ARSD 44:05:07:02. Approval of hardship exemption application

The department shall approve a hardship exemption if an ambulance service: (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) Provides documentation that the program director selected has: (a) A minimum of two years of clinical experience as a physician assistant or nurse practitioner; (b) Agreed, in writing, to be responsible for the supervision and healthcare direction of the ambulance service; and (c) Attested to having reviewed and to understanding the Rural EMS Healthcare Direction in South Dakota document on the department website.