<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>p.sb8be6c72-c6e1-4993-848a-a237c236428cP0 { 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.sb8be6c72-c6e1-4993-848a-a237c236428cC0 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sb8be6c72-c6e1-4993-848a-a237c236428cC0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sb8be6c72-c6e1-4993-848a-a237c236428c000002 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sb8be6c72-c6e1-4993-848a-a237c236428cC0-000003 { 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="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    </span><a href="https://sdlegislature.gov/Rules?Rule=44:05:07:01"><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000000">44:05:07:01</span></a><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001">.  </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001">Application form</span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001">.</span><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0"> </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">An application for a hardship exemption must include:</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428c000002"> </span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    </span><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">(1)  </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">The name of the ambulance service</span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">;</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    (2)  </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">The ambulance service owner s or chief executive officer s name, official title, address, email address, and phone number</span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">;</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    (3)  </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">Documentation that the ambulance service solicited applications from family medicine, internal medicine, emergency medicine, or other qualified medical specialty physicians who are within a fifty-mile radius of the ambulance service coverage area and credentialed to work at the primary receiving facility for the ambulance service and from whom no applications were received</span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">;</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    (4)  </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">Documentation that any fee that might be charged by physician willing and available to serve as the medical director is not reasonable and customary and would pose a financial hardship to the ambulance service; and</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    (5)  </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">The name, credentials, and contact information for the program director being requested</span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">.</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428c000002"> </span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">An application must be received by the department at least thirty days prior to the intended start date of the program director</span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">.</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428c000002"> </span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001">Source:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0"> </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">51 SDR 36, effective September 30, 2024</span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">.</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001">General Authority:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-11-12.2"><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000003">34-11-12.2</span></a><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">.</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    </span><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001">Law Implemented:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-11-12.2"><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000003">34-11-12.2</span></a><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">.</span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428c000002"> </span></p><p dir="ltr" class="sb8be6c72-c6e1-4993-848a-a237c236428cP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">    </span><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000001">Cross Reference: </span><span style="white-space: pre-wrap;" xml:space="preserve" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">Approval of hardship exempion applications, § </span><a href="https://sdlegislature.gov/Rules?Rule=44:05:07:02"><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0-000003">44:05:07:02</span></a><span style="white-space: pre-wrap;" class="sb8be6c72-c6e1-4993-848a-a237c236428cC0">.</span></p></div></body></html>