Ambulance director suggests tax levy for emergency services

MARENGO — In the face of rising costs and pay freezes, Iowa County Ambulance Director Adam Rabe suggested that Iowa County consider an emergency medical services tax to help pay for services.

  Buy Photo

Rabe explained during the June 27 meeting of the Iowa County Board of Supervisors why the county would benefit from a voter-approved EMS tax.

In lowa, Emergency Medical Services is not considered an essential service as are police and fire departments, said Rabe in a document he provided to county supervisors.

However, Iowa counties may declare EMS an essential service and allow residents to vote on a tax levy up to 75 cents per thousand dollars of assessed valuation to help fund emergency medical services, he said.

The tax would have to be approved by voters, and the money would be held in an EMS Trust Fund for emergency medical services.

A special election could be held as early as March 3 for a levy that would collect taxes beginning in fiscal year 2027, Rabe said.

The county doesn’t have to act this quickly, said Rabe, but “we feel like we need the money fiscal year ’27.”

County Supervisor Abby Maas said she doesn’t want to levy the tax at any time. “What’s the goal?” she asked.

“Funding,” said County Supervisor Kevin Heitshusen. “It’s to fund our essential services.”

“We are funding it. We’re currently funding it, right now,” said Maas.

“We can’t give raises to anybody this year because we have no funding,” said Heitshusen.

“We had other options to cut other services that were not essential,” said Maas. “That could have been done. And I think that should be done first before we ever raise taxes.”

  Buy Photo

Maas has argued for discontinuing the home health services provided by the public health department. Home health services are not mandated by the state.

Rabe said he suggested the EMS levy because the county ordered a new ambulance and has to find $300,000 to pay for it, and because his staff was not given pay raises this year.

“We can’t go another year without giving raises or we’re gonna really start losing people. That’s why I brought it up,” said Rabe. “It’s time to look at this.”

A 75-cent levy is an $887,000 increase in property taxes, said Maas. That’s still $410,000 short of the entire EMS budget.

The county will still have to partly fund EMS, said Rabe. He suggested the general fund pay personnel costs and the levy money pay for equipment and facilities.

Maas said she understands other counties using the levy. Buchanan County tried last year to get an EMS levy, she said. It failed by less than 1%, she said.

That county’s EMS is volunteer, Maas said. The county has never paid for an ambulance department, and trying to find $1 million to start one is difficult because of the State’s property tax legislation capping tax increases.

“However, for us, we’ve been funding it … It’s just going to raise taxes,” said Maas.

The county has to raise revenue, said Heitshusen. “We haven’t cut the other services that you say we can,” he told Maas.

“We have to be able to fund the essential services for the county,” said Heitshusen. “I’m going to call the ambulance service essential.”

“I absolutely agree it’s essential,” said Maas. “But we have nonessential services that we’re providing.

“We need to sit down and have a hard look this summer at what services are we providing, how are they mandated, are they mandated by law or are we doing them … just because, and what are they costing the tax payers,” said Maas.

“I think that should be done before we ever put a resolution together to raise taxes.

“And I also think if we’re going to open this can of worms, it’s time to look at the hospital and get a proposal from them on what it would take for them to take over the ambulance service,” Maas said. “That’s the due diligence to the tax payers right there.”

  Buy Photo

Due diligence is making sure residents have a service, said Heitshusen. The hospital had been approached before, and nothing came of it, he said.

“We don’ have to do anything,” said Rabe, but during budget sessions the county had trouble finding money for a new ambulance and denied pay raises.

“As long as you can pay for all of that out of the general fund, we don’t have to do anything,” Rabe said. The levy offers the county a funding option.

“The state is limiting us with how we can fund stuff any more,” said Heitshusen. “We have to reach out and do it other ways.”

Maas said she doesn’t support raising taxes.

“I’m supporting supplying the services that we can,” said Heitshusen. “You’re trying to cut services that we’re providing. I’m not for that.”

“I don’t think the government should be doing services that we’re not required to do by law and that maybe we’re not the best at anyways, that private sectors can easily do for less money than us. I think that’s the foundation of most conservatives,” said Maas.

“I will not have anything to do with this.”

“This is not the board raising taxes,” said Rabe. “This is the board asking citizens if they want to raise taxes.”

“But it’s already being funded,” said Maas.

“The funding is not adequate, is what I hear,” said Rabe.

Supervisor Chris Montross said he’d like to look at other counties the same size and see how they’re funding ambulance service.

The Iowa County EMS System consists of lowa County Ambulance Service and six volunteer first responder teams located in Amana, Ladora, Millersburg, North English, Victor, and Williamsburg, said Rabe.

Iowa County Ambulance staffs two ambulance 24/7, one based in Williamsburg and one based in Marengo.

The general fund budget provides some support for first responders, such as training, disposable medical supplies and EMS related software that is shared with the ambulance.

Costs have increased more than 100% in the last 10 years, said Rabe. The county general fund is not adequate to meet the current and future needs.

Call volume has increased from 583 calls in 1981 to 1936 calls in 2024, an increase of 232%.

The Marengo ambulance station, built in 1998, no longer provides adequate space for storage for supplies or for increased staff and ambulances.

Money from an EMS levy would be used to maintain the EMS system, to purchase ambulances and equipment necessary to provide emergency medical services, to build or lease a new building to house additional EMS staff, ambulances, supplies and alleviate current overcrowding.

The county general fund is at maximum capacity, said Rabe. There is no path forward to meet the increased demand on our EMS system without additional funding.