In 1997, the Ministry of Health announced the downloading of responsibility for land ambulance services to counties, regions and districts within the province of Ontario. Traditionally, the Ministry had been responsible for ambulance services as an integral part of the health care system and, in the District of Kenora, these services were provided by hospitals and municipal operators.
The delivery of land ambulance services was identified as one of the optional services that could be provided by a District Social Services Administration Board and in 2000 the Kenora District Services Board voted to become the designated delivery agent for land ambulance including the municipalities and unincorporated areas of the District.
The Ministry required delivery agents to determine by January 1, 2001, whether services would be contracted or provided directly. Negotiations with hospitals for the continuation of service and a Request for Proposal from private contractors were not successful and the decision was made that the KDSB would operate the land ambulance service directly with the exception of the municipalities of Pickle Lake and Sioux Narrows-Nestor Falls which remained as municipally run services under a one year renewable contract with the KDSB.
The municipally operated services elected to not renew the service contracts and therefore all land ambulance operations are now part of an integrated, district wide service known as Northwest EMS.