By: John Hult
PIERRE, S.D. (South Dakota Searchlight) – South Dakota doesn’t recognize emergency medical services as essential under state law, and that wouldn’t change under an ambulance bill passed Monday by a state Senate panel.
A legal designation of “essential” in this case would have put the onus on state or local units of government to guarantee availability. A legislator-led summer study on emergency medical services concluded that the state ought to add the designation to state law, but the Senate Health and Human Services Committee struck a clause that would have added that designation from Senate Bill 89 in its first hearing at the state capitol.
“We’re not ready to designate emergency medical services as essential — yet,” said Sen. Tim Reed, R-Brookings, prime sponsor of the bill and chairman of the 2025 emergency medical services summer study.
As written, the bill would’ve required counties or municipalities to make sure “a minimum level of emergency medical service is available within its jurisdiction for prehospital emergency medical treatment and transport.”
Need spurs legislation
Ambulance services function as essential at the moment, lawmakers learned during the 2025 summer study, but there’s no guarantee it always will. Most emergency medical technicians in South Dakota are volunteers. Their average age is 52, and the level of training now required makes it difficult to find volunteers willing to commit to it without compensation, study group members heard.
Reimbursements for services often don’t cover the cost, and rural ambulance services struggle to keep up with expenses as a result. A 2023 consultant’s report to the state Department of Health recommended state funding for ambulance services.
That same report said the state faces consistent shortages in emergency medical staff in rural areas. It recommended allowing ambulance services to use drivers without advanced medical training, rather than two EMTs, and encouraged volunteer services to engage with business owners to encourage paid time off for training.
Current law requires drivers to either be EMTs or have advanced training and certifications from the state to respond to calls.
The Legislature has already advanced two bills meant to address workforce issues. House Bill 1024 lets police officers, firefighters or drivers trained in CPR and emergency vehicle operations to drive ambulances. House Bill 1023 allows registered nurses or people with advanced life saving training to respond to emergency medical calls.
Both bills have passed the full House of Representatives and await hearings in the Senate.
Supporters: Funding first
During Monday’s hearing on SB 89, health committee members heard similar testimony.
Brian Hambek, who leads Spearfish Ambulance Services and is president of the South Dakota Ambulance Association, told the committee that the state’s gone from 131 ambulance services to 121 in the past 10 years.
“We can’t make it with the funding we have right now,” said Brian Hambek, who leads Spearfish Emergency Ambulance Services and is president of the South Dakota Ambulance Association.
EMS is essential, Hambek said, but “listing us as an essential service without funding to back it is useless.”
The state doesn’t have a plan to pay yet, Reed said, as he asked for and received support to strike the “essential service” verbiage from his bill. Counties in particular are already overburdened by “unfunded mandates” in other areas and struggle to keep budgets in the black, Reed said.
“We probably got the cart in front of the horse,” Reed said.
The amended bill takes an important step toward essential service recognition, according to Rosebud Democratic Rep. Eric Emery, who works in emergency medical services. Like Reed, he was a member of the 2025 legislative summer study group that heard testimony from emergency medical services leaders around the state and endorsed the original version of SB 89 and the bills on ambulance staffing.
The task force, the bill says, will “examine funding mechanisms to support counties and municipalities in the provision of emergency medical services as an essential service.”
Emery brought a bill in 2025 to designate ambulance services as essential and to collect fees from convicted drunken drivers to pay for it. That bill, which failed, “started an important discussion” that needs to continue with the funding task force, he said.
“Ultimately, Senate Bill 89 acknowledges a simple truth,” Emery said. “South Dakotans already rely on EMS as an essential service, and it’s the responsibility of the legislature to make sure that infrastructure is sustainable.”
The amended bill passed unanimously out of the Health and Human Services Committee and now moves to the full Senate.
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