January 6, 1983

Mr. Michael E. Sebastian 
Brule County Deputy State's Attorney 
Kimball, South Dakota 57355

Official Opinion No. 83-02

Counties' duty to provide certain ambulance services

Dear Mr. Sebastian:

You have requested an official opinion from this office in regard to the following factual situation:

FACTS: 

Brule County contracts with certain individuals to provide ambulance service in the county.  The service is not self-supporting and the county provides funds to keep the ambulance running. 

At various times individuals request that the ambulance be used to transport sick individuals from Brule County to counties in other parts of the state.  These requests have been granted in the past but have caused problems because of the failure of the patients transferred to pay the bill, the wear and tear on the ambulance from long trips, and the lack of ambulance service when the ambulance is making a trip.

Based upon the above facts you have asked the following questions:

QUESTIONS: 

1.  May the county direct that the ambulance service not be used to transfer any individuals from Brule County to other counties in the state? 

2.  May the county direct that the ambulance service not be used to transfer any individuals from Brule County to other counties in the state except in the case of medical emergency? 

3.  In view of the county's obligation to relieve poor persons (SDCL 28-13-1) may the county direct that the ambulance service be used to transfer  individuals from Brule County to other counties in the state in non-emergency cases only if prior payment is made?

IN RE QUESTION NO. 1:

It is my opinion that once the county decides to provide full ambulance service it may not limit the ambulance service in a manner that would restrict access to necessary medical service.  Be cognizant that the scope of full ambulance service need not include 'transport' service to those individuals who need transportation only.

IN RE QUESTION NO. 2:

It is my opinion that the county could place certain restrictions on the type of ambulance service provided to its residents and therefore restrict the ambulance service to only emergency service.  However, whatever services the county decides to provide will need to be provided to all residents of the county.

IN RE QUESTION NO. 3:

It is my opinion the county may not refuse service pending payment.  I refer you to my Official Opinion No. 82-17.  This opinion fairly sets out the county's obligations regarding poor relief pursuant to SDCL 28-13-1 and certain relevant case law.

Note that SDCL Chapter 28-13 provides for previous approval of medical services to indigent county residents in non-emergency cases.

Respectfully submitted,

Mark V. Meierhenry
Attorney General