04/09/2026
Fayette County EMS Essential Service – Questions & Answers
Why is this tax levy needed?
Emergency Medical Services are currently not classified as an essential service in Iowa, unlike law enforcement and fire. Because of this, there is no dedicated, consistent funding source to ensure EMS coverage.
At the same time:
• Costs for ambulances (~$500,000 fully equipped), medications, equipment, and staffing continue to rise.
• Insurance reimbursement remains low and unreliable, often not covering the cost of providing care.
• Volunteer numbers continue to decline, requiring more full-time paid staffing, which increases costs.
Across Fayette County, ambulance services are losing money every year, which is not sustainable long-term. Currently, even the two largest paramedic-level services receive no direct county funding to provide 911 EMS coverage.
Without a stable funding source, maintaining timely, high-quality EMS care for residents and visitors is at risk.
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Where will these tax funds go?
Under Iowa Code 422D, all revenue generated must be placed into a dedicated EMS Trust Fund.
These funds:
• Can only be used for EMS-related purposes
• Include things like:
• Ambulances and equipment
• Training and education
• Wages for EMS providers
• Communication systems and facilities
The law clearly restricts these funds—they cannot be used for anything outside EMS.
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Who oversees the funds?
Iowa law requires the creation of an EMS System Advisory Council to guide how funds are used and to report annually to the Board of Supervisors .
In Fayette County, the Fayette County EMS Association already exists as required by Iowa code as an advisory committee for the Fayette County EMS System.
According to the bylaws :
• FCEMSA includes every EMS service in the county
• It exists specifically to:
• Serve as an advisory board for EMS
• Improve coordination between agencies
• Promote high-quality patient care
This means:
• Every service has a voice
• No single agency controls decisions
• Funding recommendations are made collaboratively and transparently
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Why the Fayette County EMS Association?
FCEMSA is uniquely positioned because:
• It already represents all EMS providers in Fayette County
• It operates as a nonprofit, non-biased organization
• Each member service has equal voting power, regardless of size
• It has an established working relationship with the Board of Supervisors
Additionally, Iowa Code requires:
• Ongoing system assessment
• An annual public report
• Continuous evaluation of EMS needs
FCEMSA already has the structure and participation to fulfill these requirements.
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How will the money be distributed?
Funds will be distributed as fairly as possible, based on:
• The taxable property value within each service area
Example:
• If you live in West Union, your tax dollars will support EMS services in your area
The goal is to ensure every community in Fayette County benefits, while maintaining fairness and accountability.
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Why not use an income surtax instead of property tax?
While Iowa law allows both options, property tax is preferred because:
• It is stable and predictable
• Property valuations are publicly available, allowing accurate budgeting
• Revenue does not fluctuate significantly year-to-year
In contrast:
• Income surtax revenue is unpredictable
• It depends on personal income, which fluctuates
• There is no reliable public data to estimate expected revenue for Fayette County
For planning and sustainability, property tax provides a much more reliable funding source.
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How much will this cost me?
The maximum levy allowed under Iowa law is $0.75 per $1,000 of taxable value .
Example:
• Property value: $450,000
• Annual cost: $337.50
That’s less than many people spend annually on things like:
• Cell phone plans
• Streaming services
• Dining out
But this investment helps ensure EMS is there on your worst day.
