Million-dollar question for EMS service: ‘How much to tax?’

WASHINGTON — Washington County decision-makers hope to add a local issue to this November’s general election ballot, asking voters to approve the designation of ambulances and other emergency medical response teams as an “essential service.” If at least 60% of voters at the polls Nov. 5 cast ballots in favor of the measure, the move would authorize new property taxes to help fund the services.

Officials say the levy’s revenue would be split three ways: 50% for municipal volunteer quick response groups, 35% for the county ambulance department and 15% for the county emergency communications system. Officials say that would represent a much-needed boost for the services, currently strained by a mix of state-mandated tax cuts at the county level, and a history of volunteer-based models that struggle to afford modern training or equipment at the city level.

First response officials say the tax is necessary to maintain the medical services, which, unlike fire protection and law enforcement, local governments aren’t legally required to provide.

“EMS is not guaranteed right now,” said Hogan Miller, president of the Kalona First Responders group. “This tax levy, it helps ensure when you call 911, you’re going to get first responders, and you’re going to get an ambulance service.”

The windfall would be greatest for volunteer quick-response groups like Miller’s, most of which are funded through a mix of donations and a small slice of their municipal fire department budgets. Members say they badly need more money to cover rising costs of vehicle maintenance, insurance, equipment and training.

“The days of having to flip pancakes so you can make a difference in the outcome of somebody’s medical condition (are) past,” said Washington County EMS Association President Toby Hancock, also a higher-up at Riverside’s emergency response service. “It’s not feasible for … volunteers who get out of bed in the middle of the night to have to rely on donations to have the equipment they need.”

The potentially million-dollar question, then, is how much to tax.

Members of the Washington County EMS Advisory Board — established in 2021 to help guide development of the proposed ballot issue — said they recommended a levy of 50 cents per $1,000 of valuation, a move that would pour around $740,000 into emergency response assets across the county.

But Washington County supervisors said Tuesday that they’d pursue ballot language authorizing levies of up to 75 cents, the maximum allowed by state law. The decision-makers stressed that the tax wouldn’t be that high every year, but would rise and fall from one annual budget to the next, depending on local EMS needs, likely starting with the recommended 50-cent levy.

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Supervisor Jack Seward Jr. said the approach would ensure reliable funding and budget flexibility in the future, since state law forbids the county from changing the levy for 10 years after its approval by voters, unless it holds another election to do so. And with most ambulance-adjacent equipment costs going up, officials said they were hesitant to lock in a precise property tax.

“If we put it on at 50 cents, then we’re stuck with that,” Seward said. “I wouldn’t want to hogtie anybody that’s on the board six or eight years from now, because I’m not going to be here.”

The more flexible approach has some drawbacks, however.

For one thing, it could result in higher taxes than the 50-cent levy recommended by the county’s EMS advisory board. The potentially increased cost for taxpayers may prove less persuasive at the polls, potentially delaying implementation for any of the funding.

“We need to make sure the voters are going to approve that,” said EMS Advisory Board Chair Jim Lester. “EMS definitely needs some additional funding.”

Additionally, several members of the EMS advisory council said they were unaware of the county’s plans to take the more flexible, up-to-75-cent approach. Those members said they believed their recommendation was for a specific, 50-cent levy, while others said they believed the board was “open to” a higher maximum. The disconnect between officials could complicate campaign efforts in favor of the ballot issue.

Still, Katrina Altenhofen — Washington County’s former interim ambulance director, a current member of its EMS Advisory Board, and an EMS instructor since 1989 — said she was confident the essential service designation could pass even with higher levies attached.

“I think the individuals of Washington County, despite all of the stumbles … they realize we need EMS, and they’re very thankful for the citizens that provide it,” she said. “I feel that they would support it.”

The extra revenue would give local governments and quick response service groups cash they could spend on vehicles, supplies and even land purchases, among other things listed in the state code. It could also be spent on training for volunteers and staff members.

Altenhofen said classes were increasingly required for rapid response volunteers, no longer trainable through informal meetings in fire stations and break rooms.

When Altenhofen was first certified in 1985, it cost under $100, by her estimation. Now, she said the courses typically totaled thousands of dollars. Sometimes, that cost falls to volunteers themselves, a reality that likely deters would-be first responders from getting involved.

“Gone are the days of going into the fire station (to) hold a class,” Altenhofen said. “Because of the standards of EMS, it has to be done at an accredited college … the cost of being able to provide education to EMS providers has gone up, plus all of the equipment needed to do the actual training.”

While emergency responders say they’re excited about the possible new tax revenue, the recommended levies are hardly written in stone. Language for the ballot issue is not yet crafted, though it is on Supervisors’ agenda, with a deadline before the month’s end.

And ultimately, the final decision on any EMS-specific property tax will fall to voters in November.

“This isn’t up to me to make a determination,” Supervisor Marcus Fedler said. “If the people don’t want it, they’re going to say they don’t want it … it’s up to the public to make a determination.”

Comments: Kalen.McCain@southeastiowaunion.com