REMSA, the Regional Emergency Medical Services Authority for the Truckee Meadows, has been using Reno and Sparks Firefighters as free labor, since they began business in 1986. Our local Fire Departments are dispatched at the same time as REMSA, responding to the same Emergency calls. The lion’s share of those calls are MEDICAL in nature. Roughly 95 percent of our local Emergency Response Requests are Non Fire related. Yet fully equipped Firefighters with Advanced Emergency Medical Response training and years of experience, follow REMSA in their huge firetrucks, offering the best, most professional assistance that money can buy; free of charge.
The cities of Reno and Sparks are not compensated by REMSA for the manpower; the months and years of training necessary to make a professional Firefighter; the fuel used in the Firetrucks to accompany them; the Insurance carried on the Firefighters; nor the compensation paid to the people if they should be injured performing their duties. Firefighters HAVE hurt themselves hauling people on gurneys up or down dangerous stairs. REMSA pays those Firefighters ZERO in sick time, medical bills or any other form of compensation. ALL of those costs are born strictly by area Taxpayers. Who also get the privilege of paying REMSA’s No Bid/No Competition fees, directly out of their own pockets and insurance policies.
REMSA enjoyed a total income of $330 million dollars, according to their 2010 tax returns. And, they only employ 330 people. REMSA bills itself as a “non-profit community service” on their website, which means they don’t pay the City of Reno a Franchise Fee. They are also the “exclusive ground and helicopter ambulance provider for Washoe County” while claiming they offer “the lowest competitive price.” Who, exactly, are they competing with? How can they use our Firefighters for free and claim they’re a community service?
This isn’t to say that REMSA itself does a bad job. They hire great people to perform miraculous duties in a rough occupation. The people who do the actual work at REMSA have proven time and again that they are brave, dedicated, community-minded professionals. The excellent service and swift help they provided after the tragic events which unfolded at Sparks Middle School in late October, stand as mute testimony to their skills. And, they provide other great services, like their Nurse Health Line which allows you to speak to a Nurse 24/7 to get your emergency medical questions answered, free.
This is merely pointing out that Reno/Sparks/Washoe County citizens could reallocate $330 million dollars a year, if the City and County simply rented or purchased the Ambulances. We have the necessary Skilled Professionals available, already on staff. Which says nothing of the the additional tax savings. We are currently supporting a Fire Department already stretched so thin we periodically close some of them, just to save money.
OR – and this is what some insiders are saying would be the best solution on a number of levels – the City of Reno could start requiring REMSA to stop using our Firefighters for free, and start charging the non-profit organization for the use and dispatch or our people. That would only be fair.
Op-Ed
By Ben Gaul
Reno.gov 1
Reno.gov 2
REMSA 2
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20 Responses
Great blog here! Also your website loads up fast! What host are you using? Can I get your affiliate link to your host? I wish my site loaded up as fast as yours lol
I read and understood the story as such that the fire departments should run ambulances and transport because they respond to the scene any way.Often in the out lying areas fire is on scene first and is waiting on REMSA any way, so why not transport to hospital ? Three hundred million for REMSA is a big chunk that could well go to support the budgets for all the fire departments. REMSA has a monopoly on every transport in Reno and Washoe county. Time to share some money and follow what other jurisdictions have ready begun to do ,provide ambulance service .And REMSA being non-profit is a load of horse poop ,just research them and you will find out . And I agree ,REMSA underpays and overworks their employees for the amount of work they do .
Now that I have had a little time to digest this after my comments yesterday I would like to point out that the title is misleading and quite frankly is there to cause problems.
Fire Fighters do not work for REMSA free… at least not entirely free. THEY WORK FOR THE PUBLIC … you know, the ones who pay taxes. They work and respond to medical emergencies.
I know this is a difficult concept to wrap one’s head around… but it is for safety and care of the public. And that really should be the focus…. not some dividing tittle
I remember in the 90’s when RPD and RFD were at each others throats… it was in the newspaper and the tax dollars blah blah blah….
Do you know who suffered? A patient. I responded to a car accident in which the damage was somewhat significant… the patient, a good friend of mine today and someone I had gone to high school with worked for Reno Police.
Both agencies were not willing to help each other out due to pride and territory complaints/fights.
The top of the car had to be cut off. I was not willing to risk a fracture of C-1/C-2. The fire dept was annoyed at RPD because they didn’t want to do the work AND a pissing match. There was a delay in cutting the top off due to the extraordinary egos at play. I was yelled at …”who ordered the top cut off”?? I did. Do you your job… there is a patient here.
