Health Sciences Association of Alberta v Alberta Health Services, 2011 ABQB 684

Court of Queen ’ s Bench of Alberta Citation: Health Sciences Association of Alberta v Alberta Health Services, 2011 ABQB 684 Date: 20111108 Docket: 1103 08111 Registry: Edmonton In the Matter of the Judicial Review Application of the May 9, 2011 Decision of the Alberta Labour Relations Board, Made Pursuant to The Labour Relations Code , R.S.A. 2000, C. L-1, and the Regional Health Authority Collective Bargaining Regulation, Alta.

Reg. 80/2003 Between: Health Sciences Association of Alberta Applicant - and - Alberta Health Services and Alberta Labour Relations Board Respondents _______________________________________________________ Memorandum of Decision of the Honourable Madam Justice J.H. Goss _______________________________________________________ Introduction

[ 1 ] The Health Sciences Association of Alberta (the Union) seeks judicial review of the Labour Relations Board (LRB) decision to refuse to include the EMS Supplementary Pension Plan (the Plan) for the paramedic members of the Union in the “ receiving agreement ” , the collective agreement between the Union and the successor employer of the paramedics, Alberta Health Services (AHS) implemented as part of ongoing restructuring on Alberta Health Care. Facts The consolidation process [ 2 ] The AHS is a regional health authority established under the Regional Health Authorities Act , RSA 2000, c R-10 (the Act).

The Union is a certified bargaining agent representing AHS employees employed in paramedical professional or technical services in a province-wide bargaining unit. The Union and the AHS are parties to a collective agreement, part of which is known as the AHS/HSAA EMS Addendum (the Collective Agreement). [ 3 ] Among other things, the Regulation created, as of April 1, 2009, a single Province-wide health care employer and four province -wide health care bargaining units to replace the previous nine health employers and many separate bargaining units.

The City of Edmonton EMS/ Paramedics, previously represented by Canadian Union of Public Employees, Loc. 3197 (CUPE 3197), and the City of Calgary EMS/Paramedics, previously represented by Canadian Union of Public Employees, Loc. 3421 (CUPE 3421), were merged into one of the four bargaining units.

AHS became the new employer, while the City of Edmonton and the City of Calgary were the previous employers. [ 4 ] Under the Regulation, the Union, one of the four mandated bargaining agents, and AHS were required to consolidate all the existing health care collective agreements into a series of province-wide “ receiving agreements ” , an amalgamation of existing collective agreements and Letters of Understanding carried over from existing collective agreements.

These receiving agreements were then subject to further bargaining to create a final “ amended receiving agreement ” to be used as the basis for the next round of collective bargaining. [ 5 ] The province-wide receiving agreement for EMS/Paramedic employees, the AHS/HSAA EMS Addendum, included 55 Letters of Understanding grandfathered from the pre-April 1, 2009 collective agreements.

These Letters of Understanding contain variations to the general terms of the receiving agreement to address certain stand-alone terms and conditions of employment for the different EMS/Paramedic employees operating in different areas of the Province.

As a result of Charter challenges to the new legislative regime by, among others, CUPE 3421 and CUPE 3197, the Letters of Understanding providing for supplementary pension plans for Calgary and Edmonton paramedics negotiated with the municipal employers were not initially included in this grandfathering, and are now the subject of this application. [ 6 ] On May 19, 2009, the LRB confirmed that the AHS was the employer of the emergency health service employees who had been members of CUPE 3197 and CUPE 3421.

It further concluded that the Union was their bargaining agent and that the receiving collective agreement was the AHS/HSAA EMS Addendum, inclusive of all Letters of Understanding and Local Conditions. It ordered the parties to begin collective bargaining within 30 days to amend the receiving agreement (Re: Alberta Health Services, [2009] ALRBD No. 23).

These latter LRB determinations were stayed pending the outcome of the constitutional challenges (Re: Alberta Health Services, [2009] ALRBD No. 32 , 170 CLRBR (2D) 170 ). [ 7 ] As a result of the stay, from April 1, 2009 until May 18, 2010, AHS bargained directly with CUPE 3197 and CUPE 3421, and it was not until the stay was lifted following the constitutional challenges that the Union became the bargaining agent.

