North Dakota
Amid Rural EMS Struggles, North Dakota Lawmakers Weigh Solutions
North Dakota lawmakers are exploring using telemedicine technology to ease staffing strains on rural emergency medical services, a potential solution to a growing shortage of paramedics and volunteer responders across the state.
Though some solutions were floated and passed during the 2025 legislative session, lawmakers are working to understand the scope of the problem before proposing additional legislative changes in 2027.
The state has been facing a societal decline in volunteerism, which strains traditional volunteer firefighter and emergency medical services that support rural communities, said Sen. Josh Boschee, D- Fargo. Adding to pressure, when a rural ambulance service shuts down, the responsibility falls to neighboring ambulance services to answer calls in the defunct ambulance service’s coverage area.
How could telemedicine ease strains on rural EMS staffing?
One idea presented to the Emergency Response Services Committee on Wednesday to potentially alleviate some of the stress on rural ambulances is expanding access to technology in the field for emergency medical personnel.
Emergency medicine technology company Avel eCare presented to the committee its system, which allows ambulance personnel to be connected by video with emergency medicine physicians, experienced medics or emergency nurses in the field wherever there is cell reception. The company already operates its mobile service in South Dakota, Minnesota, Nebraska and Kansas, according to the company’s presentation.
Avel eCare said this allows medics and paramedics to have any questions they have answered and provides a second person to help document actions taken when there is only one person in the back of an ambulance with a patient, which they say is increasingly common in rural areas. This allows one medic or paramedic to put more focus on the patient.
The company said it is innovating the ability to also bring medical personnel into the call from whatever care center the ambulance is heading to, allowing the care center to better prepare for the ambulance’s arrival.
Lawmakers said they were interested in the system and could see how it would provide a benefit to thinly stretched EMS personnel.
Boschee said the state should consider funding the system, citing its potential to support local EMS providers and help retain volunteers.
Avel eCare did not provide a cost estimate for North Dakota, but offered South Dakota as an example. That state used general fund dollars to provide the Avel eCare service free of charge to agencies. The state paid $1.7 million in up-front costs for equipment — enough to outfit 120 ambulances — and an annual subscription cost of $937,000 to provide their services to 109 ambulances serving 105 communities in the state.
“I think specifically … how affordable that type of solution is for us to not only support our local EMS providers, but also to keep volunteers longer,” he said. “Folks know that they have that support network when they’re in the back of the rig taking care of a patient. That helps add to people’s willingness to serve longer. And so I think that’s a great, affordable option we have to look at, especially as we start going in the next couple months and continue to talk about rural health care transformation.”
Rural EMS shortages go beyond pay, state officials say
There are 28 open paramedic positions in the state, according to Workforce Services Director Phil Davis’ presentation. The difficulty in filling these positions is not just about money, though that certainly plays a factor in recruiting people, his report said.
“I’ll just speak from my experience with my own agency,” Davis said. “After 18 years, it’s very hard for us to even recruit individuals into Job Service North Dakota because of the lower wages.”
Davis showed that 2024 salaries for emergency medical technicians were fairly even across the eight regions Workforce Services breaks the state into, with a roughly $6,500 gap between the highest and lowest averages. Law enforcement officer pay varied by about $8,320, while firefighter salaries were the biggest outlier, with a $20,000 difference between regions. While state wages may lag nationally, other factors are making rural recruiting particularly difficult.
Davis said it was largely a lifestyle change; people are not seeking to live rurally as often.
“We’re starting to see the smaller communities, for the most part — not all — starting to lose that population. And it is tougher to get individuals to move there or to be employed there,” Davis said.
Job Service North Dakota is holding job fairs to try to recruit more emergency services personnel, with some success, he said, and has nine workforce centers across the state working directly with small communities to help with their staffing shortages.
Davis advocated for more education in schools about career paths in emergency services and the openings that are available in the state.
© 2025 The Bismarck Tribune (Bismarck, N.D.). Visit www.bismarcktribune.com. Distributed by Tribune Content Agency, LLC.