There are many examples of the politics at play…and not many have the integrity to stand up to it to do the right thing. As stated, I am sticking my name and hard fought reputation as a good medic on the line. Something many posters here wont do.
I am grateful to the Fire Dept. They had my back when I needed help too.
The City of Reno needs to get their act together. Period. Only when someone dies and it hits close to home will there be changes. The problem… you never know when the day will come that YOU need help.
Always about the EGOS … has been since 1990 when I started at REMSA. Medics at REMSA are paid like crap, run into the ground… and frankly use REMSA as a launching point for nursing/fire department gigs.
The fire dept would be dead in the water budge wise without medical emergencies… they have gotten so good at fire suppression.
REMSA has always tried to keep the fire dept from doing more advances skills… it is about retaining power…
And money is power… so let’s not forget that.
Let’s also take a look at the EGOS involved in both being a fire fighter and paramedic. Sadly… where is patient care in all of this hubbub???
I am going out on a limb here posting my name…but I refuse to hide behind anonymity.
The Majority of the 19 Paramedics that were recently hired came from neighboring departments (Carson, East Fork, Truckee, Las Vegas, North Lyon, Story Co. to name a few). They did hire A FEW from REMSA as well that have a good amount of experience. The minimum requirements included Firefighter I and Paramedic. So to say they have no fire experience is simply incorrect. And they did NOT hire paramedics to “Just say they have them”. They do not receive more funding for this at all. They get the same amount of money but the chose to allocate it toward better medical care for their citizens. They do this to provide ALS care to the citizens of Washoe County that fall within REMSA’s “15 minute” and “best effort” zones. TMFPD paramedics have identical protocols to REMSA’s. So again its not to “Just say the have them”. They can work up to the scope of any ALS provider in Washoe County.
I don’t understand why REMSA administration and management feels the need to fight TMFPD in providing ALS care in the areas they cannot cover within 8 minutes. TMFPD is on scene to most of their calls within 5 minutes. REMSA argues that only 1-2% of 911 call actually require ALS intervention. There are around 150 EMS call in Reno, Sparks and Washoe county every day. So that is still 2-3 calls everyday that will benefit from ALS intervention. A few minutes may be acceptable in areas that are within the 8-minute zones because the first couple minutes are mostly BLS/ILS and REMSA is on scene quickly. But it is not acceptable in the outlining areas of the county where REMSA has an admittedly longer response (by labeling it “15 minutes” or “best effort”). So how can REMSA say they are about patient care and for the community but fight any agency that tries to provide a higher level of care to the citizens that are underserved by REMSA? They use absurd reasoning to attempt to sway commissioners and councilmen to help protect the greater good of their BUSINESS.
Yes, some of the medics trained and/or worked at REMSA for a very short time but there are 47 paramedics at TMFPD and they just hired 12 more. So in January they will have 59 paramedics on-line. And “most” of those medics have al least 5 years under their belt… And yes there are some with considerably less experience. So, if say 75% of their medics fall within that range there would still be 15 medics with less experience. So “most” is not an exaggeration.
FD does pay better in comparison to REMSA that is a fact. But it’s not that firefighters make an outrageous amount of money. It’s that REMSA pays their ground employees so poorly and they don’t take care of those that stick around unless they promote (even that is arguable). Firemen make a respectable wage, as do many other professionals. Just Because REMSA pays so poorly doesn’t mean that should be the industry standard and doesn’t make them any better than anyone else. That’s why so many of their ground employees leave or are trying to leave to become a policeman, fireman, RN or something else…. Somewhere they feel like they are being taken care of. An open dialogue with any ground level employee will shed light on that.
And nowhere in any comment does it say TMFPD should take over EMS. This article is bogus and anybody that knows anything about Washoe Co EMS services knows that. The point I was trying to make is that it is beneficial to have experienced providers on scene. I was making this point in response to the comments on “Why does the fire dept even respond to EMS calls?” Well… In the rest of our region the fire department is all you get… A fire rescue (ambulance) and an engine. These agencies provide ALL EMS care: Carson, Incline, Fernley, Story Co, East Fork (Douglas Co.) Central Lyon Co, Truckee, North Lake Tahoe, South Lake Tahoe…. So Fire department are more than capable of providing ALS care. So yes that is “evolving as a profession” when an agency within Washoe County increases it’s level of care to the industry standard by providing it’s citizens with ALS care. TMFPD is the first agency to accomplish this in Washoe County. The delay in “evolving as a profession” to provide ALS care by a fire department is largely in part because of REMSA’s push back and political influences over the years…
So once again, I was just trying to say that it is beneficial to have experienced providers on scene while waiting for a transporting agency to arrive.