The Supplementary Pension Plans [ 8 ] The Edmonton and Calgary paramedics had long lobbied the Federal government for amendments to the Income Tax Regulations to include “ paramedics ” in the list of “ public safety occupations ” , that were eligible for a supplementary pension plan. The supplementary pension plan was intended to take into account the paramedics' shortened careers and accordingly reduced pensions in contrast to other health care professionals. The sought-after amendment to the Income Tax Regulation came into effect on August 31, 2005.

[ 9 ] In the collective bargaining rounds immediately following the amendments to the Income Tax Regulation , both CUPE 3197 and CUPE 3421 proposed to the previous employers, Edmonton and Calgary, that supplementary pension plans be established for the paramedic employees.

However, the collective agreements negotiated in those bargaining rounds did not include supplementary pension plans. [ 10 ] On July 29, 2008 Edmonton and CUPE Local 3197 concluded a new collective agreement (the CUPE/Edmonton Agreement) that included a Letter of Understanding, providing that: Effective no later than January 1, 2010 the City of Edmonton shall introduce a Supplementary Pension Plan that will provide enhanced early retirement benefits for permanent employees. [ 11 ] The Letter of Understanding set out 11 provisions that would be required in the plan, including a 55-45% split on contributions, a 30 year unreduced benefit (3% per year reduction for early retirement), compulsory 55 years of age with five years of service to retire, deficits to be cost shared, and that the total cost to the City would not be greater than 2%. [ 12 ] On September 17, 2008 Calgary and CUPE 3421 concluded a new collective agreement (the CUPE/Calgary Agreement) that included a Letter of Understanding providing for a Supplementary Pension Plan.

The Letter of Understanding provided: Effective no later than June 30, 2009 the employer shall introduce a Supplementary Pension Plan that will provide enhanced retirement benefits. The employer understands what CUPE 3421 membership is looking for in this respect and will come back with a competitive plan.

In addition, we will commit to regular updated, no less than once every two (2) months. [ 13 ] The City agreed that it would “ endeavour to include ” certain features in the proposed plan: the ability for eligible members to buy back service, consider early retirement at 25 years service, and a Pension Advisory Committee.

The Letter of Understanding concluded: “ These features will be solely dependent on plan structure selected. ” [ 14 ] It is relevant to the LRB's decision to note that on May 15, 2008, two months before the Edmonton agreement and four months before the Calgary agreement, the Minister of Health and Wellness, by Ministerial Order #50/2008, ordered that the nine existing regional health authorities be consolidated into a single regional health authority, the AHS. [1] Further, on May 29, 2008 the Alberta Government issued a news release announcing that province-wide responsibility for emergency health services would be transferred to AHS, effective April 1, 2009.

In its Reasons, the LRB suggested that Edmonton and Calgary and the CUPE locals likely knew that they would not “ be around... to see the development of the supplementary plan through to its conclusion ” since they would have been aware of the Minister's announcement that ambulance services would be rolled into AHS. [ 15 ] As a result of the stay order (see para. 45 of [2009] ALRBD No. 32) and s. 20 of the Regulation, the July 29 CUPE/Edmonton Agreement and September 17 CUPE/Calgary Agreement bound AHS as the successor employer.

These agreements required the employer to take steps to implement the supplementary pension plans, and so while the stay of the LRB's decision was in effect and the Union was not yet the bargaining agent, AHS entered into a series of Letters of Understanding with CUPE 3197 and CUPE 3421 providing interim measures for implementing the supplementary pension plan. [ 16 ] These Letters of Understanding included timing for when CUPE 3421, and CUPE 3197 members would join the plan (July 6, 2009 and January 1, 2010 respectively), provisions for contributions to be paid into a formal Trust, and specific design and implementation requirements for the Plan to be included in the collective agreement.

As a result, AHS began deducting and retaining contributions to the Supplementary Pension Plan on July 6, 2009 (Calgary) and January 1, 2010 (Edmonton). [ 17 ] The Union became the bargaining agent for the paramedics on May 18, 2010 when the Court of Queen's Bench dismissed the CUPE locals judicial review applications and upheld the LRB's decision.

[ 18 ] The Union and AHS attempted to bargain the amended receiving agreement, but were unable to agree on whether a number of terms and conditions from the existing Edmonton and Calgary collective agreements should be grandfathered. The Union wanted to maintain a number or provisions, including the Plan, that were seen as more beneficial to the Edmonton and Calgary paramedics; AHS wanted the Edmonton and Calgary provisions to be consistent with the main amended receiving agreement.

