Washoe County District Board of Health Meeting - July 23, 2026

The Washoe County District Board of Health met on Thursday, July 23, 2026, at 1:00 p.m. at the Washoe County Administration Complex in Reno, Nevada. The meeting covered recognitions, consent items, a REMSA franchise report and agreement revisions, presentations on the Inter-Hospital Coordinating Council (IHCC) and the FY27-30 NNPH Strategic Plan, and staff reports from multiple divisions. Public comment and board discussion focused on franchise agreement details, REMSA performance, and community health initiatives.

Recognitions

• New hire: Jamie Morales, PHD Int/Hrly Public Health Investigator I, effective July 13, 2026.
• Years of service: Sahara Cruz-Ramirez, 5 years, CCHS Office Specialist, anniversary July 6, 2021.
• Health Heroes: Ten staff members recognized for going above and beyond, including Jordyn Marchi, Raquel Depuy Grafton, Stephen Shipman, Melissa Shaffer (PHD), Lauren Huntsman, Steve Kutz, Bianca Trujillo, Charmaigne Roque, Beth Reeve, and Kellisa Suarez (CCHS).
• Washoe Stars: Dawn Edwards, Benjamin Davis, and Genine Rosa recognized for Quality Public Service.

Consent Calendar

• Approved the June 25, 2026 draft minutes.
• Approved a subaward from the State of Nevada DHHS Grants Management Unit retroactive to July 1, 2026 through June 30, 2027, in the amount of $278,963.00 (no required match) for the CCHS Family Planning State Vaccine Program, authorizing the District Health Officer to execute the subaward and any future amendments.

Both items passed unanimously.

REMSA Health Monthly Franchise Report (Item 7)

Barry Duplantis, CEO and President of REMSA Health, presented the June 2026 franchise report. Key statistics:

• Responded to 8,682 EMS calls and transported 5,619 patients.
• For the first time in REMSA's history, responded to over 100,000 calls of service in fiscal year 2026.
• Average response times for priority one calls: Reno 5 minutes 31 seconds, Sparks 6 minutes 13 seconds, Washoe County 8 minutes 46 seconds.
• Priority two average response times: Reno 7 minutes 6 seconds, Sparks 7 minutes 51 seconds, Washoe County 9 minutes 36 seconds.
• Year-to-date compliance in zone A: 90%; in zones B, C, D: 93%.
• 52 exemptions in June, all for system overload.
• Patient satisfaction scores: May 97.54, June 98.63.
• New customer survey system allows real-time access; patients contacted within 10 days.
• Survey results for May and June indicate patients rank professionalism, care provided, and caring as most important; response times ranked third in May and fifth in June.
• Common computer aided dispatch (CAD) system Go Live expected around April 2027; current software platform fully supported.
• Presented contributions to Northern Nevada Peer Support and Trauma Intervention Program from the community investment fund (formerly penalty fund).

Board members discussed system overload exemptions, extreme weather effects on response times, and priority two calls escalating to priority one. REMSA Chief Operating Officer Adam Hines noted that after-action reviews examine system overload events and that mutual aid agreements with fire service partners are in place when ambulances are consumed.

Public comment: Aaron Abbott (Technical Medical EMS) noted 195 system overload exemptions and 63 weather-related exemptions since July 2025, and expressed concern that REMSA did not contact Technical Medical as a closest available resource for a recent motorcycle accident.

The board voted to accept the report (motion by Driscoll, second by Andreola; passes unanimously).

Inter-Hospital Coordinating Council (IHCC) FY26 Accomplishments (Item 8)

Andrea Esp (NNPH Preparedness EMS Program Manager) presented the IHCC report. Highlights:

• Coalition established in 1994, now connects over 122 partners (EMS, fire, public health, hospitals, long-term care, schools, emergency management).
• In FY26, IHCC delivered major exercises including Operation Western Skies (staged aircraft crash involving 40+ agencies and over 80 volunteers), supported the Davis Fire response, and hosted training on WMD, radiation, burn care, decontamination, cybersecurity, and healthcare facility evacuation.
• Hospital Preparedness Program capability assessments response rates increased from 35% to 46%, exceeding the 38% goal.
• Regional hazard vulnerability analysis identified earthquake, external fire, and unplanned power outage as highest risks.
• Coalition spent more than $128,000 on supplies, equipment, and travel for 22 partners attending 6 trainings/conferences.
• Federal project officer Captain Kevin Sheehan described IHCC as "a shining example of what a unified committed forward-thinking health care coalition can achieve."
• Multiple partner representatives (Washoe County School District, Technical Medical EMS, REMSA, Sparks Fire Department, Washoe County Emergency Management, NeuRestorative) testified to the coalition's value in preparedness and response, particularly during the Davis Fire and the Medline Fire supply chain disruption.

No action required; board expressed gratitude.

