The Wapello County EMS Advisory Council (EMSAC) has approved its full recommendation for the county’s emergency medical services system. The Council approved its Interim Recommendation for the Hub on September 16, 2026, and its Final Recommendation for the Spokes on September 30, 2026.
Together, the two recommendations describe one system: a protected ALS transport hub at the center, six capabilities
around it that keep avoidable demand off that hub, and an EMS Academy that trains and replenishes every part of it.
The hub: two ALS crews, around the clock EMSAC approved six actions for the hub, covering the next twelve months:
- Hub operator — Continue with the existing hub operator (ORMICS).
- Service floor — Adopt two staffed ALS crews, 24 hours a day, measured in crew-hours and verified monthly — not as a unit count.
- Staffing priorities — Focus staffing efforts where data shows the greatest need.
- Back-up ambulance — Pursue an Ottumwa Fire–operated back-up third-out ambulance.
- Interfacility transfers — Pursue a dedicated out-of-county transfer crew to protect the availability of the 911 crews.
- Dispatch and response — Develop a Recommended Unit Protocol short-term and pursue Emergency Medical Dispatch long-term.
An ALS crew is two EMS personnel staffing one ambulance, at least one of whom is a paramedic. The end state is two ALS crews available for 911 response around the clock, with surge capacity from Ottumwa Fire, Blakesburg, and other transporting services.
Six spokes and the rim that holds them together A spoke is a capability that keeps avoidable demand off the ALS hub. Each
names an outcome, not an operator, so any qualified entity can scope a way to deliver it, with EMSAC supplying the data.- Dispatch — A Medical Director–approved Recommended Unit Protocol at both PSAPs now; countywide Emergency Medical Dispatch once
PSAP staffing is funded. - First response — Formalize the roles volunteer EMS, fire, and law enforcement already perform, with county support allowed by code.
- Community response and assist teams — Pilot a United First Aid volunteer response team.
- Alternative and non-emergency transport — The county coordinates and provides data, and pursues an on-call ride concept.
- Community paramedicine / mobile integrated health — Pursue the program.
- Public education and access guidance — Wapello County Emergency Management leads, in partnership with the Wapello County EMS Association and its member agencies.
The rim — EMS Academy. EMSAC recommends endorsing an EMS Academy training consortium and forming a workgroup to draft its charter.
What comes next
The recommendation describes capabilities, not a price tag. It does not set a levy amount, set a ballot date, or describe a publicly operated ambulance service. The next phase is studying the public operator model.
