A single, brand-new, ambulance sits outside of the Calhoun County EMS building in Rockwell City. Once it gets the registration from the state, it'll be up and running. Though, most days, Calhoun County only has the staff to provide a single ambulance for the entire county.
"Our community is stressed, really stressed, really pulled to the max to cover what is needed," said Luke Winkelman, interim director.
Some days another one-person crew serves as a backup and can respond when the other ambulance crew is on another call. Though, that one-person crew needs a driver to take someone to a local hospital.
Winkelman says the county hasn't missed any EMS calls, but there are times when people are put on hold waiting for an ambulance.
"The people that are still left [working] are going for broke, emotionally and physically," Winkelman said, describing long shifts and extra overtime for the five workers still serving.
Last year, KCCI Investigates traveled to Calhoun County after some workers left because of a change in pay. Now, the number of employees is basically half what it was a year ago.
The county is actively looking for people who want to become EMS workers, Winkelman says they'll pay for training.
"We're looking for strong applicants that have a strong desire to care for their community and help where it is needed most," he said.
Voters in Calhoun County turned down a chance to deem EMS "essential" and raise taxes to better fund the service. Calhoun County was one of three in the state who turned it down, voters in five others approved the move.
Calhoun County is one of three to receive a $50,000 grant to test a new state pilot program that treats EMS like Uber. The app, once implemented, will send the closest staff member to respond to an emergency before and ambulance can arrive. Winkelman just hopes he has the staff.
"I would be lying if I said I wasn't struggling to get the Iowa United First State off the ground, as well as meet the needs of EMS," he said.
KCCI Investigates has spent more than a year uncovering problems with Iowa's Emergency Medical Services. To watch an eight-part series, click here.