Floyd County supervisors agree to likely EMS levy question, ask Floyd County Medical Center to continue contributing toward ambulance service cost
By Bob Steenson, bsteenson@charlescitypress.com
A countywide ambulance service funding proposal will likely be put before the voters in the general election Nov. 5, and another part of that proposal will be presented to the Floyd County Medical Center Board of Trustees at a special trustees meeting early Tuesday morning, July 23.
The proposal, passed by the Floyd County Board of Supervisors at its meeting Monday, July 22, would ask county voters to approve a $450,000 Emergency Medical Services (EMS) levy, to be collected through property taxes, for a period of five years, to help pay to continue service by the current ambulance service provider, the private company American Medical Response (AMR).
Another part of the funding proposal to support AMR service would be for the Floyd County Medical Center to continue contributing more than $100,000 a year toward the AMR subsidy.
At the supervisors meeting Monday morning, Supervisor Chair Mark Kuhn said the Medical Center trustees “want to renege on the 28E Agreement they approved in April to help pay for AMR’s services, and not make their $106,090 payment to the city and the county from July 1, 2025 through June 30, 2026.”
He also said the Board of Trustees did not want to contribute toward subsidizing ambulance service if there is a new three-year contract with AMR after the current contract ends June 30, 2026.
Dawnett Willis, the CEO of the Medical Center, told the Press after the meeting that Kuhn’s statement does not accurately represent the Board of Trustees’ position, because the board has not discussed that topic or made a decision about it.
Kuhn’s statements were made based on a long and wide-ranging discussion held at a July 16 meeting of the Floyd County Ambulance Commission. Both Kuhn and Willis are members of that commission.
“The board has not met yet to discuss this topic,” Willis said when asked about Kuhn’s Monday morning comments.
“We meet tomorrow morning. What I told him at the (Ambulance Commission) meeting, that I could not speak for the trustees, nor did I. I’ve had no conversations with him (Kuhn) since then and we have a meeting tomorrow morning where he can present his case to the trustees and they can make their decision,” Willis said.
She said the trustees had also not discussed whether the Medical Center would participate in funding any future contracts with AMR.
The Medical Center Board of Trustees are holding a special meeting beginning at 7:45 a.m. Tuesday, July 23, to listen to Kuhn’s proposal and discuss it. The meeting will be held in the Veteran’s Room at the Medical Center.
(Editor’s note: The meeting was incorrectly published in a previous Press article as being in the evening. It will be at 7:45 a.m.)
The meeting will also be available remotely through Microsoft Teams at Meeting ID 283 294 442 12, passcode hc2F5v; or by telephone conference call at 872-242-8222, conference ID 978 428 438#.
Last year, when AMR’s annual subsidy increased from $200,000 in the final year of a previous three-year contract, to $415,000 in that first year of a new three-year contract, the Medical Center agreed to contribute $100,000 toward that cost, which was being split evenly between the city of Charles City and Floyd County.
Earlier this year, in April, the trustees approved an agreement to continue contributing to the annual subsidy through the end of the current contract, with $103,000 ($100,000 plus a 3% increase) in the second year of AMR’s contract and $106,090 ($103,000 plus another 3% increase) in the third year.
The supervisors and other groups have been discussing ways of funding ambulance service for years, ever since AMR began charging an annual subsidy that has grown significantly over the past several years.
AMR has said that service reimbursement rates from private insurance companies and government payments do not cover the cost of providing that service, and some patients are indigent and do not have insurance coverage or the ability to pay ambulance fees.
Cities and counties in Iowa are required to provide law enforcement and fire protection, and do so mostly through property taxes as part of their general funds, but not EMS. Under Iowa Code, counties can declare EMS an essential service and ask voters to approve a tax levy to support that service.
That is what’s being discussed currently, although the amount of levy being sought has changed significantly from an initial recommendation of up to about $776,000 annually for 15 years – an amount that would include funding for starting a new publicly operated ambulance service to replace AMR.
The Board of Supervisors have the final say on whether an EMS levy question goes on the ballot and for what amounts and what duration, and Kuhn has said he does not believe Floyd County voters would support the $776,000 figure or the 15-year duration, and he will not support putting that on the ballot.
At the supervisors meeting Monday morning, Supervisor Dennis Keifer – the only one of the current three supervisors who will remain on the board at the start of the new year – said several times during the meeting that he thinks the Medical Center should pay one-third of the cost of supporting ambulance service, along with the city and county, because the hospital benefits from the service being available.
“It’s an insult to taxpayers, in my opinion,” he said. “The hospital’s got the cash, they don’t pay property taxes, we give them a half million dollars a year from the county (in property taxes they collect), and they can’t afford $100,000 or even the full third? It should be a no-brainer.”
Part of the proposal the supervisors passed at the meeting says:
“The Board of Supervisors request the Floyd County Medical Center Board of Trustees continue to contribute their annual $106,090 payment in the final year of the recently amended 28E Agreement plus any percentage increase charged annually by AMR for the three-year extension of the AMR Agreement from July 1, 2026, through June 30, 2029, up to a maximum of one-third of the total cost of the emergency ambulance services provided by AMR. The current payment to the City and County from the Hospital for the final year of our 28E Agreement is 24% of the total cost paid to AMR by the City and County.”
Kuhn said, “They really can’t have a full-service hospital without providing an ambulance.”
No additional contract with AMR has been approved beyond the current contract that ends June 30, 2026, although Kuhn said he had talked with AMR representatives and they said they would be willing to negotiate another contract. He said they would not discuss what the subsidy cost might be in a new contract.
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