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Marshalltown council approves consultant to study countywide 911/EMS after UnityPoint reports $1 million loss
Summary
After hearing that UnityPoint Health’s 911 ambulance service loses roughly $1 million a year and that volunteer and staffing shortages threaten coverage, the Marshalltown City Council voted unanimously June 21 to hire consultants to explore long-term countywide EMS options and funding, including a potential levy.
Marshalltown — The Marshalltown City Council on June 21 voted unanimously to direct city staff to hire a consultant to study long-term, countywide solutions for 911 ambulance service after UnityPoint Health told the council its 911 operations are running an estimated $1,000,000 annual loss.
Sher King, representing UnityPoint Health and the EMS task force, told the council that UnityPoint currently provides the 911 ambulance service in Marshalltown and that the service receives no dedicated city or county funding. "This service costs us about 1 million a year in losses," King said, describing increasing denials from insurers, unreimbursed calls when patients decline transport, and a statewide decline in EMT and paramedic entrants.
The consultant engagement will scope service needs, stationing and staffing models, and funding options that could include the state’s essential-service mechanism that allows a local-option income tax (not to exceed 1%) or a property tax levy (up to $0.75 per $1,000 assessed value). King said the task force has been meeting for roughly 10 months and that the consultant’s work product is expected back with a relatively quick turnaround; she noted a target date of August 15 for initial deliverables.
Council members pressed staff and UnityPoint on financial details. "How much in the red is UnityPoint running?" Council member Greg Nichols asked; Sher King answered that the 911 component is responsible for about 33–35% of the ambulance-service volume and that the hospital’s financial analytics indicate the 911 side is operating at a loss while transfer services are roughly break-even.
Fire Chief Christopher Cross, participating remotely, said fire-department first-response practices would continue and that operational impacts and coordination between ambulance and fire responses should be addressed in the consultant report.
During public comment, residents asked practical questions about who would respond in emergencies and whether insurers have been convened; an industry commenter offered to facilitate meetings with insurance carriers. Several speakers urged the council to place any levy proposal on the ballot once options are clear.
After discussion, the council moved and seconded a directive for staff to proceed with the consultant engagement and related coordination with county officials. The roll-call vote was recorded as yes by council members present; the motion passed.
The consultant study will evaluate service models (county-run, contracted private providers, or hybrid approaches), stationing and staffing levels needed to avoid EMS “deserts,” and funding options. UnityPoint will retain responsibility for hospital transfer services under the scenarios discussed.
