Emergency Medical Services (EMS) are not considered essential in the state of Ohio. In fact, emergency services are only considered essential in 19 states as of 2024.

Police and firefighters are considered essential in Ohio, while local EMS departments face funding challenges around the state.

The Indian Lake EMS (IL EMS) Department is requesting an 8-mill, five-year operating levy on the Nov. 3 General Election ballot. Logan County voters in the following precincts will cast their ballots on this issue: Lakeview, Russells Point, Stokes North, Stokes Southeast, Stokes West, Washington North and Washington South.

The Chronicle spoke with Chief Josh Strayer, Captain Logan Brown, and Lieutenant Chuck Wirick of IL EMS for more details.

“Mills” for tax levies do not equate to millions of dollars. A mill levy is a property tax rate of $1 for every $1,000 of a property’s market value.

Chief Strayer said the department is currently operating from a permanent 1.5 mill levy from 2012, plus a 2.5 mill levy from 2017, which will expire at the end of 2027.

The 8-mill levy would increase the ILEMS funding from approximately $2 million to $4 million per year. Property tax levies for EMS departments are fixed at the property values when levies are passed, and do not increase as assessments rise with the markets.

Property owners would see an increase of $280 per year for every $100,000 in the most recent property valuation, as the 2017 levy is phased out, and the new one is implemented at the start of 2027.

Chief Strayer understands the “sticker shock” of an 8-mill levy, as voters weigh their options. Captain Brown noted that in urban areas, the amount of EMS levies can reach as high as 17 mills.

The main cost driver for this requested levy increase is to enable IL EMS to add a second crew of seven full-time medics, offering 24/7 coverage.

The other cost component is equipment, as the department currently has four ambulances, the oldest of which is from 2008. The two trucks from 2020 have over 100,000 miles each, reaching serious maintenance thresholds.

Chief Strayer also pointed out that equipment such as power ambulance cots and CPR machines reduce physical strain on medics, plus increase efficiency of crew operations.

He said that new drug regimens, as mandated by Mary Rutan Hospital, also have increasing costs, and sometimes require refrigeration.

A new integrated power-cot system currently costs $78,000, however this allows medics to push buttons and elevate patients seamlessly into the ambulance. The IL EMS chief also mentioned that ambulances use diesel fuel, which is approaching $7 per gallon in the area. The cost to replace the aging ambulance is over $300,000, with a three-year wait time.

Chief Strayer stressed that the population of the Indian Lake region is aging, which is increasing the frequency of ambulance runs. He provided a chart showing that 61% of the population is over the age of 60.

From 2019 to 2025, IL EMS saw a 36 percent increase in runs to over 1,700 trips in one year. He gave an example of one day in which there were five runs, and only one crew.

The tornado of March 2024 saw 22 ambulance runs amidst multiple road closures in one day – and budget forecasting for natural disasters is next to impossible.

The three men are concerned that wait times will continue to increase without a second crew. IL EMS has 11 full-time and 25 part-time personnel, including 19 paramedics and seven advanced EMTs.

The three townships in the IL EMS district are 93 square miles in total and the entire joint ambulance district covers over 180 square miles.

The chief also mentioned the time delays in driving to the various islands, plus trying to find addresses in densely populated areas like Turkeyfoot.

He addressed comments and concerns from voters in the area regarding spending and revenue. IL EMS has applied for and been denied multiple grants from the federal government, primarily because the department does not provide firefighting services.

The department received a substantial FEMA grant during the pandemic, but that funding has been depleted, the chief noted. He said that Ohio law does not allow EMS departments to be funded through income and sales taxes.

Chief Strayer also addressed questions about tourism in the area, and added that Indian Lake residents are not charged for ambulance runs. Insurance and Medicare cover some of the cost (up to 80 percent), however much depends on deductible limits and Medicare reimbursements. Any amount not covered by insurance is written off by the department for residents. Strayer’s charts show that the cost for a single ambulance run has increased to $995.

The proposed $4 million budget for 2027 breaks down as follows: $2.5 million for pay and benefits, $827,000 for equipment and vehicles, and $627,000 for operations and other expenses. The 2026 budget was $2.3 million, and the proposed increase comes from the second crew, additional medical equipment, increased vehicle maintenance, and the replacement ambulance.

If the levy fails, Strayer said the IL EMS Board will need to explore other funding options, coupled with the prospect of longer wait times. He also mentioned that the lack of sufficient automated equipment, such as the power cots, could increase medic injury and workers compensation claims.

Chief Strayer personally answered the door before the interview, and he said this is common. He said that anyone is welcome to walk in for a visit at 280 N. Oak St., Lakeview.

While visiting, the public is also welcome to view the accounting books and expenditures of IL EMS.