Members | Thursday, October 23, 2025 |
Devon Reese, Chair | 1:00 p.m. |
Clara Andriola, Vice Chair | |
Paul Anderson | |
Michael Brown | Washoe County Administration Complex |
Dr. Eloy Ituarte | Commission Chambers, Building A |
Steve Driscoll | 1001 East Ninth Street |
Dr. Reka Danko | Reno, NV |
Chair Reese called the meeting to order at 1:01 p.m. Members present: Devon Reese, Chair
Clara Andriola, Vice Chair Michael Brown
Dr. Eloy Ituarte Steve Driscoll Paul Anderson
Dr. Reka Danko, arrived at 1:14
Board Member Driscoll led the pledge to the flag.
Chair Reese noted that Molly Rose Lewis from Senator Rosen’s office is watching this meeting online and wishes to make sure that the Board and staff know she is available during the shutdown for any needs that constituents of Northern Nevada Public Health may have.
Chair Reese informed the Board and audience that item 10 will be coming off of today’s agenda upon agenda approval.
Aaron Abbott thanked the Board for pulling Agenda Item 10, but expressed concern regarding the proposed amendments to REMSA’s franchise agreement, as shown in the agenda. He stated that the proposed language under Section 2.1.a. would grant REMSA exclusivity over airport medical transfers, where multiple providers are necessary for reliable
coordination between air medical and ground ambulance services, and that exclusivity could limit service options.
As a business owner, he feels it's an unnecessary regulation, and that piece of language in the proposed franchise agreement causes great concern, as his business is providing many of those transports, and they try very hard to meet customer needs. He also expressed concern regarding language that compels REMSA, as the franchise holder, to contract and subcontract for services, with their primary subcontractor being RASI, a subsidiary of REMSA.
Brad Kitts was going to comment on item 10, but with that item being pulled, he will retract his comment.
William Baker expressed strong opposition to Section 2.1 of the proposed franchise agreement with REMSA Health, which would grant them exclusive rights to provide ground ambulance transport for patients arriving via air ambulance from outside the franchise area. He believes this is not in the best interest of patients or the regional healthcare system and may conflict with federal law, specifically the Airline Deregulation Act of 1978, which preempts local regulations affecting air ambulance services. Intermountain Health has transported over 250 patients to Washoe County in the past year, with REMSA serving as a reliable partner. However, he emphasized the need to utilize the most appropriate ground transport provider for each patient. Mr. Baker urged the Board to remove or amend that section to protect patient choice, maintain competition, and avoid potential legal conflicts by eliminating the exclusivity language. He affirmed his commitment to working collaboratively with REMSA, the County, and other stakeholders to ensure high-quality, patient-centered emergency medical services.
Chad Kingsley shared the plaque received as a result of the Public Health Accreditation Board reaccreditation.
Special Recognition
Andrea Esp – Nevada Emergency Management Certification Years of Service
Scott Strickler – EHS – Environmental Health Specialist – 10 years, hired 10/31/2005 Jessi Salim – EHS – Office Specialist – 10 years, hired 10/12/2015
Health Heroes
Dianna Karlicek – EHS – Environmental Health Specialist – Compassion and Trustworthiness
Dave Kelly – EHS – Environmental Health Specialist Supervisor – Adaptability,
Collaboration, and Trustworthiness
Danika Williams – PHD – Epidemiologist – Adaptability
Scott Oxarart – ODHO – Public Health Communications Program Manager – Adaptability, Collaboration, Inclusivity, and Trustworthiness
Erin Dixon shared kudos to the team for the accreditation, which included 18 months of gathering documentation. She also congratulated Ms. Esp on attaining her certification and Mr. Strickler and Ms. Salim on their years of service.
Frenchie Rubio shared the accomplishments of the Health Heroes and thanked them for their great work.
Possible approval of September 25, 2025, Draft Minutes.
Approve and Adopt the Proposed Additions and Changes to the Northern Nevada Public Health Employee Policy Manual for Fiscal Year 2026. Changes include Updates to Thirteen (13) Policies (Cash Handling, Code of Conduct, Employee Training, Health Services to Staff and Their Families, HIPAA Privacy Policy, HIPAA Confidentiality and Security Policy and Protocol, Incompatible Activities, Jury Duty, Personal Appearance, Public Records Requests, Recording of Time-Approval of Leave/Overtime, Refund Policy, and Technology and Equipment), Addition of Five (5) policies (Bilingual Pay Process, Relationships in the Workplace, Smoking Policy, Tuition Reimbursement Policy, Wellness Policy), and the Combination of Two (2) Policies ( Alternative Work Schedule and Telecommuting-Hybrid Schedule) into a new Policy called Work Schedule. Approve the Notice of Subaward from the State of Nevada Department of Health and Human Services, Division of Public and Behavioral Health for the period retroactive to July 1, 2025 through June 30, 2026 in the total amount of $290,772.00 (no match required), in support of the Northern Nevada Public Health’s various health initiatives to include prevention of tobacco use in youth, providing immunizations, conducting STI surveillance and reporting, and providing continuing training to public health staff, and authorize the District Health Officer to execute the Subaward and any future amendments.
