The Iowa County Board of Supervisors advanced a first reading to declare emergency medical services an essential county function after a detailed presentation from the county EMS director.

Adam Ravi, who identified himself as the EMS director and president of the EMS association, told the board that EMS “is a kind of the lifeline that bridges the gap between the scene of emergency and definitive care,” and outlined mounting equipment and staffing needs. He said county ambulance call volume has risen from roughly 600 calls in 1981 to nearly 2,000 now, an increase he described as about 232 percent, and that new ambulances and medical equipment have become significantly more expensive.

Ravi gave several specific cost examples: an ambulance currently on order is expected to cost more than $300,000; EKG/defibrillator units cost roughly $48,000 each; and EMT training runs about $2,500 per student. He said current ambulance funding is roughly 53 percent from charges for service and about 47 percent from the general fund/property taxes (he cited figures near $1,000,000–$1,100,000 annually for the ambulance budget).

Ravi told the board declaring EMS “essential” would not automatically place a levy on the ballot but would authorize the board to put an EMS property-tax levy (up to 75 cents per $1,000 of assessed value) or a local-option income surtax on a future ballot, with 60 percent voter approval required and up to a 15-year duration if approved. He said the designation is the first step in a multi-stage process: the EMS advisory council conducts a needs assessment and the board would thereafter decide whether to place a levy before voters.

Board members asked clarifying questions about timing, the relationship to existing debt service and levies, and whether equipment replacement cycles were baked into the presented projections. After discussion, Supervisor [roll-call names recorded separately] moved to approve the first reading of the resolution related to EMS being declared essential; the board approved the first reading by roll call.

Next steps: the board approved the first reading (resolution referenced in the minutes as 2025-12-5b) and will continue the statutory hearing/reading process in subsequent meetings before taking any final action to place a levy before voters.