By: Sylene Argent, Local Journalism Initiative Reporter, Essex Free Press
Council for the County of Essex received a report detailing the annual operational status for Essex Windsor EMS (EWEMS) as information at the June 3 meeting, which detailed the organization’s performance, pressures it faces, and the actions being taken to respond.
“Call volume continues to grow and remains consistent with our Master Plan projections,” EWEMS Chief Justin Lammers relayed to members of County Council.
In 2025, call volume increased by around 4.4%. Over the course of the year, paramedics responded to more than 68,000 urgent and emergent incidents that required over 76,000 deployed units.
That speaks to not only the rising demand, but the growing complexity of calls and the need to assemble multiple resources in many situations.
A significant portion of EWEMS’s workload continues to be assigned to Code 4, which requires lights and sirens under the current dispatching system. EWEMS will switch to the Medical Priority Dispatch System (MPDS) this September, which will make changes to how it responds to calls.
EWEMS also carried out over 44,000 deployment movements, above incident response, to maintain balanced coverage across the region.
“Overall, the system continues to operate under sustained pressure,” Chief Lammers said. While EWEMS has recorded a slight decrease in response time performance in the most critical categories, there has been an increase in Code Black events – when no ambulances are immediately available.
In providing more information at the request of Essex Mayor Sherry Bondy, Lammers said they are trending down from an overall high in 2022. It did peak again in 2025 at 57%. So far this year, 111 Code Black minutes have been recorded.
The Report to County Council notes codes Yellow and Red saw reductions in 2025.
“Code Blacks are very dependent on call volume, time on task for the units – whether it’s prolonged care on scene or inability to offload at the hospital – as well as available units on the road,” Lammers said. While no Code Blacks is something desired, 111 minutes appears to be low, but the rest of the year will indicate where EMS will be with it. It is hard to predict, yet it is something EMS takes seriously.
“Taken together, these indicators show there are times when demand is exceeding the resources available in the system,” he explained.
One area Lammers is seeing encouraging progress is offload delays at hospitals. Total hours EMS spent at the hospital declined in 2025 and continue to trend downward in 2026, Lammers added, noting 1000 fewer off-load hours were noticed in the first quarter of 2026 compared to the same period the year prior.
That improvement is because of the strong collaboration with hospital partners to improve patient flow and reduce time spent waiting to transfer care from EMS to the hospital.
Workforce capacity remains one of the most significant constraints in the system, Lammers relayed to County Council. While EWEMS continued hiring in 2025, the growth was offset by retirements, resignations, and a high number of leaves.
At times, as many as 65 part-time paramedics were filling full-time vacancies. “This reduces our flexibility and contributes to ongoing down-staffing pressures,” Lammers said. Even though there was a slight improvement compared to previous years, these workforce dynamics were a major contributor to the operational pressures he outlined in the Report to County Council he prepared.
“In response to the pressures, we are making adjustments where we can,” he explained. One such example is that planning is underway now for its net-new vehicle enhancement in 2027. He said in the 2027 pre-budget vehicle procurement report, EWEMS is introducing a new version of the rapid response units to improve response to the most time-sensitive calls. EWEMS will also be more innovative in how it uses its resources.
In addition to moving to the MPDS System to improve call triage and resource allocation this fall, Lammers said EWEMS is continuing with CPR training and AED placement to strengthen cardiac arrest outcomes.
As EWEMS continues to grow, it is facing infrastructure limitations, Lammers added. That includes space for staff, equipment, and vehicles.
Operating costs increased by 6% in 2025, reflecting continued pressure in staffing, fleet, and supplies. Capital investments also rose, with spending focused on fleet, equipment, and infrastructure.
Strategic land acquisitions were also made to support EMS facilities and long-term growth.
“We remain focused on doing better, strengthening operations, supporting our staff, and improving how we serve the community,” he said, thanking all EWEMS team members for their professionalism, resilience, and ongoing commitment to residents. He also thanked the County and County Council for continued support and engagement with the issues EMS is facing.
Lakeshore Mayor Tracey Bailey was particularly thrilled to see the drop in off-load delays in 2025.
In responding to Amherstburg Deputy Mayor Chris Gibb on staffing pressure and
whether that is a local issue or an industry problem, Lammers said the Province is experiencing a shortage of paramedics.