Approve the Grant Agreement from the U.S. Environmental Protection Agency (EPA) in the amount of $127,598.00 to include $54,728 of EPA In-Kind Support retroactive to April 1, 2025 through March 31, 2026 for the Air Quality Management, EPA PM2.5 Air Monitoring Network Program, IO# 12513 and authorize the District Health Officer to execute the Agreement and any future amendments.
Approve the Notice of Subaward from the State of Nevada Department of Health and Human Services, Division of Public Health and Behavioral Health for the period
retroactive to June 1, 2025 through May 31, 2026 in the total amount of $376,124.00 (no match required) in support of the Northern Nevada Public Health HIV Prevention Program and authorize the District Health Officer to execute the Subaward and any future amendments.
Adoption of the “Rescinding General Provisions (020.005 to 020.095), Source Registration and Operation (030.000 to 030.3104), and Emergency Episode Plan (060.010 to 060.025) of the EPA-Approved Air District Regulations in the Nevada State Implementation Plan (SIP) for Washoe County.
Recommendation for the Board to uphold an uncontested citation issued to Renn Transportation, Inc., Case No. 1581, Notice of Violation No. AQMV25-0016 with a
$500.00 Administrative Penalty for failing to utilize the District Approved Vapor Control System required by Permit to Operate No. AAIR18-1148 causing the release of gasoline vapors to the atmosphere while distributing gasoline to an underground storage tank.
Recommendation for the Board to uphold an uncontested citation issued Maverick, Inc., Case No. 1580, Notice of Violation No. AQMV25-0015 with a $500.00 Administrative Penalty for failing to utilize the District Approved Vapor Control System found in Permit to Operate No. AAIR18-1148 causing the release of gasoline vapors to the atmosphere while distributing gasoline to an underground storage tank.
Acknowledge receipt of the Health Fund Financial Review for September, Fiscal Year 2026.
Recognize the week of November 17 - 21, 2025 as Crash Responder Safety Week.
Before reading the proclamation, Andrea Esp shared that several providers in the room are directly impacted by this proclamation, and she would like to thank them for all the work they do. They are members of the coalition, where they meet and talk about healthcare matters, including traffic safety. While regional EMS strategic planning works on safety for first responders, it is often forgotten that they put their lives on the line to save individuals, at the risk of those not paying attention.
Presentation and Recognition of Peg's Glorified Ham N Eggs on Lemmon Drive as the recipient of the Excellence in Food Safety Award.
Olivia Alexander Leeder presented the Excellence in Food Safety Award to Fred Lee and the team at Peg’s Glorified Ham N Eggs on Lemmon Drive. The award recognizes food establishments that demonstrate exceptional food safety practices, maintain active managerial control, and promote a culture of food safety. The recipient exceeded the requirements by maintaining a clean and organized facility, executing complex food handling procedures correctly, and fostering staff engagement through regular meetings, training, quizzes, and
communication tools that support continuous food safety. Approximately 70% of the restaurant’s staff, including part-time employees, are certified food protection managers, exceeding regulatory requirements. Mr. Lee attributes their success to a workplace culture that emphasizes training, communication, and accountability. Ms. Alexander Leeder congratulated Mr. Lee and his team for their outstanding commitment to protecting public health and maintaining high food safety standards.
Mr. Lee shared the history of how Peg’s came into existence, which started with one location, and now 9 throughout Nevada, remaining family-owned and operated. They are proud to be serving the community and thank everyone for their support.
Recommendation to accept the REMSA Health Monthly Franchise Report for September 2025 which includes REMSA Health Accounts Receivables Summary, Compliance by Zones, Average Response Times, Incident Details Reporting, Summary Penalty Fund Reconciliation, Personnel, Ground Ambulance Operations Report, Patient Experience Report and Comments, Education Report, Public Relations Report, and Frequently Asked Questions, and provide possible Board direction.
Barry Duplantis presented the September 2025 monthly performance report, where REMSA met or exceeded franchise response compliance for all Priority 1 calls in all zones for September and the fiscal year to date. During September, REMSA responded to 8,471 Priority 1 calls and transported 5,539 patients to area hospitals. The transport rate was slightly higher than in August, with customer survey results averaging a 93.71 satisfaction score, consistent with the prior month, and highest marks for ambulance cleanliness and medic professionalism. Mr. Duplantis also reported that penalty funds were used to provide nearly $5,000 in signal kits to the North Lake Tahoe Fire Protection District and to support 127 flu immunizations administered in partnership with Northern Nevada Public Health at the CARES Campus and Our Place.