They were unable to reach an agreement, and on December 2, 2010, the LRB appointed John Moreau, Q.C. as a Special Officer under s. 14 of the Regulation to try to mediate and resolve the outstanding issues, including the Plan. [ 19 ] On December 20, 2010 AHS and the Union entered into an “ Agreement and Declaration of Trust ” for the Plan, appointing the trustees and creating the Plan, and an “ EMS Supplementary Pension Plan ” agreement setting out the terms and conditions of the Plan. [ 20 ] The Special Officer issued his report and recommendations on January 31, 2011.

He recommended adoption of almost all of AHS's positions, and the Union adopted those recommendations. In regards to the Plan, however, he noted: ... a number of meetings have taken place to implement the terms and conditions of the Supplementary Pension Plan over the last few years and it is my view that those efforts should continue into the future. [ 21 ] AHS objected to the Special Officer's recommendation regarding the Plan and the matter was referred to the LRB under s. 15 of the Regulation.

The LRB's decision [ 22 ] The LRB noted that in reaching its decision, it must consider the statutory complexities of the legislation and the Regulation as well as the labour relations realities.

In particular it noted that the timing of the announcement of the transfer of ambulance services to AHS with the subsequent agreement between the two CUPE locals and the municipalities “ gives us more pause for concern, and in any event, provide an answer to the issue before us. ” It noted that a change like adding a Supplementary Pension Plan requires a great deal of effort and consideration, and that the Plan was not yet operational.

Further, it expressed concern that the actuarial evaluations obtained by both parties suggest that the design of the Plan was deficient, “ leaving suspect benefits, potentially high costs and real financial risks borne by employees.

There are serious and legitimate concerns that, in their present form, the plans may prove to be unworkable. ” Moreover, from a labour relations standpoint, it was concerned about the impact on AHS and the Union of the supplementary pension plans incorporated into the collective agreements when neither were parties to the initial bargain. [ 23 ] The LRB specifically noted that when the supplementary pension plans were incorporated into the collective agreements, the municipalities and both CUPE locals knew that they would likely not see the development of the Plan to completion.

It ascribed no bad faith to them, but found that the timing and bare bones nature of the Letters of Understanding suggested hurried negotiations in order to bind future employers or bargaining agents. It concluded that given its concerns about both the way the plans were incorporated into the agreements and the outstanding questions about implementation, the Plan should not be included in the receiving agreement and should be left to full collective bargaining. The standard of review [ 24 ] The parties agree that the appropriate standard of review is reasonableness: Dunsmuir v.

New Brunswick , 2008 SCC 9 , [2008] 1 S.C.R. 190 (at para. 47 ): Reasonableness is a deferential standard animated by the principle that underlies the development of the two previous standards of reasonableness: certain questions that come before administrative tribunals do not lend themselves to one specific, particular result. Instead, they may give rise to a number of possible, reasonable conclusions. Tribunals have a margin of appreciation within the range of acceptable and rational solutions. A court conducting a review for reasonableness inquires into the qualities that make a

decision reasonable, referring both to the process of articulating the reasons and to outcomes. In judicial review, reasonableness is concerned mostly with the existence of justification, transparency and intelligibility within the decision-making process. But it is also concerned with whether the decision falls within a range of possible, acceptable outcomes which are defensible in respect of the facts and law. (Emphasis added) [ 25 ] Our Court of Appeal in Alberta Union of Provincial Employees v.

Health Sciences Assn. of Alberta , 2009 ABCA 266 noted that labour relations boards are generally entitled to the highest level of judicial deference. Moreover, when determining reasonableness the Court must evaluate the tribunal's reasons as a whole, and address whether there is a line of reasoning sufficient to reasonably support the decision, and must not review the given reasons individually and in isolation to find defects: United Nurses of Alberta, Local 301 v. Capital Health Authority (University of Alberta) , 2009 ABCA 202 (at para. 8 ).

