The Senate Health and Human Services Committee unanimously approved a bill Monday to form a task force on emergency medical services funding.
This action recognizes the significant challenges facing the state’s ambulance system, particularly in rural areas.
Senate Bill 89, sponsored by Sen. Tim Reed, R-Brookings, would establish an Emergency Medical Services Funding Task Force to examine how counties and municipalities can sustain ambulance services amid rising costs, workforce shortages and declining volunteerism.
Prior to enactment, the committee modified the bill, striking out text requiring counties and municipalities to furnish EMS services by July 2028. As amended, the bill focuses on creating a task force to study EMS funding, including whether and how emergency medical services should be treated as an essential service.
“We probably shouldn’t designate EMS as an essential service yet,” Reed told the committee. “I do believe it needs more study.”
The legislation follows work by a 2025 interim EMS committee, which documented worsening conditions statewide. South Dakota has lost 10 ambulance services in the past decade, dropping from 131 to 121. Ground ambulance calls increased to 116,740 in 2024, even as system capacity weakened.
Over 86 percent of South Dakota counties contain “ambulance deserts,” where patient transport times exceed 20 minutes. Many rural and frontier areas experience considerably longer response and transport times.
The average age of EMS personnel is 51, according to the Department of Health.
“If something is not done, we’re going to have a major disaster in this state with not having people to transport patients and take care of them as we have in the past 50 years,” testified Maynard Konechne, representing the South Dakota EMS Association.
Matt Helling, a Brookings paramedic testifying remotely, pointed to recent news coverage of Brandon’s ambulance service struggling financially.
“There was just recently an article from KELOLand about the ambulance service right outside Sioux Falls in Brandon and how they can’t make enough money to cover. And Brandon’s a relatively, you know, prosperous suburb of Sioux Falls, and they can’t even make it work,” Helling said.
Municipal and county government groups raised concerns about the bill’s language directing the task force to “support” local governments.
Sara Rankin, executive director of the South Dakota Municipal League, said the word “support” does not clearly indicate what if any direct, reliable, or ongoing state funding is required.
“The use of the word support is vague. From a municipal perspective, support can mean many things,” Rankin testified.
Reed responded that the bill explicitly directs the task force to examine funding mechanisms and avoids creating an unfunded mandate.
The bill now advances to the full Senate.
