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Third time around for this call for a state ambulance service study

Responses from some of Iowa's 50 state senators

June 29, 2018
Toledo Chronicle, Tama News-Herald

A News-Herald editorial concerning the need for a study of mandating ambulance service in Iowa was emailed to Iowa's 50 state senators. Some replied - some did not.

The idea is this issue might be one the legislators take up for a look during the interim committee work.

The editorial has even included suggesting a funding source - not involving tax money.

Here's the introduction, the editorial and how Iowa State Senators who chose to reply responded:

Dear Senator ____________,

There is an ongoing crisis in areas of Iowa involving ambulance service. I'm forwarding to you an editorial I have run not once, but twice in The Tama New-Herald asking for further exploration of this matter.

I sincerely hope you will be able to take thee time to read the following and find it due not only your consideration but action during this summer season.

A News-Herald editorial has asked (twice):

Time to mandate Emergency

Medical Services in Iowa?

By John Speer

Editor - Tama News-Herald

jspeer@tamatoledonews.com

Since the November, 2016, General Election, it's been said: the rural areas have spoken - the heartland has felt left out - the cities and big counties have dictated too much policy.

This year we have read calls for action on mandated ambulance service.

Sandy Heick, a 35-year veteran paramedic in West Branch called for mandated ambulance service in a West Branch Times editorial In a medical emergency, WHERE you live may determine IF you live in August. - www.westbranchtimes.com/article.php?id=14041

It does not take much to make a case someone in need of medical care west of Clutier or south of Tama deserves the same response, within reason, of someone on the steps of the capitol in Des Moines.

It is simply vital the emergency medical services are maintained in rural Iowa.

Marshalltown Times-Republican staff member Adam Sodders reported in September (2017) Marshall County Emergency Medical Services Association President Steve Vannatta wants to see emergency medical services designated essential services -

www.timesrepublican.com/news/todays-news/2017/09/were-always-there/

Now is the time to MAKE SURE in Iowa the Legislators in Des Moines listen to and hear this message from all areas-

It's time for them - (THE IOWA) lawmakers - to get together with their local ambulance provider and first responders service personnel.

It's time to meet with the Bureau of Emergency and Trauma Services of the Iowa Department of Health (BETS).

It's time to for the Iowa Emergency Medical Services Association to be joined in the discussion.

Ambulance service in Iowa should be required just like fire protection.

Here's the issue heard more strongly in Tama County as time goes by: personnel to staff the rural ambulances and first responders is, and continues to shrink.

Is it at a critical stage? That assessment is up to the volunteers who devote their many hours of dedicated service.

As reported in early 2017, there were more than 85 persons certified in Tama County to provide Emergency Medical Service according to BETS. This includes emergency medical technicians, advanced EMTS and paramedics. They are listed with services in Tama - 18; Toledo - 20; Montour- 4; Elberon- 5; Garwin- 3; Traer- 15; Gladbrook- 19; Dysart- 11; and first responders at Clutier. Additionally, the services providing transport have drivers. (The number can fluctuate due to new or loss of members and some may be licensed outside of the county because of the actual location of their home.)

Concern is voiced due to the age of some of the volunteers who will be retiring and the time required for the volunteers to staff the ambulances 24-hours-a-day, seven -days-a-week.

Now, more and more it seems, there are times when one service is relying upon another service because they cannot get a crew together for a run.

It does not take much to make a case someone in need of medical care west of Clutier or south of Tama deserves the same response, within reason, of someone on the steps of the capitol in Des Moines.

It is simply vital the emergency medical services are maintained in rural Iowa.

Since taking over in Tama County for the funeral homes "station wagon ambulances" in 1972, the local volunteer services have grown and done a most remarkable job of providing dependable and highly regarded care and service.

But now, some 47 years later, could it be time for the State of Iowa to provide a better backbone of support?

As stated to be made clear in the beginning: the local persons on the day-to-day emergency runs have the pulse of the matter.

A cohesive effort putting them in the forefront in conjunction with BETS and the EMS Association acting with the Iowa Legislature can determine if mandated service is appropriate.

And, what comes with required service what will make some legislators howl: the money.

Tama County's ambulances operate primarily upon claims paid for service, donations, some city support and a lot of work by volunteers.

Let's now look toward the state-licensed casinos if mandated service is the decision.

Too long have cities and counties with gambling licenses (it's up to 19 casinos) been rewarded the benefits of employment, local taxes, tourist money and generous charitable donations. While the 84 other counties received $11.9 million in 2015-16 for the County Endowment Program, those 15 counties with casinos had a whopping $84 million in grants distributed - that on top of the employment, tourist dollars and local taxes paid.

The time has come for the Iowa Legislature to change the way the casino money flows to a more equitable way and what's more fair of a start than to boost medical services across Iowa?

The casinos, by their own words, "stimulated economic development - generated more that $6 billion in tax revenues since 1991."

If the gambling industry and the areas chosen to benefit cannot aid the rest of the state then there is true hokum in the whole granting of gambling licenses.

Iowa senators respond:

Jeff Edler (-R State Center) (Senator Edler also called me to add counties do have a method to finance service and to say he is continuing to meet with officials on this issue.) Thank you for reaching out about this issue. I have been in discussions with state and local officials on emergency response.

It is important to understand proximity is a key issue to response. Just because a service is denoted as essential doesn't mean it is any faster or easier to get to a remote rural location.

Currently law enforcement is an essential service. The response time to any rural location will still take longer than an urban location. It is simple logistics. The reference to response times between rural and urban is like comparing apples to oranges.

The federal and state governments have a role to facilitate an environment in which local governments have access to the tools and resources to provide these services in a reasonable manner.

I will be meeting with local officials in the near future to continue discussions on emergency response.

