Iowa County supervisors debate EMS levy, staffing and billing changes; no levy vote held

Iowa County supervisors spent a major portion of their June 27 meeting debating whether to put a property-tax ballot question before voters to fund emergency medical services and weighing alternatives including asking the county hospital to take over ambulance operations.

The discussion centered on a proposed maximum levy of 75 cents per $1,000 of assessed valuation that, as presented during the meeting, would raise roughly $887,000 if approved. County staff and supervisors said the levy would be used to stabilize EMS staffing, equipment and facilities; they also noted the proposal would not eliminate the county's current general-fund contribution.

The matter drew sustained debate. Some supervisors urged exploring non‑tax options first — including cutting nonessential county services or asking the hospital to operate ambulances — while others said asking voters is the appropriate next step to sustain what they described as an essential service. No motion to place a levy on the ballot was voted on at the meeting.

County staff described next steps and timing if supervisors decide to proceed. Meeting discussion included a timeline that would require public notices and multiple public hearings, and that the ballot question must be published at least 60 days before a general election. Supervisors asked the county EMS advisory group to make a recommendation and discussed scheduling follow-up work for August and the fall budget process.

Supervisors and staff also reviewed operational and financial details for the ambulance service. County staff reported year‑to‑date EMS call and revenue figures, and described staffing challenges: several upcoming leaves and the need to hire replacements. Staff said they had three interviews scheduled for an open full‑time position and proposed starting a replacement on Aug. 1 to overlap training with a departing employee; supervisors said hiring would be placed on a future agenda for formal approval.

On billing, the board approved updated ambulance fee rates for fiscal year 2026. The billing company’s recommendations include higher charges for the most common billing categories; staff said the increase likely will have limited near‑term revenue impact because payer rates (Medicare/insurers) often determine final payment but that higher charges are needed for long‑term contracting and reimbursement negotiations. A motion to adopt the FY2026 fee schedule carried.

Supervisors also discussed outreach to the county hospital and other private providers to ask whether they would consider operating ambulance services. Multiple supervisors said the county should at least solicit proposals from Compass Health (the local hospital referenced in meeting discussion) or similar providers; others cautioned that critical‑access hospitals often lose money on ambulance operations and that a hospital takeover is not guaranteed.

Why it matters: Supervisors said the county is already funding EMS from the general fund and that recent budget pressure — including the purchase of a new ambulance — and recruiting and retention issues have made long‑term funding uncertain. The choice to put a levy to voters would shift some costs to a dedicated property‑tax levy but would require public approval and might still leave a gap between projected costs and revenues.

What’s next: Supervisors asked staff and the EMS advisory group to return with more detailed cost estimates, staffing scenarios and potential proposals from private and hospital partners. No final decision was made during the June 27 meeting.

Sources and attributions: Statements summarized in this article come from meeting remarks by county supervisors and county staff during the June 27 Iowa County meeting. An EMS operations and finance summary and the draft levy language were discussed at length during the period recorded in the meeting transcript.