BIG SKY, Mont. — Big Sky voters will soon decide whether to create their own hospital and wellness district. A decision that could redirect millions in property tax dollars back into the community to fund local health and behavioral services.
The May mail-in ballot will ask residents in both Madison and Gallatin counties whether to form two hospital districts that would cooperate under a unified “Big Sky Hospital/Wellness District” through an interlocal agreement. If approved, the districts would allow existing hospital taxes collected from Big Sky properties to stay local, rather than be distributed to facilities nearly 90 miles away in Ennis.
“This potential district would provide a sustainable funding source for health and wellness services,” said Kiernan Volden, director of programs at Wellness in Action, a Big Sky nonprofit offering reduced-cost mental health counseling and community care coordination. “It’s really about keeping local dollars local to support the community where people live and work.”
The effort stems from years of advocacy and planning aimed at improving access to care in the unincorporated resort town, where high costs of living and transient workforces compound mental health challenges. Volden said demand for counseling through Wellness in Action has grown by 50% annually since 2021, reflecting an escalating need for behavioral health services.
Data shows one in three Big Sky residents report depression or anxiety, and roughly 20% feel isolated most days, Volden said.
“These aren’t things that are just specific to Big Sky,” she said. “Resort towns across the mountain West also face these exacerbated challenges due to factors like high cost of living, party culture due to living in a resort town community. So having this potential district and funding source just provides a lot of hope for all of us working in health and wellness services that we might be able to create a more sustainable system.”
Previous efforts to withdraw Big Sky properties from the Madison Valley Hospital District failed twice before lawmakers cleared a path through Senate Bill 260 which passed in 2025. The legislation allows Madison County Big Sky taxpayers to gradually redirect hospital funds back into Big Sky over an eight-year step-down period.
Under SB 260, 70% of Big Sky’s hospital district taxes would continue flowing to the Madison Valley Medical Center in the first year, decreasing to 20% by the eighth. Hospital district funds in Montana are governed by local trustees and drawn from property taxes to support medical, wellness, and behavioral services.
The push for withdrawal follows years of frustration among Big Sky residents who claim they receive virtually no benefit from paying into the Madison Valley Hospital District. The Madison Valley Medical Center, located in Ennis, is roughly an hour and a half from Big Sky by public roads. Most residents instead seek care at Bozeman Health’s Big Sky Medical Center, just 15 minutes away.
According to previous NBC Montana reporting, commissioners denied previous petitions from the Big Sky Wellness Coalition, which includes Wellness in Action, the local fire department, and Big Sky Community Food Bank. Coalition members argued that Madison Valley Medical Center serves virtually no Big Sky patients and that health dollars should support the facilities residents actually use.
The coalition’s case gained momentum after the passage of SB 260. Now, Volden said, the upcoming vote marks a final step in a five-year effort to align resources with Big Sky’s expanding health needs.
“This isn’t a new thing for Big Sky, we’ve been talking about health and mental health for five plus years at this point,” she said. “We have the opportunity right now to make this happen in order to support people that live and work here.”
Local organizations, including the Big Sky Chamber and Big Sky Wellness District, will host a series of voter education events ahead of ballots being due May 5, including a “Ballots & Breakfast” forum April 14 at the Big Sky Center for the Arts.
For more information on the proposed district, visit bigskywellnessdistrict.org.
