10/08/2026
EMS FUNDING: LET’S TALK ABOUT THE ACTUAL OPTIONS
We have seen a lot of good questions and discussion lately about the proposed Fayette County EMS levy. We want people to understand not only what is being proposed, but also why this funding method was selected and what the other options actually look like under Iowa law.
First, there is no “magic money tree.” EMS has to be paid for somehow.
Ambulance billing remains an important source of revenue, and patients and insurance companies will continue to be billed. But reimbursement—especially from Medicare and Medicaid—does not cover the full cost of maintaining staffed, equipped, 24/7 ambulance services throughout Fayette County.
So what other tax options are available?
What about an income tax?
Iowa Code Chapter 422D does allow counties to use an EMS income surtax. However, it is important to understand what that means.
The maximum EMS surtax is 1% of your Iowa state individual income tax liability—not 1% of your income. It is also paid only by individuals who reside in the county.
That means businesses themselves do not pay it, and people who work in Fayette County but live elsewhere would not contribute through that surtax even though they may rely on Fayette County EMS while they are here.
Most importantly, projections show that the income surtax alone would generate nowhere near the amount necessary to provide the stable EMS funding needed countywide.
What about a sales tax?
This is probably the most common alternative we have heard.
Iowa already has a 6% state sales tax, and Iowa law allows a 1% Local Option Sales and Services Tax, commonly called LOST. The local option rate must be one whole percent.
Fayette County communities are already using this local-option sales-tax mechanism. For example, West Union currently has a voter-approved 1% LOST.
So the county cannot simply say, “Let’s add another 1% sales tax for EMS.” That additional local sales-tax authority does not currently exist.
Existing LOST money is also not simply one large countywide pot sitting unused. The State collects the tax and distributes the money among participating cities and the unincorporated county. Iowa’s distribution formula is based 75% on population and 25% on historical property-tax levies. Those communities already use that revenue for existing public purposes such as property-tax relief, streets, public safety equipment, economic development and other local needs.
Moving existing sales-tax dollars to EMS would therefore largely mean taking money away from something else, not creating the new sustainable revenue EMS needs.
A statewide sales-tax solution could certainly be something for the Iowa Legislature to consider someday. But Fayette County cannot create a new statewide tax on its own, and we cannot fund ambulances today with a tax that might exist sometime in the future.
So how does the proposed property tax actually work?
The ballot language refers to a levy of up to $0.75 per $1,000 of assessed value, because that is the language established in Iowa Code Chapter 422D. The law also states that the EMS levy applies to taxable property in the county.
This is where Iowa property taxes can get confusing.
Your assessed value and your taxable value are not necessarily the same number.
For most property, the assessor establishes an assessed value. The State of Iowa then applies what is commonly called the rollback, formally called the assessment limitation. That percentage determines how much of the assessed value is actually taxable. Property-tax levy rates are then applied to taxable value.
For example, Iowa’s certified 2025 residential assessment limitation is 44.5345%.
So, using a $100,000 residential property as an example:
$100,000 assessed value
× 44.5345% residential rollback
= approximately $44,535 taxable value
Then:
$44,535 ÷ 1,000
× $0.75 EMS levy
= approximately $33.40 per year
That is about $2.78 per month.
Because the rollback changes from year to year, we have frequently used a simple rule-of-thumb of roughly $38 per year for every $100,000 of assessed residential value, assuming approximately 50% taxable value.
The exact amount will depend on your property classification, the applicable assessment limitation when the levy takes effect, and any exemptions that apply to your property.
Agricultural property is also different from residential property. Iowa does not generally assess agricultural land based simply on what the farm could sell for on the open market. Agricultural real estate is valued based on its productivity value, and it has its own state assessment limitation. For 2025 that agricultural limitation is 59.4401%. Residential dwellings located on agricultural property are treated as residential for assessment-limitation purposes.
That distinction is important when trying to calculate what an individual farmer or landowner would actually pay.
Why property tax?
Because it provides a broad, predictable and stable funding base.
It includes residential property, agricultural property, commercial property and industrial property throughout the county. Businesses that bring workers into Fayette County contribute. Farms contribute. Rental properties contribute. Commercial and industrial operations contribute.
That matters because EMS does not serve only the people whose mailing address says Fayette County.
EMS responds to residents, employees, visitors, motorists, farms, factories and businesses.
And emergency services require much more than simply paying someone when a call happens. Funding maintains ambulances, cardiac monitors, medications, radios, stations, insurance, training, equipment and—most importantly—the trained personnel necessary to have someone available 24 hours a day, 365 days a year.
Is property tax a perfect funding mechanism?
No.
We do not believe there is a perfect tax.
But after examining the options available under Iowa law, we believe it is the most stable and workable mechanism currently available to provide the level of EMS funding Fayette County needs.
This project has been worked on for years. It was not created overnight, and the alternatives have not been ignored.
We encourage everyone to ask questions, look at the numbers and make an informed decision.
Ultimately, the question is simple:
Do we want a sustainable EMS system available throughout Fayette County, and are we willing to fund what it actually costs to provide it?
That is the decision voters will make.
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Sources: Iowa Code Chapter 422D; Iowa Department of Revenue Property Tax Overview; Iowa Department of Revenue assessment limitations; Iowa Department of Revenue Local Option Sales Tax guidance.