FY27-30 NNPH Strategic Plan (Item 9)

Rayona LaVoie (NNPH Director of Programs and Projects) presented the strategic plan. Key points:

• Plan grounded in three data sources: Washoe County community health assessment, public health workforce needs survey, and Bay Area Regional Health Inequities Initiative assessment.
• Board reaffirmed four priorities: (1) reduce health disparities; (2) operational excellence (new goal focusing on efficiency and effectiveness); (3) expand use of community health assessment data; (4) explore legislative opportunities to advance public health.
• Shift from tracking process measures (e.g., number of inspections) to impact measures (e.g., improving compliance rates, reducing repeat violations, decreasing foodborne illness trends).
• Staff held workshops with every program to align activities with board direction and emerging community needs.
• LaVoie committed to presenting quarterly progress reports to the board.
• Dr. Eloy Ituarte asked about inclusion of lung cancer indicators; LaVoie responded that the plan focuses on the most pressing needs identified in the community health assessment, and that indicators evolve every three years.
• Chair Reese clarified that the strategic plan is an organizational function, not directly tied to the health officer's performance evaluation.

The board voted to accept the plan (motion by Reese, second by Brown; passes unanimously).

Revisions to the Amended and Restated Franchise Agreement for Ambulance Service (Item 10)

Andrea Esp presented proposed revisions following meet-and-confer meetings with REMSA Health (held May 4, May 14, and June 16, 2026). Changes include:

• New franchise agreement review guidelines as an attachment.
• Clarified penalties, performance metrics, exemptions, corrections, and complaint reporting.
• Community Investment Fund (penalty fund) will now be held by NNPH instead of REMSA, with spending approved by the District Health Officer.
• Cleaned up enforcement language, including termination triggers.

Public comment: Aaron Abbott (Technical Medical EMS) urged removal of language in Article 2.1 granting exclusivity to REMSA for ground ambulance transports originating outside the franchise area for air medical transports, arguing the Airline Deregulation Act preempts local regulation. Joey Lochner (Battleborn Medevac) echoed concerns, stating competition has improved service.

Board discussion:

• Board Member Anderson moved to delay the effective date from July 23, 2026 to March 1, 2027, and continue discussion until February 2027, with staff to work with member agencies and REMSA to address all concerns. The motion failed (3-4: Anderson, Brown, Ituarte in favor; Andreola, Driscoll, Reese, Danko opposed).
• Deputy District Attorney Reed stated that the Airline Deregulation Act does preempt grant of authority for air medical transports, but noted that discussing attorney-client privilege in public could waive it.
• Vice Chair Andreola expressed concerns about process transparency and legal analysis not being fully shared with the board before the January vote. Chair Reese disputed that, noting extensive vetting and public meetings.
• Board Member Driscoll supported the revisions, stating staff did what was asked and the agreement provides mechanisms for ongoing review.
• Board Member Brown expressed concern that the agreement lacks a defined term and that recurring amendments may not address fundamental issues.

The revised agreement was approved (motion by Driscoll, second by Andreola; roll call: Andreola no, Driscoll yes, Reese yes, Anderson yes, Brown no, Danko yes, Ituarte yes; passes 4-3).

Staff Reports and Program Updates

11A. Air Quality Management (Francisco Vega): The DC Circuit upheld the 2024 PM NAAQS. In June, one ozone exceedance occurred; 54 plan reviews processed in an average of 3.7 days (100% on time). Vega discussed monitoring for fires, noting a delay between smoke observations and data on airnow.gov.

11B. Community and Clinical Health Services (Christina Sheppard): Customer service survey results showed word-of-mouth and referrals from hospitals and social services agencies are key sources. Family planning, sexual health, and immunization programs are collaborating to offer no-cost HPV vaccine to uninsured individuals. WIC transitioned from Moana location to Ninth Street clinic; participation increased 5% compared to June 2025. Sheppard noted partnerships with Orvis School of Nursing and the School of Medicine for clinical rotations.

11C. Environmental Health Services (Robert Fyda): Food inspection boot camp held with 33 establishments. Five recurring food truck events and special events active. PFAS residential well sampling: 40 samples, about one-third had PFAS hits, 5 above drinking water standard. Scheduled inspection program launched via email; challenges with ensuring correct contact information. Board members commended inspectors for their educational approach.

11D. Population Health (Dr. Nancy Diao): Chronic disease program conducted a Grab Healthy Food Access Survey in Sun Valley after closure of a grocery store; findings confirm residents travel outside the area for groceries and that convenience stores are important but inconsistent sources of healthy food. Second quarter disease statistics published; animal bites remain elevated. One case of cyclosporiasis reported (travel-related, not local exposure).

11E. Office of the District Health Officer (Dr. Kingsley): Dr. Kingsley briefed the board on the National Association of City and County Health Officials (NACCHO) conference, highlighting federal focus on OMB changes affecting grants, rural transformation funds, and AI efficiency improvements. Board members thanked communications staff for a busy month of earned media.

Public Comment (Items 3 and 12)

• Item 3: No public comment.
• Item 12: One speaker commented on the January 2026 vote on the REMSA franchise agreement, stating the motion was for staff direction, not final approval, and that a request to rehear the item was denied without explanation.

Board Comment

Board Member Anderson indicated he would discuss a future agenda item with the chair. No other announcements.

Key Outcomes

• Accepted REMSA Health June 2026 franchise report.
• Accepted the FY27-30 NNPH Strategic Plan.
• Approved revisions to the Amended and Restated Franchise Agreement for Ambulance Service (4-3).
• Approved consent calendar items unanimously.
• Noted upcoming quarterly reports on strategic plan progress.
• Staff directed to follow up on community health collaborations (street health, harm reduction) and to continue modernizing food inspection notification methods.