North Dakota
Challengers declare victory after ND Supreme Court rules against Legislature’s attempt to alter term limits
BISMARCK — A constitutional ballot measure to amend the state’s term limits law as proposed by the Legislature will not appear on November’s ballot, the North Dakota Supreme Court ruled Thursday, siding with petitioners who argued the Legislature exceeded its authority and violated the state constitution in proposing the changes.
“The people’s voice was heard,” Grand Forks County Commissioner Terry Bjerke said in reaction to the news.
Bjerke was a member of the sponsoring committee behind the successful 2022 effort to pass a term limits initiative, which amended the state constitution by capping legislative term limits to eight years in the House and eight years in the Senate. The amendment, which became article XV of the state constitution, also included a clause barring the Legislature from making constitutional changes to term limits.
During the 2025 session, however, lawmakers narrowly approved Senate Concurrent Resolution 4008, in which the legislature proposed Constitutional Measure 1, a ballot measure to amend the term limits language to allow legislators to decide in which chamber they want to serve their 16 years, and to repeal the clause limiting the legislative assembly’s authority to propose an amendment to alter or repeal term limits.
Bjerke and former Minot legislator Oley Larsen brought the lawsuit challenging the validity of the Legislature’s action in January, and the state Supreme Court
heard oral arguments in the case
this spring.
“Those term limits may only be altered by a measure proposed by the people rather than the Legislative Assembly. And yet a few years later, the Legislative Assembly is doing what they are prohibited from doing,” attorney Zachary Wallen argued on Bjerke and Larsen’s behalf.
Tanner Ecker / The Bismarck Tribune
The Legislature’s attorneys argued the clause prohibiting legislative proposals to alter the constitutional term limits language “infringes on our republican form of government” by “limiting the people’s ability to vote on amendments proposed by their elected officials.”
Justice Jon Jensen seemed skeptical of that argument during the April 2 hearing, questioning whether a second vote was appropriate.
“The public did speak on this. The public spoke on it when it passed the original constitutional amendment and they said, ‘Legislature, you don’t even get to propose a change.’ They have already spoken on it,” Jensen said. “You want a second shot, or a second bite at the apple, not a first one, a second.”
In Thursday’s ruling, all five justices sided with Bjerke and Larsen.
“We … conclude the Legislative Assembly’s adoption of S.C.R. 4008 violated N.D. Const. art. XV … and declare S.C.R. 4008 and Constitutional Measure 1 void … We enjoin the Secretary of State from placing Constitutional Measure 1 on the November 2026 general election ballot,” the ruling said.
Bjerke thanked the legal team that worked on behalf of their lawsuit, and said he was grateful the court reached the conclusion it did.
“I’m thrilled that what the people voted on and approved has been validated,” Bjerke said.
He added that the Legislature had “multiple opportunities” to address term limits prior to 2022’s initiated measure and chose not to, and gave a nod to the country’s coming milestone and the process by which voters expressed their support for term limits.
“We’ve lasted 250 years,” Bjerke said. “I have two words for those elected leaders who think they aren’t: everyone’s replaceable.”
North Dakota
Fargo woman convicted in North Dakota fraud case now faces charges in Minnesota: A deeper dive
FARGO, N.D. (Valley News Live) – A North Dakota woman who was sentenced to 180 days in jail in Cass County for defrauding healthcare providers and Medicaid programs is now facing additional fraud charges in Minnesota.
Christine Marie Pryor, 55, pleaded guilty in November 2024 to theft by deception involving more than $50,000. She was sentenced to first serve 180 days with a 3-year sentence suspended. She received credit for 44 days already served.
Pryor was ordered to pay $82,584.78 in restitution to Southeast Human Services in Fargo, where she worked between 2018 and 2019.
How the scheme unfolded
According to court documents, Pryor worked at multiple healthcare facilities in North Dakota and Minnesota between 2018 and 2023, using the identities and credentials of three licensed professionals without their knowledge. She submitted fraudulent Capella University diplomas and transcripts to gain employment.
Investigators say Pryor admitted she searched state licensing websites for therapists who shared her first name, then used those therapists’ last names and license numbers when applying for jobs.
At Southeast Human Services, where she worked as a Licensed Addiction Counselor, Pryor earned $55,584.82 while providing therapy services to approximately 150 patients. She also opened her own counseling center, NIAM Brain Injury Center, in Fargo between 2020 and 2021, and worked at The Lotus Center in Moorhead, Minnesota, from 2021 to 2023.
