District Board of Health Meeting – April 23, 2026

The District Board of Health (DBOH) of Northern Nevada Public Health (NNPH) met on Thursday, April 23, 2026, at 1:00 p.m. at the Washoe County Administration Complex, Commission Chambers. Chair Devon Reese presided. A quorum was present with six members: Reese, Vice Chair Clara Andriola, Paul Anderson, Michael Brown, Steve Driscoll, and Dr. Reka Danko (present later, left at 3:00 p.m.). Dr. Eloy Ituarte was present. The meeting included recognitions, proclamations, consent items, a detailed update from REMSA Health, discussions on the EMS franchise agreement, the annual evaluation of the District Health Officer (DHO), and staff reports.

Consent Calendar

• Approved the March 26, 2026, draft minutes.
• Approved a Notice of Subaward from the State of Nevada DHHS for the STD Prevention and Control Program: $179,505 (retroactive March 1, 2026 – February 28, 2027, no match).
• Approved a Notice of Award from DHHS for the Title X Family Planning Program: $391,216 (retroactive April 1, 2026 – March 31, 2027, with a required match of $1,901,989).
• Adopted revisions to DBOH Regulations Governing Air Quality Management Chapter 040, Part 040.033 (Food Establishments).
• Acknowledged receipt of the Health Fund Financial Review for March Fiscal Year 2026.
• Motion passed unanimously.

Public Comments & Testimony

• Mark Tyer (President, Truckee Meadows Fire Protection District Union, Local 2487) spoke on item 10. He supported the unionization of REMSA Care Flight by the Transport Workers Union. He expressed concerns about: (1) the REMSA board lacking adequate inclusion of public fire agencies that are primary co-responders; (2) the need for defined performance standards for priority 2 calls; and (3) the need for closest unit response to improve patient outcomes.
• Patrick Walsh (paramedic, Local 2047, 19-year veteran) argued that current dispatch and franchise models do not consistently achieve getting the closest appropriate unit to the patient. He called for closer unit response standards, measurable benchmarks, transparent reporting, and enforcement in the franchise agreement.
• Aaron Abbott (CEO, Technical Medical) during the later public comment period raised concerns about the January 2022 REMSA franchise extension, questioned why a request by Board Member Driscoll to reconsider the item was not placed on the current agenda, and stated that proposed airport transfer language (item 16 of the franchise concerns) violates federal law, referencing a letter sent to the board on February 20, 2026.

Discussion Items

• Item 8 – REMSA Health Monthly Franchise Report: Barry Duplantis (CEO, REMSA Health) presented March 2026 data: 8,647 EMS calls, 5,737 transports. Average response times for priority 1 calls: Reno 5:30, Sparks 6:09, Washoe County 8:37. REMSA meets compliance in Zone A (90% <8:59) and year-to-date in zones B, C, D. Duplantis explained dynamic deployment, fire co-response, dispatch triage (all wheels roll for echo determinants), and financial challenges (average collection: Medicare $440, Medicaid $245, private insurance $1,700, uninsured $48). Board Member Anderson questioned why fire apparatus arrives first 44% of the time in Sparks and raised billing concerns. Chair Reese requested data sharing to evaluate claims. Board accepted the report unanimously.
• Item 9 – Uphold Decisions of Hearing Boards:
  • 9A: Upheld the Sewage, Wastewater & Sanitation Hearing Board’s approval of Variance H26-0002VARI for a reduced setback from a building sewer line to a well at 2425 Warrior Lane (unanimous motion).
  • 9B: Upheld the Air Pollution Control Hearing Board’s denial of appeal of Notice of Violation AQMV26-0001 to JC Golden Mesa, LLC, with a $1,000 administrative penalty for failure to control fugitive dust (unanimous).
• Item 10 – EMS Franchise Agreement Meet and Confer Items: Dr. Chad Kingsley presented 19 items synthesized from board direction (January 2026) and stakeholder workshops (March 18 and April 1, 2026). The first meet-and-confer is scheduled for May 4, 2026. Board members Andriola and Driscoll noted a lack of prioritization in the item list. Kingsley will bring back results in May or June 2026. Chair Reese and counsel confirmed board oversight and annual compliance reviews.
• Item 11 – District Health Officer Annual Performance Evaluation: Dr. Kingsley received an overall “Effective” rating: comparable rating of 2.08 (on a 3-point scale) and 2.07 including a new group of supervising staff. Participation was 84.24%, the highest in years. Board members provided comments: Reese highlighted strengths in stakeholder engagement and emergency response; Driscoll attributed lower supervisory scores to change management resistance; Andriola expressed lack of confidence, noting significant drop from 2025 (2.40 to 2.08) and minimal improvement; Anderson noted communication gaps and concern over scores; Brown acknowledged progress. Dr. Kingsley requested clearer board goals and a revised evaluation process. Motion to accept results, renew contract for one year, and approve 5% merit increase passed unanimously.
• Item 12 – Staff Reports and Program Updates:
  • 12A – Air Quality Management: Francisco Vega reported 90% of plan reviews completed on time, no red burn codes during the season, and successful elimination of overtime through technology improvements.
  • 12B – Community and Clinical Health Services: Christina Shepard highlighted World TB Day, a new TB clinic, a shortage of syphilis medication (bicillin conservation for pregnant patients), and successful initiation of a client on injectable PrEP.
  • 12C – Environmental Health Services: Robert Fyda noted a new Spanish-language AMC program, improvements in food plan review, a new app for food trucks, and the opening of online pool inspection scheduling (~600 pools).
  • 12D – Population Health: Dr. Nancy Diao reported 25 pertussis cases in 2026 (80% of 2025 total by one-third of the year). Influenza-like illness peaked in late December 2025 (highest in 5 years) and declined by late February. RSV peaked late in February. New informatics dashboards have saved staff hours and external vendor costs.
  • 12E – Office of the DHO: Dr. Kingsley noted the REMSA response to Board Member Driscoll’s question was included as an attachment.

Key Outcomes

• Consent calendar approved unanimously.
• REMSA Health monthly franchise report accepted; board directed staff to follow up on data concerns from Board Member Anderson.
• Decisions of the Sewage and Air Pollution Control Hearing Boards upheld (both unanimous).
• District Health Officer’s contract renewed for one year with a 5% merit increase, effective rating accepted, and board directed staff to develop a revised evaluation process within 90 days.
• Meet-and-confer with REMSA Health set for May 4, 2026; staff to report back on outcomes in May or June.
• Board directed Dr. Kingsley to establish bi-monthly “two-by-two” meetings with board members for improved communication.