October 9, 2024

Table 1: Summary of Laws Pertaining to Local Government Autonomy and Local EMS Funding Mechanisms, in Effect as of January 31, 2022

This table is part of the Emergency Medical Services (EMS) Home Rule State Law Fact Sheet.
The list included five US states: Alabama, California, Georgia, Massachusetts, and Ohio.

Overview

The Emergency Medical Services (EMS) Home Rule State Law Fact Sheet was created to describe the influence of local government autonomy on emergency medical services and its relation to cardiovascular disease outcomes in medically underserved communities.

Data sources

Table 1, Summary of Laws Pertaining to Local Government Authority and Local EMS Funding Mechanisms
	Alabama	California	Georgia	Massachusetts	Ohio
Permitted Local Taxes	Property	Property Sales Realty Transfer	Property Sales/Excise	Property	Property Sales Realty Transfer
Special Districts Authorized	Tax Increment (state authorization required)	Fire Services Hospital Emergency Medical Services Community Services Health	Tax Fire Services General Services	Tax Fire Services Special Improvement	Tax Fire Services Hospital Emergency Medical Services
Local Fees Authorized	User/Services Fees	User/Services Fees	General Fees User Fees Impact Fees License Fees	User/Services Fees License Fees	User/Services Fees
Local Tax Restrictions	Alabama	California	Georgia	Massachusetts	Ohio
Authorized Public Purposes for Local Property Taxes	Debt Repayment Capital Expenditures Hospitals General Health Care	Debt Repayment Capital Expenditures Fire Services Public Safety Health Hospitals	Debt Repayment Hospitals Fire Services Emergency Medical Services Capital Expenditures Health Public Safety	(None Identified)	Debt Repayment Hospitals Fire Services Emergency Medical Services Capital Expenditures Health
Property Taxes Assessed	Annually	Annually	(None Identified)	Annually	Annually
Maximum Tax Assessment Rate	(For Counties^a) General Property: 5% Debt Repayment for Infrastructure Projects: 25% Additional 10 mills per $100 authorized for hospital expenditures Additional 4 mills per $1.00 for hospital expenditures	General Property Tax: 1% Property Tax for Debt Repayment: 4% Sales Tax: 2%	Sales Tax: 1% Property Tax for Hospitals: 7 mills Municipal Development Property Tax: 3 mills Non-Residential Real Property Tax for Community Improvement: 2.5%	Maximum Municipal Property Tax Assessment Rate: 2.5%	General Property Tax: 1% or 10 mills Property Tax for Hospitals: 1 mill Realty Transfer: $0.30/$100
Circuit Breaker Programs	General Population Age Veteran Status Disability Income	General Population Age Veteran Status Disability Income	Age Income Veteran Status	General Population Age Income Veteran Status Disability	Age Disability
Split Rate Land Tax	(None Identified)	For Improvements Only	(None Identified)	(None Identified)	(None Identified)
Other Limitations	Geographic Limitations Minimum Population	(None Identified)	(None Identified)	(None Identified)	(None Identified)
Local Government Bond Restrictions	Alabama	California	Georgia	Massachusetts	Ohio
Permitted Local Government Bonds	Municipal Bonds Revenue Bonds General Obligation Bonds	Municipal Bonds Revenue Bonds General Obligation Bonds Special Purpose Bonds	Revenue Bonds General Obligation Bonds Special Purpose Bonds Tax Increment Bonds	Municipal Bonds	Municipal Bonds Revenue Bonds General Obligation Bonds
Authorized Public Purposes for Local Government Bonds	Capital Expenditures General County Purposes Hospitals Fire Services Public Safety Municipal Infrastructure	Capital Expenditures General County Purposes Hospitals Fire Services Public Safety Municipal Infrastructure Emergency Medical Services	Capital Expenditures General County Purposes Hospitals	Capital Expenditures Municipal Infrastructure	Capital Expenditures Hospitals Fire Services Public Safety Emergency Medical Services
Bond/Debt Percent to Not Exceed^b	75% of annual proceeds from local special tax^c	Up to 85% of the county’s income or revenue for the fiscal year^d Percentage of the local government’s assessed property value^e	10% of local government’s assessed property value (general limitation)^f 75% of all taxes levied from preceding fiscal year (temporary)^g	Total taxes levied from preceding fiscal year (temporary borrowing)^h,i 10% of local government’s assessed property value^h,j	2% of the local government’s assessed property value for hospital construction & 1 mill per taxable dollar for maintenance^k 75% of estimated proceeds of special taxes levied^l
Other Limitations	Maximum Term Geographic Limitations	Maximum Term Maximum Interest Rate	Maximum Term Maximum Interest Rate	Maximum Term Amount Borrowed	(None Identified)
Voter Overrides, Voter Approval, and Public Awareness	Alabama	California	Georgia	Massachusetts	Ohio
Override Limits	“Hard ceiling”: Voters may override the general tax limits up to a specified maximum.^m	No general override of 1% tax limit, but tax limit is not applicable to some specific taxes or special assessments to cover bonds.	No general property tax limit to override.ⁿ Specially authorizes property taxes, such as a tax authorized for hospitals, may have limits that cannot be overridden.	Tax limit can be overridden with supermajority vote.	Property tax limit can be overridden by a majority vote or a charter provision.
Requires Voter Approval	Additional taxes to fund hospitals. Adjustment of tax assessment ratios.	Tax rate increases Special taxes Special district borrowing to be repaid through taxation Establishment of special districts authorized to impose taxes and provide services Issuance of bonds	Imposition of sales tax Issuance of bonds Creation of special districts or redevelopment zones	(None Identified)	Hospital tax in excess of the general 1% limit.
Requires Public Hearings and Notices	Public hearings and notices required for debt and for the creation of “emergency assistance programs,” including those related to ambulance services.	Public hearings and notices required for mutual aid contracts for services such as emergency medical services and police, and fire suppression assessments. Public notices required for short term borrowing.	Public hearings and notices required for municipal bonds. Public notices required for development impact fees which can pay for emergency, rescue, and other facilities.	Public hearings required prior to issuance of local bonds.	(None Identified)

October 9, 2024

Sources Print Share

Content Source:

National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); About the Division for Heart Disease and Stroke Prevention

Table 1: Summary of Laws Pertaining to Local Government Autonomy and Local EMS Funding Mechanisms, in Effect as of January 31, 2022

About

Overview

Data sources

Local Tax Restrictions

Local Government Bond Restrictions

Voter Overrides, Voter Approval, and Public Awareness

Emergency Medical Services (EMS) and Community Paramedicine