Mr. Duplantis also recognized EMS Manager Caitlin Roberts, who was nominated and selected to represent REMSA Health and the region at the American Ambulance Association’s “Stars of Life” event in Washington, D.C., where she will meet and share experiences with Congress, advocating for the future of EMS. The annual national event honors EMS professionals who demonstrate exemplary service, compassion, and dedication in emergency medical services. Ms. Roberts was selected for her exceptional leadership, commitment to employee wellness, and supportive engagement with staff and the community.
The Board and audience congratulated Ms. Roberts on her recognition and upcoming participation in the national event.
Chair Reese congratulated REMSA Health on their customer survey, which was several points higher than in the past. He also noted that there is a new executive director for CareFlight, and he would like to have him present for introductions at a future meeting.
Mr. Duplantis indicated he would be happy to introduce Joe Drago to the Board. They are proud that he has joined the organization.
Recommendation to approve the revised Regional Emergency Medical Services Authority (dba REMSA Health), Amended and Restated Franchise Agreement for Ambulance Service, which includes revisions from the EMS Joint Advisory Committee and the workgroup coordinated by the City of Reno. The recommendation also requests the Board approve the amendment of the current franchise to a perpetual basis, retroactive to July 1, 2025, and approve staff to work with REMSA Health on an updated Comprehensive Compliance Review Checklist and collaborate with REMSA Health and stakeholders to collect data to address the impacts and outcomes to the franchise and participating regional partners, to include but not limited to, franchise governance, interfacility transfers, Hexagon CAD implementation, the fire regionalization and study, and increased service demands by June 30, 2028.
Recommendation to approve the proposed 2026 District Board of Health meeting calendar. Chad Kinglsey presented the proposed 2026 Board meeting calendar for approval.
Staff Reports and Program Updates
Air Quality Management - Legislation Would Designate Prescribed Burns as Exceptional Events, August 2025 EPA Small Business Newsletter, Divisional Update, Program Reports, Monitoring and Planning, Permitting and Compliance.
Francisco Vega discussed the proposed Wildfire Emissions Prevention Act, expressing optimism about its potential to streamline processes related to wildfire impacts on air quality. He noted that the division continues to work closely with partner agencies on fuels management, forest management, and prescribed fire activities. Under the proposed legislation, excluding prescribed fire impacts from regulatory air quality data would be more efficient, reducing staff workload and allowing focus on other air quality priorities. There were no exceedances of air quality standards in September, and plan review performance returned to 100 percent completion. He also provided an update on the Stationary Source Permitting Program, noting challenges with compliance under the new regulations approved by the Board in late 2024. The regulations require businesses to renew their permits every five years to ensure they reflect current operations and associated air quality risks. To assist businesses in meeting these new requirements, multiple workshops were
conducted between November 2024 and March 2025, and staff support continues. Several notifications are sent before permit expiration, and when applications are not submitted, staff have hand-delivered letters and applications that include QR codes for scheduling assistance. As of the reporting date, seven of twelve expected renewal applications for the June through August period had been received. With this, he asked the Board for any suggestions for improvement.
Vice Chair Andriola shared that she recently attended a symposium at a conference where Mr. Vega was a panelist, and he did a great job representing Northern Nevada Public Health.
Chair Reese noted Mr. Vega’s reference to the WEPA, which is currently moving through the Senate, and recommended maintaining communication with congressional representatives.
Mr. Vega responded that they have spoken with Senator Cortez Masto’s staff and will continue to coordinate as needed.
Community and Clinical Health Services - Fetal Infant Mortality Review; Data & Metrics; Immunizations, Tuberculosis Prevention and Control Program, Reproductive and Sexual Health Services, Maternal Child and Adolescent Health, Women Infants and Children, and Community Health Workers.
Christina Sheppard presented her report for September and noted a correction on page four, where “Assemblywoman Health Goulding” should read “Assembly Member Heather Goulding”. She shared that the division has received COVID-19 vaccine shipments for all funding sources and began offering vaccinations to the community this week. They are prioritizing children and uninsured adults due to access concerns and are encouraging insured individuals to obtain their vaccines from pharmacies.
Ms. Sheppard also shared that the state is currently funding the Women, Infants, and Children (WIC) program on a week-to-week basis, contingent upon the receipt of federal funds. Services are expected to remain operational through October 31, with updates received weekly. In preparation for possible disruptions, the division is developing contingency plans to maintain minimal staffing at WIC clinics to ensure continued community access to benefits and essential support services.
