T-R PHOTO BY ROBERT MAHARRY Gilman Fire Chief Jacob Patterson, who is also a Marshalltown firefighter and EMT, and Marshall County Emergency Management Coordinator Kim Elder address the Board of Supervisors about the future of EMS services in the county during a special meeting held Wednesday morning at the courthouse. The supervisors voted unanimously to share the cost of an approximately $60,000 consultation with the city of Marshalltown aimed at determining the best course of action after UnityPoint Health-Marshalltown Hospital Administrator/Executive Director of Operations Shari King reported that her organization is currently losing about $1 million a year providing 911 transport services.

Less than two days after the Marshalltown city council heard from UnityPoint Health-Marshalltown Hospital Administrator/Executive Director of Operations Shari King about the current state of local emergency medical services (EMS) and agreed to help fund a consultation aimed at determining the path forward, the Marshall County Board of Supervisors also discussed the topic and reached a similar conclusion during a special session held Wednesday morning.

As the conversation began, Board Chairwoman Carol Hibbs noted that a task force on the issue has been assembled and includes stakeholders like herself, Marshall County Emergency Management Coordinator Kim Elder, Sheriff Joel Phillips, Marshalltown Fire Chief Christopher Cross, Gilman Fire Chief Jacob Patterson (who is also a professional Marshalltown firefighter and EMT) and State Center Fire/EMS Chief Brad Pfantz. UPH-Marshalltown is currently losing approximately $1 million a year providing 911 ambulance services, and, echoing what King shared at the city council meeting, Hibbs said it is an unusual arrangement for a private hospital to do so, hence the discussions on assessing the situation and considering potential solutions.

The proceedings were then briefly interrupted by an apparent hacker who gained access to the meeting remotely before county IT Director James Nehring kicked the individual responsible for the disruption out of the meeting. Hibbs laid out a summary of the current situation.

“We have, basically, a shortage of personnel and coverage for first responders, and we have (an) unsustainable 911 transport service. I don’t know, Kim, if you want to add any comments to this, but what we’re looking at doing is hiring a consultant and sharing the cost with the city and looking at having them present different scenarios and options that would be available to us as we look at how to structure things for the future. So that’s a quick summary,” she said.

Elder and Patterson came forward to the speaking podium, and Elder noted that outside of Marshalltown, Albion, Gilman, Le Grand, Liscomb, Melbourne, Rhodes, State Center and Green Mountain all currently have active volunteer EMS agencies providing transport services in the county.

“I think that’s the biggest thing we discuss at every meeting is just personnel. You know, there’s just not enough personnel out there whether they’re paid or volunteer, and that’s not just Marshall County, not just Iowa. It’s all over the United States. That’s a huge part of this is (figuring out) how do we remedy that, and again, the losses for UnityPoint, how do we remedy that?” Elder asked. “EMS in general, people just aren’t, they’re not volunteering as much. They’re not going to EMT, EMS school whether they’re going into the volunteer or whether they’re going into the paid (positions). And again, it’s not just us. It’s everywhere.”

The main focus, she added, is deciding how to improve that outlook for the future, and one consistent possibility has been placing an EMS as an essential service levy of up to $0.75 per $1,000 of property valuation. Hibbs said that could mean creating a countywide service or contracting with a private provider such as UPH, which she felt the study would assist in determining.

The firm the county and city would use, Iowa EMS Consultants, is based in Sac County and has collaborated with other counties to perform similar work in the past.

“We just don’t have a lot of information right now. I think that’s the big thing is we want to make sure we have everything before we go back out and say ‘Here’s what we’re looking at.’ But we’re trying,” Elder said.

The city council unanimously approved moving forward with the consultation on Monday night, and after Auditor/Recorder Nan Benson asked if a ballot initiative would be coming forward, Hibbs said the study would help to decide if that was the right course of action.

“It’s an important issue. I think what we’re trying to do is address something we know is a problem in the making here. It’s going to be pretty critical in the next few years,” Hibbs said.

Supervisor Jarret Heil commented that the funding question is important, but he agreed with the goal of establishing a stronger EMS service and determining the most cost effective path to pay for it.

“I’ll be excited to see what they come up with so we can start figuring out what we can do to make sure that people are covered in emergency situations,” he said.

Hibbs added that the county is not required to provide the service — as was noted during the city council meeting, no formal contract is currently in place — and because UPH-Marshalltown is not classified as a Critical Access Hospital, certain funding and reimbursement mechanisms are not available to the hospital.

“I think it’s important to be appreciative of UnityPoint because they don’t have to do that. They could pull the rug out from us at any time, and they’ve been working and partnering with us in making sure that whatever the plan is, we’re working together on it. So yeah, when you’re losing a million dollars a year and you’re still doing it for Marshall County, I think that’s something we should be appreciative of,” Heil said.

The study would cost just under $60,000, and Hibbs said the county would be expected to commit an amount not to exceed $30,000 to fund it in partnership with the city. After the council meeting on Monday, Mayor Pro Tem Mike Ladehoff told the T-R the expense would be split three ways between the city, the county and UPH, but King and Ladehoff have since clarified that UPH is not able to participate in covering the consultant fee. Ladehoff added that a formal motion to clarify the 50-50 split will be on the agenda at the next council meeting.

A motion by Heil to approve the commitment of up to $30,000 for the study received unanimous support from the board, and it will be pulled from the county’s economic development funds.

In other business, the board:

• Approved the consent agenda as listed.

• Approved extending dental coverage for dependents through age 26 as part of the county’s insurance plan.

• Approved the DeltaVision contract for employee vision benefits.

• Approved an annual transfer of $1 million in Local Option Sales and Service Tax (LOSST) revenue from the Rural Services Fund to the Secondary Roads Fund.

• Approved the Iowa Department of Transportation (IDOT) federal aid agreement for a surface transportation block grant program project for the resurfacing of 11.9 miles of E29 from Highway 330 to the Story County line with 80 percent federal funding.

• Heard concerns from Mark Wyant about conditions and ruts in the 260th Street/Ridge Road area, with County Engineer Paul Geilenfeldt noting that a project would require all local money and planning and forethought to pave and grade the road while maintaining driveway access for the at least 40 affected residential property owners just south of Marshalltown.

• Approved the appointments of county department board liaisons for each supervisor as follows.

• Kevin Goodman — Public Health, Engineer and Secondary Roads, Conservation, Information Services, Treasurer.

• Jarret Heil — Emergency Management, Veterans Affairs, Assessor, Planning and Zoning.

• Carol Hibbs — Sheriff, Auditor/Recorder, Attorney, Courts, Buildings and Grounds.

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Contact Robert Maharry at 641-753-6611 ext. 255 or

rmaharry@timesrepublican.com.