About REMSA
Since 1986, REMSA has provided nationally recognized ground ambulance service within Washoe County, Nevada. As the largest employer of EMS personnel in Northern Nevada, REMSA provides residents and visitors with 9-1-1 response and transport, interfacility transport, disaster preparedness, special events coverage, search and rescue, tactical medical support, and public education. REMSA provides ground ambulance services under a performance-based franchise agreement with the Washoe County Health District and is the sole provider of emergency and inter-facility ground ambulance transport services within Washoe County (excluding Incline Village and Gerlach). REMSA is a private, nonprofit community-based service which is solely funded by user fees with no local community tax subsidy.
REMSA maintains its operational and clinical standards as one of the most recognized high-performance EMS systems in the country. REMSA responds to approximately 90,000 requests for service per year.
How REMSA Health Was Established
In 1986, an Interlocal Agreement (ILA), authorized under Nevada Revised Statutes, was created between Washoe County and the cities of Reno and Sparks. This established a shared responsibility for a unified regional public health authority known as Northern Nevada Public Health. It is governed by the District Board of Health (DBOH) to oversee and deliver all public health services countywide, ensuring consistent standards, coordinated operations and joint governance to benefit all of Washoe County. The DBOH is comprised of seven members which includes two representatives each from Washoe County and the cities of Reno and Sparks, as well as a Nevada-licensed physician. One of the core services covered under the ILA is the delivery of emergency medical services (EMS).
Also in 1986, the DBOH, under the ILA, entered into a franchise agreement with the Regional Emergency Medical Services Authority (REMSA) to provide dispatch, emergency and non-emergency medical services transport to all of Washoe County.
About The Franchise
In communities across the country, municipalities enter legally binding contracts with private (non-government) providers for things like electric or telephone services. In some cases, like in Washoe County, a franchise can be used to provide EMS. However, unlike investor-owned utility providers like electric companies which are overseen by the State of Nevada Public Utilities Commission, cooperatives, non-profits or authorities like REMSA have their own governing bodies (the DBOH) who are generally elected by customers (the citizens of Washoe County, Reno and Sparks).
A franchise means that for the benefit of being the only provider in an area, a single agency (in this case, REMSA) is legally bound to:
- deliver consistent and efficient services to the community (i.e. the same clinical and operational service across all of Washoe County),
- is held to strict performance standards (i.e. the 8 minute and 59 second response time for life-threatening calls),
- and is regulated by government oversight (i.e. the DBOH).
While some people say this looks uncompetitive, it isn’t. The DBOH, not REMSA, sets the rates and determines who can access the services and the policies related to the services. This structure is an important guard against harmful races to the scene of accidents. Also, REMSA Health responds and provides care, regardless of someone’s ability to pay. The design is intentional because EMS is considered an essential public service and the barriers to entering this business are high (expensive infrastructure, limited reimbursement, 24/7 requirements, high fixed costs) and runs best under a single coordinated system that ensures reliability and avoids fragmented response and care.
What It Means to Be a Private, Nonprofit Organization.
It’s simple. Private means we are not a government organization and do not receive any local tax dollars. Washoe County citizens do not pay a penny of taxes for REMSA Health to serve the community. The only time there is a cost is if you are transported by REMSA Health – and that charge is set and governed by the DBOH. There is no bill if we respond and provide care but don’t transport. We are not a burden on the taxpayer.
Nonprofit means we reinvest all our income into the communities we serve through wages, benefits, services, outreach and equipment. We are required to do this as a part of our mission-based work. The community members we serve are our shareholders. Plus, our financials are audited by a third party, are publicly available and our billed transports are shared monthly with the DBOH in our required reporting packet.
About Care Flight
Care Flight, a program of REMSA, was established in 1981 with a single aircraft and has expanded over the years to four helicopters, one fixed-wing aircraft, and one ground critical care transport (CCT) ambulance. Care Flight also operates the ground 9-1-1 ambulance service for Plumas District Hospital in Quincy, California. Care Flight is a private non-profit community-based service which is solely funded by user fees and no local community tax subsidy.
Care Flight provides services throughout northwest Nevada and northeastern California region with base locations in Reno, Gardnerville and Fallon, Nevada and Truckee and Beckwourth, California. The Plumas Ground Ambulance Service has three ambulances and one quick response supervisor vehicle. One ambulance is staffed 24/7 with an on-call crew for a second-out ambulance. Care Flight transports an average of 1,500 air medical patients per year and the Plumas Ground Ambulance Service is projected to transport an average of 670 patients per year.
