providing front-line care. Further, and as we were proceeding virtually, if she was
urgently needed to make a decision within her role, we could have a brief adjournment
to allow her to participate in meetings before reattending to provide evidence virtually.
 Mr. Littlechild confirmed his group, the Siksika Emergency Medical Services, is
one of several services overseen by SHS. SHS offers health services at the clinic on the
Siksika Nation where there are doctors, nurses, dentistry, and mental health services.
The SEMS operates out of the Fire Station which Mr. Littlechild is also responsible for.
SHS offers various other programs including Elders Services, Clinical Service,
Community Health, Home Care, Elders Lodge, Community Wellness, Disabilities,
Recreation, and Cultural Support Services.
 SHS gets its funding for SEMS from four sources. The largest portion of its
funding comes from Alberta Health Services (AHS) – about $88,000 per month. Health
Canada, a federal entity, covers non-insured coverage which is a fee-for-service. When
crews go out to service a call, SEMS is paid a fixed amount per kilometer and service
provided. This amount varies month to month and year to year as it depends on the
number of calls received. In a typical year, SEMS invoices Health Canada between
$600,000-$800,000. The third funding source is insurance payable as a result of motor
vehicle accidents. Again, this is another fee-for-service for which SHS receives between
$15,000-$20,000 annually. The last funding source is Alberta Blue Cross which pays for
elder transport in a fixed amount. This accounts for between $15,000-$18,000 in
revenue annually. The ambulance service has no other source of funding and,
according to both Mr. Littlechild and Ms. Yellow Old Woman, receives no funding from
the Siksika Nation. Both Mr. Littlechild and Ms. Yellow Old Woman agreed the contract
with AHS is negotiable and SHS is paid the amount agreed upon with AHS. Neither
witness had knowledge of entities who were unionized with contracts with AHS so
neither could speak to how, or how much, AHS contracts with these other ambulance
 SHS employs 16 full-time paramedics consisting of 8 Advanced Care
Paramedics (ACPs) and 8 Primary Care Paramedics (PCPs) as well as a pool of
approximately 50 casual paramedics who are called on from time-to-time as needed.
Pursuant to the contract with AHS, SHS must provide two Advanced Life Support
vehicles 90% of the time to Siksika Nation and the buffer zone around the Nation.
SEMS has two front line trucks and two mechanical back-ups. The back-ups are older.
The front-line vehicles are relatively new having become operational in March or April
2021. One of the older vehicles is quite old while the other is one of the former front-line
ambulances. Another new truck is on order which will technically be a back-up.
 According to Mr. Littlechild, the Employer’s desired – and needed schedule –
should include two ACPs and two PCPs on shift at any time; one ACP and one PCP per
vehicle. If they do not have an ACP in an ambulance, it does not qualify as an