North Dakota Code § 23-27-07

Required formation of rural ambulance service district - Organizational
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meeting - Exemption - Eligibility for relicensure.
1. Emergency medical service operations licensed under this chapter as a basic life 
support or advanced life support ambulance service for which a territory has been 
assigned pursuant to this chapter does not include a city with a population greater than 
six thousand five hundred according to the 2020 census data published by the United 
States census bureau, and is not otherwise exempted, must conduct a rural 
ambulance service district organizational meeting pursuant to the procedure in section 
11-28.3-06 prior to June 30, 2025. After such organizational meeting the district shall 
be deemed organized and operating under the provisions of chapter 11-28.3.
2. The following licensed ambulance services are exempt from this section:
a. Licensed ambulance services that are county owned.
b. Licensed ambulance services that are city owned.
c. Licensed ambulance services that are part of a joint powers agreement with a city 
or county-owned ambulance.
d. Licensed ambulance services owned by tribal or federal government.
e. Existing rural ambulance service districts organized pursuant to chapter 11-28.3.
3. Ambulance services not in compliance with this section may not be eligible for 
relicensure under this chapter.

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