(Editor’s note: May 19-25, 2024 was National EMS Week.)

Q: I call 911, an ambulance shows up, how does this happen?

A: UnityPoint Health-Marshalltown Ambulance is dispatched by the Marshall County Communications Center. When you call 911, the communication’s center gets the pertinent information and dispatches the ambulance on our radios.

Q: Why do I see four ambulances at local restaurants?

A: The crews need to eat too! Most of the staff live 30-60 minutes away and are working 12-24 hour shifts, if not longer. They like to get out and get fresh food from the local restaurants as well.

Q: Who provides the ambulance service?

A: In Iowa, emergency medical services are not an essential service, so no one is required to provide it. In some communities, this is done by city or county government entities, while others are provided by hospital or non-profit organizations. Locally, UnityPoint Health-Marshalltown provides this service. We are one of four non-profit hospitals in Iowa providing ambulance service.

Q: Elaborate, one of four non-profit hospitals providing ambulance service?

A: That is correct. There are county or municipal hospitals who also provide ambulance service to their communities. These organizations receive government funds through taxes or other subsidies; however, UnityPoint Health-Marshalltown is a non-profit hospital, we are not municipally owned or county funded.

Q: This is a good segway into the next question. We have heard talk around town about meetings regarding a sustainable ambulance service system in Marshall County, what is that about?

A: We have had several productive conversations with local elected officials regarding the fact that the ambulance model is not sustainable for the future. This is not isolated to Marshall County, as we have seen several counties around Iowa push the “EMS essential service” conversation. We continue to see the costs associated with providing this community service rise, both in labor and supplies, while we still see small reimbursement rates. Just like other public safety entities in our area, we are in direct competition with Des Moines, Waterloo, and Cedar Rapids for employees. We need to continue to invest in the wages but also a positive work environment to ensure we can attract great talent.

Q: Let me get this straight, if I call 911 and ask for an ambulance to come to my house, to help me from my shower to my bed, do you get paid for that?

A: No. That type of situation you outlined, the hospital would absorb the cost on (labor, supplies). We do not receive a subsidy from the government/taxpayers for this service.

Q: If Marshall County does the essential service route, will that help the ambulance?

A: In theory, it could provide the financial resources to the first responder community to continue to stock, equip, and staff their services. Unfortunately, it does not help with the reality we have a first responder shortage nationwide. We see fewer volunteers in the smaller communities and fewer career paramedics across the nation, as well as here locally. Our nearest paramedic education programs are in Des Moines, Waterloo, and Cedar Rapids. As these students are attending classes and doing clinicals, the local services are actively recruiting them to join their services. For places like Marshalltown, we really need to show the candidate why they should bypass those local services and come to Marshalltown.

Q: If you could ask the community for one thing, what would it be?

A: Support your local first responders. The first responder community is not growing but dwindling. At the same time, the calls for service are not decreasing; however, the demand is increasing. Continue to support those who continue to do this work, especially those who volunteer to do it.

Nicholas Heintz is the Regional Director of Safety, Security, and EMS for the UnityPoint Health – Waterloo Region.