NBC | Covid package, federal program offer lifeline and herald change for ambulances services

March 18, 2021, 3:54 PM EDT

Features Empress EMS and REMSA!

By Phil McCausland
During the height of the pandemic, a quiet financial crisis was brewing for ambulance companies.

As hospitals became overwhelmed and patients begged not to be taken to crowded emergency rooms for fear of potential infection, paramedics and emergency medical technicians began treating patients where they met them — outside homes, alongside roadways, in parking lots.

The trouble is that ambulance companies are only paid to transport people, not for treating them.

Now, an aid package in the American Rescue Plan and a new federal health care program could provide a financial lifeline for ambulance companies and herald a permanent shift in emergency medicine as a whole.

The attempt to reimburse ambulance companies began with a bill introduced by Sens. Catherine Cortez Masto, D-Nev., and Bill Cassidy, R-La., but the legislation was ultimately rolled into the $1.9 trillion Covid relief bill. Cortez Masto voted for the plan, and Cassidy did not.

“Our first responders have gone above and beyond in caring for patients during the pandemic, and it’s just wrong that ambulance companies weren’t getting paid unless they took patients to the hospital,” Cortez Masto said.

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REMSA in 2020

Reno, Nevada
500 Staff | 300 Quarantined in 2020

REMSA is a high-performance, high-value, out-of-hospital healthcare provider and emergency medical services agency headquartered in Reno, Nevada. Since 1986, through an exclusive franchise agreement, REMSA has served the region as a private, nonprofit, community-based organization funded only by user fees with no local tax subsidy. REMSA’s ground ambulance program responds to ~80,000 calls for service and transports ~57,000 patients annually. REMSA is composed of Care Flight – a ground and air critical care transport provider, the Center for Prehospital Education – a licensed, post-secondary education institution and its fully accredited medical dispatch center which manages ~250,000 calls annually and offers a co-located Nurse Health Line. REMSA and Care Flight are Always Ready.

Despite civil unrest, record-breaking heat and weeks of heavy smoke due to wildfires, as well as the global pandemic, employees remained optimistic, committed to safety and provided compassionate, clinically-excellent patient care. We are pleased that our Logistics department anticipated the need for PPE and stockpiled enough for providers and patients as well as donations to first response partners. The health district, overwhelmed by calls, asked us to launch and staff a 24/7 COVID-19 call center; from March through September, 28,514 calls were answered. More than 60 process and practice changes were made including an employer match of an additional 80 hours of paid time off for sick employees, pandemic protocol call-taking and a tiered response system. In other news, we launched on-demand healthcare programs, graduated paramedics, offered CPR training, added ambulances to our fleet, refurbished a mobile operations center and earned CAMTS reaccreditation. Plus, we announced a new team of FTOs, delivered 200 flu shots to homebound citizens and consistently outperformed other organizations of similar size on the EMS Survey.

REMSA’s Tiered System Featured on Aging & Awesome

Recently, Reno’s REMSA launched a tiered response model. The news segment from Aging and Awesome featured below offers a clear explanation about how using a variety of healthcare provider levels for an out-of-hospital medical response is an effective and safe way to help patients access the healthcare they need – which can range from an urgent ambulance transport to the emergency room or access to a telehealth provider.

Great Idea | REMSA’s Thank You Notes Page

Reno, Nevada’s REMSA provides nationally recognized ground ambulance service within Washoe County, Nevada. Don’t miss their amazing new “Thank a Healthcare Provider” page, where members of their community are able to share digital thank you notes with REMSA’s Paramedics, EMTs, telecommunicators, pilots, and nurses as well as administrative and operations staff.

Check Out the REMSA Thank You Page

The Hill | Coronavirus crisis squeezes ambulance operators

From May 19, 2020’s The Hill article by Reid Wilson

…The coronavirus crisis is putting an unexpected financial squeeze on ambulance operators, ratcheting up costs and tanking revenue even as they audibly remind people of the virus’s proliferation throughout the county…

Read the full article featuring interviews with many AAA members, including Bell Ambulance, Empress EMS, Great Falls Emergency Services, and REMSA!

40 Under 40: Adam Parker (Sanford Health – Bismarck, ND)

40 Under 40 nominees were selected based on their contributions to the American Ambulance Association, their employer, state ambulance association, other professional associations, and/or the EMS profession.

