Emergency measures

County medical centers seek to create special ambulance district

Citing an increase in demand for emergency services, as well as an ongoing, albeit expected budget deficit, Madison County’s two hospitals are asking the community to approve the creation of a special ambulance district.

The 12-mill request for $465,000 per year would raise 2021 property taxes by about $16.20 per $100,000 of property. The district, if approved, would not go into effect until 2023, so the actual amount will be slightly different in reflection of 2023 tax values.

Just over 6,000 letter notices notifying property owners of a 60-day petition period were sent from Madison Valley Medical Center and Ruby Valley Medical Center to residents whose properties lie within the potential district earlier this month, explaining the Resolution of Intent to create the Madison and Ruby Valley Rural Ambulance District. The letter also included info on the upcoming public hearing slated for Feb. 1, 2022.

If more than half of the residents in the district send letters of protest, the issue will be tabled for one year. If there is not a majority in protest, the commissioners will record a resolution calling for an election to create the new ambulance district. That resolution, said Madison County Clerk and Recorder Paula McKenzie, must be received by her office by Feb. 7, 2022.

If that occurs the ask will be on the May 3 ballot at the same time as school elections.

Only registered voters within the special district would be able to vote on the measure. If those voters approve the ask, the new district would be recorded, but would not be up and running until the start of 2023.

A few Madison County locales are excluded from the district, including Big Sky which is serviced by its own fire and ambulance district, and the northern portion of the county near Cardwell where the Jefferson Ambulance District provides service.

The current Ruby and Madison Valley Ambulance Districts already work together when calls come in. For example, if an emergency arises in Virginia City, depending on what’s taking place in Ennis or Sheridan, help could come from either hospital.

The Board of Madison County Commissioners will play a role in the process – they will be the ones managing the district’s annual income of $465,000 which will be split between the two hospitals. The idea is the funds will be split 50/50, though that has not yet been officially decided.

“That’s the opportunity here,” said MVMC CEO Alan Rohrback, “Is for both hospital ambulance services to work together, with joint training, education, and maybe even staffing, since finding welltrained EMTs and paramedics  in a rural area can be challenging. So, for us to be able to work together could be really beneficial.”

A website detailing the effort will go live soon at www. It will address a number of frequently asked questions and include a detailed map of the district’s boundaries.

A word from Madison Valley Medical Center

The private, not-for-profit Madison Valley Medical Center took over the Ennis area volunteer ambulance service on May 1 of this year. Since then, a combined total of 24 part time EMTs, including five paramedics and community back up crew members have joined the center’s ranks, not only running the 24/7 ambulance service but also working hand in hand with the emergency room crew, performing wellness checks on patients and transporting patients to larger hospitals when needed.

Since May MVMC has handled 280 calls for emergency service – notably taking in a whopping nine calls for service in one exceptional Friday in mid-May. With the extra crew the center’s ambulance service has maintained a two-minute period between an initial call and an ambulance leaving the parking lot, a number Rohrback conveyed with pride.

The center currently has one two-wheel-drive ambulance and one four-wheel-drive ambulance. Another four-wheeldrive ambulance is on the way thanks to $250,000 being raised via the Madison Valley Medical Center Foundation. That second FWD vehicle will be delivered as soon as the chip shortage is sorted. In the meantime, a loaner will be utilized for wintery trips.

As the level of service has increased, so has the need for more funding. MVMC’s ambulance service, which runs at a substantial operating loss, is a department of the hospital and part of the overall operating budget. The service has also received assistance from MVMC’s non-profit foundation. Additionally, ambulance services are reimbursed from Medicare Part B and other commercial outpatient health insurance coverages for medically necessary services.

The new district, said Rohrback, would allow for the MVMC to maintain the level of service the community has come to expect. So, what if the community votes down the special district, and the related rise in property taxes? Rohrback said his hospital’s ambulance service would not be impacted, but other hospital services would potentially affecting other programs and services.

“Madison Valley Medical Center will continue to provide the best emergency medical services possible, and keep up with the needs of the community, while continuing to seek options for financial support,” said Rohrback. “Our hospital has committed to providing EMS because it is such a vital component to our community’s welfare, and our goal is to provide the best services possible, especially those that are identified by our community as among the most important.”

A word from Ruby Valley Medical Center

Ruby Valley Medical Center took over the community’s volunteer ambulance service in 2017. The center’s 24/7 ambulance service funding structure is akin to MVMC. According to RVMC CEO Landon Dybdal the emergency team is a 16-person crew comprised of EMTs that volunteer for shifts, responding to calls but also working within the emergency room. Four of those crew members are paramedics.

In the last fiscal year, which ended Oct. 31, RVMC’s ambulance team responded to 324 EMS calls. The center has four active four-wheel-drive ambulances.

Dybdal said he sees the combined ambulance district as a benefit to all residents of the county.

“It allows us to work together and have better coverage over the entire county,” said Dybdal. “What this district will do is make sure that these services are sustainable in this county going far into the future.

Since 2017 RVMC’s ambulance service has run anywhere from $200,000 to $300,000 in the red. Dybdal says the additional special district funds would help fill that gap. Since Dybdal joined the RVMC team in June of 2019 he’s seen the number of emergency calls and ER visits increase along with the community’s population.

“If you want to make sure that EMS ambulance services are sustainable and able to function in this community far into the future, this is a good idea,” he said. “It’s going to help us to make sure we continue to provide excellent service now and into the future.” 

Make Top Lead Story on Website

More Information

The Madisonian

65 N. MT Hwy 287
Ennis, MT 59729

Cori Koenig, editor:
Susanne Hill, billing: 
Ad orders, inserts, classifieds: 
Comment Here