Pella City Council ponders EMS services

Jul. 6—PELLA — Several items related to Pella's emergency management services were up for discussion by local officials as the city continues to ponder its funding options.

Staffing and financial obstacles for Pella Ambulance, upgrades to the police department's dispatch center and ongoing challenges for the county's emergency management services were discussed in length by Pella City Council members at a policy and planning meeting Wednesday.

Due to a lack of part-time employees for the city's ambulance service, the city plans to ask for funding from Pella Regional Health Center to help cover the cost of hospital transports.

City administrator Mike Nardini says Pella Ambulance relies heavily on part-time employees. Nardini did not give an exact number, but the ambulance has recently lost part-time employees who have transitioned to full-time employment with other agencies.

Pella Ambulance averages about 500 hospital transports annually, Nardini said, with 462 in 2022. The number of hospital transports has slowly decreased since 2020, but 911 calls and total runs have continued to increase. In 2020, the ambulance received 1,238 911 calls for a total of 1,739 runs; 1,406 in 2021 for a total of 1,886 runs; and 1,711 in 2022 for a total of 2,173 runs.

Greg Higgenbotham, chief of Pella Ambulance, said the ambulance typically makes transports to Cedar Rapids, Iowa City, Waterloo, Des Moines and sometimes as far as Rochester, Minnesota. Turnaround times can range anywhere from 3-5 hours. Nardini said this puts the ambulance out of service in their coverage area.

"What makes transports difficult for the ambulance service is the length of time an ambulance is out of service," Nardini said. "Any time an ambulance is out of service for an extended period of time, that increases the possibility that we'll have to call in a third ambulance. That's where we run into difficulties with staffing."

The city could receive additional tax dollars to help fund Pella Ambulance through the passage of an Essential Services Tax. Iowa Code 422D allows the Marion County Board of Supervisors to hold a county-wide referendum, or vote, to collect a tax to fund emergency management services. The Essential Services Tax allows counties to use a local option income surtax or to levy up to 75 cents per $1,000 of taxable valuation.

To meet requirements for a referendum, supervisors must declare EMS as an essential service. Sixty percent of county voters would then need to vote in favor for the tax for it to pass.

Lake Prairie Township, which represents Summit, Black Oak, Richland and the City of Leighton — all within Pella Ambulance's coverage area — also intends to pursue an Essential Service Tax to provide financial support for Pella Ambulance. Currently, they do not contribute any funding for ambulance services.

Updates needed for dispatch center

In addition to Pella Ambulance, the Pella Police Department's dispatch center is in need of a system upgrade, which Nardini estimates will cost between $590,000 to $1.2 million, depending on whether an additional radio communication tower is needed.

The center's current system is outdated by industry standards, Nardini said. The system is unable to provide the necessary coverage required for safe operations and public safety needs, and lacks the ability to "provide immediate and effective system redundancy and backup." Shane McSheehy, Pella's chief of police, also added that an upgrade is needed to establish effective and reliable interoperability with law enforcement agencies, local schools, businesses and other city departments.

"We're a standalone system. Twenty years ago, that might have been a brag. Now, it's a hindrance," he said.

The police department requested $590,000 in funding from the Marion County 911 Board to upgrade the dispatch center that was on the board's agenda for April 26, along with other funding requests from other 911 departments throughout the county. Nardini said the only project the board did not take action on was the police department's request for the dispatch center.

The city's next steps are to ask the 911 board why their request was denied. Council will then need to decide to either continue with the project without additional funding from the county or re-evaluate the project during fiscal year 2024-25 budget discussions.

Challenges for local EMS

To evaluate county EMS operations in order to determine if current models are adequate and financially sustainable, an ad hoc committee was established by county supervisors in late February. Based on their review, the committee will make recommendations and offer potential solutions for improvement to benefit county residents.

Teri Van Kooten, committee member and service area coordinator at Marion County Public Health, told council members some of their biggest obstacles are funding due to the state's current reimbursement structure, employee recruitment and retention, and how to disseminate funding obtained through the Essential Services Tax, if passed.

"EMS was structured initially in the fire department. That's how it originally started," Van Kooten said. "The reality is that EMS is part of the healthcare system, and we have to recognize that as part of the healthcare system. So the structure of reimbursement should reflect that, which it doesn't currently."

It is also the committee's job, Van Kooten said, to make sure elected officials understand how EMS functions before making changes to the current structure and declaring EMS an essential service — which is not an easy task.

"I think it's going to be a little bit difficult for some, but I think we all have to be accepting that what we are doing now isn't working. It's not sustainable," she said. "We have to come up with a system that's sustainable for our citizens and that is efficient and effective."

No action was taken at the meeting.

Emily Hawk is the associate editor of the Ottumwa Courier and the Oskaloosa Herald. She can be reached at ehawk@oskyherald.com.