EMS Funding
Frequently Asked Questions

Read a Statement from the EMS District Commissioners on why this funding option is being pursued.

Star News – April 4, 2024

Dear Residents of Valley County,
We reach out to you today concerning a pivotal issue that affects each one of us – Emergency Medical Services (EMS) in Valley County.

Since our appointments last December, we have embraced the challenge of establishing the Valley Countywide EMS District. With unwavering support of Valley County officials and invaluable insights from Fire District Boards and their staff, we have made strides in understanding our current system of emergency ambulance services. This system, built on efficiency and cost-effectiveness, faces a critical challenge – adequate funding.

The reality we confront is stark. The model under which our EMS operates was designed in an era of volunteerism and significantly lower operational costs. As costs have risen, our fire districts have generously filled the financial gap, a situation that is unsustainable. It is with a clear understanding of our duty, that we have proposed a permanent levy override measure in the upcoming May election.

This decision was not made lightly.

We acknowledge the impact of this measure on our community and assure you it would not be pursued if any viable alternative existed.

In the weeks ahead, we commit to providing transparent, factual information about the necessity of this levy override. Our intention is not to pressure, but to provide you with knowledge, enabling you to make an informed decision that aligns with your values and circumstances. We have launched a dedicated website for the District, designed to address all conceivable questions from residents, valleycountywideems.com.

Additionally, we are committed to being accessible to every resident for any queries that we might not have anticipated (see contact information below).

The strength of our community lies in our collective action. We urge you to engage with this issue, to understand the implications of the proposed measure, and most importantly, to exercise your right to vote. It is through your participation that the future of our EMS services will be decided.

With gratitude and in service,

The Commissioners of the Valley Countywide Emergency Medical Services District
Cascade Sub District: Ronn Julian
Donnelly Sub District: Travis Smith
McCall Sub District: Greg Irvine


Contact Information:

General Questions

What is the ballot measure I am voting on?

On May 21, 2024, registered voters in Valley County will vote on a measure to provide seperate, sustainable funding for EMS services:

An EMS levy rate increase of .0002423 ($24.23 per $100,000 of taxable value) is proposed to fund EMS services throughout Valley County.

How many votes does the levy rate increase need to pass?

This measure must pass by a two-thirds supermajority, or 66 and 2/3 percent.

Wasn't this on the November ballot?

Yes. In November 2023 voters approved the new EMS district but the funding mechanism was not put in place. The proposed levy rate increase on the November ballot failed by just 48 votes.

Where can I vote on May 21st?

POLLING LOCATIONS (open 8am – 8pm on May 21st):
▪️ American Legion Hall at 105 E. Mill Street in Cascade will be the polling location for the Alpha, Cascade and West Mountain precincts.

▪️ Donnelly Bible Church at 159 FW Gestrin Street in Donnelly will be the polling location for the Donnelly and Roseberry precincts.

▪️ Idaho First Bank at 475 Deinhard Lane in McCall will be the polling location for the McCall and Payette Precincts.

Not sure which precinct you are? Find your location here.

EMS Funding Questions

How is the EMS District currently funded?

The current EMS district levies .00012 (or $12 per one hundred thousand of taxable value).

This provides the current EMS district with $1.2 million annually.

The original EMS district was formed in 2009 and was overseen by the Valley County Commissioners. The District was originally formed to maintain a volunteer ambulance service.

Why are there current budget shortfalls?

The current levy rate was originally set in 2009 and provided for an annual EMS budget of $740,000, three times less than what EMS service providers had asked for. This was based mostly on the assumption that the district could rely on volunteer ambulance services.

However, what worked in 2009 is not working in 2024. For example, in 2009, the Cascade Rural Fire Protection District had only three full-time staff members and 24 local volunteers. Today, they have nine full-time staff members and four local volunteers.

How are budget shortfalls currently being covered?

While funded separately, EMS services are provided by the fire districts. Historic funding shortfall has been subsidized by the fire districts, a burden that is unsustainable for all stakeholders. 

What will EMS funding be used for?

The new levy rate will generate a $4.06 million annual budget that will fund staffing, equipment, and maintenance of EMS services for all communities in Valley County. 85% of the budget will go toward personnel costs.

I thought the fire departments provided EMS Services. How are they different?

Under the county levy-based tax system, EMS services are funded separately from fire services.

