(adapted from Camas Fire Department History)

1935
The Camas Fire Department (CFD) establishes the first emergency medical aid car in the State of Washington, serving a large area that stretches from what is known today as Cascade Park in Vancouver to areas within Skamania County.

1959
The Camas City Council votes to discontinue the CFD aid car service, citing the existence of a private ambulance company.

1962
The Camas City Council, after three years without community-based EMS, reverses the 1959 decision and reinstates the CFD aid car service.

1979
Following a study, a regional paramedic ambulance service for east Clark County is proposed at a cost of 25¢ per $1,000 on home valuations.  This first EMS levy is passed by voters in Camas, Washougal, Clark County Fire District #1 (CCFD1), and Clark County Fire District #9 (CCFD9).

1980
Following the successful passage of the EMS Levy, CFD hires four paramedics and commences providing Advanced Life Support (ALS) ambulance service to the greater east county community.  Funds from the EMS levy are also passed through to the other agencies in the forms of training, supplies and equipment.  There are 831 ambulance calls.

1982
The EMS Levy is renewed by all areas by a 91% margin.

1983
CFD  hires a fifth paramedic.  There are 850 ambulance calls.

1987
Call volume is increasing, there are 1,160 ambulance calls.

1988
The EMS Levy is renewed by all areas by an 84% margin.  CFD hires a sixth paramedic, and there are 1,169 ambulance calls.

1990
CFD hires a seventh paramedic, and there are 1,308 ambulance calls.  Camas also increases their full-time firefighting staff and is now able to ensure immediate response to all ambulance calls.

1991
CFD hires an eighth paramedic, and two paramedics on duty 24 hours a day becomes standard.  There are 1,399 ambulance calls.

1993
There are 1,930 ambulance calls, a 232% increase within thirteen years.

1994
The EMS Levy is renewed by all areas.  CFD hires a ninth paramedic to maintain service levels.

1997
CFD opens a second fire station to cover the Prune Hill area annexed into the City, and hires six more paramedics to staff an ambulance in this station, resulting in three ambulances staffed 24 hours a day.

1999
CFD adds a fourth ambulance, to ensure that three ambulances remain in service when one of the fleet is being serviced.

2000
The EMS Levy is renewed by all areas.  There are 2,288 ambulance calls.  The first ambulance responded to 1,912 calls, the second to 331, the third to 45, and the reserve ambulance responded to 3.  Call volume is up 275% since the program began twenty years ago.

2006
CCFD1 formally merges into CCFD9, and the new entity formally changes its name to East County Fire & Rescue (ECFR). For the first time in the history of the EMS Levy, the rate is increased from 25¢ to 35¢ per $1,000 on home valuations to cover rising costs of fuel, supplies, inflation, and unfunded training mandates.