Less than two days after he stood before the Marshalltown City Council to present the results of the EMS study and discuss next steps, Cross made a similar presentation to the Marshall County Board of Supervisors on Wednesday morning, and the board unanimously voted to accept its findings and consider a path forward on the matter.

Cross provided a history of the conversations surrounding EMS over the last two years, why UnityPoint is currently considering no longer providing transport services and conversations with Supervisor Carol Hibbs evolved into the task force now focused on addressing the matter and the commissioning of the study from Iowa EMS Consultants.

He noted that the county sees a high volume of calls over a widespread area and is heavily reliant on volunteers outside of the city of Marshalltown, which has the only professional fire department in all of Marshall County.

“These realities reinforce that the status quo, as it exists today in Marshall County, is not sustainable for future EMS delivery,” Cross said.

He then presented the three options as reported in the adjacent story and the task force’s preference for the unified city/county operation with the county serving as the fiscal agent contingent on the passing of an essential services levy. A standalone county operation, Cross said, would come at a much higher startup cost than the preferred option.

Cross told the board that the city/county arrangement would emphasize local control and accountability, and he reiterated that accepting the report on Wednesday did not “pigeonhole” the board into an immediate binding decision. Hibbs thanked Cross for his leadership on the issue and called the situation “a winding road” to get to this point, and he credited each member of the task force for their efforts before laying out the financial implications of each proposed solution.

Hibbs reiterated that the problem is not unique to Marshall County, but Cross felt that the approach the task force is taking is “innovative” and “awesome.” Board Chairman Jarret Heil said city and county officials still have a long way to go in terms of finalizing a long-term proposal and also responded to concerns about a tax increase to fund EMS as an essential service.

“But at the same time, we’re talking about a problem of the future of our EMS and making sure we have a pathway to having it. So that’s the balance that we have to look at as leaders, and it’s the balance that our people have to look at too,” Heil said.

Cross then expanded on why a tax levy would likely be necessary, detailing the history of the local hospital providing transport services dating back to the 1960s and how fire departments in most places gradually took over the administration of EMS.

Now, individual counties can decide on their own whether or not to declare EMS an essential service as it is not established statewide in Iowa Code, so voters would decide the fate of a levy up to $0.75 per $1,000 of property valuation.

“I’m not insinuating that UnityPoint is going to pull the trigger or shut the valve off on us. I don’t get that feeling at all, and I fully trust UnityPoint in the administration and delivery of the service today as I always have. They do fine work, but I think that everybody is seeking a change on both sides of the fence,” Cross said.

Hibbs also sought to clear up the misconception that UPH can simply bill for every 911 call they respond to, which is not always the case.

“They are limited in what they can recoup for costs,” she said.

A publicly funded EMS system, Cross added, would have more mechanisms to recoup costs and generate revenue to sustain operations.

“I’m not a hospital billing expert at all, but I believe that they’re hamstrung on the way that they bill their services for EMS, and they include them into their ER stay. And they’ll never be able to realize or recover the potential of EMS billing by virtue of the fact of the way that they are,” he said. “It seems rather obvious that they’re in the situation that they’re in because they are limited.”

Even with declining volunteerism rates, Cross said the public still expects a high level of service, and the MFD intends to continue providing it however it looks going forward. After Hibbs motioned to accept the report, Elder again stepped forward to comment, commending Cross for his work with the task force and providing some history of EMS services in Marshall County.

“We have a good system. We just have to figure out how to make it better, and like you said, sustain it,” Elder said. “Ultimately, we’re doing this to better our process and to save lives. It’s not to find another way to spend tax dollars.”

The motion to accept the report passed by a unanimous 2-0 vote.

In other business, the board:

• Recognized Heil for 15 years of service to Marshall County, Tabrina Eggleston for five years of service with the Marshall County Sheriff’s Office and Shari Coughenour for five years with Veterans Affairs.

• Approved the consent agenda as listed.

• Approved an alcohol license renewal for The Harvester Golf Club.

• Approved setting the standalone tax levy public hearing for Wednesday, Feb. 25 at 5 p.m.

• Approved a $500 contribution to support the Lincoln Highway Heritage Byway App.

Approved the bid and thr • ee-year lease agreement with Chad Southard, Southard Farms LLC, for the Klauenberg Prairie Reserve Crop Ground at $250 per acre for 85.75 acres for a total of $21,437.50 per year. The lease will run from April 1, 2026 to March 31, 2029.

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Contact Robert Maharry at 641-753-6611 ext. 255 or rmaharry@timesrepublican.com.