Is South Dakota required to provide ambulances to 911 callers?

South Dakota hasn’t declared emergency medical services, or EMS, to be an “essential service,” meaning the state and county governments aren’t required to provide them.

For example, residents in rural areas may call 911 for an ambulance, but it may not arrive due to distance, high demand or other reasons.

South Dakota is among the majority of states that don’t require emergency medical services, according to the National Conference of State Legislatures, a bipartisan organization that serves legislators and staff.

In January 2025, South Dakota state Rep. Eric Emery, a Democrat from Rosebud, introduced a bill co-sponsored by Republican legislators that would have required cities and counties to provide EMS, but it failed to make it out of committee.

In 2020, Nebraska declared emergency medical services to be an essential service and is one of at least 15 states to do so.