Current Valley County taxing districts include:

  • Valley Countywide EMS District
    • Revenue is generated under the county levy-based tax system, as defined by state statue.
    • The EMS district has an independent and separate board of commissioners from the County and Fire Districts.
  • Cascade Rural Fire District
  • Donnelly Rural Fire Protection District
  • McCall Fire Protection District

While funded separately, EMS services are provided by the fire districts.

In some counties (i.e. Ada County), EMS services are completely separate.

In Valley County, EMS services are provided by the fire districts for two primary reasons:

  1. It is more cost effective. Rather than maintaining separate buildings, overhead, supplies, management, personnel, etc., EMS services can be paired with existing fire department infrastructure for mutual benefits.
  2. Surge capacity. Fire districts work to cross-train personnel for both fire and EMS calls.

Overall, this model saves taxpayers money and provides higher quality emergency services.

Can the new fire district impact fee revenue be used to subsidize EMS services?

In recent discussions of impact fees, it is also important to note that EMS and Fire are separate, and the fire district impact fees are not used to support EMS services.

Levy Rate Questions

What is the current levy rate and what is the proposed rate increase?

An EMS levy rate increase of .0002423 ($24.23 per $100,000 of taxable value) is proposed to fund EMS services throughout Valley County.

The current EMS levy rate is .00012 ($12 per $100,000 of taxable value).

This increase would bring the levy rate up to .000359 ($36.23 per $100,000 of taxable value) and increase the overall EMS District funding from $1.32 million to $4.06 million annually.

“Taxable Value” is assessed value less the $125,000 homeowner exemption (if applicable)

What is the wording of the Levy Rate question on the ballot?

INSTRUCTIONS: To vote in favor of the Special Tax Levy, place an X in the square at the left of the words “IN FAVOR OF.” To vote against the Special Tax Levy, place an X in the square at the left of the word “AGAINST.” If you change your mind, tear, or make a mistake on this ballot, request a new ballot from an election worker.

QUESTION: Shall the Board of Commissioners of the Valley Countywide EMS District be authorized and empowered to increase its levy and budget, pursuant to Idaho Code Section 63-802(1)(a), to defray its costs of staffing, equipping, and maintaining the District’s operations to provide ambulance transport and emergency medical services throughout Valley County. Specifically, an increase in the District’s budget from property tax, beyond the amount the District is currently authorized to levy pursuant to Idaho Code § 63-802, by the sum of TWO MILLION SEVEN HUNDRED FORTY TWO THROUSAND SIX HUNDRED THIRTY FIVE and No/100th Dollars ($2,742,635.00), commencing Fiscal Year 2024-2025, and which amount shall then be added to the District’s current established base budget amount for the purposes of Idaho Code § 63-802.

STATEMENT: The levy will be used to fund all District operations and will be a tax increase of $24.23 per $100,000 of taxable assessed value, per year, based upon current conditions.

How would this levy rate impact the EMS District budget?

This increase would bring the levy rate up to .000359 ($36.23 per $100,000 of taxable value) and increase the overall EMS District funding from $1.32 million to $4.06 million annually.

How is demand for EMS services rising in Valley County?

A 2020 study conducted by Emergency Services Consulting International (ESCI) projected (click for full report):

  • An overall increase in ambulance demand in Valley County of 58% by 2030.
  • 53% increase in the Cascade Rural Fire District
  • 42% in the Donnelly Rural Fire Protection District
  • 80% in the McCall Fire Protection District
  • An increase of 55% in the elderly population in Valley County by 2030

Fire departments report a significant increase in EMS calls over the last 10 years:

  • Donnelly: 100.6% increase in EMS calls in the last 10 years with an average run time of 80 minutes per call.
  • Cascade: 79% increase in EMS calls from 2010 – 2022.
  • McCall: 41% increase in EMS calls from 2010 – 2022.

The Valley County Master Facilities Plan estimates a population increase of 22% by 2030 (based on a ten-year growth rate) – click for full report.

The number of new homes being built in Valley County has increased 276% over the last 10 years (and 150% between 2019 and 2021 alone) – click for detailed numbers.

Idaho Transportation Department Automatic Traffic Counters located in Donnelly show – click here for the data::

  • A 30-year annual increase in vehicle traffic of 62.8%
  • A 20-year annual increase in vehicle traffic of 48.9%
  • A 24-hour annual average in vehicle traffic in the last 10 years of 44.5%

The Idaho Department of Commerce lodging tax collections for Valley County (an indicator of visitor volume) has increased 141% in the last five years.

