T-R PHOTO BY RUBY F. MCALLISTER Members of the newly-formed Tama County Emergency Medical Services Advisory Council are pictured on Thursday, July 11, during the council’s very first meeting which was held at the Dysart Ambulance Service building. The council, along with the Tama County Board of Supervisors, is hoping the county’s voters will approve a new property tax levy designed to fund EMS as an essential service similar to fire and law enforcement on Tuesday, Nov. 5.

DYSART — Local emergency medical service agencies are hoping a supermajority of Tama County voters will give the thumbs up this November to funding EMS as essential by approving a new property tax levy.

Last Thursday, the newly formed Tama County EMS Advisory Council held its inaugural meeting at the Dysart Ambulance Service building. The council was formed in mid-June following the adoption of a resolution on May 20, 2024, by the Tama County Board of Supervisors declaring EMS an essential service.

Back in 2021, Iowa Gov. Kim Reynolds signed into law legislation allowing counties to declare EMS an essential service and subsequently levy up to 75 cents per $1,000 of assessed taxable value to fund such services similar to law enforcement and fire. Previously, there was no required, guaranteed funding mechanism for EMS in Iowa, and there still isn’t unless a county’s voters approve a new EMS tax levy by at least 60 percent.

“Primarily, we’re at the phase now where we got the [resolution] signed [and] we have the advisory board which has been approved,” Dysart Ambulance Service Director Julie Scadden told the council.

Those present included representatives from each of the county’s ambulance service agencies as well as Tama County’s 911 Director, Jeremy Cremeans, and EMA Coordinator, Ryan Goodenbour.

“This board is not just a one-time deal. This is a board that every year is going to have to see where this money was spent, how this money was spent,” Scadden continued. “We’re going to be answerable to the board of supervisors. … This is a [council] that is pretty important overall to the county.”

As part of the council’s initial meeting, officers were elected including Scadden as chair; Billie Van Egmond of Dysart EMS as vice-chair; and Goodenbour as secretary.

Also in attendance at the meeting Thursday evening was Anna Demuth, the president of the Benton County EMS Association – an entity that successfully guided the passage of EMS as essential in Benton County during the November 2023 election. According to reporting by KCCI, EMS has been declared essential and funded accordingly in a dozen Iowa counties including Benton, Cedar, Ida, Iowa, Jones, Kossuth, Lee, Osceola, Pocahontas, Shelby, Winnebago, and Wright.

“You’re already ahead of the game with getting the resolution and all of that passed,” Demuth said.

Demuth then described in detail the process her county undertook to get the tax levy approved by voters. Part of that process involved surveying all of Benton County’s EMS agencies to determine staffing, call numbers, financials (billed versus collected), expenses including training and supplies, and fundraising from both grants and donations.

“We put [the data] together to figure out what our current deficit was,” Demuth said. “We came in with a large deficit.”

Demuth said her council then used the data from the survey to determine the amount of tax to put before the voters.

“Somebody threw out 68 cents,” Demuth said. “We did the figuring … and that allowed us to cover the deficit for the year and have money to grow.”

In October 2023, ahead of the Nov. 8 vote, Demuth said Benton County’s EMS agencies began campaigning in favor of the new tax.

“We kind of left everything up to response areas – towns, per se – because who knows their citizens better … The biggest thing that we found [while campaigning] is citizens don’t realize that EMS isn’t already tax-funded. They don’t realize any of that,” she said.

Ahead of Tama County’s first advisory council meeting, Scadden said she and Van Egmond sent out a survey to 17,000 homes in the county to determine property taxpayers’ willingness to fund EMS as essential through a tax levy. The survey garnered 981 initial responses with more trickling in since the window unofficially closed.

“What’s really encouraging about this (is that) right at 70 percent of responses [said yes, they’re willing to pay taxes to fund EMS as essential],” Scadden said.

She added that many of the survey’s responses were received by voters aged 40 to 60 and aged 60 to 80 – groups “very dedicated to voting.”

Van Egmond said a majority of the comments received indicated a willingness to pay taxes alongside a desire to know “the money is going to EMS.”

Later in the meeting, Scadden addressed how money generated by the tax can be spent, telling the council there are “no restrictions in the bill as long as it’s being used to keep your service open.”

There were concerns, however, from some council members that if Tama County does approve the new tax, cities may stop funding their local EMS agencies.

“There’s nothing we can do about that,” Scadden replied.

The biggest hurdle Tama County EMS agencies face currently, Scadden said, is staffing – volunteers or otherwise – which is where the bulk of the levy’s funds will more than likely be spent.

“There’s not a lot of people out there to hire,” Scadden said at one point. “We can’t compete with the urban areas wage-wise. … We can’t compete with those wages and benefits. We just can’t.”

According to a recent posting on the Tama County EMS Association’s website addressing the need for an EMS tax levy, “EMS in Tama County has traditionally been provided by dedicated volunteers who were often able to leave work to attend to the needs of the community.”

But as the county’s Main Streets have either “lost these businesses or have become more corporate,” such volunteers have disappeared.

“A decrease in volunteers coupled with increased education requirements along with increased expectations for EMS care capabilities has resulted in paid staff to cover gaps in staffing,” the Association further wrote. “Currently, ambulance services can only charge if they transport the patient to a hospital or specialized care center except in cases defined by the Centers for Medicare and Medicaid Services (CMS). Therefore, many ambulance calls for service do not result in billed charges. First responder units cannot bill for any of their responses.”

The tax

Most of the council’s work over the next several weeks will involve determining what dollar amount to attach to the ballot question. That amount must be presented to the Tama County Board of Supervisors by the second week of August, Scadden said, in order to be approved at least 60 days before the Nov. 5 election, per Iowa Code.

During the meeting last Thursday night, Scadden presented council members with five options for the EMS tax levy – 65 cents, 68 cents, 70 cents, 72 cents, and 75 cents (per $1,000 taxable valuation) – along with the corresponding amount each tax would generate. The 65-cent levy would generate roughly $767,083 annually based on fiscal year 2025 valuations, while the 75-cent levy would generate roughly $885,096.

The tax would be implemented for 15 years if approved.

“You need to look at where you’re at now and where you want to be five, 10, 15 years from now,” Scadden told the council. “We need to set a dollar amount that isn’t going to look ridiculous to the public but will be feasible 15 years from now.”

Essentially, Scadden said, the tax should be enough to replace the need for fundraising.

“Try to take the fundraising piece out of it because that’s the part we need to try and step back from. That’s what this should be replacing,” she said. “We all fundraise until we’re blue in the face … I just think the days of fundraising are going to be rapidly going away. People just can’t afford it anymore.”

Before the meeting’s adjournment just shy of 8 p.m., the council decided to meet weekly by Zoom going forward – settling on July 18 and July 25 at 6:30 p.m. – with plans to set the tax amount during the July 25 meeting.

“We have a fairly optimistic view of this passing, but we still have work to do,” Scadden said toward the end of the meeting.

For more information on Tama County’s efforts to fund EMS as an essential service, refer to the Tama County EMS Association webpage: https://tcemsa.org/news/essentail_services_faq/.