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Emergency Medical Services (EMS) Levies

This page provides an overview of emergency medical services (EMS) levies for local governments in Washington State, including a comparison of 6-year, 10-year, and permanent levies, levy lid lifts, and examples of local EMS resolutions and ordinances.

For a more comprehensive discussion of the intricacies of the property tax in Washington State, refer to MRSC's City Revenue Guide and County Revenue Guide, or the Department of Revenue's Property Tax Levies Operations Manual.


Local governments in Washington State may, with voter approval, impose a property tax of up to $0.50 per $1,000 assessed value for emergency medical services (EMS) under RCW 84.52.069.

The revenues may be used only for the provision of emergency medical care or emergency medical services, including related personnel costs, training for such personnel, and related equipment, supplies, vehicles and structures needed for the provision of emergency medical care or emergency medical services (see RCW 84.52.069(5)).

The levy may last for 6 consecutive years, 10 consecutive years, or permanently. There are different requirements depending on which option is selected.

Who Can Impose an EMS Levy?

An EMS levy may be imposed by any city, town, county, fire protection district, regional fire authority, EMS district, urban EMS district, or public hospital district, as long as no other taxing jurisdiction within its boundaries has already imposed an EMS levy. For instance, if a city is annexed to a fire protection district that levies an EMS levy of $0.30 per $1,000 assessed value, the city cannot impose its own EMS levy. There are special provisions for countywide EMS levies – see below.

6-Year and 10-Year EMS Levies

The initial imposition of a 6-year or 10-year EMS levy requires at least a 60% supermajority vote, subject to validation (minimum voter turnout) requirements as discussed further down on this page. The only exception, under legislation passed in 2018, is for newly formed fire districts, which can pass an initial 6-year or 10-year EMS levy with a simple majority vote and no validation if its entire geographic region was subject to EMS levies immediately prior to the regional fire authority’s creation (RCW 84.52.069(2)).

For the “subsequent renewal” of a previously imposed EMS levy – often referred to as a “continuation levy” – a simple majority vote is all that is required, with no validation. (Previously, a simple majority vote was only allowed for an “uninterrupted continuation,” but that language changed with 2018 legislation.)

Unlike a permanent EMS levy, temporary 6-year or 10-year levies do not require separate accounting or the adoption of a referendum procedure.

Permanent EMS Levies

A permanent EMS levy requires a 60% supermajority vote, subject to validation (minimum turnout) requirements as described further down on this page. In addition, any taxing district imposing a permanent EMS levy must account separately for the receipt and expenditure of the EMS levy monies and provide a statement of accounting that is updated at least every two years and made available to the public upon request at no charge (RCW 84.52.069(3)).

For a permanent EMS levy, you must also provide for a referendum procedure to apply to the ordinance imposing the tax, as provided in RCW 84.52.069(4), regardless of whether or not your jurisdiction otherwise has powers of initiative and referendum. The referendum procedure must specify that a referendum petition may be filed at “any time.” The procedures and requirements of this referendum provision are exclusive to the EMS levy adopted and supersede the procedures provided under all other statutory or charter provisions for initiative or referendum.

However, EMS levies tend to be pretty popular, and we are not aware of any recent EMS levy referendums that have been attempted.

Comparison of 6-Year, 10-Year, and Permanent EMS Levies

  6-Year or 10-Year Levy Permanent Levy
Requirements for initial imposition 60% supermajority with validation 60% supermajority with validation
Requirements for subsequent renewal Simple majority; no validation N/A
Separate accounting required? No Yes
Referendum procedure required? No Yes

Countywide EMS Levies

Any county may submit a countywide EMS levy to voters. However, if the county contains any cities with a population in excess of 50,000, the county must first get city legislative body approval from at least 75% of those cities located within the county (RCW 84.52.069(6)).

If a county has imposed an EMS levy at the maximum rate of $0.50 per $1,000 AV, no other taxing jurisdiction within the county may impose an EMS levy.

However, if a county has imposed an EMS levy below the maximum $0.50 rate, any eligible taxing jurisdiction within the county may still impose its own separate EMS levy, as long as the combined rate does not exceed $0.50. For instance, if a county imposes a $0.30 EMS levy, a fire district within the county could still impose a $0.20 EMS levy. However, if the county ever increased its EMS levy to the maximum $0.50, the EMS levies of any other taxing districts within the county would be eliminated.

No taxing district may place an EMS levy on the ballot at the same election as a countywide EMS levy. If the county imposes a temporary 6-year or 10-year EMS levy below the maximum $0.50 rate, any subsequent temporary EMS levy approved by a taxing district within the county must expire at the same time as the countywide levy.

There are also two specific exceptions for the cities of Bothell and Milton, both of which lie partially within King County (which has a countywide EMS levy) and partially within another county that does not impose an EMS levy (Snohomish County and Pierce County, respectively). In Bothell’s case, the city has established an urban EMS district under RCW 35.21.762 to collect an EMS levy within the Snohomish County portion of the city only. In Milton’s case, the city is exempted from the King County EMS levy under RCW 84.52.069(10).