This is a skewed view at best. Recently the fire services took 19 paramedics that are not fire trained simply to say they had them. Why you ask, well you just read it, they want compensation. I did not see anywhere in the article where he mentions their ability to administer life saving drugs (please list the protocols), their life support equipment or simply what the cost of responding to 9/10 of their call volume is. Maybe the fire guys should post what they make a year versus REMSA (Please don’t forget your extras) and tell me one more time how this is about evolving professionals. Maybe if they get out of the medical business and back into the fire business they won’t be stretched so thin.
FF replied
I have two points for which to take issue. First, it is not REMSA’s decision to utilize the fire service on ALL calls. The Reno Fire Department’s command level has decreed that that service will respond to ALL medical calls, with command retaining the option of opting out on certain obvious low-priority needs. Second, to the seemingly factual comment that “most” Paramedics with the Truckee Meadows Fire Protection District have “5 plus years” Paramedic experience. This statement may be exagerated. Many TMFPD Paramedics trained and practiced at REMSA for considerably shortly periods than 5 years. The crux of this entire issue is, that a certain fire service (TMFPD) looks only at REMSA’s bottom line, and then experiences visions of grandure that if we (fire) were the sole medical provider, we (fire) could have all that money. NOT… REMSA is not a tax based service like fire, they operate on patient insurance reimbursement only. Let me reiterate – REMSA is not tax based. When the fire service finds a way to provide the highest quality emergency medical services to the taxpayers of Washoe County for free, then let’s revisit this pompous argument. Thank you for your time.
FF replied
You do realize that the tax payer provides REMSA with all of their ambulances, helicopters and equipment. Therefore, tax payer subsidizing private enterprise. Oh, and what about REMSA failing to pay a franchise fee for years on end to the cities and county. So many missing pieces of information to the public. REMSA/RASI is quite the business enterprise.
Also Reno has three fire divisions Reno, truckee meadows, sparks fire depts. with all those a 20 min mutual aid request is unacceptable. The family lost their home.
The question is what would taxpayers be paying for if they did not respond to medical calls? A whole lot of training and what else? They are emts and response to medical is still a public service. Keep in mind that if fire did transports there’s still a separate bill for transport in most systems. This story is deceiving in that fact like fire transporting would be free. Fire service is taxpayer money and medical is billed. Even in fire based ems services the fire engine still responds with the ambulance. What is the difference?
Foe someone who writes about government waste, I’m surprised that you can write this without looking at Fire Dept. problems such as overtime abuse, and onerous union contracts. A clearer thought question should be, “Why does fire respond to medical calls?”
FF replied
Where does patient care fall into this?
Exactly… which was always my biggest complaint when I worked at REMSA. Patient care seems to suffer at the hands of squabbling and rights to who does what …where… when and how.
Most all staff at REMSA are good folks who really get into the work for good intentions…MOSTLY.
As I stated in another post, REMSA is not necessarily a place that one would start and end their career. It typically is a launching pad for other ventures in one’s career: Fire Dept, police in some cases and nursing/med school.
I also know a fair amount of Fire Fighters did not much care to respond to medical emergencies. I get that… but they are best equipped to do so. And they do make a difference.
There has to be some middle ground here in which the patient AND Fire Dept’s/REMSA win. When it comes down to it, it truly can be a life and death situation far more times than not.
30 million not 330 million.
Rob, FD responds because REMSA takes a long time to get on scene, exspecially in the county. TMFPD is ALS… Most (not all) of their medics have 5 plus years experience as a paramedic and even more experience in EMS. That’s more than most (not all) REMSA crews. I’m not saying one is better than the other but I’m saying that it is helpful to have someone on scene that is experienced while waiting for the ambulance to arrive. Then once they arrive the guy with a broken arm already has an IV and pain meds on board. That’s not padding stats that’s called doing our job and evolving as a profession. Anyone that doesn’t understand how this streamlines the emergency call is ignorant to what really goes on at an emergency scene.
Did you ever consider that the fire departments (Reno, Sparks and Truckee Meadows) insist on responding to these medical calls to boost their call volume numbers? More calls equals more budget money allocated to the department.
FF replied
Good story makes no sense to me this needs to be fixed.