The initiative was originally on the 2023 November ballot, but was removed due to red tape. It returns this fall with the full support of the Hamilton County Board of Supervisors, which voted on it Tuesday.

When November rolls around, voters in Hamilton County will be asked to approve the levy that would add 30 cents per $1,000 of taxable property value to fund a request from the Emergency Medical System Advisory Council. This levy, if it passes, would continue for 15 years.

It will be called Proposition A on the November 5 ballot.

Duane Hendrickson, chief of Jewel Fire and Rescue, read the resolution Tuesday during the supervisors’ regular meeting. He leads Hamilton County’s EMSAC, an early county entrant into the greater state EMSAC that is a part of the Iowa Department of Public Health.

The money would be for EMS services only, Hendrickson said.

“Fire is supported by taxes,” he said. “EMS is not.”

Supervisor Rick Young elaborated. “If you call the fire department, they have to come.” EMS is strictly volunteer.

“There is a difference between fire and EMS. Fire call, they have to go out, they have to, they’re bound by law to go because they’re supported by the public. EMS systems, if you get a call they don’t have to go. The whole reason they go, they care about the people.”

Hendrickson has in the past explained that in most of Hamilton County’s small communities, where EMS service largely relies on good will and good-hearted people, there is little or no money to purchase advanced life-saving equipment needed in emergency situations.

One problem in the small towns is that calls are billed to people who use the service, and it is increasingly common that those bills are never paid.

“More and more move from the area and ignore the invoice,” he has said in the past.

Or, they are Medicare calls, which means only 60% of the invoiced charge is paid; in cases of Medicaid billing, only 10% of the invoice is paid.

As for the need, he said lift equipment which can bear greater human weights is increasingly necessary. Sophisticated heart monitors can cost $30,000.

Supervisor Jerry Kloberdanz voiced his support.

“Everybody should know that EMS is a vital service throughout the county, regardless of where you live. If there’s an accident out on the roads and there is need for it, EMS comes out and assists the deputies … It’s a very important service and there shouldn’t be anybody in the county that should have to suffer …”

Kloberdanz has said in the past that the point is to be “consistent throughout the county. Nobody will be left out.”

If the initiative passes in the fall, the funds would be held by the Advisory Council and distributed as needed to agencies upon request.

The expectation is that the levy could generate roughly $350,000 a year.

Young has been reported saying Iowa allows this kind of EMS levy to be as high as 75 cents per $1,000.

To pass in November, the initiative must get at least 60% of the vote.