The department shall approve a hardship exemption if an ambulance service:

1. (1) Demonstrates by clear and convincing evidence that no physician who is within a fifty-mile radius of the ambulance service coverage area or credentialed to work at the primary receiving facility for the ambulance service is available and willing to serve as the medical director of the ambulance service for a fee that is less than five percent of the ambulance service’s annual budget; and

2. (2) Provides documentation that the program director selected has:

   1. (a) A minimum of two years of clinical experience as a physician assistant or nurse practitioner;
   2. (b) Agreed, in writing, to be responsible for the supervision and healthcare direction of the ambulance service; and

   3. (c) Attested to having reviewed and to understanding the Rural EMS Healthcare Direction in South Dakota document on the department website.

      Collateral Reference: Rural EMS Healthcare Direction in South Dakota, 2024. Copies available at no cost at https://doh.sd.gov/healthcare-professionals/ems-trauma-program/ambulance-services/.

Source: 51 SDR 36 , effective September 30, 2024 .

General Authority: SDCL 34-11-12.2 .

Law Implemented: SDCL 34-11-12.2 .