Two bills aimed at easing staffing pressures on South Dakota ambulance services advanced Tuesday from the House Health and Human Services Committee, with supporters saying the measures clarify liability rules and restore flexibility for rural and volunteer EMS crews.
Together, the two measures address long-standing workforce shortages in South Dakota’s ambulance services, particularly in rural and frontier areas where most crews rely on volunteers. Lawmakers say the bills are designed to clarify who can legally staff and operate ambulances, reduce liability uncertainty, and give local services more flexibility to keep units in service when EMTs or paramedics are unavailable.
House Bill 1023 would formally allow registered nurses and licensed practical nurses to serve on ambulance crews under state law, while House Bill 1024 would modify training and certification requirements for ambulance drivers who are not EMTs.
Both bills came from a legislative summer study on emergency medical services and were passed by the committee unanimously, with “do pass” recommendations.
Nurses on ambulances, liability clarified
Supporters of HB 1023 said nurses have long served on ambulances in practice, but gaps in statute created uncertainty after changes to interstate licensure compacts and EMS oversight.
Rep. Tim Walburg, R-Madison, said the bill closes a gray area by explicitly authorizing nurses to operate within EMS services under medical direction.
“There’s a lot of agencies in South Dakota that do have nurses operating in the back of their ambulance,” Walburg told the committee. “We’re trying to close up this gray area and help these rural services.”
The committee amended the bill to remove a hardship requirement, making nurse participation available to all ambulance services rather than only those with state-approved hardship exemptions. The bill allows RNs and LPNs to serve on ambulance crews if they demonstrate competence approved by a medical or program director and provides civil liability protection unless their conduct amounts to gross negligence or willful misconduct.
Linda Young, executive director of the South Dakota Board of Nursing, said the measure could help stabilize ambulance staffing.
“It provides that liability protection, which may encourage more nurses to want to serve or volunteer on the ambulance,” Young said.
Driver rules shifted back to local control
House Bill 1024 covers ambulance drivers who lack EMT licenses, including law enforcement officers, firefighters, or trained community volunteers.
Walburg said that prior statutory changes shifted driver training oversight to the state, creating barriers for rural services.
“What we’re looking to do is tell the individual service what’s best for them, not the state,” Walburg said.
The bill keeps training requirements in place — including CPR and emergency vehicle operation courses — but allows ambulance services to maintain records locally rather than through state certification. An amendment added firefighters to the list of individuals explicitly authorized to drive ambulances, alongside law enforcement officers and trained volunteers.
The emergency vehicle operator course consists of at least six hours of instruction, offered by a state or national organization and approved by the medical or program director.
Supporters said the change reduces liability risk and makes it easier to recruit drivers, allowing EMS personnel to focus on patient care.
“This would put this back in the hands of the ambulance service and assist those rural services,” said Maynard Konechne of the South Dakota EMS Association.
Also, they unanimously passed HB 1024 and placed it on the House consent calendar.
Both measures now move to the House floor.
