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Marshalltown and Marshall County consider joint EMS district, voter funding after UnityPoint signals exit
Summary
A joint task force recommended forming a city/county EMS district funded by a voter-approved levy and surtax after UnityPoint Health indicated it may discontinue ambulance transport; officials accepted the report and agree to refine the plan and pursue public education before a possible March 2027 special election.
Fire Chief Chris Cross presented a consultant study and final task force report recommending that Marshalltown and Marshall County establish a joint emergency medical services (EMS) system through a 28E agreement and an EMS district under Iowa Code Chapter 357F. The report, presented March 24, 2026, was accepted by both the City Council and the Board of Supervisors, and the task force requested direction on next steps.
The task force said the current EMS model is not sustainable, citing risk exposure from third-party providers, lack of local control, workforce shortages, declining volunteer recruitment and financial challenges. The presentation noted UnityPoint Health (UPH) has provided emergency transport since 1969 but faces ongoing business-model and billing limitations. The recommendation calls for a voter-approved property tax levy and a local option income surtax under Iowa Code Chapter 422 to fund operations.
The governing bodies agreed that EMS should be treated as an essential service but stopped short of making a formal motion at the joint meeting. Officials and staff said more public education and additional refinement of the proposed model are needed before pursuing a ballot measure; a special election in March 2027 was discussed as an option to allow time for outreach. Each governing body will consider formal action at its subsequent meetings.
