By Chad Drury
Ottumwa Courier
OTTUMWA, Iowa — There was a time when Emergency Medical Services was a booming sector of health care, but it’s been a struggle for at least a couple of decades.
How to get out of it? According to Wapello County Director of Emergency Management Tim Richmond, the way is to turn the rudder of the ship.
Richmond floated a pair of ideas to make EMS more desirable from a reimbursement standpoint and efficient during a board of supervisors meeting two weeks ago, but the item came up again during Tuesday’s meeting at the courthouse.
Richmond told the supervisors on June 13 he was in the process of looking into creating an EMS board, as well as forming a resolution to make EMS an essential service for the county. He said he would likely come back to the board with specific details in July.
“An EMS board would actually be an arm of you (the supervisors). We already have our EMA association that focuses on things like system development, education, etc.,” Richmond said at the previous meeting. “But we want to take perhaps some of the core people in that organization and formally appoint them as a board.”
Richmond’s second idea is something the supervisors will need more information on. Making EMS an essential service, which is not required in Iowa, is something that will have to be levied for and voted on, supervisor Brian Morgan said Tuesday.
Under an Iowa law passed in 2021, counties can ask for up to 75 cents per $1,000 of assessed property value for EMS. It also must pass with 60% of the vote.
“There are some counties starting to put it on the ballot. I think last fall, maybe five were approved and three failed,” he said. “So it’s definitely something that would be a last-case scenario because it is adding to that tax base. A lot of the services Ottumwa Regional Health Center does provide, but if it gets down to a situation where we need it, or looks like we might, it’s something we’re really going to have to explain to the voters what that money is going to be.
“Tim’s putting a lot of that together right now, just so we have what the costs of different programs and running different services, would actually constitute,” Morgan said. “It’s a long process. You can’t just throw something like that on the ballot. You have to have everything in a row.”
At that June 13 meeting, supervisor Bryan Ziegler, who serves on the county’s volunteer rural fire department, opened the conversation about being more “proactive” with EMS. Richmond began an internship program with three other counties to train and develop EMS personnel, but it’s only one way to boost a career path that has been lagging.
“My thinking is that we would do small steps, but take some steps to influence this,” Ziegler said. “Part of the purpose is to have a contingency plan in place in case something happens. I also think maybe there’s some leadership things we can do to bridge a gap with some resources we already have.
“Some of the small towns in Wapello County in the past had ambulance services that they were able to run, and that’s not so much the case anymore,” Ziegler said. “Perhaps it’s just a matter of helping them to achieve what they use to have. That’s the intent.”
If EMS becomes an essential service at some point, it would guarantee an ambulance shows up at a residents when 911 is called, but many counties are feeling a crunch from the shortage of EMS personnel. Richmond also said there are other ways to make sure residents get the response they need.
“One thing I think could be a game-changer is community paramedicine. Basically you have paramedics who go out in an SUV and do preventive visits. So many of our 911 calls are from people who don’t have anyone helping them at home,” he said. “And they just spiraled to a point where they need critical health. But if we get to them prior, we can prevent that kind of volume of 911 calls.
“Years go we were doing that through home health care programs through public health, but they got out of it because private entities were doing it and we didn’t see the need,” Richmond said. “The private entities dried up, so nobody’s doing it now. We have that huge need that’s not being addressed, and I think community paramedicine would be an answer to that.”
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