The Legislation [ 26 ] The Regulation, Regional Health Authority Collective Bargaining Regulation , AR 80/2003, as amended, AR 64/2009, provides: 1. (d.1) “ emergency health services ” means emergency health services under the Emergency Health Services Act; (d.2) “ emergency health services agreement ” means a collective agreement that applies to employees employed to provide emergency health services by an employer, other than a regional health authority, prior to April 1, 2009; 11 Within 30 days after the Board has designated a bargaining agent and a receiving collective agreement in respect of each region-wide functional bargaining unit, the regional health authority and the bargaining agent shall meet and commence to bargain collectively in good faith and make every reasonable effort to negotiate amendments to the receiving collective agreement so that the resulting amended agreement contains terms and conditions of employment for all employees in the region-wide functional bargaining unit. 14 At any time after bargaining has commenced under

section 11, either or both parties to bargaining may make a request to the Board for assistance in the negotiation process, and the Board may appoint any person as an officer of the Board to inquire into the dispute and endeavour to effect a settlement. 15(1) Where the parties are unwilling or unable to negotiate an amended receiving collective agreement as required by

section 11, the Board shall make an award with respect to all issues in dispute, and that award shall be binding on the parties to the dispute and shall be included in the terms of the receiving collective agreement.

(2) In making an award under subsection (1), the Board may adopt any procedure that it considers appropriate and, in addition to its powers under the Act , it may exercise any of the powers of a compulsory arbitration board under

Part 2, Division 16 of the Act. 16 Where the parties negotiate amendments to the receiving collective agreement as contemplated under

section 11 or where the Board makes an award under

section 15 , the resulting agreement is a collective agreement that is in force for the purposes of the Act . 20 Where a regional health authority becomes the employer of employees who were, prior to April 1, 2009, governed by one of the types of collective agreement referred to in

section 1(d), the collective agreement continues in force and binds the regional health authority, the bargaining agent or agents and the employees until a receiving collective agreement comes into force by virtue of the operation of

section 16. (Emphasis added)

Submissions [ 27 ] The Union argues that the LRB placed undue emphasis on the relative timing of the government's announcement that ambulance services would be transferred to AHS and the inclusion of supplementary pension plans in the Letters of Understanding in the CUPE/Edmonton Agreement and the CUPE/Calgary Agreement. In particular, the Union suggests that had the LRB been deciding the issue when the first fairly limited Letters of Understanding were entered into, the decision might be defensible, but the LRB here failed to consider that AHS, over 1 ½ years, bargained and implemented the Plan.

It suggests that AHS did not back away from the Plan or attempt to bargain an exit to the initial Letters of Understanding. [ 28 ] Further, the Union argues that an “ open period ” for collective bargaining had likely commenced for the Calgary agreement, which expired on July 5, 2009, and AHS could have attempted to bargain the supplementary pension plan out of the Calgary Agreement. As well, the Union argues that AHS could have approached CUPE 3197 in regards to bargaining an interim Letter of Understanding varying or removing the supplementary pension plan from the Edmonton agreement.

Instead AHS continued to negotiate further in regards to terms and implementation of the Plan. [ 29 ] The LRB, the Union argues, did not address or consider that AHS negotiated and executed a series of Letters of Understanding, the Trust Agreement and the EMS Supplementary Pension Plan, and began deducting employee contributions and making employer contributions to the Plan. [ 30 ] Moreover, the LRB noted that the supplementary pension plan was worthy of consideration, but required “ a great deal of effort and consideration ” and required the parties to work closely together to establish the terms of the plan, the mechanisms to oversee it, costs, implementation and roll out.

This, the Union argues, was unreasonable, because it ignores the evidence before the LRB that the parties had worked closely together in bargaining the Letters of Understanding, the terms of the Plan, and the Trust Agreement, that Trustees had been appointed to oversee the Plan, and that the parties had sought actuarial and pension expert advice.

The Union notes that if AHS and the Union were to negotiate a new supplementary pension plan, they would go through the same process already conducted. [ 31 ] The LRB noted that the Plan was not yet operational because it was still awaiting government approvals and it expressed concern that the actuarial valuations suggest that the Plan may be unworkable. The Union notes that these concerns were unreasonable because: a. the Plan is operational, since the Trust Agreement and the Plan text are in effect, trustees have been appointed, and employee and employer contributions are being made; b.

Regulatory approval is not a reasonable consideration and not within the Board's expertise; c. the actuarial reports obtained by AHS and the Union flag some concerns that may need to be addressed by the trustees and the parties, but these concerns are speculative and the reports note that future events will determine the benefits, costs, and financial requirements of the Plan; and d. the Plan agreement provides that the Trustees may increase or decrease contribution rates depending upon the actuarial report, thus giving the Plan and its members the flexibility to address the issues that may (or may not) arise in the future. [ 32 ] The Union therefore asks for the LRB's decision to be set aside and also submits that the matter should be remitted to a new Panel, asserting that there is a reasonable perception of bias by the first panel.