Ballot Measure Requirements

An EMS levy may be presented to the voters at any special, primary, or general election. The statute says the levy must be submitted at a “special or general election,” which at first glance might seem to rule out the August primary election. However, RCW 29A.04.321(2), which establishes the election schedule for local governments, authorizes the county to call up to four “special elections” each year, including the primary election. So for these purposes, “special election” includes the primary election.

The ballot proposition must follow the general format provided in RCW 29A.36.210. For examples of both temporary and permanent EMS ballot propositions, see the examples further down on this page.

For information on the ballot measure process generally, including election timing considerations, voters' pamphlets, pro/con committees, and more, see our page Local Government Ballot Measures.

EMS Levy Lid Lifts

EMS levies, like all regular levies, are subject to the 1% annual levy lid limit (sometimes known as the 101% limit) under RCW 84.55.010. This means that the levy amount – the total revenue generated by the EMS levy – may not increase more than 1% per year, plus add-ons for new construction, new annexations, increases in state assessed properties, and construction of certain renewable energy generating facilities.

For jurisdictions with a population of 10,000 or more, the increase is capped at 1% or the rate of inflation, whichever is less. For more details, see our page on the Implicit Price Deflator.

The EMS levy rate is calculated based on your jurisdiction’s total levy amount divided by its total assessed valuation:

Mathematical calculation showing EMS levy amount divided by assessed valuation equals EMS levy rate

Because all property tax levy amounts may not be increased more than 1% each year (plus add-ons), if your jurisdiction’s assessed valuation is increasing faster than the 1% cap, your levy rate will start to decrease. For instance, if your voters initially approved an EMS levy of $0.50 per $1,000 AV, you may find after a few years that your EMS levy rate has dropped to $0.40.

If you wish to increase your levy rate back to the rate originally approved by voters – which requires increasing your total levy amount more than 1% – you have two options:

  1. If your jurisdiction has taken less than the maximum 1% increase in a previous year: You can use your remaining “banked capacity” (RCW 84.55.092) to increase your levy more than 1%. For more information, see our webpage on Property Tax in Washington State.
  2. If you do not have banked capacity and your levy rate is less than the maximum rate approved by your voters: You can submit a levy lid lift (RCW 84.55.050) to voters, requiring simple majority approval. For more information, see our Levy Lid Lifts page.

However, note that you cannot use a levy lid lift to increase the levy rate above the EMS levy rate initially approved by voters. For instance, if voters approved a permanent $0.30 EMS levy, you cannot increase the rate to $0.50 through a levy lid lift. To raise the EMS levy rate above $0.30, you would need to submit a new permanent EMS levy to voters (see RCW 84.52.069(8)).

Validation Requirements

Permanent EMS levies, as well as the initial imposition of a 6-year or 10-year EMS levy, must meet validation (minimum voter turnout) requirements. Validation means that the ballot measure must meet at least one of the following two requirements:

  • 40% minimum turnout: At least a 60% “yes” vote AND the number of voters voting on the proposition must be at least 40% of the number of voters who cast ballots in the most recent state general election, OR
  • “Backdoor” provision if turnout is under 40%: If the number of voters voting on the proposition is less than 40% of the number of voters who cast ballots in the most recent general election, the number of “yes” votes must be at least 60% of 40% (or, in plain English, 24%) of the number of votes cast in the most recent state general election. This means the measure can still pass with less than 40% turnout, but the required “yes” percentage starts climbing above 60%.

Validation is not a problem for most jurisdictions in most years, but it can create issues in low-turnout elections (particularly special elections in February or April) following a high-turnout general election (particularly the presidential election that takes place every four years).

Validation is not required for a 6-year or 10-year continuation levy, an EMS levy lid lift, or for the initial imposition of a 6-year or 10-year EMS levy in a newly formed regional fire authority whose entire geographic region was already subject to an EMS levy.


Washington state law limits the amount of property taxes that may be imposed on any property – in particular, there is the $5.90 statutory limit and the $10 constitutional limit (also known as the 1% constitutional limit). For a better understanding of these concepts, see our page Property Tax in Washington State.

If either the $5.90 or $10 limits are exceeded, local property tax levies must be reduced or eliminated – a process known as prorationing – until the combined levy rates are reduced to $5.90 or $10, respectively. State law establishes a “pecking order” of which jurisdictions’ levies will be reduced or eliminated and in what order, depending on which limit was exceeded.

EMS levies are exempt from the $5.90 statutory limit under RCW 84.52.043, so if the $5.90 limit is exceeded there will be no impact on EMS levies.

However, EMS levies are still “regular” levies subject to the $10 constitutional limit. If the $10 constitutional limit is exceeded, the EMS levy could potentially be reduced through prorationing, but this is unlikely as there are many other local levies that would be reduced first (see RCW 84.52.010). In short, EMS levies are unlikely to be affected by prorationing.

Examples of EMS Levy Resolutions and Ordinances

6- and 10-year EMS Levies

Permanent EMS Levies

EMS Levy Lid Lifts

EMS Levy Resolutions/Ordinances of Substantial Need

Other EMS Levy Documents

Recommended Resources

Last Modified: May 16, 2023