The million dollar question for EMS service: “How much should be taxed?”

WASHINGTON — Washington County decision-makers hope to add a local issue to the November general election ballot, asking voters to approve designating ambulances and other emergency medical response equipment as an “essential service.” If at least 60% of voters at the polls Nov. 5 cast ballots in favor of the measure, the measure would authorize new property taxes to help fund the services.

Officials say revenue from the tax would be split three ways: 50% for municipal volunteer rapid-response groups, 35% for the county ambulance department and 15% for the county’s emergency communications system. Officials say that would represent a much-needed boost to services, currently hobbled by a combination of state-mandated tax cuts at the county level and a history of volunteer-based models struggling to afford training or modern equipment at the city level.

First responders say the tax is necessary to maintain medical services, which, unlike fire protection and law enforcement, local governments are not legally required to provide.

“Right now, medical care is not guaranteed,” said Hogan Miller, president of the Kalona First Responders group. “This tax helps ensure that when you call 911, you will be served by emergency services and an ambulance service.”

The benefits would be greatest for volunteer first-response groups like Miller’s, most of which are funded by a combination of donations and a small portion of municipal fire department budgets. Members say they urgently need more money to cover rising costs of vehicle maintenance, insurance, equipment and training.

“Gone are the days of flipping pancakes to make a difference in the outcome of someone’s medical condition,” said Toby Hancock, president of the Washington County Emergency Medical Services Association and also a senior official in Riverside’s emergency response service. “It’s not feasible that … volunteers who get out of bed in the middle of the night have to rely on donations to get the equipment they need.”

The potentially million-dollar question then is how much to tax.

Members of the Washington County EMS Advisory Board, created in 2021 to help guide the development of the proposed ballot item, said they recommended a 50-cent tax per $1,000 of valuation, a measure that would invest about $740,000 in emergency response assets countywide.

But Washington County supervisors said Tuesday they would seek to put on the ballot language authorizing levies of up to 75 cents, the maximum allowed under state law. Decision makers emphasized that the tax would not be that high every year, but would rise and fall from one budget year to the next, depending on local emergency medical services needs, likely starting with the recommended 50-cent levy.

Supervisor Jack Seward Jr. said the approach would ensure reliable funding and budget flexibility in the future, since state law prohibits the county from changing the tax for 10 years after it is approved by voters, unless it holds another election to do so. And since most ambulance-related equipment costs are rising, officials said they were hesitant to set a precise property tax.

“If we put it at 50 cents, then we’ll stick with that,” Seward said. “I wouldn’t want to tie the hands and feet of anyone who’s on the board in six or eight years, because I’m not going to be here.”

However, the more flexible approach also has some disadvantages.

For one, it could result in higher taxes than the 50-cent tax recommended by the county’s emergency medical system advisory board. The potentially higher cost to taxpayers may prove less persuasive at the ballot box, potentially delaying implementation of any part of the funding.

“We need to make sure the voters approve this,” said Jim Lester, chairman of the EMS advisory board. “EMS definitely needs additional funding.”

Additionally, several EMS advisory board members said they were unaware of the county’s plans to take a more flexible approach, up to 75 cents. Those members said they believed their recommendation was a targeted rate of 50 cents, while others said they believed the board was “open to” a higher maximum. The disconnect between officials could complicate campaign efforts in favor of the ballot issue.

Still, Katrina Altenhofen (former interim Washington County ambulance director, current member of its EMS advisory board and an EMS instructor since 1989) said she was confident the essential service designation could be approved even with higher levies attached.

“I think the people of Washington County, despite all the setbacks … realize that we need emergency medical services and they are very grateful to the citizens who provide them,” he said. “I think they would support it.”

The additional revenue would give local governments and first responder groups cash they could spend on vehicles, supplies and even land purchases, among other things listed in state code. It could also go toward training volunteers and staff members.

Altenhofen said more and more classes are required for first-response volunteers, who can no longer be trained through informal meetings at fire stations and break rooms.

By his calculations, when Altenhofen first earned his certification in 1985, the cost was less than $100. Now, he says, courses often cost thousands of dollars. Sometimes, that cost falls on the volunteers themselves — a reality that likely deters would-be first responders from participating.

“Gone are the days of having to go to the fire station to teach a class,” Altenhofen said. “Because of EMS standards, they have to be taught at an accredited college… the cost of being able to train EMS providers has increased, along with all the equipment needed to actually conduct the training.”

While emergency responders say they are excited about the potential new tax revenue, the recommended levies are not set in stone. The language of the vote is not yet drafted, though it is on the supervisors’ agenda, with a deadline before the end of the month.

And ultimately, the final decision on any EMS-specific property tax will fall to voters in November.

“It’s not up to me to make a decision,” said Supervisor Marcus Fedler. “If people don’t want it, they’ll say they don’t want it … it’s up to the public to make a decision.”

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