<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.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 style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><a href="https://sdlegislature.gov/Rules?Rule=44:05:07:02"><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000000">44:05:07:02</span></a><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">.  </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Approval of hardship exemption application</span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">.</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> </span><span style="white-space: pre-wrap;" 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 style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">(1)  </span><span style="white-space: pre-wrap;" 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 style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">(2)  </span><span style="white-space: pre-wrap;" 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 style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">        (a)  </span><span style="white-space: pre-wrap;" 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 style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">        (b)  </span><span style="white-space: pre-wrap;" 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 style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">        (c)  </span><span style="white-space: pre-wrap;" 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 style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Source:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">51</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> SDR </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">36</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">, effective </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">September 30, 2024</span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">General Authority:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-11-12.2"><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000003">34-11-12.2</span></a><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Law Implemented:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-11-12.2"><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000003">34-11-12.2</span></a><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39000002"> </span></p><p dir="ltr" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39P0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">    </span><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0-000001">Collateral Reference:</span><span style="white-space: pre-wrap;" 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 style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C2">https://doh.sd.gov/healthcare-professionals/ems-trauma-program/ambulance-services/</span></a><span style="white-space: pre-wrap;" class="s39ad1f2f-5948-4c02-81d5-9107a32c6e39C0">.</span></p></div></body></html>