Attorney General Opinions 
Relating to County Government

2013 Fire & Emergency Services

• A county may establish the payment of any reasonable franchise or other fee by a private ambulance service authorized to operate within the county regardless of where the ambulance service provider is based.  The county may establish any fee that is reasonably related to the regulation of the ambulance service provider, including defrayment of the county’s costs in regulating the provider.  The county’s governing body regulates ambulance services, including setting the fees and providing for their collection.  Counties may enforce any ordinance, rule or regulation by fines, forfeitures, penalties, or proceedings in court.  A municipality or county-authorized ambulance service may only provide service within another municipality or county with the approval of that municipality’s or county’s governing body.  If two or more jurisdictions enter into an agreement for joint provision of ambulance service within their jurisdictions, the terms, including any fees to be paid, should be set out in the interlocal agreement.  There are no distinctions between for-profit and not-for-profit ambulance service.  Opinion No. 13-09 (February 4, 2013).