[33] AHS submits that the general thrust of the Union's argument is that the LRB ignored important facts in reaching its decisionand that the written reasons do not adequately deal with this evidence. It notes that under s. 7 of the Administrative Procedures andJurisdiction Act, RSA 2000, c A-3, the LRB has no statutory obligation to provide reasons.

Further, there is no requirement onadministrative tribunals to address every point nor should a court on judicial review assume that silence on a point means it wasoverlooked: Service Employees' International Union, Local No. 333 v.Nipawin District Staff Nurses Assn., (SCC),[1975] 1 SCR 382 (at 391); Alberta (Labour Relations Board) v. International WoodWorkers of America (IWA) Local 1-207 (1989),1989 ABCA 7 , 94 AR 293 (CA); Johnston v. Alberta (Energy and Utilities Board), (1997), 1997 ABCA 265 , 200AR 321 (CA).

AHS asserts that the LRB's reasons, assessed in the context of the entire record, are more than adequate to support itsconclusions. [34] As to the reasonableness of the decision, AHS notes that the series of steps it took in negotiating the Plan with CUPE 3197and CUPE 3421 were steps it was required to take as a successor employer bound by the CUPE/Edmonton Agreement and theCUPE/Calgary Agreement.

In particular, AHS notes that while the stay was ongoing, s. 20 of the Regulation applied and it was bound bythese agreements and could not negotiate variations to the agreements, until either an amended receiving agreement was negotiated bythe parties or awarded by the LRB.

In the interim, it continued to negotiate terms and conditions for the implementation of thesupplementary pension plans because that was its obligation under the Letters of Understanding negotiated by the predecessoremployers. [35] Further, it notes that the Union knew that AHS was opposed to incorporating the supplementary pension plan into theamended receiving collective agreement, and reference to that intention, and the Union's intention to bargain to retain it, was made in theLRB stay decision, [2009] ALRBD No. 32 at para. 34. [36] Therefore, AHS argues, it was reasonable for the LRB to consider that these implementation steps were immaterial todeciding whether it was appropriate for such a plan to be imposed in a radically different collective agreement that included emergencymedical services for the entire province. [37] Moreover, the LRB specifically noted the facts which the Union says it ignored at paras. 5, 23, 25, 26 and 27 of the Reasons,and the LRB expressly describes the Union's position (at para. 32): HSAA argues the Supplementary Pension Plan should be included in the receiving agreement.

Although it was only included in theCUPE collective agreements after the announcements of the change in regionalization structure and inclusion of the paramedics in theparamedical professional or technical services bargaining unit, it has been a process 10 years in the making. Far from being simply anadd-on at the last minute, it has been a negotiated item a long time in the making. Currently there are letters of understanding, moniesdeducted and trustees in place.

It would be inequitable to remove the Supplementary Pension Plan from the transitional agreement. [38] Therefore, argues AHS, the LRB referenced the facts relied on by the Union and considered the Union's submissions andthen rejected the Union's position. The LRB accurately assessed the fact that the Plan was not yet operational because governmentapproval had not yet been obtained, there were unresolved details and the Plan design, according to the actuarial reports, left suspectbenefits, potentially high costs, and real financial risk for the employees.

AHS submits that these findings were reasonably open to theLRB to make on the evidence before it. Analysis [39] The LRB's decision must be assessed for reasonableness and its reasons should not be minutely dissected for error (UnitedNurses of Alberta, Local 301). [40] The Union argues that the LRB made essentially three errors: 1. It placed undue emphasis on the timing of the Letters of Understanding in regards to the announcement by the government thatambulance services would be transferred to AHS;

2. It ignored the fact that AHS negotiated a series of Letters of Understanding, the Trust Agreement, and the EMS Supplementary Pension Plan, and did not attempt to resile from the provisions of the initial Letters of Understanding entered into by the municipalities; 3. The LRB unreasonably concluded that the Plan was not yet operational and that the actuarial reports suggested that the Plan was unworkable. [ 41 ] I note first of all that the LRB based its decision on what it called “ labour relations realities ” , and its overall conclusion was based on its expertise and understanding of these realities.

