EMS essential services bill gets late passage


FORT MADISON – A bill to make EMS services essential services under Iowa law was passed in the late evening hours Wednesday night, the last day of the 2021 legislative session.

The bill could allow, but doesn’t require, Iowa counties to put a ballot measure in front of voters that could generate a levy to help pay for the costs of Lee County’s newly acquired EMS Ambulance service.

Lee County is taking over the operations of Lee County Ambulance EMS Inc, effective July 1 of this year.

The bill was on it’s way to being passed during the last session, but was pulled from a vote at the last hour and was brought up again this year with heavy pressure from rural Iowa counties who were having trouble with private and public EMS services making ends meet.

Lee County Supervisors Chairman Matt Pflug called the measure “a game changer”. The bill allows for county supervisors to pass a resolution making the service an essential service under Iowa code, but doesn’t require a tax piece.

However, Iowa counties that pass a resolution categorizing EMS services as essential, would be required to form a council to assess the county’s financial needs associated with EMS services, and make a recommendation as to whether or not a levy is required and what that levy would be set at.

The county already has a steering committee overseeing the transition from the private service to the public county-owned service.

Then following public hearings on the issue, the levy would have to be put in front of voters and would need a supermajority approval of 60%.

“It’s a game changer. We’ve gotta make this work and now we can try to levy for it if we have to, but it has to go through a vote,” Pflug said.

“I think people understand the importance of an ambulance service in Lee County. I didn’t get one call from anyone about what we are trying to do.”

Pflug said he heard there was a lot of other things thrown into the bill in the last session and that had something to do with it not being put up for a vote in the Senate.

State Sen. Jeff Reichman (R-Montrose) said he had concerns that the bill wouldn’t make it out of the session again.

“With every action there’s a reaction. EMS, Hey you need to make it essential – fantastic. But there were other things in it,” Reichman said.

“It had the impact of an EMT having the same scope of practice as a nurse. So a nurse takes two or three years to get through school and get a license, and then an EMT with less training could have gone into a hospital, the way it was written, and go to work taking jobs from nurses.”

But he said he was happy that deliberations resulted in the passage of the bill at about 10 p.m. Wednesday night.

State Rep. Joe Mitchell (R-Wayland) said he thought it was the most historical piece of legislation to come out of the session in 2021.

“We finally got it done this year,” Mitchell said.

“Honestly, I don’t think it would have happened if House Republicans hadn’t made that a top priority right down to the end of the session. We did everything we could in our power to make sure that was in there because of how important it is to rural Iowans.”

Mitchell said there is a 15-year sunset on the law and it will have to be brought back up at that point.

Reichman said he hopes rural ambulance services can make it a go without raising taxes, but he’s happy they have this option going forward.

Dennis Cosby, Lee County EMS Ambulance director said any forward movement to support EMS services is good.

“While no one wants to see more tax increase, EMS remains a safety net from everyone. If we can’t fund them we will eventually lose our safety net,” he said.

“It’s a great step in the right direction for Iowa.”

Rep. Martin Graber (R-Fort Madison) said this is a nice way to do it in his opinion because it gives the people of the county a voice in whether they want to support a levy for the service.

“They’ve been working on this for decades from what I’m being told and we were finally able to get it done,” Graber said.

“In Lee County we’re in the process of going to a county run system. And from what I’m hearing if they continue billing the amount the private service did, they may not need to raise a tax.”

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