Lammers also outlined the MPDS implementation as part of a report that Essex County Council received as information.
This will be implemented through the Windsor Central Ambulance Communications Centre, and launched by the middle of September.
While EWEMS does not operate the dispatch centre, “it represents an important advancement in how 911 medical calls are triaged and managed across our region,” Lammers said.
One of the key challenges with the current system is over-prioritization, Lammers said. Right now, a large portion of 911 calls are treated as life-threatening emergencies, and this leads to inefficient deployment of paramedic resources. That “limits our capacity to respond to true, high-acuity events.”
He explained that in 2025, 82% of EWEMS’s responses were sent out with lights and sirens, but only 17% of those calls required a lights-and-sirens response on arrival.
“So, we are consistently over-prioritizing, and it is creating significant strain on system capacity and working against our ability to meet response time targets,” Lammers said.
He said EWEMS sees what improvement can look like. He said Simcoe County, after implementing MPDS in 2024, achieved a 37% reduction in lights-and-sirens responses in the first year, reflecting more accurate triage and a meaningful reduction in over-prioritization.
The calls are still there, and the workload remains; it just balances out, Lammers said. What changes is how quickly EMS responds and how appropriately it matches resources to the need.
Another key issue is EWEMS’s limited ability to distinguish between low and high-acuity patients. As a result, it is difficult to meet response time targets as demands continue to rise and resources continue to stretch.
MPDS will add precision and flexibility to how EMS responds to calls. It has six priority levels, ranging from immediate lights and sirens for the most critical calls to lower acuity calls where paramedics have more flexibility to respond, based on deployment plans and available resources.
It uses robust questioning to gather information. There are also diagnostic tools built into the system to help dispatchers make more accurate decisions about the level of care required. For every single call, there are pre-arrival and post-dispatch instructions, which could include lifesaving interventions before paramedics arrive, Lammers said.
Depending on patient acuity, Lammers said there may be situations where police or fire wait longer for an ambulance to arrive on scene. Residents will also, at times, wait longer for an ambulance to arrive on scene.
EMS has worked with fire and police, and he is confident they will be able to work out any hiccups.
As part of the transition, ambulance availability codes will be changed. His report noted if 11 more ambulances are available, it will be called Code Normal instead of Code Green, between four and 10 Code Surge instead of Code Yellow, between one and three Code Critical instead of Code Red, and if no ambulances are immediately available, Code Zero instead of Code Black.
In answering LaSalle Councillor Mark Carrick’s question about how long the questioning will take through the new system as it pertains to real emergencies, Lammers explained to his knowledge, there are early indicators that will get a unit rolling as more information is collected.
Essex County Council also authorized administration to proceed with the purchase of five new ambulances, four remount ambulances, and two Rapid Response Units for a total of $2,577,791, as part of pre-budget approval for 2027.
This will be funded through the EMS equipment and vehicle reserve. The deposit is around $728,000, which will be required in 2026. The remaining balance is due upon delivery in 2027.
The Report to County Council adds approval of this purchase will result in an increase in the 2027 EWEMS budget request to partially restore the reserve. Any funds contributed to the reserve are shared between the City and County.
The request came in now as manufacturing response time remains long, around a 12-18-month range, Lammers said. Without early approval, EWEMS risks not receiving these vehicles in 2027, which would affect service levels, fleet reliability, and add maintenance costs to aging units.
Annually, EWEMS replaces seven ambulances as part of its asset management plan.
The Report notes Essex-Windsor EMS currently operates a fleet of 42 ambulances and 20 emergency and logistics vehicles. Two net-new ambulances approved in early 2025 will enter service in May 2026, bringing the total ambulance complement to 44.
Lammers explained the Rapid Response Units are designed to respond to Obvious Immediate Threat (OIT) calls, such as cardiac arrest, choking, not breathing, unconscious patients, and severe respiratory distress. They will also be equipped to support large-scale motor vehicle collisions and other low-frequency, high-risk events.
This approach enables rapid response to the most critical emergencies and helps free-up transport ambulances from events that require longer on-scene times.
The service will continue to use Crestline Coach Ltd. as its supplier. EWEMS will also pilot one TriStar ambulance, recently approved by the Ministry of Health for production.