KEEP LOCAL AMBULANCE SERVICE STRONG
Renew the Madison & Ruby Valley Rural Ambulance District
Residents of the Madison and Ruby Valleys will soon vote on renewing the Madison & Ruby Valley Rural Ambulance District, which helps support local emergency medical services based at Madison Valley Medical Center in Ennis and Ruby Valley Medical Center in Sheridan.
This locally controlled funding helps ensure that trained EMS crews, ambulances, equipment, and training remain available to respond to emergencies across our large rural service area.
Ballots will be mailed in April and must be returned by May 5, 2026.
Watch for Ballots in Mid April
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Return Mail Ballot by May 5, 2026
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Support Our Local Ambulance District
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Watch for Ballots in Mid April ✳︎ Return Mail Ballot by May 5, 2026 ✳︎ Support Our Local Ambulance District ✳︎
Ballots mailed: April 2026
Ballot return deadline: May 5, 2026
Reliable emergency medical services help ensure that when someone calls for help, trained responders are ready to answer.
Important Dates
The proposed measure continues existing funding for local emergency medical services—it is not a new cost, but is slightly more than what property owners are currently supporting.
For most property owners, the estimated annual cost would now be about $26.39 per $100,000 of assessed property value.
Estimated annual cost to property owners:
• $26.39 per $100,000 of assessed property value
• $72.52 per $300,000 of assessed property value
• $147.05 per $600,000 of assessed property value
This funding helps ensure ambulance crews, vehicles, and equipment remain ready to respond when emergencies occur.
Cost to Property Owners
RURAL EMS - A LIFELINE FOR OUR COMMUNITIES
Why This Matters
Emergency medical services must be ready long before a call comes in.
Maintaining a reliable EMS system requires:
Trained EMTs and paramedics on duty
Ambulances fully equipped and ready to respond
Continuous training and certification
Vehicles capable of traveling long distances across rural terrain
When emergencies happen, our communities depend on trained responders being ready immediately.
EMS Serves the Whole Community
EMS crews respond to emergencies across the region, including:
• Highways and county roads
• Ranches and homes
• Community events and gatherings
In 2025, EMS teams provided standby coverage for 19 community events, including football games, rodeos, and other local gatherings to ensure medical care was immediately available if needed.
Local Support is Important
Ambulance services bill insurance when patients are transported, but these payments only cover part of the actual cost of providing emergency medical services.
Insurance reimbursement:
• Pays only after a patient is transported
• Covers only a portion of the cost of care
• Does not pay for staffing, readiness, or standby coverage
Like fire protection and law enforcement, EMS is an essential public safety service that communities often help support locally.
EMS Readiness in Our Communities
EMS crews operate 24 hours a day, 365 days a year
Ambulances have an approximately two-minute response time
Crews provide Advanced Life Support care
Full-time staff, on-call responders, and additional trained personnel are needed to ensure reliable coverage.
EMS By the Numbers
1,003 EMS CALLS IN 2025
Madison Valley EMS
578 calls for service
Ruby Valley EMS
425 calls for service
• Medical emergencies
• Trauma incidents
• Patient transports
• Community standby coverage
Demand for EMS services continues to grow across the Madison and Ruby Valleys.

