Floyd County EMS levy educational strategy focuses on costs, needs

By Bob Steenson, bsteenson@charlescitypress.com

Members of the Emergency Medical Services Advisory Council in Floyd County will first tell people what it might cost them if an EMS support levy passes in the upcoming general election, because that’s the information that most people most want to know, the group decided.

But they will also tell them why the levy is being proposed and what it might mean if the levy question fails, because that is the most important information, the group members said.

The members of the EMS Advisory Council spent their meeting again this week discussing the particulars of an educational campaign to inform people about the question that will appear on the ballot in the Nov. 5 election, fewer than five weeks away.

The question will ask voters if they approve allowing the county to begin collecting an EMS property tax to be used to fund ambulance and other emergency medical services, at up to 69 cents per $1,000 of taxable valuation, to collect no more than $670,000 annually for five years.

Keith Starr, a Charles City Council member and chair of the EMS Advisory Council, said he has been working with County Auditor Gloria Carr, and if the full $670,000 is raised the additional annual property tax collected would be about:

• $30 per year on a home with an assessed value of $100,000.
• 80 cents per acre on tillable farmland with a CSR (corn suitability rating) of 77.
• $30 per year on commercial real estate with an assessed value of $100,000.

Starr said the full 69 cents rate would likely not be collected, because total countywide property valuation has increased, and 69 cents per $1,000 would collect more than the maximum $670,000 that the ballot issue would allow.

He also said that less than the full $670,000 – he estimated about 25% less – would likely be collected in the first couple of years.

If the ballot measure passes, the EMS Advisory Council would come up with a proposed EMS budget each year and present it to the county Board of Supervisors, which would have the final say on how much of the levy is collected each year and how it is spent.

Iowa law requires that the EMS taxes collected be put in a special EMS Trust Fund, and they can only be spent on EMS services that are listed in the Iowa Code.

The reason the levy is important is simple – the old method of providing ambulance service no longer works, said Steve Diers, the Charles City city administrator.

Diers isn’t a member of the Advisory Council, but often sits in and helps provide information.

Just a few years ago, both private and public ambulance services could stay in businesses because the fees they received for providing service covered their costs.

But now, for a variety of reasons that have been discussed by this and other county groups, most rural ambulance services require a subsidy to operate, and many services have gone out of business.

The reasons they must be subsidized, they said, include low reimbursement rates from Medicare and Medicaid; delayed, reduced or denied payments by insurance companies; staff shortages and staff burnout creating higher labor costs; and increasing equipment and supply costs to provide service.

Diers often gives the example that several years ago, AMR ambulance, the private company that provides service in Floyd County, was covering its own costs as well as paying the city annual fees for rent to house ambulances in the fire station, paying the county for dispatch services, and covering overtime compensation for firefighters who drove the ambulances on calls.

But since 2019, first the city and then the city and county have been paying a subsidy to AMR to keep it operating in the county, starting at $50,000 five years ago, and now $427,450 in the second year of the latest AMR three-year contract, with an increase to $440,275 next year.

The cost AMR will ask in a new contract after the current one expires June 30, 2026, is unknown, but everyone expects it will continue increasing.

Twice in the last several years the city and county have sent out requests for proposals from other ambulance companies to provide service in Floyd County, with no responses.

Part of the EMS funds collected would be used to support other organizations that provide service in Floyd County, including the Nora Springs Volunteer Ambulance, Greene Volunteer Ambulance and Marble Rock Fire Department First Responders.

Both Dave Luett, service director for Nora Springs Volunteer Ambulance Service, and Jeff Stirling, Greene Volunteer Ambulance Service director, said their services are struggling to find enough volunteers to keep operating, and being able to offer a stipend for when volunteers go on calls would help.

Luett and Stirling are both members of the EMS Advisory Council.

Luett has also said his service will need to replace its ambulance soon.

Iowa law requires cities and counties to provide law enforcement and fire protection, and those services are usually supported by the cities’ and counties’ general fund property taxes. But city and county officials say the state has restricted property tax collections to a point where they can’t be increased enough to add the cost of subsidizing EMS.

That means, those officials say, that another funding source must be found such as the EMS support levy that will be voted on next month, or the city and county will have to cut spending on other services to support ambulance service.

Several other mostly rural counties have passed EMS support levies, and many more are considering it. The ballot measures must pass by at least a 60% majority to be approved.

“This levy will help provide certainty, stability,” Diers said. “Without it there’s uncertainty.”

The Advisory Council members discussed setting up a series of advertisements in county newspapers and on radio to provide information, as well as other places where members of the group can speak about the proposed levy and hand out information.

One of the chief sources of information and answers to questions is expected to be a website, and providing people with instructions on how to get to that website will be one of the focuses of the educational campaign, the group discussed.

However, Mayor Dean Andrews, who also frequently attends the EMS Advisory Council meetings, said there are still people – including himself – who will not go to a website for more information, so the group needs to make sure that information is also available in other ways.

The group will hold another meeting Tuesday evening, Oct. 8, beginning at 6 p.m. in the City Hall Council Chambers.