By MES Dispatch Staff
The Briefing
- The Rapid City Fire Department has notified Pennington County it will cease providing ambulance service to rural county areas effective December 31, 2026, unless county officials establish a funding agreement to continue operations.
- The department estimates approximately $800,000 annually is required to sustain ambulance coverage for unincorporated areas, which generated 2,655 emergency calls in 2025.
- RCFD has provided ambulance service to county residents since 2003 without subsidy or a formal service contract with Pennington County since 2007; ambulance operations are funded through a city enterprise fund supported by user fees.
- The Pennington County Board of Commissioners voted unanimously July 7 to formally request RCFD clarify funding requirements and service parameters needed to continue rural coverage during a transition period.
- Under current South Dakota law, Emergency Medical Services are not designated as essential services that municipalities or counties are mandated to fund; a state task force created by 2026 legislation is evaluating whether to classify EMS as an essential service requiring statutory funding mechanisms.
RAPID CITY, S.D. — The Rapid City Fire Department notified Pennington County officials in December 2025 that it would cease providing ambulance service to rural unincorporated areas after December 31, 2026, absent a formal funding agreement, prompting county commissioners to seek solutions for maintaining medical response in outlying regions.
RCFD Chief Jason Culberson stated that ambulance service operations are funded through a city enterprise fund that relies on revenue from patient transports. The department does not seek to expand operations but rather to establish a funding mechanism to continue providing services already being delivered to county residents.
The Rapid City Fire Department has operated ambulance service in rural Pennington County since 2003 without municipal subsidy. No service contract between RCFD and Pennington County has existed since 2007. Ambulance enterprise fund operations were approved at $7.2 million for the city’s 2026 budget.
Commissioner Jerry Derr stated that rural ambulance service in the county’s unincorporated areas, particularly eastern Pennington County including New Underwood, requires approximately $800,000 in annual funding to sustain. Emergency calls for ambulance service in those areas totaled 2,655 in 2025.
The Pennington County Board of Commissioners voted unanimously on July 7 to formally send a letter to Chief Culberson requesting clarification on five operational and financial questions, including estimated funding levels, geographic coverage areas, willingness to enter short-term agreements, and conditions required to continue service during a permanent funding model transition.
Under South Dakota law, Emergency Medical Services are not designated as essential services that local governments are required to fund. In 2025, House Bill 1043 proposed requiring counties and municipalities to fund EMS but did not advance past committee. In 2026, Senate Bill 89 established the Emergency Medical Services Funding Task Force to evaluate whether EMS should be classified as an essential service; conclusions and potential legislative outcomes remain undetermined.
Commissioner Derr’s presentation to the board outlined three funding mechanisms: a mill levy ranging from 0.251 to 0.329 mills, a special assessment of approximately $119 per owner-occupied home, or direct allocation from county general funds. Commissioners also discussed the option of establishing an independent ambulance district to contract with providers other than RCFD.