Emergency Medical Services (EMS) is a program which provides ambulance and emergency medical care to Iowans throughout the state. The Iowa Department of Public Health is the lead agency and is responsible for the development and coordination of the program. While fire and police services are required by state law, ambulance services are not. For many Iowans, this means increased concerns over lack of volunteers, increased medical costs, and increased waiting time for medical personal during emergencies.
For several years there has been a growing concern over the sufficiency of EMS in rural Iowa. When addressing EMS sufficiency in your own county, there are several basic issues to consider. Counties should consider what level of government should be addressing this issue, how the program should be financed, and what services the county requires.
While township trustees are not required to provide EMS for the township, they still have the ability to do so if they choose. One way to finance EMS may be to raise taxes. Townships may levy 40.5 cents for EMS and fire services, up to 54 cents if the township has agreements with a special charter city with a paid fire department, and up to 67.5 cents if the township is in a county with over 300,000 people. If those limits are insufficient to pay for emergency services, the township trustees may impose an additional 20.25 cents levy.
County residents may choose to create an Emergency Medical Services District for a rural area. Iowa Code Chapter 357F allows townships to vote in an election to approve a levy up to $1 per thousand of land value on all taxable property. Agricultural land and centrally assessed property would not be included in the assessment. An incorporated city may also create an Emergency Medical Service District through a similar process. This annual tax could be used to operate EMS in the district.
A third option to provide EMS for a rural area is through resolution. The county may adopt a resolution to allow township trustees to assume the duties relating to fire protection and EMS. This would allow the county to coordinate all fire and EMS in the unincorporated areas with cities and other private providers.
One main area of concern is lack of volunteers. If the main challenge is a lack of volunteers, cooperating with other townships and counties may be beneficial when creating an overall picture of emergency services in the county and identifying possible solutions. Intergovernmental agreements allow townships, cities, and counties to work alongside public and private emergency service providers to make sure all areas of a county have many services available.
It is important to understand the underlying issues of implementing a fully function EMS into a community. Cooperating with townships trustees and officials at the state and county level will help EMS became a service all Iowans can use.