<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000003 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s39ad1f2f-5948-4c02-81d5-9107a32c6e39C2 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><a href="https://sdlegislature.gov/Rules?Rule=44:05:07:02"><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000000">44:05:07:02</span></a><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">.  </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Approval of hardship exemption application</span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">.</span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">The department shall approve a hardship exemption if an ambulance service:</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">(1)  </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">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</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">(2)  </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">Provides documentation that the program director selected has:</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">        (a)  </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">A minimum of two years of clinical experience as a physician assistant or nurse practitioner;</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">        (b)  </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">Agreed, in writing, to be responsible for the supervision and healthcare direction of the ambulance service; and</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">        (c)  </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">Attested to having reviewed and to understanding the Rural EMS Healthcare Direction in South Dakota document on the department website.</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Source:</span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">51</span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> SDR </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">36</span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">, effective </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">September 30, 2024</span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">General Authority:</span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-11-12.2"><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000003">34-11-12.2</span></a><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Law Implemented:</span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-11-12.2"><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000003">34-11-12.2</span></a><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Collateral Reference:</span><span xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> Rural EMS Healthcare Direction in South Dakota, 2024. Copies available at no cost at </span><a href="https://doh.sd.gov/healthcare-professionals/ems-trauma-program/ambulance-services/"><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C2">https://doh.sd.gov/healthcare-professionals/ems-trauma-program/ambulance-services/</span></a><span class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p></div></body></html>