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Local governments, REMSA reach agreement on improvements to emergency medical services



The city of Reno, city of Sparks, Washoe County, Washoe County District Board of Health and Regional Emergency Medical Services Authority (REMSA) announced yesterday the approval of a number of measures improving the region’s Emergency Medical Services (EMS) system after almost 12 months of working in collaboration.

The measures include the Principles of Agreement and the development of an Inter-Local Agreement between the three local governments, affecting the region’s EMS system. Resolution was also reached on all 38 recommendations provided in the study completed by the TriData EMS consulting group hired by the Washoe County commission in 2011, and completed in 2012.

At a concurrent meeting held Monday of the two city councils, Washoe County’s Board of County Commissioners and District Board of Health, the Principles of Agreement and the development of an Inter-Local Agreement were approved by the collective group. The Principles of Agreement and the Inter-Local Agreement resolution were generated from a collaborative EMS (Emergency Medical Services) Working Group that was formed to address topics identified in the TriData study.

The study identified 38 topics for the EMS working group to address, including areas of fire first response and also REMSA ambulance services. The Principles of Agreement addresses the franchise agreement between REMSA and the District Board of Health. The Inter-Local Agreement, which represents the provision of EMS services for the three local governments, will also form a new regional Emergency Medical Services oversight program and a Regional EMS Advisory Board under the direction of the District Board of Health.

The franchise agreement, which was originated in 1986, created REMSA and provided that organization with the authority to oversee paramedic ambulance services and Care Flight emergency medical helicopter services. It has been updated since then, but the revisions from the EMS working group offered the most innovative changes to the franchise agreement since its inception. The revised franchise agreement would be in effect for 16 years with the possibility of two six-year extension periods if REMSA continues to perform under the requirements of the franchise agreement.

The Principles of Agreement are a negotiated consensus by the EMS working group of the changes to be incorporated into the existing franchise. It was a process in which all parties fairly negotiated their viewpoints, and the Principles represent a unified position to benefit the future of EMS in the region.

The members of the EMS working group include the managers from the city of Reno, the city of Sparks and Washoe County; the health officer from the District Board of Health; the fire chiefs from the city of Reno, the city of Sparks, the Truckee Meadows Fire Protection District (TMFPD) and the North Lake Tahoe Fire Protection District (NLTFPD); the Washoe County Sheriff (WCSO); the CEO of REMSA; and the other agency staff as requested desired by the EMS working group

The EMS working group executive committee comprised Shaun Carey, Sparks city manager, who chaired the group, and Andrew Clinger, Reno city manager, John Slaughter, Washoe County manager, Kevin Dick, district health officer, and Jim Gubbels, CEO of REMSA.

“The EMS Working Group members worked intensively, in collaboration, and addressed differences through extensive discussion and negotiation, and the outcome represents a new level of trust and a spirit of cooperation between all of the agencies involved,” said Carey, EMS working group chair. “We are very proud of the hard work we have done to improve the collaboration between all of our agencies, and the overall quality of our regional EMS system.”

The new Regional EMS Advisory Board under the Washoe County District Board of Health agency will provide oversight over the entire Regional EMS System, while maintaining the organizational identity of the individual provider services. Goals include enhanced integration and coordination of the Regional EMS System and greater performance monitoring to ensure quality patient care

Operational performance of all EMS agencies, including fire service first response, REMSA and the emergency dispatch centers will be evaluated. Performance standards and quality assurance will be discussed and evaluated on a system wide basis. This advisory board will make recommendations to the District Board of Health for system improvements.

After the concurrent meeting vote by all of the involved agencies to approve the development of an amended franchise based on the Principles of Agreement, the Washoe County District Attorney’s office will prepare the legal documents for execution by the District Board of Health and REMSA following ratification by all parties.

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