Iowa County makes EMS tax levy possible

MARENGO — Following a public hearing, Iowa County Supervisors approved the third and final reading Friday of a resolution that declares emergency medical services an essential service and makes a tax levy for the service possible.

Supervisor Abby Maas voted against the resolution for the third time. Supervisors Kevin Heitshusen, Jon Degen, Chris Montross and Seth Meyer voted “yes.”

“I think most lowa County residents would agree that EMS is an essential part of our lives,” wrote Ray Garringer in a letter read by Heitshusen during the public hearing. Passing the resolution doesn’t make a tax levy certain, Garringer wrote.

“Any new levy under this section of the Code will only go into effect if the Supervisors decide to put it up for a public vote and if 60% of voters casting ballets vote in favor of approval,” Garringer wrote.

“Our residents are capable of deciding this for themselves,” Garringer said.

David Rettig, of Middle Amana, wrote to the Board of Supervisors, “I would assume that most voters will vote for this issue as everybody wants to have good EMS Services. My concern is that to fund the services more completely will lead to another increase in property taxes of up to $0.75/$1,000. I fear that the general public will not understand that this is a possibility.”

Retting urged Supervisors to fully explain to the public via mail or email that EMS services are already provided, “and if the measure were to pass the general election how it will be paid for.”

Iowa County Paramedic Dane Markegard said in an email read by Degen that Iowa County ambulance struggles more with funding than any other emergency medical department he’s worked for.

“The equipment we use is not even comparable to ambulances in surrounding communities,” Markegard wrote. Monitors fail to accurately measure all the vital information paramedics need to complete diagnostic tests “vital to our patients’ well-being.”

The number of 911 calls in Iowa County can’t be adequately staffed two ambulances, Markegard said, and patients can wait up to 30 minutes for an out-of-county ambulance when an Iowa County ambulance is unavailable.

Iowa County struggles to keep paramedics when it pays less than $24 an hour while Johnson County pays $30 an hour and Compass Memorial Healthcare pays $29, Markegard said.

“EMS should be deemed essential and adequately funded to ensure continued high-level care,” Markegard wrote. He encouraged the county to declare EMS essential and to put the levy question on the ballot.

Iowa County Paramedic Jason Schott said during the public hearing that the debate isn’t really whether EMS is essential. Everyone agrees it is, he said.

The debate is about the tax levy. “Nobody wants taxes to go up,” said Schott, but the cost of everything goes up.

“The way things sit currently… we don’t have enough money,” said Schott. “We operate in the red. There is no way for us to ever operate in the black.”

“I agree with most what’s been said,” James Johnson, of Ladora, said. “It is an essential service.

“My only concern is the tax levy,” said Johnson. The county should make sure there are not other opportunities for funding before putting a tax levy to the vote.

Johnson said that since he move to Iowa County in the early 1990s, his property has depreciated 10 times and his taxes have raised about 15 times. “That’s not sustainable.”

An additional 75 cent per $1,000 of valuation would wipe out any raise he gets in social security, Johnson said. “We need to be judicious about raising taxes, make sure it’s absolutely necessary.”

Adam Rabe, EMS director, reminded the public that the resolution doesn’t levy a tax, it “just opens the door for a potential levy.” The county won’t know if it needs additional money until it looks at the budget next month.

The resolution also establishes an EMS advisory council to look at EMS needs. “The board [of supervisors] may very well fund EMS. This just gives them an option if they don’t have enough money,” Rabe said.

Brad Ramsey, of Homestead, said the major problem is that 95% of people have no idea that EMS is not an essential service under Iowa law. “All they know is, I call 911, an ambulance shows up.”

No one wants to pay more taxes, but you have to pay for things you need, Ramsey said. “Without funding, nothing is essential. You have to have the funding to back it.”

People look at it the tax levy as something different from what it is, said Ramsey. It’s more like an insurance premium than a tax. ““I want to pay a health insurance … premium to the county so that in case something happens, they’re there to save me.”

Voters are capable of making the decision, said Ramsey. Let them have an opinion.

While EMS is being funded now, “we’re one vote away from not funding it,” Ramsey said. A new board might decide not to fund EMS because the state doesn’t require it if it's not an essential service.

Iowa County resident Pete Georgakakos, medical director for the Johnson County Ambulance Service, said that EMS staff numbers are declining across the state. About 75% are volunteers, and that generation is retiring. Young people are not coming in to smaller counties, he said.

“I don’t think anyone disagrees that it’s essential,” Georgakakos said. “The debate is that you have to look ahead.”

Johnson County Ambulance gets more calls for mutual aid into Iowa County every year, said Georgakakos. “I just hate the idea that someone would not respond because both your ambulances are busy.

“This is not a field where I think we can get behind,” Georgakakos said, “and unfortunately, as you’ve been hearing for weeks, we already are behind. And so while it’s unfortunate it will cost money, this is just to get us caught up so that then we can get back onto the front lines.”

EMS is hamstrung because it doesn’t have the resources to implement things that are new and progressive, Georgakakos said. He would hate to see something bad happen because of lack of funding due to “moral outrage or stubbornness against raised taxes.”

Before voting against the resolution, Maas said “I truly do appreciate our EMS service.” She wanted supervisors to separate the resolution so they could vote separately on the issues of essential service and the tax levy.

Maas would have voted for a resolution declaring EMS essential, and that would have bound future boards to pay for it, she said. She voted against the levy, not against EMS, she said.

“I just can’t see increasing property taxes for very many reasons,” said Maas. Property taxes in total — county, city and schools --- have gone up 20% in the last five years, said Maas, but people aren’t being paid 20% more.

Though the county didn’t give employee pay increases this fiscal year, it has raised wages 25% in the six years she’s been on the board, Maas said. EMS employees received an additional 5% increase in 2021, totaling a 30% increase over six years.

In lieu of a pay increase, the county absorbed a 13.5% increase in health insurance this year, said Maas. “And we still offer a plan that is completely free to the employees, which is archaic and sort of unheard of. That was the raise,” Maas said.

“Once again, I just don’t think the people that are footing these bills can afford this.”

Since Maas has been on the board, the county has built a new emergency management building, an engineer’s office and a jail kitchen, updated the courthouse and approved an $8 million bond to pay for an EMA communications contract.

The EMA communications contract will triple the debt service levy, Maas said. “We can’t keep adding.”

Maas had several meetings with Compass Memorial Healthcare about taking over ambulance service for the county, she said, but misinformation, rumors and negative comments put an end to that.

“I can tell you for a fact that would have saved taxpayer dollars. I can tell you for a fact that would have been managed by health care professionals instead of a Board of Supervisors who have no idea if we’re doing a good job or not. And that would have been a win-win for the taxpayers in my mind,” said Maas.

“I think the taxpayers lost on that one.”

Maas is afraid that people are going to see yard signs or social media posts calling for a tax levy and assume the county hasn’t been funding EMS. “We’ve been paying for this decades,” she said.

“I think we need to tighten our belts this budget, and I think we can afford things without going to the tax payers and asking for additional levy.”