Adam Parker
Operations Manager
Sanford Health
Bismarck, ND


Linked In
Nominated By: Kelly Dollinger (North Dakota EMS Association – Bismarck, ND)



Adam Parker has been involved in North Dakota EMS for over 15 years working for volunteer, private, and hospital-based EMS services. Adam is currently employed by Sanford Health as an Operations Manager overseeing AirMed operations, EMS education and outreach, and a Community Paramedic program. Adam is also a Board Member for the North Dakota EMS Association and serves as Chairman of the Advocacy Committee and Co-chair of the Service Leaders Committee. Adam lives in Bismarck, ND with his wife, Jessica, and two children.


Reason for Nomination:

As President of the North Dakota EMS Association – I am thrilled to have the opportunity to nominate Adam Parker for consideration in the AAA’s Inaugural Mobile Healthcare 40 Under 40 – due in part to his exceptional and continued rise through the leadership of North Dakota EMS.

Adam’s full-time position is with Sanford Health as the Operations Manager for the Bismarck and Dickinson AirMed bases, as well as the Sanford EMS Department. In his position, Adam oversees the daily and strategic operations for two air medical bases, as well as EMS outreach and education. Adam also spearheaded the creation of the newly developed Community Paramedic program. Currently, Adam supervises over 50 mobile health care professionals including Paramedics, Community Paramedics, Critical Care Paramedics, and Advanced Certified Registered Nurses.

Adam has successfully obtained his Master’s Degree in Business Administration and also completed the Certified Medical Transport Executive course. Adam is always learning and applying what he learns to better himself and the EMS industry.

On top of his busy schedule, Adam serves on the North Dakota EMS Association Board of Directors. Adam serves as the Co-chair of the Service Leader Committee and is currently the Chairperson for the Advocacy Committee. It is in this capacity where Adam has contributed greatly to our EMS Association and the agencies throughout North Dakota. Adam has been instrumental in obtaining Legislative Grant Funding for North Dakota EMS agencies and assisted in developing a formula to determine funding that would allow for as many ambulance services as possible throughout the state. This proved highly contentious, and risked the loss of all state grant funding, but Adam developed a successful strategy and managed the situation extremely well by negotiating with legislators to find a workable agreement. Adam also serves as our State Advocacy Coordinator and Affiliate Advisory Council representative for the NAEMT.

Adam was also instrumental in advancing the Recognition of EMS Personnel Licensure Interstate CompAct (REPLICA) legislation. This bill successfully passed and North Dakota became the 17th State to be recognized as a REPLICA state.

Adam is very knowledgeable in various aspects of state and local politics, policies, and procedures. Adam is the go-to expert on establishing local taxing districts and he advocates heavily for every ambulance service to establish themselves as a political subdivision, since this is the best way to ensure sustainability in rural areas. Adam freely donates time to meet with and assist ambulance services going through this process as it is very complex and daunting for most rural agencies.

Most recently, Adam has taken it upon himself to educate himself on the inner workings of the Medicare cost data collection process and has contacted every ambulance service selected in the state to ensure they understand what they need to do and has helped them organize themselves to collect the necessary information. Despite Adam’s employer not being selected to submit cost data this year, Adam still gives a lot of his time to ensure that rural ambulance services in North Dakota are successful with this important requirement.

Adam is very generous with this time and freely gives out his phone number and encourages anyone to call if they need help – with anything. There is no doubt that Adam would be of the finest selections for the Inaugural Mobile Healthcare 40 Under 40 in recognition of his contributions to the entire state of North Dakota and the mobile healthcare profession.


View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

40 Under 40: Adam Heinz (REMSA – Reno, NV)

40 Under 40 nominees were selected based on their contributions to the American Ambulance Association, their employer, state ambulance association, other professional associations, and/or the EMS profession.

Adam Heinz
Executive Director Integrated Health
Reno, NV


Linked In | Twitter
Nominated By: Alexia Jobson (REMSA – Reno, NV)



Adam Heinz is the Executive Director of Integrated Health for Regional Emergency Medical Services Authority (REMSA) in Reno, Nevada. With an intense focus on leading and engaging teams to provide compassionate, clinically excellent prehospital care, Adam brings 18 years of Emergency Medical Services (EMS) experience to the organization. Having progressed in roles from Paramedic to EMS Supervisor, Clinical Development Manager to Director of Clinical Communications, Adam is now responsible for advancing REMSA’s innovative mobile health care projects. Through collaboration with regional partners, regulators, and elected officials, Adam represents the organization on a local, state, and national level. In addition, Adam overs sees REMSA’s clinical division and its Center for Prehospital Education.