Chair Reese thanked Ms. Sheppard for the update on the COVID vaccine and for making an excellent point on getting it through a primary healthcare provider, clinic, or pharmacy.
Environmental Health Services Program - Consumer Protection (Food Safety Plan Review & Operations, Commercial Plan Review, Foodborne Illness, Special Events, Permitted Facilities); Environmental Protection (Land Development, Safe Drinking Water, Vector-borne Disease Surveillance, Waste Management / Underground Storage Tanks).
Rob Fyda presented highlights from his division’s report. He noted that the food safety program serves as a mentor to other jurisdictions, recently hosting representatives from Whatcom County and Walla Walla County to exchange best practices and support alignment with retail food standards. Division staff also presented to the University of Nevada, Reno public health class, sharing information about environmental health careers and launching a student shadowing pilot program. He reported strong engagement in the food plan review program’s office hours and noted that staff are evaluating ways to expand the program to meet demand. The vector control season has wrapped up, and a summary is being prepared for the Board. Additionally, improvements have been made to the septic system permitting process, including the launch of a new online septic record system to simplify customer applications. The division also hosted two public workshops on proposed septic regulation updates, with approximately 100 attendees providing feedback that will be brought to the Board for review.
Chair Reese noted he is proud of the division's accomplishments and Ms. Alexander Leeder’s presentation at this meeting. This is a good opportunity to engage with the restaurant community. He enquired about the status of the consultant interviews and when the report might be ready.
Mr. Fyda noted that the interviews were conducted by Dr. Wrangler to evaluate the environmental health division. He collected data and is in the process of drafting a report that should be available soon.
Chair Reese noted that Dr. Wrangler was very impressive and shared during the interview that EHS was doing very well, with a goal of making something good even better.
Vice Chair Andriola enquired as to whether Dr. Wrangler would be presenting his findings in person or if they would be via Zoom.
Dr. Kingsley noted that Dr. Wrangler would be back in person to present his findings at the December meeting.
Population Health - Epidemiology, Statistics and Informatics, Public Health Preparedness, Emergency Medical Services, Vital Statistics, Sexual Health Investigations and Outreach, Chronic Disease and Injury Prevention.
Nancy Diao highlighted from her report the Extensively Drug-Resistant Organisms (XDRO) database, developed in collaboration with Epidemiology and TS, which tracks carbapenemase-producing organisms (CPO) and Candida auris in Washoe County. It is designed to alert participating hospitals if a patient being admitted has a history of these pathogens. Two hospitals are fully onboarded, with one more in active testing and one pending testing. The database also supports quarterly CPO surveillance reports, with these reports transitioning to a real-time public dashboard in
January 2026. She reported that the respiratory virus season is underway, with COVID, RSV, and influenza circulating at low levels. The most commonly identified influenza strain is flu A H3, which is included in this season’s vaccine. A new interactive respiratory virus disease dashboard is live and on the website, allowing public access to current and historical data. The 3rd Quarter 2025 publication of Epi News was published, covering tables and figures to compare reported morbidity for selected communicable diseases over the most current quarter, with a comparison to the past five years. The most notable increase this quarter was in animal bite reports, consistent with seasonal trends.
Dr. Ituarte shared that he has used the dashboard. It is wonderful, and he appreciates having the data available to the public.
Office of the District Health Officer Report - Northern Nevada Public Health Communications Update, Accreditation, Quality Improvement, Workforce Development, Community Health Improvement Program, Equity Projects/Collaborations, Community Events, and Public Communications and Outreach.
Chad Kingsley provided an update on public health initiatives, highlighting the Community Health Assessment and noting that engagement with the community continues to identify priorities for health improvement and resource allocation. A report on this assessment is expected in January, which will lead into the February strategic planning meeting. He recognized staff and community partners for their contributions to this work. He also acknowledged the work of the Deputy District Health Officer in coordinating the recently approved state public health funds, supporting infrastructure development, and community health initiatives. He noted that staff recently attended a 3-hour training course, conducted over multiple days, that focused on system processes, data analysis, and the application of new tools to improve efficiency.
Chair Reese asked if there was a post-training report showing how well the staff responded.
Dr. Kingsley shared that pre- and post-training assessments showed a general increase in staff confidence in applying the processes, which helped to demonstrate the training’s effectiveness.
At 1:55 p.m., Dr. Danko stepped away from the dias and returned at 1:57 p.m. Quorum remained while away.
Public Comment.
There were no requests for public comment, so the item was closed.
Board Comment.
With no Board members requesting to comment, the item was closed.
Meeting adjourned at 2:03 p.m.