Three Ways to Pay for an Ambulance Around Summerset

Account 101-4220-42900 in Summerset's budget worksheet has one plain note next to it: "ambullance 77,565 and BH Fire 1,500." In 2025 and 2026 the city budgeted $35,257 on that line. For 2027, the request is $79,065. That's the cost of most of Summerset's emergency ambulance coverage, and it comes out of the city budget. It isn't a separate tax district.

Go a few streets in one direction, or a few miles in another, and the same service is paid for a different way. Inside Summerset city limits, one neighborhood pays an ambulance district levy on its property tax. Out on the unincorporated land toward Rapid City, homeowners have had Rapid City ambulance coverage at no cost to the county for more than twenty years, and that ends after December 31, 2026. If you're comparing a Summerset address with acreage just outside town, the ambulance is one more line item that changes with the address, and part of it is being decided this winter.

Six votes in December 2016

Summerset ended up with its own contract because of an election it narrowly turned down. On December 6, 2016, Meade County held a special election on expanding the Piedmont Ambulance District, with the polls at Summerset City Hall. The county auditor who signed that election notice was Lisa Schieffer, who is now Summerset's City Administrator.

The expansion failed. Meade County Commission minutes from November 9, 2018 record that the attempt to bring Summerset into the district "was defeated by six (6) votes." The same minutes explain why the district wanted it. About 25% of its calls came from Summerset, so the people inside the district, who paid the tax, were covering service for people who didn't. The district president said it had already used an opt-out the year before "to keep the ambulance district afloat."

At that meeting the district proposed redrawing its boundary to match its response area and leave Summerset City out. The district's attorney said the city would prefer to find another provider.

What Summerset's city contract covers

The other provider was Rapid City. In May 2019, Rapid City's Legal and Finance Committee took up an ambulance services agreement with the City of Summerset. Under it, Rapid City Fire Department responds to "all areas of Summerset that are not within the Piedmont Ambulance District." The terms work like this:

• Summerset pays a yearly fee set by a formula that uses the city's population, housing units and area.
• The fee can go up each year with the Medical CPI, and the whole formula is recalculated every five years.
• Patients who are transported are still billed at Rapid City's standard rates on top of the city's fee.
• It's a one-year agreement that renews automatically, and either side can end it with 90 days' notice.

The formula explains why the budget line moves. Every new rooftop in Summerset feeds into the fee calculation. The jump from $35,257 to the $79,065 request for 2027 matches what the Black Hills Pioneer reported this fall: Summerset pays Rapid City more than $77,000 a year for ambulance coverage. For a buyer, that means the cost of ambulance coverage inside most of Summerset is spread across the city's general budget rather than showing up as a separate ambulance levy.

Sun Valley Estates kept its original arrangement

Sun Valley Estates is the exception inside city limits. The 2018 minutes describe it as a Summerset neighborhood that was already in the Piedmont Ambulance District before the City of Summerset was formed. It is "already being taxed" for Piedmont Ambulance, and it "has strong support for the Piedmont Ambulance District." The district told commissioners it had no intention of ending service there, and noted it would make no sense for a Rapid City ambulance under the city's contract to be sent to Sun Valley Estates.

Piedmont EMS says it is based at the Piedmont Fire Department and serves Piedmont, Tilford, and parts of Summerset and Black Hawk. So two homes that both have Summerset addresses can be covered by different ambulance services and pay for them through different mechanisms.

The no-cost coverage outside town ends December 31

Ambulance coverage for unincorporated Meade County near Rapid City changes at the end of this year. Rapid City Fire Department took over ambulance operations from American Medical Response in 2003, and it has served southern Meade County ever since without a county contract. In a letter dated December 12, 2025, Chief Jason Culberson wrote that the department had done this "with zero subsidy." He also said rising costs and flat reimbursement made that impossible to keep up.

The Black Hills Pioneer's coverage of his presentation to Meade County commissioners gives the math. The service answers about 22,519 calls a year, and 2,655 of them are outside Rapid City limits. In the year before he spoke, it handled 255 calls in Meade County's unincorporated areas and 850 in Box Elder. A response outside city limits costs about $1,080, and Medicaid pays about $255 of that. About 72% of patients have government insurance that pays less than $9 a mile, against an average mileage cost of $20.59 per call. The department has 40 employees and four 24-hour ambulances, and Culberson wrote that it is "at max capacity" with no money to add units.

The letter set a December 31 deadline for a contract and noted that state law doesn't require the department to respond in other counties. KOTA covered the same warning in May 2026. Summerset made a version of this deal in 2019. Unincorporated Meade County never did, and now it has to.

What the November 24 hearing starts

Meade County commissioners approved initial resolutions for two new ambulance tax districts, East and South Central. They came out of months of public meetings and the county's Ambulance Working Group. The South Central district covers the rural area near Rapid City. It leaves out Piedmont and Summerset, and its eastern edge follows the Viewfield and Hereford voting precincts. Commission Chairman Gary Deering said the boundaries follow precinct lines to keep the elections organized. Box Elder isn't included either, and the Pioneer reported that the city has a grant to study a regional ambulance system.

Here's the order of steps the county laid out:

1. Public hearing at 10 a.m. on November 24.
2. The commission votes on whether the districts are in the county's best interest.
3. An election in each district within 60 days of that vote. If the vote happens on November 24, that means by January 24, 2027.
4. South Central has more than 1,000 people, so its election runs like a regular election, with polls open 7 a.m. to 7 p.m. and early voting allowed.
5. If voters approve, a second election chooses the district's board of trustees, and that board sets the budget and the levy.

The county attached budget scenarios to the resolutions. South Central has nearly $1.26 billion in taxable valuation. At a $150,000 annual budget, the county's sheet works out to $35.79 a year for a $300,000 house. At the highest budget listed, $1 million, it's $238.61. Deputy State's Attorney Ken Chleborad explained that a new district gets two years to set and adjust its budget and levy. After that, state law limits budget increases to 3% a year. The rules for forming a district and levying taxes are in SDCL chapter 34-11A.

Meade County has used another model before. The Rural Meade County Ambulance District on the west side of the county charges $75 per residence and $150 per commercial property. The South Central scenarios on the table are mill levies, so the dollar amount would rise with a property's taxable value.

Summerset is still paying attention even though it's outside both proposed districts. At the November 5 council meeting, Schieffer reviewed the proposal, said she may attend the November 24 meeting, and outlined "future actions that may be required of Summerset if approved."

Quick answers

Does Summerset's Rapid City contract show up as an ambulance levy on my tax bill? The 2019 agreement has the City of Summerset paying Rapid City a yearly fee, and that fee sits in the city's budget. Sun Valley Estates is the neighborhood inside city limits that pays the Piedmont Ambulance District levy.

If I'm covered, do I still get a bill for a ride? Under the Summerset agreement, yes. Transported patients are billed at Rapid City's standard rates on top of the city's fee.

Is this only a Meade County issue? Culberson's letters went to each county, city and township his department serves. The Pioneer also reports that state lawmakers have a task force studying 8 to 14 ambulance service regions across South Dakota, which lawmakers say would take years to set up.

All of this is general information, not legal, tax or financial advice, so please check how a specific property is taxed with the Meade County offices or your own tax professional.

If you're deciding between a Summerset address, Sun Valley Estates, or a few acres just outside town, I'm happy to help you figure out which ambulance arrangement each one falls under and keep an eye on the November 24 decision with you. Reach out to Cheyenne McGriff and we'll go through the addresses on your list together.