I note further that the Regulation gives the LRB authority to make an award when the parties are unable or unwilling to negotiate an amended receiving collective agreement, and that authority extends “ to all issues in dispute ” . [ 42 ] As noted by the LRB, this decision was a relatively unique exercise in that it was dealing with the terms and conditions to be included in an amended receiving collective agreement in the health care transition process (at para. 1): Such is the situation involving this Decision where we must determine for the first and probably only time, what terms and conditions of employment should be included in a “ receiving agreement ” as contemplated in

section 162.1 of the Labour Relations Code and the regulations enacted under that section. [ 43 ] In my view, it was well within the expertise of the LRB to take into account the timing of the Letters of Understanding following the Government's announcement; its experience gave it insight into the likely collective bargaining process that went into those agreements. The Union suggests that the LRB did not explain why it thought the timing was relevant, but in my view it did.

The LRB noted that the Letters of Understanding were “ bare bones ” , likely negotiated in a hurried fashion, and negotiated by parties who knew they were unlikely to be responsible for ultimate implementation. This was an entirely reasonable consideration. [ 44 ] Further, the LRB did not ignore the Letters of Understanding entered into by AHS with the CUPE locals or the process by which AHS and the Union undertook to implement the Plan.

It specifically referenced these facts and acknowledged the Union's argument. [ 45 ] The Union argues that rather than entering into the Letters of Understanding and taking steps to create the Trust Agreement and the Plan, AHS should have attempted to bargain out of the commitments to implement supplementary pension plans. AHS argues it was bound by the CUPE/Edmonton Agreement and CUPE/Calgary Agreement. [ 46 ] In the course of oral submissions on this point, AHS referred the Court to the decision in Alberta Union of Provincial Employees v.

Alberta Health Services , 2010 ABQB 344 , 491 AR 115 (AUPE) , in support of the proposition that the provisions of the Regulation limited the LRB's remedial jurisdiction under the general provisions of the Labour Relations Code RSA, 2000, c. L-1 (the Code).

While that decision dealt with whether the LRB retained jurisdiction to preserve the bargaining rights of predecessor bargaining agents under sections 46 and 48 of the Code (successorship), AHS argues the same principles apply to whether AHS could rely on the general principles in the Code to bargain changes to the Edmonton and Calgary agreements, either in an open period or generally. Essentially the argument comes down to whether the Regulation, in its specific and unique context of province-wide health care restructuring, limits the Board's general jurisdiction under the Code.

In AUPE, the LRB concluded that it did, and that even if it retained jurisdiction, the bargaining units were appropriate. Without discussion of the issue of whether the LRB retained jurisdiction, Belzil J. upheld the LRB's decision on judicial review as reasonable. [ 47 ] The Union intimates that because AHS had taken steps to implement the Plan, the LRB should have required the Plan be included in the receiving collective agreement. That was one approach the LRB might have taken, but its decision to not do so was not unreasonable.

Its reasons were rational and fall within the range of possible, acceptable outcomes. [ 48 ] As to the LRB's concerns regarding the operational readiness of the Plan, those conclusions were also reasonable in the entire context of the evidence and materials before it.

Its concern about labour relations practicalities, the fact that the burden of the uncertainties in the Plan would fall on a bargaining agent and employer who had not negotiated the inclusion in the collective agreement, and the conclusion that supplementary pension plans would be more appropriately bargained in the collective bargaining process, rather

than the amended receiving collective agreement process under the Regulation, were adequate, intelligible, and justifiable. [ 49 ] Accordingly, I dismiss the application for judicial review. Conclusion [ 50 ] The application is dismissed. The parties may speak to costs within 60 days of this decision. Heard on the 13 th day of September, 2011. Dated at the City of Edmonton, Alberta this 8 th day of November, 2011. J.H. Goss J.C.Q.B.A. Appearances: Dan Scott Seveny Scott for the Applicant Craig W. Neuman, Q.C. Neuman Thompson for the Respondent, Alberta Health Services Shawn McLeod Alberta Labour Relations Board for the Respondent, Alberta Labour Relations Board

[1] AHS suggests that this Ministerial Order let to AHS becoming the employer of the Edmonton and Calgary EMS personnel, formerly represented by the CUPE locals. In fact, the Order merely consolidated the Regional Health Authorities, and did not deal with emergency health services. It was amendments to the Regulation (AR 64/2009) that included "emergency health services" and "emergency health services agreements" within the "paramedical professional or technical services" bargaining unit, and expressly referenced "employees employed to provide emergency health services by an employer, other than a regional health authority, prior to April 1, 2009".