The Birmingham Regional Emergency Medical Services System (BREMSS) is administratively a component of the University of Alabama at Birmingham (Health System) with policy direction provided by a Board made up of representation of local governments, hospitals, physicians, nurses, emergency medical services personnel (EMSP)  and other EMS provider groups from throughout the seven-county region.  This seven-county region is located in north-central Alabama and encompasses the counties of Blount, Chilton, Jefferson, St. Clair, Shelby, Walker, and Winston.  BREMSS is responsible for overall coordination of and improvements in the pre-hospital emergency medical care system within these seven counties and the subsequent city jurisdictions.
 
BREMSS works with all components of the Emergency Medical Services System, which is inclusive of over 200 Emergency Medical Services (EMS organizations), 15 hospitals, over 2500 EMSP’s, 9 trauma centers, 11 stroke center hospitals, 8 STEMI hospitals, over 80 different municipalities, and many different 911 agencies.