S.D. Codified Laws § 34-10-25
In lieu of issuing bonds, the hospital district board may levy an annual tax not to exceed five mills for the purpose of purchasing, constructing, equipping, leasing, or otherwise acquiring and maintaining a hospital, and shall direct the treasurer of the district to place such moneys in a district construction fund. When a sufficient amount of money is accumulated in the district construction fund the board may proceed to purchase, construct, equip, lease, or otherwise acquire a hospital, except that the electors of the district shall first approve the purchase, construction, leasing, or other acquisition of a hospital by a majority of all votes cast on such issue. An election on such issue shall be called and held in the same manner as an election on a proposal to issue bonds.
SDCL 34-10-25