Dan Walderbach, EMS Director (pictured to the right), and Jacob Dodds, EMS Operations Coordinator/Training Specialist (shown to the left), had the opportunity to meet with Iowa Representative David Heaton on Thursday, February 9, at the Iowa State Capitol Rotunda regarding issues facing Emergency Medical Services in Iowa. The event was sponsored by the Iowa EMS Association.
“Our pressing concerns discussed with Representative Heaton were the issues related to EMS funding, Medicaid reimbursement and mental health services,” stated Dodds.
According to Dodds, EMS in Iowa is not considered an essential service. This means there is no requirement for a local government to provide ambulance service, unlike law enforcement and fire protection. As a result, the mechanism to collect tax specifically for the provision of emergency medical services is limited. Public hospitals can levy a tax for ambulance service like HCHC does, but this tax makes up about 10% of the operating budget. The state EMS Association has pushed for years to make EMS an essential service without success. This year, the approach was to push legislation that would allow townships to tax for EMS services as they do with fire protection.
Dodds went on to explain that just like all other aspects of healthcare in Iowa, EMS is feeling the pinch of Medicaid funding and reimbursement changes. Currently, an ambulance service can collect a base service rate plus mileage when transporting patients. The difference in mileage rate reimbursement between Medicaid and Medicare exceeds $5.00 per mile. “We were asking for no change in the base service rate, but an increase in the loaded mileage rate to be on par with the Medicare rate. The current reimbursement does not even cover our costs for providing the service, but an increase in the mileage fees would certainly help offset this,” he said.
“On mental health, we have probably brought the same concerns that everyone else has. There simply aren’t enough beds available in the state to address the mental health crisis. This affects EMS because these patients requiring hospitalization often must be transported to the other side of the state to places like Atlantic, Carrol, Spencer, Council Bluffs and Sioux City, and they are often transported by ambulance,” said Dodds. “This taxes the already limited resources of ambulance services across the state by taking an ambulance out of service and making it unavailable for other calls for an extended period of time, sometimes 12 hours or more.”