The City of McCall 3% Local Option Tax on lodging properties has increased 314% over the last 10 years.

How do increasing assessed values impact the levy rate?

Under the levy-based system used in Valley County, as assessed values go UP, the actual levy rate goes DOWN because the levy rate is based on a set district budget.

Each year, all taxing districts (including the EMS district) set a budget via public hearing. To get the levy rate for that year, the district budget is divided by the total countywide assessed value.

Using the proposed $4.06 million budget for the new EMS district, we can see how the ACTUAL levy rate each homeowner is assessed decreases as the total assessed value increases.

Total Assessed Value
(less homeowner exemption)
Levy rate
(based on a $4.06 million budget)
2015 $3,237,384,744 0.00125
2016 $3,476,795,989 0.00117
2017 $3,667,484,423 0.00111
2018 $4,037,087,474 0.00101
2019 $4,520,402,102 0.00090
2020 $5,058,027,119 0.00080
2021 $6,356,789,852 0.00064
2022 $10,195,910,860  0.00040
2023 $11,258,100,713  0.00036


Key data impacting the future of EMS demand in Valley County:

Demographic Information:

Valley county has a population of 12,464 (2022) and grew by 26.4% (2,602 residents) between 2010-2022, ranking 6th for population growth out of the 44 Idaho Counties (U of I Indicators Idaho, 2023).

Approximately 15.1 million visitors come to southwest and north central Idaho every year, many of whom visit Valley County as a top tourism destination outside of the Treasure Valley (Idaho Tourism Data, 2023).

The median age in Valley County is 49.4 (2022), 10 years older than the median age in the US, and 12 years older than the median age in all of Idaho. 26.7% of the population is over the age of 65, compared to 16.6% in Idaho (U of I Indicators Idaho, 2023).


Economic Information:

In 2021, there were 12,162 housing units in Valley County. The number of housing units increased by 30% between 1980-1990, by 21.7% between 1990-2000, by 45.8% between 2000-2010, and 3.4% between 2010-2020. Between 2017-2021, housing units were 24.6% owner occupied, 5.7% renter occupied, and 69.7% vacant. The median value of owner occupied housing increased by 102.1% between 1980 and 2017-2021 and ranked 3rd of 44 counties in Idaho (U of I Indicators Idaho, 2023). A high level of second homes and vacation rentals likely accounts for these numbers, and has put a strain on the local housing market in Valley County (Boise Dev, Valley County Grapples With Housing Supply Shortage, April 2023).

The labor participation rate (the proportion of people 16 years old and older who are employed or available for work) is relatively low in Valley County at 54%. Wage per job ranked 20th (highest to lowest) of the 44 Idaho counties at $46,388 in 2021 and increased by only 0.8% between 2020-2021 (U of I Indicators Idaho, 2023). A livable wage in Valley County ranges from $15.75 per hour for a single person without children up to $55.41 per hour for a single person with three children–presumably due to the cost/scarcity of childcare in the region. Poverty wages are $6.53 per hour for a single person without children and $13.34 for a single person with three children (MIT Living Wage Calculator, 2023). The average home value in the county was $660,973 as of August, 2023 (Zillow, 2023).


Financial Information:

The overall operating cost of EMS service in Valley County is estimated to be $3,303,030.00 annually, not accounting for capital expenses (2023 Idaho EMS Resource Assessment Survey).

To help offset costs of capital expenses, on October 16, 2023, the Valley County Commissioners voted to adopt Fire District Impact Fees. Fire district impacte fees ARE NOT used to fund EMS services. Find more information here.

Articles and References for further reading:


Government Reports

Projected Growth -Master Facilities Plan Valley County


Volunteer Providers of EMS: Idaho Office of Performance Evaluations, Idaho Legislature


Valley County EMS Services Delivery Study – ESCI


News Articles

‘Huge safety concern’: Valley Co. feels EMS stress with limited funding


EMS in Idaho is Broken


Salmon River Ambulance District formally established


EMS providers struggle in rural Idaho, OPE reports


Waiting for help, Idaho Reports


Emergency Medical Services in Idaho: A County-Focused Resource Assessment 2023



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