(Radio Iowa) When you call 9-1-1 in parts of rural Iowa, there’s no guarantee an ambulance will be available, as emergency medical services aren’t considered essential, like fire or police. Mark Sachen, president of the Iowa Emergency Medical Services Association, says three-fourths of local departments are volunteer-run. Because the service isn’t guaranteed by local or state funding, many get their money from billing patients or bake sales.

Sachen says, “I think we’re to the point now where the demands on the system are far exceeding the available resources available to provide those services.” In the past five years, Iowa saw a four-percent decrease in the number of registered E-M-Ts. Fourteen counties are covered by just one ambulance service while Worth County has none for its 400 square miles. In Tripoli (Trip’OH-lah), director Kip Ladage has just a few E-M-Ts to cover 99 square miles in Bremer County. He notes staff shortages in neighboring areas create a domino effect.

“From six in the morning to six at night we probably have two, maybe three, if we’re lucky that are available,” Ladage says. “What if Tripoli can’t cover and Denver is already out and can’t cover. Then where do we go? Then that response time just gets that much longer.” Wright County supervisor Karl Helgevold says voters in 2018 overwhelmingly approved a property tax levy to make Wright County the first in the state to declare E-M-S services as essential. That raised a half million dollars a year for training, equipment and a countywide E-M-S coordinator.

Helgevold feels it’s something the state needs to ensure. “Would it be great if the state had a way to mandate it and fund it in a perfect world? Yeah, but we don’t live in that type of world right now,” Helgevold says. “So we need to do what we need to do and provide a good service to our citizens.” One proposal in the Iowa legislature would make it easier to follow Wright County’s example. It would allow counties to set up partnerships and use existing local taxes to fund E-M-S without voter approval.

Representative Bobby Kaufmann, a Republican from Wilton, doesn’t think the service should be declared essential at the state level as it could impose a cookie cutter set of requirements. Kaufmann says, “I still think it should be done county-by-county because there are different mechanisms that work for different areas.” Kauffman is asking the state to appropriate about five-million dollars toward the state’s various E-M-S departments.

(Reporting by Natalie Krebs, Iowa Public Radio)