Court documents say the three licensed professionals whose identities were used told investigators they had no knowledge of Pryor’s actions and did not give her permission to use their information.
Two additional charges against Pryor in North Dakota, unauthorized use of personal identifying information, were dismissed on motion of the state.
Additional charges in Minnesota
Pryor is also facing charges in Minnesota. Minnesota Attorney General Keith Ellison announced on Tuesday charges against Pryor in Clay County District Court for six theft offenses and six identity theft offenses related to defrauding Minnesota’s Medicaid program of more than $150,000.
According to the Minnesota complaint, Pryor claimed to provide psychotherapy and alcohol and drug counseling services to Medicaid recipients despite having no license or credentials to do so. Prosecutors allege she used the credentials and identities of three licensed professionals while claiming to provide Medicaid-funded services to 169 clients.
The Minnesota charges were filed as part of National Health Care Fraud Takedown Day, a joint effort involving the Department of Justice and more than 40 state Medicaid Fraud Control Units.
Copyright 2026 KVLY. All rights reserved.
North Dakota
NCAA Set to Change Unpopular Football Rule Just in Time for North Dakota State’s FBS Jump
North Dakota State playing in the FCS playoffs and College Football Playoff in back-to-back years? It’s likelier than you think.
That’s because on Wednesday, according to a report from Ross Dellenger of Yahoo! Sports, the NCAA Division I cabinet voted to repeal a rule that effectively barred teams transitioning from FCS to FBS from playing in postseason games in their first FBS seasons. The Bison are making that move along with Sacramento State in 2026.
The reported change has been a long time coming; the rule has hampered teams from immediate bowl eligibility for decades. Its good intentions of dissuading teams from rashly making the FCS-to-FBS leap have been rendered obsolete in recent years by the fact that programs generally arrive in FBS more prepared than ever before.
Consider the number of new FBS teams that have had to work within the provision in the past decade alone
That list includes: Liberty (home for the holidays at 6–6 in 2018), James Madison (8–3 in 2022 under coach Curt Cignetti, and barely able to play in a bowl at 11–1 in ’23 due to a lack of bowl-eligible teams), Jacksonville State (8–4 in ’23 before backing in like the Dukes), Missouri State (7–5 in 2025, also backed in) and Delaware (6–6 in ’25, ditto).
James Madison in particular became a cause célèbre in ’23 because it started the season 10-0, climbing as high as No. 18 in the AP Poll in mid-November. Then-Virginia attorney general Jason Miyares bandied about suing the NCAA before the Dukes lost 26–23 to Appalachian State, an event that caused the program to back off and accept a bid to play Air Force in the Armed Forces Bowl. James Madison lost that game 31–21, by which time Cignetti had left for Indiana.
There was a time when the FCS-to-FBS jump was an imposing one, and the NCAA did not want to incentivize making it lightly—not even a proud Florida A&M program could make a mid-2000s attempt at a jump stick. However, the Flames, Dukes and other teams have shown it’s not so great a climb for programs with the right resources and management.
Now the Bison and the Hornets stand to benefit.
How far can North Dakota State and Sacramento State go in the near term?
The Bison opened 12–0 last year before a shock loss to Illinois State in the FCS playoffs’ second round, so that question may answer itself. North Dakota State does not play a single Power 4 team—a potential strength-of-schedule albatross if it has designs on really surging. A potential roadblock: the fact that the Bison have to visit the Mountain West’s two favorites, UNLV (Oct. 10) and New Mexico (Oct. 24).
It’s a different story for the Hornets, a 7–5 squad a year ago whose move to the FBS is widely seen as a gamble on their growth potential. Sacramento State also does not play a major-conference team, but has a breakneck travel schedule ahead of it—the Hornets will visit Ypsilanti, Mich.; Bowling Green, Ohio; Muncie, Ind.; Mount Pleasant, Mich. and Honolulu. Combine that with a first-year coach—Oakland native and ex-MC Hammer choreographer Alonzo Carter—and it could be a long FBS debut in California’s capital.
More College Football From Sports Illustrated
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