The Red Oak City Council unanimously approved EMS 28E agreements with area communities during its latest meeting.
The agreements involve Stanton, Villisca, Elliott, Grant, and Emerson.
City Administrator Lisa Kotter said Red Oak has been meeting with the communities since November 2025 about EMS coverage.
She said Red Oak is the only full-time paramedic-level service providing either full service or backup service to those communities.
Kotter said the original compensation request was reduced significantly after feedback from the communities. The proposed agreements are for two years.
Amounts discussed include $10,000 per year for Villisca, $7,141 for Stanton, $1,733 for Elliott, and $356 for Grant. Cotter said Stanton, Elliott, and Grant have approved their agreements. Villisca has been supportive but still had minor language changes under review.
Kotter said Emerson may consider using Malvern for service, but she said Red Oak wants to make sure residents understand Red Oak cannot serve as a free second-tier backup option.
Kotter said the two-year agreements are intended to give communities time to consider longer-term EMS funding options, including a possible referendum to make EMS an essential service or other methods such as a utility bill line item.
She said Red Oak’s fire and EMS department costs approximately $1.8 million to operate and that the city has tried to balance fairness to Red Oak taxpayers with the needs of nearby communities.
