In an emergency, it matters where you live.

People in rural areas usually have to wait longer for ambulances to arrive. But the Iowa Emergency Medical Services Association is trying to change that. They want the legislature to make EMS an "essential service." That's how police and fire are labeled now, opening up more funding. Decades ago, Iowa made EMS "optional." Now, advocates say times have changed, especially in rural Iowa.

"Where you live can determine if you live in rural Iowa. It's a terrible feeling," said Brad Ratliff, Tipton's EMS director.

That's the reality Ratliff faces. As the director of Tipton's Emergency Medical Services, he sees the staffing issues his volunteer group faces.

"Sometimes there aren't volunteers to staff calls. Sometimes there's a limited access to them," said Ratliff.

Without enough trained volunteers, backup has to come from father away. Ratliff said the legislature could change that all by declaring his ambulance services as "essential."

"We would be able to get care to our communities faster with the right care from the right people every single time," said Ratliff.

The issue is that funding has to come from somewhere. The Iowa Emergency Medical Services Association has suggested some ideas but it would mean shifting money or raising taxes. That money would be used to pay for staff, training, and equipment, things that towns like Tipton have very little of.

"Rural services would have the same guarantee of an ambulance 24 hours a day that urban areas do," said Sandy Heick with the Iowa Emergency Medical Services Association, "People are dying because ambulances aren't responding or aren't responding in an appropriate time,"

Time that matters when seconds can make the difference.

"It's very frustrating to run 20-30 minutes to back up volunteer services that can't staff the ambulance and knowing that that extra time to get there can be the difference between life and death," said Heick.

Iowa EMS is planning an action day at the legislature this February.