SIOUX FALLS S.D. (KELO)–The City of Mitchell will no longer provide EMS outside of city limits unless there is a way to fund six more employees. Both Davison and Hanson counties will hold a special election, if passed the city would create an ambulance district between the two counties.

Mitchell EMS currently covers areas of rural Davison and Hanson counties that include Alexandria, Emery, Ethan, Farmer, Fulton and Mount Vernon. 

That coverage could be changing as the city of Mitchell stated that effective January 1, 2026, they will no longer provide EMS outside of city limits unless there is a way to fund six more employees to help cover those services.

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The City of Mitchell is asking for $700,000 which will pay for six employees, the money would cover the new employee’s payroll, benefits, gear and training.

Both Davison and Hanson counties will hold a special election that, if passed, would create an ambulance district between the two counties. Voting will take place from 7 a.m. to 7 p.m. on April 22, and is open to all residents in the two counties except those who live within Mitchell city limits.

Dan Pollreisz, Chief of Fire & EMS services for the city of Mitchell, said the new employees would allow them to have 1 engine crew and 2 ambulance crews.

“Mitchell is a town of 15,500 people, our ambulance serves another 8,000 people outside of town, and those are just the residents, those aren’t the people traveling through, so something’s got to give,” Pollreisz said. “We just need more people to continue our current operations.”

Pollreisz said its practically impossible for ambulance services to stay afloat unless they are taxpayer supplemented.

“Last year, our gross revenue charges was $1.7 million, our return for the payments was $658,000,” Pollreisz said. “We know when we leave the station to go just on a billable call, not other calls that we don’t bill for just billable calls, we know that our shortfall is a negative 62% every time we leave based off of our gross charges.”

Pollreisz said this isn’t a problem Mitchell is facing alone, saying many ambulance providers across the state are facing similar problems.

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“McIntosh Ambulance, which was the only one in Corson County, just shut down a couple of months ago, they just have the people, you know, Carthage Ambulance made national news saying we got to shut down because we don’t have anybody. You’re gonna find this all over the state,” Pollreisz said.” Rapid City just told Custer County, if you want us to keep covering the eastern portion, you’re gonna have to pay more money, and Sioux Falls said in the next 3 years, EMS is gonna be a burden on the city. We got to try to figure this out.”

Amy Storm, employee with the Mitchell Ambulance Service and volunteer for the Ethan Fire Department, said the vote would establish an ambulance district to ensure coverage to areas of Davison and Hanson counties.

“The call volume has increased over time and the ambulance service is funded by the city of Mitchell and Hanson County gives $5,000 towards it right now, but the need is a staffing issue that really is the bottom line,” Storm said. “Going forward the conversation was had that we need to cover the city of Mitchell, because their tax dollars are the ones that are paying for it.”

According to Hanson County’s website, in 2024, there were a total of 208 emergency calls outside the city of Mitchell with Davison having 125 calls and Hanson having 83 calls.

A yes vote would create an ambulance district between Hanson and Davison county and give those communities outside of Mitchell ambulance protection, but they would have to pay either through tax levy or special assessment of $700,000. A no vote would not form the district and after January 1, 2026 Mitchell would no longer offer its EMS services outside of town.

If the district is formed there will be a second election on June 17 to elect the members of the ambulance board. The board will then decide to fund the $700,000 through either a property tax levy or a special assessment.

South Dakota doesn’t designate emergency medical services as essential, so the state isn’t required to provide or fund them. Pollreisz said this is a misconception people have about ambulance services, saying ambulance services are unlike fire and police services that are required, adding that 87% of the services they offer are EMS services.

“When you call 911 for an ambulance, there’s no legal obligation for anybody to cover those costs,” Pollreisz said. “If you are a licensed ambulance service, there are some administrative rules, but there’s places that are shutting down.”

Storm said that just because there are surrounding ambulance systems, doesn’t necessarily mean they will be able to offer services.

“We asked if those districts would be willing to come in and cover part of this area and they have said no and that they are so short staffed and so tight themselves, they cant take on an additional area,” Storm said. “The funding and the money to create their own ambulance district is four times the amount of what it would be.”

Storm added that without an ambulance they are legally restrained in what care they can offer.

“Speaking as part of the volunteer service in Ethan, when we have our medical calls, 80% of those calls, they get in the ambulance and they go to the hospital, to not have that is cutting me off of what I can do,” Storm said. ” As a local fire department and EMS response i cannot do transport, its not legal and my insurance wont allow me to do that for liability reasons.”

Nick Rehorst, Fire Chief of the Alexandria Fire Department, said care will be limited in what they could offer.

“We run about 10 miles of interstate in our district, so anyone that would ever travel through a county on the interstate, they are not going to be good, i mean we can get them out of there, but there will be no patient care after that,” Rehorst said.

Rehorst added that they might stop offering EMR services all together.

“If this does not go through we will more than likely have to shut down our EMR services,” Rehorst said. “We wont even answer emergency calls ourselves and everyone from their parents to their grandparents, if they have a heart attack they probably aren’t going to have any help coming.”

A sample ballot for the vote on the ambulance district can be found below.