Frequently Asked Questions

In Shelby County when a person in crisis calls 911 in Harlan, EMS Medivac Ambulance is the primary responder. If the call is outside of the Harlan response area, the closest EMS volunteer squad is dispatched along with Medivac if needed due to the severity of the call or if volunteer response was limited.

Since the early 70s, all Shelby County citizens have been served by a combination of volunteers and paid EMS providers. The volunteers staff ambulances and provide basic first-response emergency care. The Shelby County Ambulance Commission contracts with Medivac Corp for 24 hours a day – 7 days a week coverage at the Paramedic level. This combination has served the county’s citizens well for over 40 years. Medivac additionally provides inter-facility transports to major medical centers in the Omaha metro area with highly specialized critical care equipment and personnel.

The Ambulance Commission of Shelby County consisting of Myrtue Medical Center and the City of Harlan is currently funding these services. In Fiscal Year 2024, the Shelby County Board of Supervisors designated tax funds to assist in supporting the contract with Medivac. The ambulance service uses these tax funds combined with revenue earned from 911 medical response calls and patient transfers to fund operations at Medivac. The contract between Medivac and the Ambulance Commission also requires the Commission to purchase and provide two ambulances for use by Medivac. 

Estimated Annual Operations

• Estimated Billing Service Revenue: $714,000
• Estimated Expenditures: $1,486,000
  • Breakdown of expenditures:
    • Salaries and Benefits: $1,121,000
    • Supplies, Fuel, Operating Expenses: $275,000
    • Local Volunteer Support (training, supplies, other): $90,000
• Estimated Funding Needed: $940,000
  • Breakdown of funding needed:
    • Net Operations to be funded: $772,000
    • Reserves for Equipment Replacement: $168,000
• Estimated Local Funding Sources: $940,000
  • Breakdown of local funding sources: 
    • Hospital Ambulance Property Tax Levy (funding for transfers): $100,000
    • County Essential Service Property Tax Levy Estimate: $720,000
    • County Essential Service Income Surtax Estimate: $120,000

The owners of Medivac, Bob and Nella Seivert, have announced they will retire in the next few years. Without this service, Shelby County and the area that Medivac serves will be without 911 support response and a critical care transfer service. Both arms of this type of service are key to saving lives in Shelby County. Shelby County has benefited for decades from the advanced care that this privately owned business has provided – a level of care that is very uncommon in other areas around the state. The goal of the Shelby County EMS Advisory Council is to maintain and eventually increase the level of support to the volunteer units and provide the same critical care transport service currently provided by Medivac. 

The transition of becoming an essential service would increase coverage, provide oversight of countywide EMS operations, and allow improved coordination of volunteers and paid providers. The essential service would allow Shelby County to tax for EMS within the county. This will be a major funding stream to maintain the EMS budget.

Yes. Medivac is contracted to provide these services. A crew of two is immediately available along with a backup crew of two who must be able to respond within 20 minutes. At times, there are limited volunteers to respond. When there is a limited or lack of response to a 911 call, Medivac fills in these gaps as well as providing Advanced Life Support (ALS) tiered support.

No, the volunteer rescue providers will continue to be a valuable medical care resource to local communities. Without our EMS volunteers in each community, there would be an increase in time to get a rescue provider at someone’s side to help. The tiered response model provides the most effective delivery of emergency care with volunteers supported by a paid EMS service. The communities of Shelby, Portsmouth, Panama, Earling, Westphalia, Defiance, Irwin, and Elk Horn all provide EMS service within their areas. The new Shelby County EMS Department will tier with these communities and provide Advanced Life Support (ALS) service as needed. The proposed budget allocates financial resources to volunteer departments for the possible purposes of supplies, equipment, or call pay. The distribution of the funds will be a collaborative discussion with volunteer departments as each department has different needs

For the fiscal year 2023-2024, the Shelby County Ambulance Commission (Hospital, City, and County) has a designated amount of $373,850 through their general basic fund and special ambulance fund that supports ambulance service in Shelby County. This allocation does not provide sufficient funds to continue the current framework or support the newly formed department. In addition, there is a shortage of EMS professionals. In order to make these positions more attractive and recruit more effectively, we will need to improve compensation packages.

When the EMS Public Measure passes, all Shelby County residents will pay for a share of the cost of EMS through a tax levy. The proposed amount is $.75 cents per $1,000 of taxable property within the county. In addition, there will be an income surtax assessment on Iowa individuals’ income tax returns for Shelby County residents at a rate of 1%.

When the EMS Proposition Passes in November, property tax funding will be collected starting in September 2024. The 2024-2025 fiscal year will be dedicated to acquiring a facility, purchasing needed equipment and supplies, and developing the program. As funds are available, a Service Director will be hired to develop policies and programs, hire staff and apply for necessary licenses. A new county-run ambulance service could start operations on July 1, 2025.

The new Shelby County EMS Service Director will work closely with the EMS Advisory Council and Medivac to ensure a smooth transition. 

An important element of EMS and the care of emergent patients is the ability of our EMS system to transfer critical patients to a higher level of hospital care, if needed. The current level of care and often immediate availability for transport is unmatched in other counties around the state. The continuation of critical care transport service located in Shelby County is imperative for the ongoing care of our citizens.

Hospital transfers are reimbursed by insurance significantly better than 911 calls and it is important that the new ambulance service capture revenue which will offset some of the expenditures.

We are hoping to staff a full crew 24/7 consisting of a paramedic and an EMT. We are also wanting to staff an extra crew 12/7 during the busiest times of the day with 12 hours of on-call time. While the staff is on shift, they will respond to 911 calls and do transfers to higher level of care from the hospital. When there is not a need for a transfer or 911 calls, the crews could be maintaining equipment, documenting patient care, and doing training around the county.

Harlan is centrally located in the county and can reach all areas of the county in the shortest time. The highest concentration of the county population is located in Harlan resulting in  substantially higher volume of calls in the same area. While based in Harlan the new services is being developed to collaborate with current county EMS and county wide volunteer resources.

Based on 2022 Valuations

• A personal residence valued at $185,023 after rollback of 45.87% equal taxable valuation of  $100,153/1000*.75= $75 property tax levy.
   
• A personal residence valued at $306,158 after rollback of 45.87% equals taxable valuation of  $165,724/1000*.75= $124 property tax levy.
   
• 40 acres of agricultural land with an assessed value of $65,847 has a taxable valuation of $58,631 would pay $43.97 property tax levy.
   
• If you owe $2,000 in state income tax and the local income surtax is 1% you would owe $20 in income surtax.
   
• To find out your personal estimated cost take your property taxable valuation/1000 *.75 and your 2022 state income tax *.01 added together.

General election in November 2023.

• You can learn more about the EMS vote on the Boards and Commissions page under EMS Advisory Council.
• You can also learn more on the Shelby County Emergency Management Facebook page.