play an even larger role as invaluable members of our medical care team.”

“I am proud of our government’s support for our world-class paramedics to deliver timely and effective care- to patients who need it most,” said Lisa MacLeod, Minister of Heritage, Sport, Tourism, and Culture Industries and MPP for Nepean. “This will assist patients to better control their care, and reduce stress on our health care system.”

“This model of care is incredibly important to the health and wellbeing of our community,” said Goldie Ghamari, MPP for Carleton. “Paramedics play a vital part in our health care system, and will now be able to provide appropriate care and treatment to patients directly or in their communities by reducing trips to crowded emergency departments, and supporting hospital staff.”

“Today’s announcement is welcome news for our city and our residents,” said Councillor Matthew Luloff, Chair of the City of Ottawa’s Community and Protective Services Committee. “This pilot program gives paramedics more options to provide patients with safe and appropriate treatment at home or in the community, while helping to protect the capacity of our hospitals. The City of Ottawa thanks the Province of Ontario for this innovative approach to local healthcare.”

“Throughout the COVID-19 pandemic, we have seen more than ever how critical it is for patients to receive timely and effective care – when and where they need it,” said Christine Elliott, Deputy Premier and Minister of Health. “As Ontario’s hospitals face unprecedented capacity pressures during the third wave of the COVID-19 pandemic, these new models of care will enable our world-class paramedics to support our most vulnerable patients in the most appropriate setting, while avoiding unnecessary emergency department visits.”

In Ottawa, 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

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.



  • To date, 9-1-1 models of care pilots have been approved for implementation in regions across Ontario covering 33 municipalities, with additional details to become available in the coming weeks.
  • Under the Alternate Destination model, specially trained paramedics assess the patient’s condition on-scene, per the Patient Assessment Standard of the Basic Life Support Patient Care Standards, followed by transport to a local hospice for palliative care patients, or to a local crisis centre for patients experiencing symptoms of mental health and addictions challenges. This model is currently available in select regions for both palliative care patients and patients experiencing symptoms of mental health and addictions challenges.
  • 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.



Media Contact for MPP Merrilee Fullerton:

Tiffany Lepack                           613-599-3000

Constituency Assistant            [email protected]