I would like to talk about EMS in Iowa. There has been a growing concern, especially in rural counties and communities, about the access to emergency medical services. A common misconception is that emergency medical services are considered an essential service under the Iowa Code. They are not. However, it is currently an option for counties to choose to make it an essential service. Under current law, county supervisors may offer for voter approval a local option income surtax or an ad valorem property tax. Additionally, if it is considered an essential service, it has to be re-approved every five years.
House File 2434 makes significant changes to the emergency medical services chapter (IA Code 422D). The first change is that it allows the county board of supervisors to declare EMS an essential service without calling for an election to approve this decision. EMS advocates believe that this will greatly reduce the burden and cost of declaring EMS an essential service.
This bill also gets rid of the five-year sunset that required the voters to re-approve emergency medical services. This gives the voters the option to end EMS as an essential service only under a reverse referendum. EMS advocates have complained that they are uncomfortable purchasing equipment if after only five years the service could not be renewed.
A new requirement under this bill is that a county that adopts EMS as an essential service shall create an EMS Advisory Council to develop how the EMS program will be structured and work throughout the county. Current law only allows counties to enter into 28E agreements with other counties. This bill removes that barrier and allows counties to enter 28E agreements with other entities besides just counties.
Currently, in the Health and Human Services Budget, there is $303,000 that is appropriated to the Emergency Medical Services Fund. The money is divided equally amongst the counties. Also, Iowa Code 422D.6(3) lays out an enumerated list of items that these funds could be spent on. This bill changes that to include any operational cost.
In addition to the above-mentioned changes to emergency medical services, House File 2224 appropriates the revenue from sports wagering (estimated between $2-3 million) to the Emergency Medical Services Trust Fund.
