Iowa Mass Gatherings — Iowa Admin. Code 641—ch. 19 (first aid and ambulance at 641—19.4(5))[1]
Summary
Iowa has no mass-gathering statute but does have a dedicated administrative rule chapter, 641—chapter 19, effective 18 March 1987 and adopted under the public health director's general authority at Iowa Code § 135.11. A "[m]ass gathering" means "an outdoor assembly which may be attended by more than 1,000 attendants for a period of more than 12 hours' duration." The scheme is notice-and-plan rather than permit-and-fee: any person planning one "shall notify the director of public health at least 30 days before the date event is scheduled to begin," with a plan addressing the chapter's requirements. The medical requirement is a single subrule, 641—19.4(5): "Each site shall be provided with an adequately staffed first aid station. Arrangements shall be made for ambulance service. There shall be some means of summoning an ambulance if required. The first aid station shall be readily accessible to ambulances." There are no clinician ratios and "adequately staffed" is undefined.
So what
Iowa's floor is thin but real, and because the rule never defines adequate staffing the event medical director effectively sets the standard of care — document a defensible staffing rationale (crowd size, duration, risk profile) inside the 30-day notice plan, since that document is what a regulator or plaintiff will read later. Coverage arrangements must run through Iowa-authorised EMS services, and closure is the state's enforcement lever, so a deficient medical setup can end the event mid-show. Expect the binding permit conditions, and any richer medical requirements, to come from the county rather than the state.