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Alternative Destination Transport

Alternative Destination Transport

REMSA’s Alternative Destination Transport program provides pathways of care other than transport to the emergency department for 9-1-1 patients. This includes transport of patients with low acuity medical conditions to urgent care centers and clinics for treatment, the transport of medically stable inebriated patients directly to the detoxification center, and the transport of medically stable psychiatric patients directly to mental health hospital for medical clearance and admission.


In cooperation with the community’s health care partners, this program will safely:

  • Improve each patient’s satisfaction with their overall health care experience
  • Reduce patient wait-times for nonemergency care and reduce patient out-of-pocket costs
  • Assure care is delivered where the patient’s insurance is accepted
  • Avoid an unnecessary emergency department visit


The Alternative Destination Transport program expands the options for transportation destinations when a patient dials 9-1-1 with a non-life-threatening, non-emergent, low acuity medical condition that could be treated safely outside of the emergency department. REMSA’s program is unique in the following ways:

Patients now have a variety of participating alternative destinations in Washoe County, including urgent care centers, clinics and other medical facilities as options to receive care.

The program features locally-developed protocols for low acuity, intoxicated and psychiatric patients and includes a rigorous clinical quality assurance program with medical director oversight and special training for all field medics.

The core element is an early destination evaluation — an advanced assessment performed in the field to determine if a 9-1-1 patient is clinically eligible to be treated at an alternative medical facility.

The medic first confirms that no priority symptoms exist that require treatments that can only be performed in an emergency department.

The medic then explains the patient’s medical condition may be appropriately treated at an alternative care location.

The selection of a location will depend upon: insurance accepted, facility hours, facility capability, facility capacity, and nearest appropriate location. Within clinical triage and destination guidelines, patient choice and consent will always be the final determinant.


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