Ballots to be Mailed April 16

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Return Mail Ballot by May 5, 2026

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Support Our Local Ambulance District

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Ballots to be Mailed April 16 ✳︎ Return Mail Ballot by May 5, 2026 ✳︎ Support Our Local Ambulance District ✳︎

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.

The current four-year levy is due to expire in 2026.

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.

Ballots mailed: April 16, 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 renews funding for local emergency medical services for another four years. It is not a new cost, but it does represent a modest increase from current levels.

For most property owners, the estimated annual cost would now be about $25.84 per $100,000 of assessed property value, approximately $2 more than in 2025.  

Estimated annual cost to property owners:

• $25.84 per $100,000 of assessed property value
• $77.52 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.

Growing Demand for EMS Services

Demand for EMS services continues to increase across the region, with call numbers steadily rising.

Local EMS teams now respond to hundreds of calls each year across a large rural service area, with steady increases driven by population, visitation, and year-round activity.

In 2025 alone:

  • Madison Valley EMS responded to 578 calls

  • Ruby Valley EMS responded to 425 calls

These calls include everything from life-threatening emergencies and trauma incidents to interfacility transfers and community standby coverage.

Behind every one of those calls is a team of highly trained professionals.

Madison Valley EMS call volume has increased by nearly 46% in just three years:

  • 396 calls in 2022

  • 463 calls in 2023

  • 530 calls in 2024

  • 578 calls in 2025

Ruby Valley EMS saw a sharp rebound in 2025, with call volume up more than 20% in a single year:

  • 365 calls in 2023

  • 353 calls in 2024

  • 425 calls in 2025