Henry County EMS is Essential

HCEMS is an Advanced Life Support (ALS) ambulance and EMS service that provides emergency medical care and non-emergency medical transport to the residents of Henry County. This patient-centric critical care ambulance service provides patient care to 14 communities. The service is staffed by paramedics and EMTs 24 hours a day, 7 days a week. It is currently owned and operated by Henry County Soldiers’ & Sailors’ Memorial Hospital. HCEMS is housed and deployed from Henry County Health Center and is licensed by Iowa Health and Human Services.

Forty years ago in Henry County, ambulance services were provided by local funeral homes and volunteer services. In 1980, Henry County leadership determined that a full-time ambulance service was needed, and Henry County Health Center was asked to start providing ambulance services for both emergency and non-emergency services. By 1997, EMS was providing services to the entire county.

HCEMS provides both emergent and non-emergent interfacility transports, critical care transfers and special event coverage. They respond to 911 calls 24 hours a day, seven days a week. In 2023, HCEMS responded to 2,644 calls, of which 1,158 were 911 transports with the remainder of calls being transfers. Crew members have additional training and experience in the care of critically ill and injured patients. EMS staff provide education and support to first responder groups within the county and provide a significant amount of public health education like CPR and ACLS classes.

HCEMS is owned and operated by the Henry County Soldiers’ & Sailors’ Memorial Hospital Board of Trustees. Iowa Code allows county hospitals to levy for ambulance services. Permissible financial support from the county currently includes a $0.27 property tax levy, along with FICA, IPERS, and insurance reimbursements.

EMS services are currently funded by the property tax levy associated with the county hospital specifically designated for ambulance services ($0.27) and the hospital receives funding from the county for FICA and IPERS expenses associated with EMS staff. Revenues from services are also used to cover expenses. Any funding shortfalls were historically provided through hospital operations or other subsidies.  

Significant changes and improvements to emergency medical services have occurred over the years. However, unlike police and fire departments, EMS has not been considered an “essential service” in promoting and protecting the health of Iowans. In May 2021, Iowa Code Section 422D.1 provided county supervisors the authorization to impose a tax levy in support of EMS, pending voter approval.

On May 16, 2024, the Henry County Board of Supervisors passed a resolution declaring EMS as an essential county service and created a county EMS Advisory Council. The Council, consisting of one Henry County Supervisor, four first responders from neighboring communities, and hospital representatives assisted in researching and assessing the service needs of the county. The Council helped to guide the implementation of a county-wide EMS resolution. If the vote is approved, an EMS Advisory Council will continue to assess the service and make recommendations for future operations.

Increasing expenses primarily related to wages and equipment maintenance have contributed to EMS revenue shortfalls. Any revenue shortfalls within the EMS program fall to Henry County Soldiers’ & Sailors’ Memorial Hospital. The former model of EMS is no longer viable, and this is evident by the state trend. As of 11/8/23, twelve Iowa counties have received voter approval to levy for EMS programming which includes Lee County. Several counties have the initiative on upcoming ballots, including Henry County. To ensure that the service continues, HCEMS must be able to utilize the EMS Essential Services Tax.

Currently, HCEMS is owned and operated by the Henry County Soldiers’ & Sailors’ Memorial Hospital Board of Trustees. Iowa Code allows county hospitals to levy for ambulance services, and currently permissible financial support from the county include a $0.27 property tax levy, and FICA, IPERS, and insurance reimbursements. 

A public vote of 60% to approve the 422D.1 Iowa Code for the Essential Services Tax will result in the following:

·  24/7 emergency medical services for the county will continue.

·  County government will levy the $0.75 Essential Services Tax for EMS.

·  The current $0.27 hospital levy will go away. 

·  This increase of $0.48 would lead to future sustainability of the service.

·  EMS will continue to operate from the same location at Henry County Health Center.

·  The EMS Advisory Council will continue to assess the service.

Tax Levy Information

Henry County Soldiers’ & Sailors’ Memorial Hospital Current Tax Levy: $0.27/$1000                     

Proposed Henry County Essential Services Tax: $0.75/$1000

Difference is $0.48/$1000

If the vote passes, the Henry County Soldiers’ & Sailors’ Memorial Hospital $.27 ambulance levy will be removed from hospital budget. 

Example of how this impacts property taxes:

With the proposed tax levy, a property with a net taxable value of $100,000 would see a $48/year increase or $4/month.

Example of how this impacts farmland taxes:

If the increased tax levy were in effect today, the projected EMS Essential Services Tax increase on the average 40-acre parcel would be $13.63 per year or $0.3408 per acre.

County-wide Impact of $0.48 tax increase:

The EMS funds raised in Henry County for FY25 at the current hospital levy cap of $0.27/$1000 is $265,629.The service is currently operating at a deficit of approximately $200,000. Other funding sources and subsidies of over $200,000 that have been used to sustain services will be unavailable in future years. Alternative funding must be secured to retain EMS.  If the new EMS levy rate is passed and goes into effect for FY25, the total EMS taxes raised would be $737,860. This amount will meet current budgetary needs and is essential to fund operations of a county EMS program.

Common Expenses related to EMS Operations:

Following are some examples of how costs have dramatically increased:

·  New ambulance: $300,000 with estimated life of 4 years

·  Continued increases in insurance related costs industry-wide:

o  Workers’ compensation: $32,000

o  Property/professional liability: increased 22% in past year

o  Technology enhancements and additional maintenance of ambulances and related equipment: $80,000/year

Henry County residents need high-quality Emergency Medical Services in our county. HCEMS respond to 911 calls 24 hours a day, 7 days a week, providing both emergent and non-emergent interfacility transports, critical care transfers and special event coverage. Crew members have additional training and experience in the care of critically ill and injured patients. EMS staff provide education and support to first responder groups within the county and provide a significant amount of public health education like CPR and ACLS classes.

Increasing expenses primarily related to wages and equipment maintenance have contributed to EMS revenue shortfalls. Because of the property tax cap for EMS services under the current $0.27 levy, future EMS sustainability is at risk. Participating in the Essential Services Tax will ensure that ambulance services remain in Henry County.

The special election for the Essential Services tax levy will be held on Tuesday, September 10, at the normal polling locations in Henry County.

Early voting starts Wednesday, August 21, at the Heny County Courthouse in the 2nd floor conference room, Monday-Friday from 8 a.m.- 4:30 p.m. 

(Courthouse closes at 4:30 p.m.)

NOTICE OF BALLOT PROPOSITION FOR IMPOSITION OF EMERGENCY MEDICAL SERVICES TAXES IN AND FOR HENRY COUNTY, IOWA

The Board of Supervisors of Henry County, Iowa, hereby gives notice that a special county election will be held on September 10, 2024, at which there will be submitted to the voters of the County the following proposition:

HENRY COUNTY PUBLIC MEASURE

SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?

□  YES

□  NO

Shall the Board of Supervisors of Henry County, Iowa (the “County”), be authorized to impose the following tax in an annual revenue amount not to exceed $_1,100,000.00_ for a period of fifteen (15) years to be used for the purpose of funding Emergency Medical Services in the County, pursuant to Chapter 422D of the Code of Iowa: 

• Ad valorem property tax at the maximum rate of .75 (75 cents) per $1,000 of assessed value on all taxable property within the County.

By order of the Board of Supervisors of Henry County, Iowa.

County Auditor