EMS Essential Service Designation Gaining Ground in Iowa

In 2021, Governor Kim Reynolds signed into law, the ability for Iowa Counties to designate Emergency Medical Services as essential. This law was the culmination of years of hard work by the Iowa Emergency Medical Services Association. The law allowed each county board of supervisors to decide if they wanted to designate EMS as essential and put to the voters the option of up to a $0.75 tax per $1000 of valuation to be used specifically for EMS. In order for the tax to be imposed, 60% of the county voters must approve the measure.

As we enter the election season once again, this measure is going to be on the ballot for many Iowa Counties in November. Currently, voters in 12 Iowa Counties have approved the measure and a secure funding source for EMS has been put into place. Only two counties have voted it down since 2021. The board of supervisors in more than 18 additional Iowa Counties have designated EMS as an essential service and placed the measure to be voted on in upcoming elections. Multiple other counties have started the process to designate EMS as essential with the hopes of future ballot measures.

I had the honor of being part of a documentary on the EMS Crisis in American which is now available for viewing on Amazon. https://www.amazon.com/Honorable-But-Broken-EMS-Crisis/dp/B0D5T945PZ The documentary is narrated by Actress Sarah Jessica Parker and produced and directed by Bryony Gilbey who is a former CBS News 60 Minutes and ABC producer and mother of three EMS professionals. It is also produced by Richard Diefenbach who is a former broadcast news journalist (ABC/CBS/FOX). This documentary outlines the crisis that EMS is in throughout the United States, but also features Iowa and other states who are actively working on essential service funding.

No one likes an increase in taxes, but when the public is educated about the crisis, the support can be overwhelmingly positive! Funding alone does not solve all of the issues in EMS, but it does provide the safety net we need to maintain, enhance, and improve the services we provide. We now have a responsibility to be good stewards of the funding and prove to the public that their support is truly essential. Dave Edgar

Leaving Las Vegas: Thoughts from the 30 thousand feet

Sep 14

Written By John Sammons

My week at EMS World in Las Vegas has come to an end. It was a great to catch up with friends, both new and old and to learn from some of the smartest people in our industry. As any good conference should, it made me think about where we are as a profession, and where we are going. How each of us has an obligation to our patients, their families, our agencies, our profession and most importantly to ourselves to continue to strive for excellence. Here are some of my thoughts as I head back east:

Innovate

We hear it so often, that we should never stop learning and that, of course, is true. The question I ask is: what are we learning? Are we learning the same thing over and over, just wrapped up in a different box with a prettier bow? Research and asking new questions are the keys to innovation and change. We know the “you call, we haul, that’s all” mindset is gone. That is just not sustainable. We need new solutions to meet our patients where they are and provide healthcare that is truly patient centered. We need to stop doing things just because we have always done them that way. Matt Zavadsky from PWW who gave a lecture titled “Myth Busters: Slaying EMS Sacred Cows” where he talked about those things we hold on to so tightly, even when we should let them go. We need passionate speakers and educators that will challenge our beliefs and make us think so we can challenge the norm and continue to help our profession grow. We need to network, to learn from those experts we look up to, and to help the next generation grow. We need to share ideas that spur new visions of where we can be in the future. Diverse backgrounds, diverse experience and diverse collaboration are the drivers of innovation. A quote I heard this week was “I don’t care about rank; I just want results”. Everyone has a voice and can bring something to the table.  If we don’t change, if we are the same people or profession five or ten years from now as we are today, then we are doing it wrong.

 Advocate

Advocacy is so important, on so many levels. We need to advocate for the profession on the local, state, and federal level. We need EMS to be properly funded, properly reimbursed for providing the proper, clinically appropriate care. EMTs, AEMTs, and paramedics need to be paid livable wages, so we are not having to work two or three jobs just to barely scrape by. For twenty-five years I’ve heard that there’s no money in EMS. Why? Because we allow it. I’m fortunate where I work, but where I work is unfortunately the exception and not the rule when it comes to pay. We need to advocate for better and safer working conditions. I saw a video recently where one of the presenters said something along the lines of being on shift for multiple days in a row, running 30 or more calls in that time, and having three hours of sleep. This was posted on a national EMS agency’s social media. On what planet is that okay? There was a study a while back now that showed if you are awake for more than 24 hours, you essentially are just as impaired as if you had a blood alcohol level of 0.08. Yet, we are able to take care of patients being awake for far longer? Challenge the negativity culture. I think it is important for people to hear that yes, I have been doing this for a long time, and yes, I still love taking care of patients, and love EMS and being a paramedic. Too often those positive voices are silenced because it’s cooler to be negative. Challenge the culture that says it is okay to treat people differently based on who they are, on what they called for, on when they called, and lets instead embrace a culture that says yes, I know you called 911 at three AM, but you know what, we’re here to help, we’re going to that, but also lets help you to identify ways that maybe we can help you to avoid needing to do that in the future. What are the barriers? And by the way, maybe we should have systems in place that say maybe we do not need to take you to the hospital, but still get you the right care. Then we walk the patient through those options, and help them to decide what may be best for them. If they still decide they would prefer the ER, so be it. Demand better. We allow what we walk by, and if we let bad behavior go unchecked, if we don’t call it out and stop it, we create a culture that says that it is okay. Inclusivity is important. For us as individuals, for our peers and coworkers, and for our patients and communities. We all deserve a safe work environment, we all deserve to feel valued, and included, and that we have a voice. Our communities need to know that, too. That we care for everyone and do our best to be aware of our biases, and that we do our best to provide the best care, all the time.

Find your people

I’m sure there were some people this week that had trouble doing this in a literal sense out on the strip making questionable life choices, but that isn’t what I’m talking about here necessarily. I cannot stress this enough, find your people, your tribe, your board of directors, your ride or dies, whatever you want to call them. Find them and keep them and tell them how much they mean to you, because it is rare to find. Despite being from six different states, all over the country, a group of us can come together and pick right up where we left off. It helps that we have an active group chat that we’ve used since EMS World New Orleans last year and have talked almost daily since before then. We laugh, a lot. We share ideas and collaborate. If one of us asks for help on a project or is looking for information, within ten minutes they have resources and all the information they could need. Most importantly, we support each other, we celebrate successes, and pick each other up when we fall. I talk a lot about mental health, and finding your people is one of the biggest things you can do to support growth and resilience. The caveat to this is, surround yourself with people that want to build you up and grow, not hold you back. Stagnation stunts growth and innovation.

I spent exactly $0 gambling in Las Vegas, and when I told my brother that, he told me spending $0 gambling means you are guaranteed to win $0. Feeling a bit philosophical, I feel like there is a life lesson there. The lesson isn’t that we should all go gambling. Sorry. If we take zero risk, we have zero reward. Be a driver of innovation, of change, of advocacy and of a culture that encourages growth. I am already looking forward to EMS World 2025 in Indianapolis, but there is a lot of work to do between now and then. Keep moving forward, stagnation smothers innovation.

John Sammons