A current study of the League of Women Voters of Iowa
Link to state website : http://www.lwvia.org/#!ems-study-info/c1a69
Current Iowa Law does not require any governmental entity (county, city, or township) to provide Emergency Medical Services (EMS) as it does for fire and police protection, thus EMS is not labeled an essential service in this state. The Law does allow fire departments to provide EMS. Various chapters of the Iowa Code do permit limited taxing to support EMS.
The Bureau of Emergency Medical Services, within the Iowa Department of Public Health, is responsible for regulatory oversight of individual EMS providers, which can be volunteer units, private providers, personnel within fire departments, or as part of another public entity.
Currently there are approximately 780 authorized EMS groups in Iowa and 12,000 individual providers. Of this latter total, about 74% work on an ambulance or as a first responder with an EMS agency. Counties across the state vary widely, as does the population, to numbers of EMS providers, from one in Chickasaw, Davis, Humboldt, Osceola, and Palo Alto counties to nearly 20 in Linn and Polk Counties. Sixty-four percent of EMS providers are volunteers, which translates to two-thirds of those responding to emergencies in our state not being compensated; 30% are career EMS providers.
There are four “levels” of EMS providers that can be certified in the state: Emergency Medical Responders (EMR) who have 48-60 clock hours of training in first aid procedures; the EMTechnician (EMT-Basic) who has 150-190 clock hours of training with at least 12 of those hours in an Emergency Room and eight on an ambulance; the Advanced EMT who has the EMT training plus training in IVs and other basic medical procedures that total 150-250 clock hours; and Paramedic, with the prerequisite EMT certification plus 1000-3000 clock hours of additional training (250-300 hours of clinical time and 350-500 hours in an ambulance, i.e. competency-based). Each type of EMS provider also has to maintain a schedule of continuing education in order to maintain certification, ranging from 12 credits/hours for the EMR to 60 credits/hours for Paramedics. Some of this continuing education is provided without cost, but other courses carry a fee.
All 12,000 providers of EMS in the state are represented by the Iowa Emergency Services Association. This professional organization was founded in 1987 and has a 23-member Board of Directors. They have been involved in initiating and supporting EMS legislation; representing its members on task forces, advisory groups, and boards addressing issues that affect EMS; and facilitating communication across the state between not just members of the organization but all EMS providers. They recently did an online survey of their official membership of 1,200, with a 75% response rate from a representative sample of the state EMS providers. The top concerns noted from this survey: Staffing/recruitment/retention; EMS not an essential service in this state; inadequate funding; and inadequate reimbursement from payee