Emergency Medical Service Advisory Council answers questions regarding county-wide EMS vote

SHELBY COUNTY  — The future of Emergency Medical Service in Shelby County will be determined by voters in the November 7 election.
Earlier this year, the Shelby County Board of Supervisors held a series of public hearings to declare EMS an “essential service” in the county. The Board’s declaration led to Measure TD being placed on the ballot.
 The Supervisors appointed an EMS Advisory council, consisting of Chairperson, Tim Plumb, Shelby County ESA; Bryce Schaben, Vice Chair, Board of Supervisors; Alex Londo, Secretary, EMA; Roger Bissen, Fire Chief, City of Harlan; Karen Schlueter, City of Shelby; Janice Gaul, City of Earling; and Barry Jacobsen, Myrtue Medical Center (MMC).
 The Advisory Council assessed the needs for an EMS system, and has proposed the creation of a county-wide EMS system, which will include both a county-wide ambulance service and volunteer departments.  
 Town meetings were held throughout the county in September and October, to inform the public on the measure and to provide answers for constituents’ questions.
Frequently asked questions and responses from EMS Advisory Council members
Why is this a property tax funding request and not a sales tax option?
Per Iowa Code – the only way entities are allowed to tax for EMS as an essential service is by using a property tax and the income tax surcharge.    If this legislation changes in the future – we will absolutely review how the department is funded.  
 How is the 1% income surcharge calculated?
The 1% income surcharge is 1% of the total STATE income tax you pay.    It is important to note that Iowa Residents do not pay State income tax on their social security benefits.     
Example – If your total Iowa State income tax asking was $500 – you would pay an additional $5 for the 1% state income tax surcharge.
Why can EMS no longer operate in the way that it is today?
The owners of Medivac, Bob and Nella Seivert, have announced they will retire by June 30, 2026. Without this service, Shelby County and the area that Medivac serves will be without 911-support response and a critical care transfer service.   Both arms of this type of service are key to saving lives in Shelby County. Shelby County has benefited for decades from the advanced care that this privately owned business has provided – a level of care that is very uncommon in other areas around the state. The goal of the Shelby County EMS Advisory Council is to maintain and eventually increase the level of support to the volunteer units and provide the same critical care transport service currently provided by Medivac.  
What would change with the transition to becoming an essential service?
The transition of becoming an essential service would increase ambulance coverage, provide oversight of county-wide EMS operations, and allow improved coordination of volunteers and paid providers.  The essential service would allow Shelby County to tax for EMS within the county. This will be a major funding stream to maintain the EMS budget.
Will this program take the place of Volunteer Services in the County?    
No, the volunteer rescue providers will continue to be a valuable medical care resource to local communities.  Without our EMS volunteers in each community, there would be an increase in time to get a rescue provider at someone’s side to help. The tiered response model provides the most effective delivery of emergency care with volunteers supported by a paid EMS service.   The new Shelby County EMS Department will tier with these communities and provide Advanced Life Support (ALS) service as needed.  The proposed budget allocates financial resources to volunteer departments for the possible purposes of supplies, equipment, or call pay.  The distribution of the funds will be a collaborative discussion with volunteer departments as each department has different needs.    
How much of EMS is currently paid for by taxes? How will this change?
For the fiscal year 2023-2024, the Shelby County Ambulance Commission (Hospital, City of Harlan, and County) has a designated amount of $373,850 through their general basic fund and special ambulance fund that supports ambulance service in Shelby County. This allocation does not provide sufficient funds to continue the current framework or support the newly formed department. In addition, there is a shortage of EMS professionals. In order to make these positions more attractive and recruit more effectively, we will need to improve compensation packages.
If the EMS Public Measure passes, all Shelby County residents will pay for a share of the cost of EMS through a tax levy.  The proposed amount is $.75 cents per $1,000 of taxable property within the county.  In addition, there will be an income surtax assessment on Iowa individuals’ income tax returns for Shelby County residents at a rate of 1%.
When would the new EMS plan go into effect, if the vote passes? What would the transition to Essential Services look like?
If the EMS Proposition Passes in November, property tax funding will be collected starting in September 2024.  The 2024-2025 fiscal year will be dedicated to acquiring a facility, purchasing needed equipment and supplies, and developing the program. As funds are available, a Service Director will be hired to develop policies and programs, hire staff and apply for necessary licenses.  A new county-run ambulance service could start operations on July 1, 2025.
The new Shelby County EMS Service Director will work closely with the EMS Advisory Council and Medivac to ensure a smooth transition.
Why are the hospital transfers to a larger facility included as a part of this operation and tax funding?
An important element of EMS and the care of emergent patients is the ability of our EMS system to transfer critical patients to a higher level of hospital care, if needed.  The current level of care and often immediate availability for transport is unmatched in other counties around the state.  The continuation of critical care transport service located in Shelby County is imperative for the ongoing care of our citizens.
Hospital transfers are reimbursed by insurance significantly better than 911 calls and it is important that the new ambulance service capture revenue which will offset some of the expenditures.
Financial Impact - Based on 2022 valuations
A personal residence valued at $185,023 after rollback of 45.87% equal taxable valuation of $100,153/1000*.75= $75 property tax levy.  
A personal residence valued at $306,158 after rollback of 45.87% equals taxable valuation of $165,724/1000*.75= $124 property tax levy.
40 acres of agricultural land with an assessed value of $65,847 has a taxable valuation of $58,631 would pay $43.97 property tax levy.
If you owe $2,000 in state income tax and the local income surtax is 1% you would owe $20 in income surtax.
To find out your personal estimated cost take your property taxable valuation/1000 x.75 and your 2022 state income tax x.01 added together.
When is the vote?
General election is November 7, 2023.    
More information may be found online at https://shelbycounty.iowa.gov/departments/ems or on the Shelby County Emergency Management Facebook page, https://www.facebook.com/shco.org