By Steve Woodhouse
Action is expected to provide notice that Emergency Medical Service will be declared as essential is expected to be on the May 28 Marion County Board of Supervisors’ agenda. Dylan Morse, chair of an exploratory committee for the future of EMS in Marion County, reviewed the findings and conclusion his group had reached to bring to the supervisors at Tuesday’s meeting. His recommendation was to model an EMS levy – in the 60-65 cents per $1,000 of taxable valuation range – based on Iowa Code Chapter 422D. Before this tax is added to anyone’s property obligation, it must be placed on a ballot for public vote. The committee’s recommendation comes after many months of discussion to find a way to help cover the costs of ambulance services around the county. Though the deficits existed prior to the City of Pella’s takeover of the ambulance service in that community, Pella’s losses on the service sparked a more serious examination of all departments’ financial woes.
“This is not going to make anybody whole,” Morse said of the proposal. “This is not going to be a moneymaker.” He continued, “What it is going to do…it’ll help to ensure folks that are receiving services will be contributing to the financial health of those agencies.” Knoxville and Pella each run at a deficit of around $600,000 per year to provide ambulance services. Meanwhile, other departments also run smaller deficits – but are not staffed full-time. The crux of financial struggles for EMS is around insufficient reimbursements from the federal government for Medicare and Medicaid services. For many years, the reimbursements have not covered these agencies’ actual costs – which continue to rise – and adds to the burden on local property taxpayers. Most rural residents pay a levy to cover fire services, but those funds are not intended to be used for EMS. If voters do not support an EMS levy, these departments will continue to have no dedicated funding source to operate their ambulance services.
“The agencies are taking from that fire levy to subsidize operations for EMS,” Morse
said. Marion County is fortunate that its emergency departments work cohesively to cover
each other when necessary. “That’s what you want, that’s what you need, but we need to be able to take care of those agencies,” Morse said.
Representatives on Morse’s committee voted unanimously to recommend this approach to the Board of Supervisors, and eventually, the voters. A more formal committee – which will continue to include EMS representatives – is expected to make more binding decisions before the question is placed on the ballot.
“I said it’s going to be a hard sell,” Supervisor Steve McCombs said. McCombs recently began to represent the supervisors on the committee and had been to one meeting. The government officials believe it is important for significant public education and input on the proposal before any vote. One concern Morse has is that if operations continue as they are, one day, rural residents could hear, “We’ll get there when we get there” when in need of emergency medical assistance. Uncertainty with emergency services can also affect economic development and growth in the county. Board Chair Mark Raymie is concerned that an EMS levy increase could erase the reductions the County has tried to make in its levy over the years. He also questioned what actions cities would take if an EMS levy is added, as a reduction could undo any benefit from higher taxes.
“The cities almost have to guarantee they will maintain their levies,” Raymie said.
“Otherwise, it’s a wash.”