Adam is a proud alumnus of the University of Nevada Reno where he earned a bachelor’s degree in psychology. Currently, Adam is pursuing a Master of Business Administration degree with an emphasis in healthcare leadership. In addition to being a Nationally Registered Paramedic (NRP), Adam is certified as a Nevada State EMS Instructor and as an Advanced Emergency Medical Dispatcher (AEMD).

Currently, Adam serves on the Clinical Practices and Standards, and Mobile Integrated Health Committees of the National Association of EMS Physicians and was recently invited to be on the board of directors for Well Care Medical and Behavioral Health Clinic in Reno, Nevada.

Having given presentations at the PeaceHealth Neuroscience Clinical Symposium and the American Heart Association’s Annual Regional Conference, Adam is considered a leading thinker and advocate for the prehospital and mobile health care industry.

Adam is a lifelong resident of northern Nevada. Adam and his wife Heather, an emergency department registered nurse, have two children, Ella (4) and Bentley (2). Adam, a self-proclaimed “Disneyphile” speaks conversational French, enjoys international travel, and has an interest in the history of medicine.


Reason for Nomination:

Passionate, articulate, supportive, confident, organized, honest, loyal, and transformational leader are just some of the ways Adam Heinz is described by his colleagues and the leadership at REMSA. Adam has an unyielding commitment to advancing the EMS industry by innovating, leading, and pursuing excellence. Starting as a Paramedic with REMSA 12 years ago, Adam has progressed through leadership positions to his current role as Executive Director of Integrated Health. Along the way, Adam consistently meets or beats budget objectives for his non-profit, non-tax-subsidized employer, implements forward-looking projects such as Alternative Destination Transport and Alpha/Omega protocols, leads groundbreaking initiatives such as REMSA’s AED drone delivery project. Additionally, Adam engages with front-line providers through educational opportunities, hosting EMS skills competitions, and highlighting exceptional care in the field at the weekly medical leadership meeting.

Adam’s contributions range from volunteering to serve on REMSA’s Employee Wellness Action Committee to the more sizable task of successfully leading REMSA’s Clinical Communications Center through two re-accreditation cycles which resulted in the International Academy of Emergency Dispatch (IAED) recognizing the center as a mentor for other dispatch agencies interested in seeking accreditation. What’s unique and universally appreciated about Adam is that he approaches all tasks no matter how big or small, with the same vigor and enthusiasm. Adam is trusted to represent REMSA on the Washoe County Health District/District Board of Health, the region’s EMS Oversight Committee, and the Truckee Meadows Fire Protection District Board. Adam is well respected among his peers in the community and actively builds relationships with community stakeholders and public safety officials.

“Many of the relationships we (REMSA) have with our healthcare partners, co-responding agencies, and community leaders today are a direct result of the framework that Adam has put in place.” – Jason Hatfield, NRP, Clinical Coordinator, hiREMSA

Adam simultaneously displays a seriousness that conveys the importance of EMS work and a playfulness that eases the often heavy tone of EMS work. Adam continues to work patch-to-patch with ground field providers and dispatchers during regular shifts, special events, and when the system needs additional support. Adam is a mentor to staff all throughout the organization and regularly shares complimentary emails highlighting a job well done.

“You can find Adam grabbing a headset to help out in the communications center as well as jumping on an ambulance to run calls which provides an opportunity to engage in the front-line staff experience.” – Sarah Vonarx, Applications Administrator/AEMD, REMSA

Over the last two and a half years, Adam has made a commitment to working closely with the public affairs department to raise awareness about EMS, safety, health, and wellness. Adam now serves as REMSA’s primary on-camera media spokesperson, at-the-ready to assist with interviews on topics that range from flu shots and heat exhaustion to reimbursement, system status management, and the misuse of 911. Adam is a tremendous asset to REMSA as it positions itself as a high-performance, high-value EMS system and the regional mobile health care expert.

Adam has received two official recognitions for outstanding service throughout his career. In 2012 Adam was honored with an Achievement Award in response to the Reno Air Races tragedy which killed 11 people and injured 69 more during a spectator special event. In 2013, Adam was given the Meritorious Award for successfully resuscitating a young fan that suffered cardiac arrest at a University of Nevada Reno sporting event.

