By Ambulance Taxing District Board

The Rugby Ambulance Tax District is asking residents to consider an increase in the local mill levy to help sustain and strengthen the Rugby ambulance service, an essential resource that has quietly operated at a financial loss for more than a decade.

Rugby EMS has been owned and operated by Heart of America Medical Center (HAMC) since 2012. While the transition relieved the community of directly managing the service, it also shifted the financial responsibility to the hospital. Since that time, the ambulance service has consistently operated at a deficit, with HAMC covering the shortfall to ensure emergency care.

Statewide, there are more than 100 ambulance services in North Dakota. Of those, only about nine are owned and operated by critical access hospitals like HAMC, making Rugby’s model relatively uncommon.

The Rugby Ambulance Taxing District board members say the rising cost of providing modern emergency medical services is a key factor behind the funding gap.

Rugby Ambulance has faced rising costs in maintaining a reliable fleet. In 2021, the service purchased a new ambulance for approximately $172,000, yet just a few years later, that vehicle is already nearing the point of replacement. By 2025, the cost of a new ambulance had climbed significantly, with another unit purchased for $240,000.

These high expenses are compounded by the heavy use each vehicle endures. Ambulances are routinely traveling long distances to provide critical care, and in the last fiscal year alone, the Rugby crew completed 217 interfacility transfers to Minot, Bismarck, Grand Forks and Fargo. This level of use results in substantial wear and tear, leading to increased maintenance needs and accelerating the timeline for replacement.

Among the other expenses are the tools required to deliver high-quality, life-saving care. Cardiac monitors, commonly known as LifePak units, cost between $45,000 and $50,000 each. These devices provide critical functions such as EKG monitoring and allow the ambulance crew to transmit patient data directly to emergency departments before arrival.

Additional equipment, like automated chest compression devices used during CPR, can cost around $20,000 each. These machines help ensure consistent, high-quality compressions during cardiac emergencies, improving patient outcomes.

Beyond equipment, staffing and training requirements have also increased substantially. Emergency medical personnel must meet continually evolving certification standards, requiring more advanced, and costly, education and ongoing training. Maintaining a skilled workforce capable of delivering advanced care in rural settings has become a continuous challenge.

Despite these pressures, Rugby EMS continues to offer a level of service that stands out among rural communities.

The service is staffed 24 hours a day, seven days a week, with a paramedic, providing an advanced level of emergency care not always available in rural ambulance services. This ensures that residents receive a higher level of care immediately when emergencies occur.

The Ambulance Tax District Board emphasizes that the strength of Rugby’s ambulance service is directly tied to the hospital’s support. However, with healthcare systems facing increasing financial strain, sustaining that support without additional community funding is becoming more difficult.

The proposed mill levy increase would help offset operational costs, maintain current service levels and ensure the ambulance remains equipped with up-to-date technology and highly trained staff.

Those that reside in the Rugby Ambulance Tax District will have the opportunity to vote on the proposed increase on June 2 from 8 a.m. – 7 p.m. at Heart of America Medical Center. The Ambulance Taxing District Board members encourage voters to consider the long-term impact of maintaining strong emergency medical services in the region. Vote YES to support your local ambulance service.

For more information, please contact rugbyambulancedistrict@gmail.com.