Chaz Allen (D-Newton)- Thanks for the note. I was on the subcommittee that reviewed trying to get a special tax levy for ambulance service. It didn't go any where, but, I will continue to look into this issue.

I know when I was Mayor of Newton, we signed several agreement with the smaller communities around us to be a back-up for their Volunteers. As time moves on we have become the First Responders to those communities and not just a back up. This then leaves our community short on coverage. So I get it, I will work to get some new ideas and try to garner some support.

Jerry Behn (R- Boone)- Thank you for contacting me. I appreciate hearing from you. When the Iowa Legislature is not in session, I do not regularly check my legislative e-mail.

Mike Breitbach (R-Strawberry Point)- The 2018 session has ended. Due to work commitments I may not see your e-mail as soon as I did when we were actively in session.

Thank you for your email. If you contacted me to: Let me know where you stand on a particular issue or bill, I will record your position; If you emailed me about something else, I will respond as soon as I possibly can.

Jake Chapman (R-Adel)- Thank you for the article!

Bill Dotzler (D-Waterloo)- Thank you for contacting me. Your thoughts & concerns are important and I want a chance to review your message prior to sending a final response. Please be assured that I have received your e-mail. I will make every effort to reply as quickly as possible. However, due to the volume of email received, those that live in Senate District 31 receive first priority on all replies.

Therefore, please provide your name and address if you have not done so already. If you do not live in my district, I still appreciate reading about your ideas and concerns.

Tom Greene- (R-Burlington)- Appreciate the info, have you contacted Sen. Jake Chapman ? He owns an ambulance service business in WDM.

Tim Kapucian (R-Keystone)- I work for Senator Kapucian up at the Capitol. Senator Kapucian wanted me to get you his response to your email regarding EMS because his email is currently on the fritz. Please see his response below:

Dear John,

Thank you for forwarding me these news articles on EMS services in Iowa. I understand that this is a very important and emotional issue because we are dealing with life and death issues here. I am generally hesitant to mandate something at the state level because it removes the flexibility and decision making that should happen at the local level. If a certain county sees a decline in their volunteers, there is a mechanism in Iowa Code chapter 422D that allows counties to impose an income surtax or an increase in property taxes to pay for EMS services. That process in 422D requires voter approval, so it will be a community decision on whether they want to increase their taxes to provide more funding for EMS services. Providing EMS services in rural Iowa is challenging because the people are so sparsely populated. It does not make economic sense to have an ambulance within 10 minutes of every household. I believe cities and counties are the appropriate venue to decide whether or not there needs to be an increase in EMS funding to decrease the response time for ambulances. Sincerely, Tim

Jeff Danielson (D-Cedar Falls)- Thank you John. I agree with you and support efforts to change Iowa's law to ensure EMS service is available everywhere in Iowa. It's time to modernize Iowa EMS service.

Joe Bolkcom (D-Iowa City) - Thanks for the note.

I agree the resources are there to address the need for improved emergency services in smaller communities and rural Iowa.

The sad truth is that Republican control of state government has been a disaster for rural Iowa. School teachers will make less, Medicaid privatizations has hurt every rural hospital and health care provider because they are not being paid. These are the same provider WE ALL DEPEND ON. There policies are draining resources out of rural Iowa. Their massive tax cut which hugely benefits rich people and large out of state corporations will make things even work in the next decade.

So. this is about priorities. This is not one of their priorities.

Can't wait for the November elections when Iowans get to decide what they want our state to look like in the years ahead.

Liz Mathis (D-Hiawatha)- Thanks for sending this John.

Matthew McCoy (D-Des Moines)- Thanks for sharing the editorial with me. I understand and appreciate the importance of ambulance service throughout rural Iowa.

Out of curiosity have you done an exploration of how much is needed to accomplish this global goal? I suspect that some smaller rural areas do better then others at providing this service? What do you think the state should pay? What do you think the local communities should pay? More than 60 percent of our city budget in Des Moines is dedicated to police and fire protection. We currently are raising local property taxes in Des Moines again to pay the increased cost of these services.

As you know, Iowa currently spreads the local option sales tax collected for schools across 99 counties. Something like this could be done for police, fire and ambulance service.

Gaming revenue is always a source for funds. I have found that in Iowa the gaming revenue is primarily invested in education. The first 50 million of revenue is general fund for schools. The next 40 million, goes towards the Environment First Fund. Following that, the remainder is spent in the RIF Budget which is primarily dedicated to the following big ticket items. Higher education buildings on regents campuses including dormitories. Water Quality initiatives passed by the legislature and finally State owned buildings. We currently have more than 1 billion dollars in deferred maintenance on State owned buildings.

When we invested in E-911 Services we understood the importance of having access to E-911 anywhere in the State of Iowa. I feel like ambulance service should also be treated in the same manner. It takes resources and the will to expend the resources to accomplish this. Understanding the balance of the global cost it critical to accomplish this aim.

Herman Quimbach (D-Ames)- The 2018 Iowa Senate has adjourned for the year, and senators have returned home to their families and communities. The Senate convenes for the 2019 session in early January.

If you need to contact Senator Quimbach for any reason during the interim, he would welcome your phone call at his home telephone number in Ames. You may reach him at 515-292-8984.

Please note that due to decreased staffing when the Legislature is adjourned, this account is not monitored between sessions.

Jason Schultz (R-Schleswig)- Thank you for sending this.

Brad Zaun (R-Urbandale)- The legislative session ended on April 22nd as I will be returning to my full-time job. During the interim I do not check my emails on a daily basis, please have patience.

Dan Zumbach (R-Ryan)- Thank you for contacting me. Your thoughts and concerns are important to me, and I will review your message. Please be assured I have received your email.

You can visit www.iowasenaterepublicans.com/ to sign up to receive my weekly newsletter.

 
 

 

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