Adam is particularly enthusiastic about enhancing the different professions across the EMS and mobile healthcare industry. Adam conceptualized and launched a standardized uniform, badge, and collar brass look for all leadership levels at REMSA. In addition, Adam advocates for accountability across all provider levels and encourages all employees to represent REMSA’s brand proudly and with integrity. Finally, Adam believes that prehospital care and the profession of Paramedicine should be standardized and recognized at the university level.

Adam’s energy, high ethical standards, and intellect inspire people around him to do their best.


View all of the 2020 Mobile Healthcare 40 Under 40 Honorees

In Memory of Patrick Wells Smith

Patrick Wells Smith, age 65, passed away unexpectedly on June 21, 2019, at his home in Reno, Nev.  He was well-known as a nationally-respected innovator and icon in the Emergency Medical Services (EMS) industry. Most recently he was the President and CEO of REMSA (Regional Emergency Medical Services Authority) and Care Flight, based in Reno, from January 1990 through March 2013 and then President of SEMSA (Sierra Emergency Medical Services Authority) also based in Reno,  from April 2013 to June 2018.

He was born on November 17, 1953 in Minneapolis, Minnesota, to parents Ted Arvel Smith and Margaret Wells Smith. He was the second of three children. He attended Minnetonka High School, got his start as an EMT in 1973 as a college student in Minnesota, and soon began taking on supervisory roles for EMS agencies in Minnesota and Oregon. In 1980 he was hired as an assistant director of Metropolitan Ambulance Services Trust in Kansas City where he consulted to establish EMS systems in Fort Wayne, IN.; Pinellas County, FL; Fort Worth, TX; and Little Rock, AK. He worked as Vice President of Eastern Ambulance in Syracuse New York after that before moving to Reno. 

He was well known for his innovation and leadership in EMS systems design and medical 911 communications systems. One of his most fascinating stories was his role as a first responder at the 1981 collapse of the walkway at the Hyatt Regency in Kansas City where he was one of the initial responders on site. It killed 114 people and injured 216. That experience inspired the ways he help REMSA to prepare for many crises in which the team needed to respond with speed and outstanding systems, but still compassion.

During his time at REMSA he created and fostered programs such as the special events coverage team, community and professional education teams, and the TEMS program which attaches specially-trained paramedics from REMSA to the SWAT teams of local law enforcement. He received numerous local and national awards, including the Secretary of Defense Employer Support Freedom Award for small businesses in 2008 where he was awarded the opportunity to meet the President of the United States.

He was proudest in his professional life when talking about his REMSA/Care Flight team. “It’s about the people,” he would often say. He was a proud and loving father and grandfather who passed on his devotion to Disney and instilled a deep loyalty to the Minnesota Vikings in his family. 

He was very active at the leadership level volunteering in the American Ambulance Association, and also NAPUM, National Association of Public Utility Model, which was a group of EMS organizations across the nation, each with the unique structure of a Public Utility Model, which provided guaranteed quality of care, response times and coverage without tax subsidies. REMSA had been one of those PUMs since its creation in 1986.

He is survived by his five children: Michelle Bergren (Matt), Aaron Smith (Divya), Danielle Sanford (Michael), Theodore Smith (Hailey), and Allison Hahn (Mark), his seven grandchildren: Blake, Sage, Bode, Rishi, Rohan, Hadley, and Cole, his nephews Jason  and Jeremy Smith, and the mother of his children and ex-wife, Linda Smith, who remained his good friend and co-parent/grandparent, as well as his many other friends and EMS and medical profession colleagues.

He was preceded in death by his parents, his sister Diana Smith and his brother James Smith. 

A celebration of life will be held on Tuesday July 2, from 4 to 7pm at 10379 Dixon Lane in Reno. 

In lieu of flowers, the family requests donations to Truckee Meadows Community College to the Patrick Smith Memorial Scholarship, which will be for students who want to study to become an Emergency Medical Technician, or a Paramedic. 

Please send donations to:

TMCC Foundation
7000 Dandini Blvd, RDMT 200
Reno, Nevada 89512-3999 

You can also donate online at: https://www.tmcc.edu/foundation/support-tmcc/make-gift. In the “Leave a Comment” box just note your donation is for the Patrick Smith Memorial Scholarship.