Arkansas Valley Ambulance District began on December 1, 2018, after the November 2018 election garnered 2 to 1 support by the voters of the coverage area. The district is responsible for emergency medical services encompassing Western Fremont County beginning from the Chaffee County line covering Wellsville, Swissvale, Howard and extending just south of Coaldale from the hwy. 50 corridor up through the Sangre de Cristo foothills.